Each Year, March 24 is set aside to commemorate the World Tuberculosis (TB) Day to raise public awareness about the devastating social, economic and health impact of tuberculosis. Despite significant progress over the last decades, TB remains the world’s deadliest infectious killer and require acceleration of efforts to end the TB epidemic globally and in Nigeria.
Every day, nearly 4500 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease. Global efforts to combat TB have saved an estimated 54 million lives since the year 2000 and reduced the TB mortality rate by 42%. To accelerate the TB response in countries to reach targets – Heads of State came together and made strong commitments to end TB at the first-ever UN High Level Meeting in September 2018 in New York.
As part of the week long planned activities to commemorate 2019 World TB Day, HIFASS in collaboration with partners from various health institutions starting from 14th – 25th March, 2019. The event kick-started with a Pre-press briefing which was held in Abuja on Thursday, 14th March with the theme being released “It’s time!” and slogan “To end TB in Nigeria (keep the promise! Find TB! Treat TB)”. At the event, the press were told to be TB advocates and create more awareness through media platforms. According to the US-CDC representative in Nigeria, Dr. Bethrand Odume, “to control TB in Nigeria, the sum of N147 billion has been estimated. N35 billon of that amount which is about 24 per cent has been met. To be very sincere, over time, there has been an increase in funding within the national TB programme and government has actually come up to rise to its responsibilities but the gap of 75 per cent still remains. No fewer than 18 people are reported to die as a result of the ailment every hour, thereby ranking Nigeria the sixth globally with nine per cent rate and the first in Africa after India and Indonesia which are at 26 and 11 per cent rate respectively. The estimated cost was expected to be raised by the government, communities, private sector, international donors and individuals. He lamented that most of the funding for the disease comes from foreign donors, adding that it was unacceptable and should be discouraged.”
In the same vein, a community outreach and screening for TB cases was conducted in Kobi village on Wednesday, 20th March where the wife of the Nigerian President/TB Ambassador, Aisha Muhammadu Buhari and Vice President, Mrs Dolapo Osibanjo flagged off the TB Wellness On Wheel (WOW) truck. She called on Nigerians to test themselves for Tuberculosis (TB), being one of the world’s most deadly diseases.
Also, in the spirit of commemorating the 2019 World TB Day, National Tuberculosis and Leprosy Control Programme (NTBLCP), partners from various health institutions and NGO organised a road walk on 23rd March 2019. The walk start off point was from Old parade ground to Area one roundabout in Abuja which was aimed at creating more public awareness about Tuberculosis. Participants were decked eye-catching branded T-shirts, face caps and reflective jackets distributing IEC materials to passers-by and by-standers sensitizing them about the disease.
Similarly, on Sunday, 24th March 2019, Dr. Mrs. Aisha Muhammadu Buhari, the wife of Nigerian President, hosted key stakeholders at the State house banquet hall, Aso Rock, Abuja to celebrate TB champions and survivors in Nigeria.
At the event, she solicited the support of the private sector and media support in the fight to end tuberculosis in the country. Mrs. Aisha noted that TB is a major challenge globally and a killer disease, adding that it should be integrated in the fight against HIV/AIDS to reduce the deaths associated with the disease. According to her, “tuberculosis, despite being a curable disease, is still a major health challenge globally and remains the number one infectious killer disease in the world. In Nigeria, one of the major challenges of TB response is attributed to low cases of its discovery both in adult and children. This is attributed partly to poor knowledge about TB that influences the health seeking behaviour of people and low treatment coverage. This is one of the reasons I personally led a team to Kobi Village in Abuja on Wednesday, to create more awareness” she said.
To end the week-long planned series of activities, was a Ministerial press briefing at Sheraton hotel, Abuja on 25th March. Stakeholders from health institutions came together to launch road map to Translate UNHLM commitments on TB into action and launch of the report of the National catastrophic cost survey. Speaking at the event was Minister of Health, Prof. Isaac F. Adewole who was represented by his Permanent Secretary, Alhaji Abdullahi Abdulazeez Mashi. He said, Nigeria’s TB treatment coverage for 2018 was 255, adding that out of an estimated 418, 000 new cases, only 106,533 cases were reported in 2018 leaving over 300,000 cases undiagnosed and funding gap, lack of awareness, technical capacity and poor private sector collaboration were crippling current efforts.
HIFASS-LOPIN 3, a five-year USAID funded project joined the Cross River State Agency for the Control of AIDS and other organizations in the state to mark the World AIDS DAY celebration from the 30th of November to the 2nd of December, 2018.
