The AIDS epidemic in Tanzania

Western Heads East chose Mwanza, Tanzania as its initial start-up site for probiotic yoghurt kitchens as it illustrates the devastation of HIV/AIDS in Africa. Around 1.2 million people aged 15 and over (just over 5% of the adult population), are living with HIV in Tanzania. An estimated 100,000 Tanzanians were newly infected with HIV in 2009, which is around 275 new cases every day.

Women/Girls particular vulnerable

Women in Tanzania are particularly affected by HIV and AIDS. In 2008, 60% of the people living with HIV were women. In women between the ages of 15-24, this figure rises to 75%

"Across the globe, women, particularly young women, are not in a position to abstain. They are not in a position to demand faithfulness of their partners…women are unwilling to even raise the issue for fear of rejection or physical assault. A woman who is a victim of violence or the fear of violence is not going to negotiate anything, let alone fidelity or condom use. Her main objective is to get through the day without being beaten up” (African Renewal, 2004). “I have a child and when I go with a man like him, he can give me something to buy milk for the child.”Aisha, a young woman at a party in the Mkinga district.

In addition to the physical impact that HIV/AIDS has, women also take on the sole responsibility of caring for their children and households. This disease can leave family members and orphaned children to deal with ostracism and a vicious cycle of poverty and disease.

HIV/AIDS related stigma

“At home my mother and myself have tested and been found positive. She has told me not even to tell my relatives; not even my own sister because she is afraid I will be stigmatised” - A young girl from Tanzania.

Unfortunately, stigma towards those with HIV/AIDS remains high and has become a significant barrier to treatment and prevention in the developing world.

Discrimination leads to an unwillingness to take an HIV test and to disclose results to family, friends or sexual partners. Stigma, specifically fear of abandonment, job or property loss and violence were reasons for this delay. Such fear increases the chance that HIV will be transmitted to a partner, that preventative behaviour will be avoided and that uptake of treatment will be delayed.

A woman who discloses her HIV status may be stigmatized and rejected by her family. In most cases, women are the first in the family to be diagnosed with HIV and may be accused of being the source of it in the family.

Reducing stigma and discrimination goes hand-in-hand with providing help to HIV-affected households. Stigma sometimes causes shame or fear of ostracism, and deters household members from seeking and receiving community-based assistance. Stigma and the beliefs that it can perpetuate (such as an HIV positive person has been cursed by witchcraft) can lead to reduced motivation to seek treatment. “Pervasive stigma remains the most formidable barrier” to taking up free antiretroviral treatment in rural areas.

Kivulini Women’s Rights Organization

Kivulini is a registered NGO grassroots community based in Mwanza, Tanzania. It was founded in 1999 by a group of Tanzanian women who could not sit back and watch the violence against women and girls taking place in their communities. Kivulini strives to tackle the root cause of domestic violence by working closely with community members and leaders to change attitudes and behaviours that perpetuate violence against women. The organization’s vision of creating violence free communities is linked with women’s economic empowerment to reduce dependency and contribute to family income. When a women is aware of her rights in the community and is economically independent she improves both her health and socioeconomic position, as well as contributes more fully to the development of the community as a whole.  The University of Western Ontario collaborated with Kivulini to design the probiotic yoghurt project that has started providing a new source of income for women in Mwanza as well as contributing to the overall health of children and adults.

Tukwamunae Women’s Group (TWG)

Tukwamunae means “women working together to alleviate poverty” in Swahili. TWG is a registered NGO that consists of 10 female women who work together at a community kitchen (Jiko La Jamii) in Mabatini district which is just outside the Mwanza city centre. They act as the main producers of the FITI probiotic yoghurt. Since WHE’s inception, they have learned to make the yoghurt and continue to develop with the assistance of WHE interns. The production and sales of the probiotic yoghurt provides these women with a source of income resulting in the economic empowerment of the women’s group itself. Another portion of the probiotic yoghurt is distributed six days per week, free of charge to 125 local community members who are living with HIV/AIDS.

Summary of my Goals

Mwanza Tanzania

1.    Yoghurt production and distribution

-          Ensure good quality control measures are being implemented consistently

throughout the process of yogurt production and distribution. (i.e opening and closing procedures, sanitation, temperatures, safe food handling, etc.)

2.    Consistent High Quality Yoghurt

-       Smooth yogurt means the probiotics are distributed throughout and therefore the yogurt offers more health benefits

3.    Education

-       Provide women’s groups with education about the health benefits of probiotics, assess AIDS related stigma, work with the mamas to develop a public education plan that they can use to educate the community

4.    Ensure Meetings are held weekly

-       Structure meetings to be more action oriented and explore the desire for a mama as a leader for each key area of the program

¨      quality control, production/sales, bookkeeping accounting, human resources

5.    I hope to visit the other 5 kitchens in Mwanza (Mahina, Igombe, Kivulini, Buswela, Baraki sisters) with Esther or one of the Mamas

-       Evaluate quality control procedures currently in place, assess areas for improvement, develop a plan for yoghurt to become probiotic asap

Meet and Greet with the Yoghurt Mamas!

Missy took Chris and I to meet the yoghurt mamas in Mabatini district, which is about a 15 minute walk from the apartment. We were introduced to four of the mamas (Mama Sabina, Elizabeth, Cecilia, and Leah), they were very welcoming and excited to meet us. I felt very comfortable with them and am excited to spend more time at the kitchen and at the school where they make chapattis and chai every morning for the children at Mtoni school. We spent some time making the yoghurt with them and observing the processes involved. They gave us a glass of the yoghurt and it was quite good, but very different from the yoghurt I am used to in Canada. It is a little bit sour and the consistency is like a thin milk shake which most people drink.

After a while at the kitchen, the mamas invited us to pay our respects to Mama Sheda. She used to be part of Tukwamunae but had unfortunately passed away in December from a disease that left her paralyzed from the waist down. It is very common to attend funerals here, and everyone is invited even if you didn’t know the person. The mamas led us up a very steep hill towards mama Sheda’s home, with uneven terrain, pot holes, and rocks. Missy told us many elderly people live up there and walk up and down that hill several times a day.  When we arrived, there were many people at her home, and we were invited inside a small room where we all gathered around in silence. This was a very unique but emotional experience as many of the mamas were crying. Pictures of Mama Sheda were passed around and we sat in silence there for over an hour. One thing that I found very upsetting was that she left behind three young children (all under 10), I am not sure if they have a father, or what the future now holds for them? Missy told us that unexpected, random events will come up all the time, which makes for a new adventure everyday!