News Stories, 8 March 2007
OSIRE REFUGEE CAMP, Namibia, March 8 (UNHCR) – With a disease that is both deadly and shrouded in stigma, everyone would like advice from someone they trust. That is the role taken on by Congolese refugee Bibish Bishimba Mwenze.
The appointment of Mwenze late last year – after training in the national programme – underlined the efforts by the UN refugee agency to combat HIV/AIDS among refugees, who have often come from countries where the rates of infection are far lower than among their neighbours in their present homes.
"For counselling, confidentiality is a big issue; they have to know you. If it was someone who was not a refugee, the language alone would be a problem," said the soft-spoken 29-year-old, who has added Portuguese and English to the French and Swahili she arrived in Namibia with. "If it is someone from outside the camp, they do not come from the same culture."
Mwenze's role-speaking to the community about avoiding HIV and counselling individuals before and after their tests – is about to expand. She will now also do the testing, meaning that individuals will no longer have to face a wait of a week before results arrive from a government clinic.
"If we do it here, we will get results in 10 or 15 minutes," said Mwenze, who passed her training with distinction and is now paid by the Namibian Red Cross Society. "We still need to work in the camp so each and everyone will know that testing and counselling is done at the health centre."
Until the refugee from the Democratic Republic of the Congo (DRC) started her work, there was no full-time counsellor for HIV/AIDS at the camp, located in a thinly populated area of dry bush land nearly three hours drive from the Namibia capital of Windhoek. The doctor at the refugee camp clinic had limited time to counsel those taking tests and there was no one assigned purely to informing the 6,500 residents of the camp about the disease.
Most residents of Osire came from Angola, immediately north of Namibia. Some 3.7 percent of the adult population in Angola between the ages of 15 and 49 were living with HIV, according to the UNAIDS figures for 2006. The second largest group of refugees at Osire came from the DRC, where 3.2 percent of the adult population were living with HIV.
The refugees of Osire are now in a country where 19.6 percent of the adult population live with HIV.
"Namibia is a high infection country," Mwenze said at the camp clinic. "In our community there is a high poverty rate, some people have lost their parents and there are some kids doing commercial sex work. If people are not informed, they are transmitting it."
Mwenze advises the residents of Osire about safe sexual behaviour and the offer of HIV testing and treatment. Testing is voluntary, but Mwenze has seen a rise in demand since she started her full-time work a few months ago.
"At the beginning when I started, people were not coming," Mwenze said at the small office where she counsels other refugees in private. "Now they are coming from the camp or are referred by the doctor."
Those who test positive are checked to see if they should start the anti-retrovirals (ARV) treatment that Namibia last year made freely available to refugees as wells as its citizens. ARVs are not a cure but delay the onset of AIDS, meaning that treatment is for life. Some 20 refugees from Osire – plus five Namibians from nearby – presently receive medication at the camp clinic.
Ideally, Mwenze would like to see couples come for testing together. But if one has contracted HIV, anger can destroy any chance for mutual support. The stigma surrounding HIV and AIDS – and the secrecy it encourages – is the biggest challenge facing the camp counsellor as she works with her fellow refugees.
"If you put yourself in the position of someone infected, you can understand – they may be blamed, it could lead to divorce," said Mwenze, who three years ago fled rape and murder in her native DRC just as she was to start a teaching career. "It is not easy."
By Jack Redden in Osire Refugee Camp, Namibia