The global event which is usually celebrated on the 1st of December was kicked off in the state with a Jumaat service on the 30th of November at the Navy Mosque, Calabar. Activities there included a sensitization speech by Shabam Abdullahi, a member of the state inter-faith coalition and HIV Testing and Counselling Services. At 6pm, it was followed by a candle light procession to remember those who have died as a result of the virus. The procession began at the Barracks Road office of the State Agency for the Control of AIDS through the 11:11 round about, Cultural center and back to the office where speeches were made by stakeholders and HIV program implementing organizations in the state.
HIFASS-LOPIN 3 Community Mobilization and Public/Private Partnership Advisor (CMPPPA), Obase-Okanke Ofem Willie, played host at the candle light event and also spoke on behalf of the organization, appreciating stakeholders and partners for the work so far.
On the 1st, a solidarity walk was flagged off at about 9am by the wife of the state governor, Dr. Linda Ayade at the Rabana roundabout and ended at the Calabar Municipality Local Government Area secretariat. Stakeholders and HIV program implementing organizations in the state participated in the walk which lasted for approximately one hour, after which the Director General, State Agency for the Control of AIDS (SACA), gave the welcome remarks, the Commissioner for Health gave the keynote address, goodwill messages were received from Implementing Partners; and after a few presentations, the First Lady made her speech.
In her remarks, DG SACA enjoined all present to intensify the fight against HIV/AIDS. She was glad about the fact that the state has provided an enabling environment for donors to work but noted that ownership needs to be taken at the state and LGA levels “for sustainability”. She commended HIFASS-LOPIN 3 and other partners for their work in the state.
The Commisioner Ministry of Health listed abstinence, mutual fidelity as well as correct and consistent use of condoms as ways to prevent HIV.
HIFASS-LOPIN 3’s Deputy Chief of Party, Dr. Al’Rashid Usman, speaking on behalf of the project, thanked the state for the enabling environment, briefly told of the project achievements so far and stated that “we can control HIV/AIDS; if Nigeria controlled Ebola, it is possible”.
In her speech, the First Lady thanked partners for their role in combating HIV in the state. She also reiterated the words of Dr. Usman that the goal is to completely eradicate HIV. She enjoined all present to take advantage of the free testing and treatment available. She said “take your life and protect it, not just for yourself…but for humanity. If you do not know your status, it means you are careless with your life. If you do not know your status, you plan to die”
Her speech brought the event to a close at about 11.30 am and organizations began testing and counselling services. Since the venue used is the same allotted for the Calabar Christmas Village which was opened on the same day and will be closed at the end of the year, testers and mobilizers from HIFASS-LOPIN 3 will be stationed there for at least 15 days for HIV Testing and Counselling Services (HTS).
Finally, on Sunday the 2nd of December, a thanksgiving service was held at the ECWA Church, Henshaw town, Calabar to thank God for the World AIDS Day celebration. Again HIFASS-LOPIN 3 CMPPPA, Obase-Okanke Ofem gave a sensitization speech on behalf of SACA and all the implementing organizations in the state on prevention and also encouraged them to get tested. The event was rounded off with HTS at the church venue.
Figure 1. At the candle light event.
The 16 days of gender activism this year took a different turn, as the focus was not solely on the female gender, as is normally the case, but on violence against all genders. The theme ‘Gender and the World of Work’ sounded quite neutral, pinning the focus on gender discrimination as it affects the workplace.
The HIFASS-LOPIN 3 project, funded by PEPFAR through USAID, has contributed immensely to empowering women and adolescents as well as worked to provide healthy home environments for children to grow in, by empowering their parents. It has also set up structures to help combat and manage Gender Based Violence, one of such structures is the furnished response center at the Child Protection Network secretariat in Calabar, a safe haven for victims of GBV. Also, Adolescent Girls and Young Women (AGYW) meetings are used to teach young girls life skills and to protect themselves.
The project organized a 2-day sensitization exercise on Gender Based Violence (GBV). The event which held at Marian Hotels Calabar began on the 5th of December, 2018 with a sensitization exercise on GBV with existing stakeholders as well as other relevant organizations in the state. In his opening remark, the Chief of Party, Dr. Ademola Adetunji, stated the need to look into GBV identification and management, then response. The Commissioner for Women Affairs, Mrs. Stella Odey, commended the project for continuous support to Cross River State and she stated that there are policies in the state to help women. She acknowledged the fact that “men are equally being violated” and assured participants that the state is coming up with a gender policy along with an implementation framework which will help address the subject.
Presentations were made on Gender Based Violence as well as GBV Care Services by the Gender and HIV Prevention Advisor to help people understand the concept as well as what to do when there are cases. In her presentation on GBV and HIV, the Director General, Cross River State Agency for the Control of AIDS (SACA), Mrs. Rose Nyambi, corrected a long-standing opinion by stating that “GBV is beyond women being beaten by their husbands, she showed other modes of violence that are not necessarily physical and spoke on the relationship between GBV and HIV.
