Wereldtalentblog
Via het Wereldtalentfonds komen buitenlandse studenten met een gebrek aan eigen financiële middelen een jaar aan de faculteit studeren. Ze houden een blog bij over hun studie, het leven in Amsterdam en hun veldwerk.
Joseph Mumba Zulu was a student in the Master’s programme in Social and Cultural Anthropology at VU University Amsterdam in 2008-2009. He comes from Zambia and studies HIV/AIDS-related social issues. During his field work in his home country he tried to find out why people are not accessing HIV drugs despite them being offered for free in public health centres.
10-6-2009 My fight against HIV/AIDS
Hey Marieke,
It was a great pleasure for me to be given an opportunity to write about my studies, especially my research. I really enjoyed writing every story. Writing the stories made me reflect on what i was doing and helped me get more focused with my reaserch. I also know that it may be possible that some of the stories that I wrote may, in future, motivate more people join the fight aganist HIV/AIDS in one form or the other.
Best regards,
Joseph.
With less than a month to go before the end of my studies, I am enthusiastically analysing the key barriers to accessing HIV/AIDS testing and treatment services in Zambia. As well as combining empirical data with existing theories on HIV/AIDS testing and treatment seeking behaviour, this phase also involves contributing to existing knowledge in this field. Producing a thesis on this same subject by 29th June 2009 is the ultimate focus.
Though requiring a lot of hard work and analytical thinking, I have found this phase not only interesting but also inspiring. Two issues have greatly contributed to this: the first being the excitement that comes as a result of being able to translate the fieldwork experience into analytical arguments for explaining HIV/AIDS health seeking habits; and also the encouragement and analytical comments from my supervisor Dr. M.H.G. den Uyl, intensive lectures on thesis writing by Prof. dr. B. Meyer as well as the continuous support from my second assessor, Dr. L.S. Nencel.
This phase has also helped in shaping my future plans. Writing this thesis has motivated me to specialise in public health matters. My dream is to continue doing research in community health problems, especially those that have to do with HIV/AIDS. Though I did my research only in Kitwe District (Zambia), it is possible that my findings may be relevant to other places, hence the need for me to conduct studies in other environments. Not only do I want to get involved in research, but also in HIV/AIDS advocacy. Under advocacy, my interest is to help reduce HIV/AIDS stigmatisation in the community.
I am confident that various research skills that I have acquired (for example how to design a research plan, conducting ethnographic research as well as report writing, will help me to successfully undertake research in HIV/AIDS matters in other settings. In terms of my plans on advocacy, I believe that the skills that I acquired in the Human Security course on how to develop analytical/logical arguments and presentations will help me achieve this.
In summary, it is clear from the above discussion that my future plans revolve around doing further research and advocacy in health related matters. Seeing HIV/AIDS infection rates as well as stigmatisation reduce; and more people infected with HIV/AIDS being able to access treatment, is my eventual vision.
Finally, I would like to express my sincere gratitude to my sponsors who made it possible for me to not only smoothly learn but also live without any difficulties in the Netherlands. I would also like to earnestly thank the Professors for the intensive as well as dynamic lectures. I believe that the knowledge that I have acquired will go a long away in contributing towards the fight against one of the threats to human security, which is the HIV/AIDS pandemic.
3-4-2009 End of My 3 months fieldwork in Zambia
‘Joseph, listen to me, the HIV/ AIDS that we have now in the villages is injected into your body by witches using a traditional HIV injection and not gotten through sex. This is real and I have even seen the traditional HIV injection in court. This type of HIV/AIDS cannot be cured using ARVs. This therefore posses a challenge to the use of ARVs.’
(Lyod Moto, 29/02/09)
Finally fieldwork has come to an end. What looked like a long time at the beginning of January 2009, moved so fast and before I realised it, I found myself packing my bags and on the plane to Amsterdam. The good thing however is that I managed to meet the targets that I had set in the research proposal.
Before I start discussing the preliminary results of my fieldwork, let me briefly take you into some of the activities that I was involved in. My research focuses on understanding why some people in Zambia are not using the HIV medicine (ARVs) and do not go for HIV testing despite these being provided for free in public heath institutions.
