OBSERVERS agree that the Global 2001 ‘International Smart Partnership Dialogue’ in Uganda came to a close on a positive note. A few projects were launched to coincide with the occasion. It is good to see that this Malaysian-initiated dialogue is still going strong, with the participation of some interesting personalities of the developing nations.
Ugandan President Yoweri Museveni was full of candour and humility when making a comparison between his country and Malaysia. He was quick to point out to African countries the many lessons that can be learnt from Malaysia.
It is true that Malaysia is a good example to follow in terms of its development strategies and success. It is also true Malaysia has surpassed many of the African states in terms of providing a higher quality of life.
In 1997 the infant mortality rate for Uganda was 97 per 1,000 people, life expectancy for males was 43 years and females 44 years. The figures for Malaysia in 2000 were 7.9, 70 and 75, respectively.
Despite being better in many aspects, there is something that Malaysia can actually learn from Uganda. The country has successfully recruited its Islamic religious leaders to help combat the HIV-AIDS epidemic.
Some 16 per cent of Ugandans are Muslims. The central ruling body of the Muslims is the Ugandan Muslim Supreme Council, headed by the mufti.
The mufti has under him 33 religious leaders known as district qadis. Each qadi is in charge of about six county sheikh, who in turn, look after 30 to 40 imam. Every imam heads a mosque that normally has a congregation of 75 or so families.
A study found that many Muslims were not aware of the potential dangers linked to some of their traditional practices. These findings indicated a need to develop sensitive and appropriate materials to approach the Muslim community.
In 1989 the Islamic Medical Association of Uganda (IMAU) organised a National AIDS Education Workshop. Every district qadi attended. The mufti was there, too. They declared a jihad (holy war) on AIDS.
After the workshop, IMAU went down to two districts of 400 mosques to conduct education workshops for imam in several districts. There were extensive discussions between health professionals and religious leaders.
From these sessions an AIDS education project was mooted and launched to reach out to Muslim families through volunteers trained with and sanctioned by the imam.
The team, comprising the imam, two assistants � a male and a female, and five family AIDS workers � is given basic facts about HIV/AIDS, sexually-transmitted diseases, risk perception, principles of behavioural change, safer sex, AIDS in relation to gender and adolescence, communication skill, counselling and how society can sustain AIDS prevention activities.
Each team member has to visit 15 homes every month to pass on the HIV/AIDS information. He or she must also be ready for counselling and consultation.
As for the imam, the training provides them with accurate information about HIV/AIDS, which they can use in their spiritual teachings and sermons at the mosque.
In order to facilitate movement and supervision, a bicycle is given to each imam, district qadi, county sheikh and the assistants.
Family AIDS workers receive two hens each, or the financial equivalent, to start an income-generating activity. This provides the incentive for the volunteers to sustain participation in the project.
Like many parts of Africa, Uganda, too, has been plagued by the HIV/AIDS epidemic for many years. In 1997 there were 1.5 million Ugandans living with HIV. This means that one in every 10 adults may be carrying HIV.
For comparison, in Malaysia since 1986 about 4,000 people have tested HIV positive. More than 3,000 of them have died of AIDS.
Among Ugandan Muslims, certain traditional practices have been identified which increase the risk of exposure to HIV. These include the use of unsterilised razors, and the lack of protective measures taken when cleaning the dead.
In view of the potential hazard of the epidemic on Muslim, as well as other, communities, the IMAU had pioneered an ingenious AIDS prevention project, known as the Family AIDS Education and Prevention Through Imam (FAEPTI) project.
As a respected community leader and head of the congregation of his mosque, the imam is the recognised and, sometimes, revered teacher and model of good social behaviour.
He has several opportunities to disseminate information during mass prayers, and family-based ceremonies such as marriage, birth and burial. This means that he can help promote a change in the individual’s behaviour.
IMAU then met with groups of imam and other Muslim leaders to look at ways of carrying through AIDS prevention programmes.
It was mutually agreed that an education campaign should combine public health with Islamic teachings, such as verse 32 of Chapter 17 translated thus: “Nor come nigh to adultery, for it is a shameful deed and an evil, opening the road to other evils.” The first step of the project was to conduct a baseline survey to obtain some information on the people’s knowledge of HIV/AIDS. The results showed that most respondents knew that the disease was transmitted sexually, but not that mothers could infect their offspring.
Every mosque team comes together at the end of every month to discuss difficulties they may have encountered during family visits and how best to address these problems.
After two years, a follow-up survey of those exposed to the education programme showed an increased knowledge about HIV/AIDS. The people were aware of the various modes of transmission. They no longer believed that the epidemic is due to witchcraft.
There was also a report of lower incidence of changing sexual partners among respondents less than 45 years of age and an increase in condom use.
The overall data of the Ministry of Health showed that the percentage of mothers testing HIV-positive at urban health clinics in 1997 was almost half of that in 1992.
Surveys of behavioural change in urban areas revealed that from 1989 to 1995 there were significant delays in age at first-time sex and less sexual relations with non-regular partners.
As for FAEPTI, between 1992 and 1997 altogether 10 districts and 859 mosques were covered. A total of 6,800 community volunteers were trained. They had made personal visits to 102,000 homes.
No doubt by incorporating health professionals and religious community leaders, AIDS prevention education can go a long way. It looks like a worthwhile campaign to embark on in this country, too.
If all quarters could begin an earnest effort to help eradicate this debilitating epidemic, surely we would be able to see a downward trend in the number of new carriers in the coming years.