During the discussion segment, observations were made by representatives from different parastatals; the representative of the Christian community stressed the need to repeat the presentations before larger representatives of her community as it needs to be shared, the representative of the Muslim community expressed his reflection on the fact that early marriage can cause GBV and promised to take the message back to the league of Imams and scholars.
There was also a question and answer session which facilitated the definition of rape according to Nigerian law by the representative from Child Protection Network (CPN), Mr. Kebe Ikpi – sex without consent as well as sex with a minor (below 18). Others were centered around spousal rape and gang-raping of boys and young men as well as of teachers by their students, same-sex rape and rape of toddlers. In response, the representative from Medical Women Group, Dr. Okoi Obuli, said there is a place set up for women who are afraid to speak up on their husbands’ defilement of their toddlers. She encouraged parents to speak with their children regularly, pointing out that in visits to secondary schools by her team, they realized that a lot of young people refuse to use condoms because their parents will find out.
The Deputy Chief of Party for the project, Dr. Al’Rashid Usman in his closing remarks pointed out the availability of pre and post exposure prophylaxis for rape victims and Female Sex Workers.
The second day’s event was basically for secondary school students. Presentations were made by the Gender and HIV Prevention Advisor on Understanding Gender, the representative of Medical Women on Knowing Yourself, the representative from Child protection Network on when sex becomes a crime and what people should do when they are abused sexually. They were also taught about hygiene and the girls were given re-usable sanitary pads which were received from The Red Cross.
The day’s event also included an interactive session which encouraged the students to ask questions which were answered immediately. The excited students were glad to share what they learnt from the workshop, like Jomso Happiness Etodem who said she learnt that “not only girls can be sexually abused”. Bassey Onoyom learnt that “rape does not have to result to HIV infection.
The project also participated in the state rally on the 10th of December to mark the sensitization on gender for the year and provided refreshment for 500 participants.
In all, the icing on the cake for this year’s activity came a few days after the state event when the Gender and HIV Prevention Advisor got a call from the chairman of Child Protection Network, Barr. James Ibor, about a young female victim of continuous rape who has had 3 abortions at age 15. She was like a sex slave who had to meet the sexual demands of old men, one of whom has been arrested, a state executive. Every time she got pregnant, her mother took her for an abortion, but the last one was not properly done and she was bleeding and collapsed in school. She confided in a teacher who escalated it. This 15 year old was terribly traumatized by her situation and fear of what her mother would do to her for speaking up that she started taking Tramadol and drinking.
With logistics support from the USAID-funded HIFASS-LOPIN 3 project, she has been moved around comfortably, her mother and the state executive have been arrested. Our case monitor assigned has provided psychosocial support continuously to the young girl who is being prepped for surgery.
This story has provided a greater drive for the fight against GBV as the media sphere has been agog with discussions centered on the issue. We hope that with this awareness, more cases will be thrown to light, more perpetrators will be prosecuted and more people will be helped out of the pain.
Anniversaries are the opportunities to recollect the year gone memories and to cherish them again. The year 2018 has been full of positives for HIFASS, from winning new contracts to old contracts successfully coming to an end. As “HIFASS is built on GOD’s foundation” it is customary that every year we gather together to thank God and bless the year ahead for the organisation. This year, the prayer/prophetic session was led by Pastor Prince Ukaegbu, It was an afternoon filled with joyful moments for staff as they all gathered together in the HQ conference room to celebrate HIFASS at 11. We look forward to more amazing years.
On the 25th of September, 2018, 13 Adolescent Girls and Young Women were given materials for business start-ups after six months of intensive training also funded by the project.
Those for hairdressing got generator sets, standing hair dryers, hand held dryers, ceramic rollers, 4 in one roller sets and hair wash basins while those for sewing got Sewing machines, weaving machines, sewing kits and scissors.
Some of the girls who received their start-up materials last year were placed in project-rented cluster shops where they can showcase their work and get their businesses running.
In attendance were the DG, State Agency for the Control of AIDS, Dr. Rose Nyambi; Permanent Secretary Ministry of Women Affairs, Ejom Freedom; and a representative from YESSO, Frances Edem.
They encouraged the beneficiaries to do well with what they have received and the beneficiaries also thanked the organization for the exercise.
To mark the end of project implementation in Ebonyi state, a dissemination meeting was held on 12th September, 2018 for stakeholders in the state. Project statistics were shown to the stakeholders and feedback was received from them regarding the implementation.
The Ebonyi team bowing out
A cross-section of participants at the event