The HIV/AIDS link between Gambia and Casamance

Wednesday, 19 January 2011 11:57

JollofNews - A report on the prevalence of HIV/AIDS has revealed a staggering correlation between the disease and cross border activities in the Southern Senegalese region of Casamance and its neighboring villages in Fonni in Gambia.
Published by Wal Fadjri, a leading Senegalese daily, this report explores the consequences of deep-rooted traditional practices indigenous to the peoples in areas between Casamance in Southern Senegal, nearby villages in Fonni across the border in Gambia and some villages in Guinea Bissau on the prevalence of the pandemic, vis-à-vis the difficulties it poses on the authorities in Senegal in their effort to containing its spread. It also draws attention to added intricacies associated with Gambian President Yahya Jammeh’s controversial treatment program on the spread of the disease and its effects on gullible patients in Senegal who supposedly cross the border in search of treatment.
Apart from obvious problems relating to the decades insurgency in the area, which in various ways hinders efforts of containing progression of the disease, uncontrolled movement of the people into the Fonni in neighboring Gambia and back raises fascinating suspicions among health authorities there. Expert expressed worries that in some border villages very high rates of between 6 and 11% infection were identified by district mobile teams. The proximity of these villages to the Gambian side, which are said to be situated often less than 20 km away, apparently arouses this suspicion.
“The whole area around Fonni is affected; and the more we advance towards the Gambia, the more the rates get higher,” Wal Fadjri quoted Penda Sonko, who is in charge of an HIV/AIDS awareness campaign team in the provincial capital Ziguinchor.
“What is more disturbing, she added, are the disparities recorded by nurses who are involved in screening patients.”
Some patients, after undergoing testing, fail to return as required. This results in a “double negative situation” as they continue to infect others. And as a result of such a disconcerting situation, the people who interrupt treatment effectively create resistance that makes the drugs ineffective and hence treatment becomes more complicated and expensive.
Despite a reticent appeal against apportioning blame on neighboring countries, vis-a-vis the porosity of the border and the high rates of HIV infection, Penda acknowledged that many people in Casamance have families in neighboring Gambia and that as such the in-and-out movement of the people couldn’t be exclusively ruled out in terms of responsibility for the pattern of infection of the disease. “But it is difficult to determine responsibility by placing blame on others,” she added.
She cited the fact that the area being mainly inhabited by the Jolas and given the frequency of certain ceremonies common with that ethnic group, people recurrently move from all the way in Gambia and Guinea Bissau and back. These ceremonies themselves appear to be the problem, given their controversial nature in terms of alleged encouragement of promiscuity. However, their cultural significance, for example the ‘Ebounay’, common to the people of northern Fonni in Gambia, whose ultimate aim is the promotion of fertility among women, makes discouraging them impossible.
Couples who have had problem making children are allowed to have affairs with as much partners as they could, Penda explained. And they may have a dozen partners and indulge in unprotected sex.
“This practice is very real even if some people in the region often deny it,” she said, arguing therefore that with such ceremonies common to areas in all three countries no one could be right to pass judgment on a particular country.
“Last year, we visited these areas and we had trouble convincing people to use condoms, because for them the goal is to have children,” she stated.
A second practice which is related to traditional circumcision for manhood involves boys and girls between the ages of 15 and 20, who are confined for 40 days, with exclusive rights, as it were, to multiple partners. At the end of this period, pregnant girls are celebrated before given out into marriage to men they would have been betrothed to prior to their confinement.
The idea behind this practice, according to Penda, is that they have to reassure the family of their future husband of their fertility and potential of bearing children. She said there is often no problem regarding the paternity of children resulting from such practices as it is officially accepted that whatever happens “the baby will be recognized as the couple's child.”
The Manhood ceremony is said to be common in the Cap-Skiring area in Senegal, as well as in some villages in Guinea-Bissau, such as Toubacouta, Bouroufay etc.
Health experts in the area strongly believe that these practices promote the rapid spread of HIV/AIDS and are in contradiction with educational messages delivered by community volunteers.
Another major problem with dealing with the disease is in how ethnically held views affect the prevalence of the disease. The Jolas and Mandingos, who form the dominant groups in the Casamance region, tend to explain HIV/AIDS and other STIs (Sexually Transmissible Infections) with mysticism. This apparently frustrates every effort in putting forward scientific explanations towards convincing these people against certain of their behaviors.
President Yahya Jammeh’s treatment programme too, apparently poses a big problem.
Citing medical sources, the report notes that treatment has been largely hindered by the attitude of infected people, some of whom adamantly stick to crude traditional herbs; as well as others who cross the border into neighboring Gambia for President Yahya Jammeh’s treatment. Accordingly, on returning home, these supposedly treated people often appear completely incapacitated and die within days.

Written by Kemo Cham