By: Yusuf M Hasan
HARGEISA (Somalilandsun) – The Country’s HIV epidemic is concentrated in high risk populations such as vulnerable women, truck drivers, port workers and young people. However, until recently, these populations have been largely overlooked in the national HIV response.
These revelations follow groundbreaking research undertaken through a series of studies, by the International Organization for Migration (IOM) between 2007-2010 that identified, for the first time, major drivers of the HIV epidemic as well as “spaces of vulnerability” or “hot-spots” in the country.
This was revealed by the senior national program officer at The Migration Health Division (MHD) of International Organization for Migration Mr. Hussein Hasan during an interview with the Somalilandsun, further informing that the findings have facilitated the reshaping of the National HIV response not only in Somaliland but Somalia as well.
The programme officer said that though the findings of the hot-spot mapping indicated low condom usage among the most-at-risk groups in Somaliland, limited knowledge of HIV and concentrated epidemic among the most-at-risk groups including female sex workers, truck drivers, port workers and youth, they also clearly indicate that the general population approach to HIV prevention in Somaliland has fallen short of reaching sex workers and their clients.
Stressing on the importance of the study the IOM officer said that apart from the superb findings the exercise demonstrated that HIV research among sex workers and their clients can be conducted in a challenging environment characterized by significant cultural and religious sensitivities, in addition to considerable population movement.
Mobility in Somaliland includes porous borders with countries that have higher HIV prevalence (Djibouti, Ethiopia,), and the presence of high-risk mobile populations associated with other HIV epidemics in the region (truck drivers and the military).
The studies were used as an evidence base for Somaliland-Somalia’s success in its Global Fund to Fight AIDS, Malaria and Tuberculosis (GFATM) Round 8 application and have directly reshaped the national HIV response.
The hot-spot mapping studies that helped reshape the national HIV response were used as an evidence basis for Somaliland-Somalia’s success in its GFATM Round 8 application as well as facilitating IOM’s presentation at the ICASA conference that took place in Addis Ababa from 5th – 8th December, 2011.
High ranking political figures including African Ministers, Former US president, George W Bush and Global Fund deputy Executive Director attended the Conference where More than ten thousand delegates accessed the information of youth survey. The Delegates posed interesting questioning about the feasibility of conducting such a survey in Somalia whose findings were presented as an advocacy tool and mobilizing resources for HIV response in Somalia.
Following the reshaped national response, IOM has been implementing the two HIV prevention programmes of Community-Based HIV Prevention and Stigma Reduction that focus on at-risk populations that include Vulnerable and At-Risk Adolescents and Youth in all three zones where being implemented in Somaliland, Puntland, and South Central where they aim to develop and implement community and youth-based HIV prevention, awareness, and stigma reduction with funding from the GFATM
Key activities include community outreach for positive behavioural change, increasing
voluntary counselling and testing utilization, reducing HIV stigma by facilitating community dialogue among key stakeholders, including religious and clan leaders, and providing forums for HIV positives persons to give them a voice and space for advocacy. IEC materials
As part of the programme, IOM in partnership with over 25 stakeholders is facilitating the development of new, timely and culturally relevant information, education & communication materials on HIV for all three zones.
IOM’s Migration Health Division In Action
The Migration Health Division has fulfilled a number of tangible activities in pursuits of fulfilling IOM’s HIV programs, among them:
Implementing an HIV prevention and stigma reduction programme through 18 local non-governmental organizations across all three zones in Somalia;
Trained 108 peer educators on HIV awareness and 60 peer educators on sexual and gender-based violence awareness and micro loan management;
5,110 at-risk and vulnerable women, port workers, truck drivers, uniformed personnel, migrants and internally displaced persons have been sensitized to HIV;
Sensitized 60 vulnerable women as “Women’s Advocates” on modes of HIV transmission, sexual and gender-based violence and the right to health;
Conducted groundbreaking research identifying priority populations where the HIV epidemic is concentrated. An Integrated Biological and Behavioral Surveillance Survey were published in leading peer review journal AIDS 24: S61-S67.
Filling the data gap
IOM continues to fill the data gap to advise the national HIV response and advocate for programming. IOM is currently facilitating one of the first studies on health vulnerabilities along coastal areas in the Puntland State of Somalia.
Increasing voluntary testing and counselling (VCT) utilization HIV knowledge in Somalia remains a major challenge
Awareness on modes of HIV transmission, prevention and treatment is lacking. Through targeted outreach activities, IOM is linking prevention to existing treatment, care and support. IOM and partners are focused on ensuring at-risk and vulnerable populations are tested for HIV. Feedback from partners shows a notable increase in HIV testing among targeted populations where VCT services are present.
Always in partnership
IOM works closely with all key stakeholders, including AIDS Commissions Ministries of Health, and United Nations agencies. IOM is also an active member of the Somalia Health Cluster Health Sector Committee and the United Nations Joint Team on AIDS to ensure all programmes are aligned with the national response on HIV.
According to Mr. Ahmed Mohamed Jim’ale, Executive Director, SCAC “IOM’s contribution to the national HIV response in somalia has been indispensable. Through quality technical assistance, groundbreaking research and effective capacity building of national partners, IOM has facilitated us to target HIV programmes for priority populations. Yet, scale-up is still needed for a comprehensive combination HIV prevention intervention. Somalia is at a critical junction. We must act now to contain and reverse the epidemic.”
And as IOM continues to work against all odds to reduce stigmatization in the three regions it is hoped that this slogan of the organization will keep it steady in its noble endeavors “we aim to create HIV awareness, reduce stigma, and build the capacity of our partners to better prevent HIV in Somaliland & Somalia”
The Migration Health Division (MHD) of International Organization
The Migration Health Division (MHD) of International Organization for Migration (MHD) Somalia has been operational in Somaliland since 2007 to carry out various projects including HIV related researchers. IOM MHD has been managing two Global Fund supported projects in Somaliland since 2010. In partnership with seven local implementation partners and Somaliland National AIDS Commission (SOLNAC), IOM conducted various social mobilization activities on HIV, Sexual and gender-based violence (SGBV) and sexually transmitted infections (STI) for the key populations including truck drivers, port workers, and uniformed services, tea sellers, khat sellers, migrants and Internally Displaced Persons (IDPs). IOM built the capacity 8 local NGOs on strategic planning, resource mobilization, advocacy and communication.
The MHD is staffed by a cadre of 12 professionals who are composed of regular, interns and UN volunteer. The numbers of Somali national staff are four; three are Kenyan national staff, one Kenyan intern, one Japanese intern, One Japanese UN volunteer, one Norwegian Somali staff seconded by NRC and two expatriate staff. With the exception of the four Somali national staff, all others are based in Nairobi.