As I write this article, some of the activities that I took part in quickly come into my mind. Like visiting the homes of people living with HIV to offer material and psychosocial support, to understand how they experience the disease and how they are responding to it, or conducting key informant interviews with the pastors, HIV counsellors, HIV/AIDS researchers, caregivers and medical personnel. I also attended HIV/AIDS group counselling and testing at a Basic school in Lusaka District and conducted 40 individual interviews.
HIV/AIDS group counselling, testing and test results.
I also held talks with the Youth in Ndola District on how HIV is affecting young people and their fears and insecurity with regards to HIV testing and access to medication. This was more of an informal talk. Related to this is coordinating focus group.
Discussion with youth in Ndola District.
Preliminary results as to why people are not using the medicine and not going for HIV testing include the following: firstly some people do not want to go for an HIV test because they fear living with the feeling that they will die anytime soon once confirmed that they are HIV positive. Thus some people would rather live in a state of uncertainty with regards to the type of sickness that they are suffering from than knowing that they are HIV positive. The other issue that shocked or surprised me is the view that other people fear to go for HIV testing because they think the people who conduct the tests take their blood to Satanists who use it for personal benefits.
HIV test results.
Other reasons which apply to both testing and medication include the fear to be laughed at and shunned by society. This so because in some communities, people living with HIV/AIDS are regarded as highly promiscuous. There is also the fear that the HIV medicine is too strong and may cause a patient to die, collapse or become insane. Some people do not have money to pay for transport to go for regular medication. Other people complained of the delay in being attended to at the hospital due to long queues and also shortage of health personnel to attend to the patients. Some people cited the African medication culture that advocates starting with traditional herbs when someone is sick before shifting to modern medicine as also a contributing factor.
Another surprising finding was that in some villages witches have invented an HIV injection which they inject people they want to kill. The injected people suffer from a disease that has symptoms that are similar to HIV/AIDS, and this type of sickness does not respond to ARVs. Therefore some people do not see an reason why they should go for an HIV test and even start the ARVs because they know that the HIV/AIDS that is more prevalent now is that which is being caused by witches and which can not be diagnosed or treated using modern medicines. In fact, I was told that one witch agreed in court that he has such an HIV injection. The other reason is the ‘myth’ that Christians are supposed to be holy and not affected by HIV while for some Christians, they believe in faith based healing and not using ARVs.
I was also surprised to find out that more men than women hide their HIV status from their spouses. When I was going in the field, I thought it was the other way round.
Well, I have a lot to write on my findings, but may be let me now look at some of the challenges in the field. As I reflect on the fieldwork, I think that all went on well though there were a few challenges. For instance when a Secretary denied me access to talk to the Director of an NGO dealing with gender based violence in Zambia. And there were a few cases, where people refused to be interviewed despite having initially agreed. I was also sick from malaria in the first week of March.
Despite these challenges, the regular support, encouragement and guidance from my Supervisor, Dr. M.H.G. den Uyl, gave me enough enthusiasm to successfully accomplish the fieldwork. I salute her efforts. I would also like to the thank all the professors that helped in preparing for this fieldwork as well as the University for funding it.
I cannot wait to start analysing the data and produce the thesis as well the video of my fieldwork.
4-2-2009: Field working in Zambia
My fieldwork in Zambia commenced on the 3rd of January 2009 on a good note. Up to today, I am receiving a lot support from the organisations dealing with HIV/ AIDS matters. The people living with HIV/AIDS are also willing to share their experiences with me. Like I mentioned in my last article, I am trying to understand why people are not accessing the HIV drugs (ARVs) despite them being offered for free in public health centres.
Though I was enjoying my stay in the Netherlands, when it was time to go for fieldwork, I looked forward to going back to Zambia and commence the fieldwork. There are a number of reasons for this. Firstly, I wanted to practice the new research skills, which I acquired at the Vrije University. Furthermore, I could not wait to explore the topic that for a long time has been of great interest to me. In addition, I wanted to meet my Zambian friends and share my experiences of the Western culture with them. I also missed the warm weather in Zambia.
From the massive support that I am getting from the community, I have concluded that most of people are aware of the negative effects that the disease has had in Zambia and are looking forward to finding a lasting solution to the problem. Most of the people in the community (including people living with HIV) have expressed happiness that I decided to study this issue, which is not only pressing but also difficult to openly talk about in Zambia, due to the mainly social stigma attached to it.
