Education as a Vaccine Against AIDS in NIGERIA (EVA)

by John Kiwanuka Ssemakula, February 24, 2003

In Nigeria, youth account for over 30% of all HIV/AIDS cases in the nation. The rising HIV/AIDS epidemic amongst Nigerian youth prompted two young women Damilola Adebiyi and Fadekemi Akinfaderin to do something about it. Through funding from the Echoing Green Foundation in New York, they formed an organisation called Education As A Vaccine Against AIDS. They have been working in Nigeria since October 2000 to educate the youth about HIV/AIDS.

Medilinks interviewed Fadekemi Akinfaderin, 'Kemi' to her friends to find out about EVA.

Kemi what exactly is "Education as a Vaccine Against AIDS"

Education as a Vaccine Against AIDS (EVA) is an education program is aimed at adolescents of ages 10/12 yrs to youth of 24yrs. The 1st program was implemented in Nigeria, the primary target being Abuja the capital of Nigeria. The idea is to eventually expand to other areas in Nigeria as the program grows. EVA is the only youth organization in Abuja, but one of the few in the whole country that is being led by young people. All the people in the organisation including some of the board members are below 27 years old. Peer education is one of the mainstays of our programs.

The inaugural program was in the reproductive health curriculum. There is not much education about sex in Nigeria. In the absence of sex education, we decided to offer health education (peer to peer) as a means of filling the gap. We held discussions on issues ranging from general health hygiene to STD's.

What was the motivation for creating EVA

The beginning of the idea was conceived by Damilola and I. In 1999 I was in S Africa doing AIDS related research in Umtata. It was my first exposure to HIV/AIDS. I was collecting blood samples from Umtata and I collected about 10-15 samples daily as part of the project. I was shocked to find that 80-90% of the samples were positive for HIV. I was very surprised at the numbers. I really had no idea. At about the same time Damilola was also conducting social research to develope effective communication messages targeted at youth at Wesleyan University. We both had both worked together on numerous projects in the past. We met at Wesleyan University and have similar backgrounds, and were motivated to help other young Nigerians like us.

Initially we worked with a health care consulting firm B.E. Medical Service (Lagos). We worked with them to map out programmes and projects that were being done by the Lagos state government, evaluating the programmes. We also looked at programs in Ogun state (Abeokuta) and talked to all of them about their National AIDS programs.

We found out that not that much was being done. They [the state governments] were implementing programs but only sporadically, they were implementing some, but it was not a lot - nothing was actually reaching the grassroots. For example the offices were printing AIDS education pamphlets, but they were all in English (but many people don't speak or read English). Our Echoing Green fellowship did not require us to conduct any formative research, but we decided it would be a good idea to get some background data and it is a good public health practice. And so we decided to carry out behavioral surveys in Nigeria.

How did you conduct the surveys and what were your findings.

We administered a formal baseline survey questionnaire. The number of children in Abuja measured in the thousands so initially we worked only with 11th graders (S2). What we found was that many young people knew what HIV was, but few knew how the disease was spread and how it could be prevented. Many had negative views about HIV/AIDS and getting it but had little knowledge of the services available to educate them or help protect them.

We also noticed that amongst the respondents there was a high level of reporting of diseases associated with STD's so we decided to start a separate program to deal with this. We are trying to provide people with access to youth friendly services. We also held informal discussions on issues of rape, sexual abuse. It was an all girls school and these subjects were not really talked about, but only dealt with by silence

What else is EVA doing?

EVA is trying to create other programs to help these people with their specific problems, programs such as a youth AIDS service program (service learning program and youth development program). Other components we are trying to include are peer to peer education / community / local leaders / advocacy / family / quizzes / debates creative ways of getting the reproductive health message across.

What difficulties did you encounter?

Difficulties, we found some…To start off with, though government was trying to get the message out about HIV/AIDS, the message is not reaching the grassroots, the people in the villages, and small towns that have no idea of the disease. As a result the population is essentially ignorant. They have focused their energies on speeches, conferences, rallies etc. but these things are only increasing knowledge of a limited number of people in the community and it is also known that knowledge doesn't always change behavior. The only people who have any real knowledge are those that interact with donor agencies. . We think the strategies need to be changed and their efforts should not be limited only to the more privileged \members of the community

Even projects in ministries do not understand the extent and nature of the problem. Trying to get approval for the programme was initially very difficult. We were getting a lot of problems, "road blocks" within the ministry. We had to meet top officials before we could get approval. Even the principals (headmasters) of the schools are limited in their awareness of the problem. Some people thought it was just a gimmick, because "there are many people implementing bogus NGO's in Nigeria.

What did you do next?

EVA decided to establish a program called Positive Living - (addressing stigma) -where we were working in collaboration with a small support group of people living with AIDS (PLA"s) in Abuja; helping these people with nutrition and general health initially and we partnered them. But we decided we were going to focus on young people living with AIDS. The issue of stigma is very devastating for young people. Many of our clients cannot come out publicly. An example the client was HIV negative but the husband was HIV positive, how does she go about protecting herself?

In another case a 23 year old man at first tested negative but in the next two months tested positive. What is he supposed to think? How is he supposed to react? All that happened was he was referred to hospital with no counseling or setup. We clearly need more health workers in the field of mental health crises to provide such services. There is a need for better coordination of services with more organizations in Nigeria. Care and support has to be better defined and provided for. It needs a lot more work, and there is still a lot of work to do.

What are EVA's future plans

In the next 6 months we are going to work with 2 PLA's associations to provide the support for the general needs of people living with AIDS in Abuja and Nigeria. We also want to work with the Federal Ministry of Education to help implement reproductive health education courses in school curricula. In addition we are thinking of establishing additional programs, related to gender relationships and behaviour to decrease the risk behaviour of adolescents. We are currently hoping to target high risk groups in adolescents.

Some strategies that we would use include mentoring programs, learning strategies to help build up protective behaviour and other factors for the high risk groups in these children. We hope to start introducing these by the summer of 2003. We are also thinking about involving and working with parents and trying to include them as part of the reproductive training curriculum, in order to teach the parents how to talk with and communicate their children and be able to give them more support at home. Other programs we are going to hold are seminars and workshops with teachers in the area of reproductive health with a focus on HIV/AIDS.