HIV testing has been set up at border-crossings, with particular attention on truck drivers and prostitutes who may be particularly vulnerable.
KIGALI - The Gatuna border between Rwanda and Uganda is bustling. Next to the truck stop, passengers disembark from the large buses that travel between the respective capital cities of Kigali and Kampala.
The people from both countries make their way across the border, and ahead toward the side of the road where little white tents are set up with nurses inside in white lab coats.
In these tents, Family Health International (FHI), an international organization working with the Rwandan Ministry of Health, has installed a “safe stop,” a place where people can get tested for HIV/AIDS.
“Here, people are more likely to be infected than in other places. Truckers, for instance, spend a lot of time on the road, away from their families and tend to have unprotected sex," explains Isaie Nsengiyumva from FHI. "There are also the prostitutes that cross the border over to Uganda or the other way around.”
He says the mobile clinic also targets the communities living near the border, from currency exchange clerks to public and private sector employees.
“I got tested a few months ago, and now I know what my status is. We are too swamped to go to the hospital to get tested, but now that the clinic is close to where we work, anyone can go, without wasting too much time,” says Janvier Uwimana, who works at the currency exchange.
Since June 2012, more than 1,300 people have gotten tested here – with 14% of them finding out they were HIV positive. To monitor and treat those who are infected with the disease, FHI has set up other mobile clinics in “hotspot” transport corridor towns in Kenya, Tanzania, Congo, Zambia, Burundi, Uganda and Djibouti, targeting approximately 2.2 million people, including 300,000 truck drivers.
According to a survey by the Rwanda Biomedical Center (RBC) in 2012, only 10% of the 530 truck drivers they interviewed said they used condoms. Two hundred of them agreed to get tested, and four tested positive for HIV/AIDS. “They have very frequent relations. But what is terrible is that few of them use condoms,” says Doctor Sabin Nsanzimana from the RBC.
Mobile clinics for a mobile population
Thanks to the FHI program, people can get treated in any one of the countries where there are mobile clinics, regardless of nationality and even if they are refugees. The goal of the clinics is to stem the HIV/AIDS epidemic that has plagued this region since the 1990s and has spread massively through cross-border conflict, displacements and returning refugees.
Refugees fleeing the war in Congo or Rwandans returning home after being displaced by conflict, represent a massive number of people coming and going, many of whom will have unprotected sex during their travels.
According to the Rwandan Ministry of Disaster Management and Refugee Affairs (Midimar), in refugee camps, tests are carried out upon arrival, while the refugees are filling out their paperwork. “We do this for their own good. Some of these people are coming in from the forests, they have no way of knowing whether they are contaminated or not,” says Dr. Nsanzimana from Midimar. “When they test positive for HIV/AIDS, we send them to state-run – free – clinics, where they can get treatment and can be given antiretroviral drugs.”
According to Midimar, the refugee camps located in south and western Rwanda (Kigem and Kiziba camps) provide testing and treatment for HIV/AIDS. They also provide condoms and use posters and pamphlets to raise awareness on the disease and how it spreads.
Another initiative is the Jeunesse Nouvelle Vision (New Youth Vision), a youth organization. “UNICEF and the UNHCR asked us to talk to the young refugees of the Nkamira about HIV/AIDS and sex education using sports and culture. Our counselors teach them to be responsible,” explains Immaculée Mukamuhiz, the organization’s coordinator.