In doing this research, am working with the Reformed Community Support Organisation, an NGO dealing with HIV/AIDS related matters on the Copperbelt province. The organisation is running a home-based care programme for people living with HIV/AIDS. Consequently, every weekend I participate in the home based care programme. This has helped in creating good relationship (trust) with people living with HIV/AIDS and also getting a deeper understanding on how people experience the sickness.
Below is a photo of the home-based care team that I am working with:
Apart from the home visitations, other fieldwork activities include making appointments for key informant and individual interviews and subsequently conducting the same interviews. The key informant interviews are being conducted with organisations operating HIV/AIDS programmes, pastors and HIV counsellors. I also intend to interview a traditional healer or doctor. In the evenings, I reflect upon the day’s activities and prepare for the following day.
Below are some pictures about my interview with a key informant and a discussion with pastors for the Reformed Church in Zambia and the Executive Secretary for the Reformed Community Support Organisation in Zambia.
Generally, I have understood that to effectively work with people living with HIV, there is need to constantly reflect upon your role in the field and to stick to it. On several occasions, I have found my self feeling pity or sympathising with them. I remember that I almost shed tears during one of the interviews when one of my interviewees was sobbing whilst narrating how the family discriminated against him once he was diagnosed HIV positive. Stories about how individuals, especially females have been divorced by their husbands once diagnosed HIV positive and how such individuals are struggling to acquire enough food/ nutrition that is required for HIV drugs to be effective are so touching and sometimes make me feel sad and stressed. I have, in most cases, found myself counselling people after interviewing them because they are stressed by some of the questions about their life experiences.
All in all, I have found the interviews and home based care activities very insightful. I am already getting a broader and deeper understanding of the dynamics that surround HIV testing and access to HIV drugs in Zambia.
20-11-2008: My programme and plans
"I am currently enrolled in three courses, namely Field Research Design, Qualitative Data Collection and Theoretical Orientation on Human Security. I have found these courses interesting, educative and generally helpful in realising my future interest or goal, which is contributing towards the fight against social problems in developing countries. I have greatly benefited from the intensive lectures, good supervision and guidance from the lecturers; and my research supervisor as well as the group discussions.
Am really very glad that the programme has granted me the opportunity to do fieldwork in one of the social problems in Zambia, the HIV/AIDS pandemic. This fieldwork will commence in January 2009 and will be for the period of 3 months. My fieldwork will focus on understanding why people living with HIV/AIDS are not accessing the HIV/ AIDS medication or antiretroviral therapy (ART) despite the medicine being offered for free in public health institutions. To make my research more clear, let me give a brief background on the HIV/AIDS and ART situation in Zambia.
Zambia has a population of about 11.5 million people. Out of this population, 17% of the adults are living with HIV and the majority of these being women (57%). Despite the government making access to ART free, most of the people in Zambia (both men and women) living with HIV/AIDS are not accessing ART. According to UNAIDS (2008), out of 1,200,000 people living with HIV/AIDS in Zambia in 2007, only about 159,000 were on ART. Its has been reported that women, compared to men face more problems with regards to accessing the AIDS medication."
(Source: ACTNOW www.actnow.com.au/files/ 20/11/09)
4-10-2008: Who is Joseph Mumba Zulu?
“Hello, my name is Joseph Mumba Zulu and I come from Zambia. In September I enrolled in the Master’s programme in Social and Cultural Anthropology at VU Amsterdam. In Zambia I pursued a degree programme in Social Work. I graduated in 2005 with a Distinction and was awarded a certificate of Academic Excellence for being the Best all round Graduating student in the school of Humanities and Social Sciences at the University of Zambia.
The reason why I decided to pursue the Master’s programma in Social and Cultural Anthropology is because the programme looks at multiple dimensions of human security and insecurity, and viewes these matters from local, national and global perspectives. Like Social Work, the programme offers intensive training in critical understanding of social problems (insecurities) through the use of qualitative data collection methods.
The programme also suites my work background. I have been working with NGOs that focus at addressing the social, cultural, existential and economic insecurities of orphans and vulnerable children, households and communities affected by the AIDS pandemic and poverty in Zambia. Currently I’m dealing with social administration matters at the University of Zambia, in the Student Affairs Unit. I’m convinced beyond reasonable doubt that my operation in these fields will be enhanced upon completing the programme.
After completing the programme, I would like to use the Human Security framework to develop and analyse human development programmes in Zambia. The goal is to facilitate these programmes to take into account the various dimensions of human security.”
