Reflections from the Field

Reflections from the Field July 7, 2009

Complicated. The issue is complicated. Our focus here is to evaluate the process and outcomes of this HIV/AIDS education program. The process part seems easy enough as we are looking at the workings of dissemination of information which, as process is concerned, is working well even though we do have some recommendations. The problem is really the outcome portion. When we arrived we immediately realized that we had a lot to learn about the culture before being able to establish any adequate recommendations. The issues of extramarital sex, prostitution, and unwillingness to protect one’s self all complicate this issue of HIV/AIDS.
Extramarital affairs are extremely common here. It is very acceptable for an older man to take on one or even multiple younger partners. People have given us reasons like men not liking their wives, men getting tired of their wives, and many similar excuses. The thing here is that the blame is put on the woman and not the man. Regardless, this is leading to the rise in HIV/AIDS among married couples.
The topic leads directly into prostitution. There are two forms of prostitution in this community: formal and informal. Formal is that most people consider when they hear the word prostitute: a person that engages in sexual activities in exchange for money. Most reasons given so far for this activity includes poverty but also women seeking independence. Women are paid lower wages and get lower paying jobs, so in order to sustain one’s self independently of a male many enter into prostitution to try to make ends meet. Informal prostitution is just as common if not more so. This includes sexual favors or relationships in exchange for clothes, rent, tuition, phones, shopping, fancy dinners, etc. This usually takes place between an older (often married) man and a university aged female. Many have also informed us that university girls will not date university aged guys because they are not financially stable and therefore can not provide for them. This lack of date possibilities and sexual partners for the university guys is leading to increase in this population of prostitutes. Because of the increase in the use of prostitution by university men, there are female prostitutes which cater to these guys charging very little since the guys do not have much money. The cost of sex without a condom only being 1,000 Ug.Shs. difference, or 50 cents U.S. Thus, we have older men seeking university girls for sex, university guys seeking formal prostitutes for sex, and there are there are two other areas which are not as clear as of yet.
There is a known increase in the number of male prostitutes yet not many people know of these because of the taboo of homosexuality here. So, we are not sure if these male prostitutes are engaging in heterosexual sex, homosexual sex, or both. In addition, popular media and under ground sources are claiming that Uganda (Kampala specifically) is big in the sex tourism industry. There are a number of articles (and newspaper photos) of European and American men traveling here for the sole purpose of sex. This further complicates matters, to say the least.
As for the issue of protesting one’s self from the disease, the ability to acquire money seems to be of more importance. There are a couple of explanations that have been given for this. First, people get so many disease here that can and do kill that they just try to live and don’t worry about getting a disease. People here often get malaria, yellow fever, typhoid, cholera, hepatitis, herpes, and HIV. They see all of them as things you get and treat. Many are not phased by the possibility of getting HIV and some even say that they would rather not know their status because they can continue to live positively. If they find out they care positive, the knowledge alone will kill them. Second is the concept of people being afraid to die alone. This statement has come up in every interview that we have conducted and is still rather perplexing. The explanation is usually that people are so scared of dying by themselves that they want to go out and spread the disease.
Lastly, there is a huge culture of dependency being fostered here. Going from the Amine era of torture and hopelessness this society entered directly into a framework of trying to move from the 3rd to the 1st world (so to speak). There were loans from the IMF, World Bank, and countless others. Secondly, the flood of NGO’s fostered an idea of aid for all. Nowhere in these years of rebuilding was their establishment of making one’s own way or building one’s own path type of mentality. Then, on top of this is everyone exploiting each other to make a quick buck. Children placed on city streets by their mothers to beg for money, women being able to be forced out of the house when the man decides on a new wife, men being exploited financially by the government, and the government being puppets to the IMF and WB. Corruption creeps in here as well when you can pay your way out of any conviction, ticket, contract, etc. This all being said to illustrate a system of interconnected dependency leaving people to chase the dollar/shilling rather than try to do it on their own. People want it free with “what will you give me; how much will you pay me; give me money; give me food” dominating the mentality of the people.
This then covers a lot of factors that are contributing to the spread of HIV/AIDS in this culture. The program that we are evaluating is promoting both HIV/AIDS and “life skills” education as being components of their curriculum. This being the case it is very important that there is an attempt to understand the socio-cultural factors that are leading people to engage in activities that put them at a risk for HIV/AIDS. New “life skills” or discussion points may need to be added to address the real-life issues that children see people facing today and may face in the future. Some things that need consideration may include issues of negotiation skills, empowerment, independence, self esteem, individuality, and many others. There is much more work to be done.