Rural Areas Said to Be in the Shadow of Aids Efforts

Abidjan – Certain West African researchers have expressed concern at the disparities between rural and urban areas in their countries as regards HIV/AIDS services and prevention initiatives.

In urban areas, says Bonfo Bassirou, a researcher in Côte d'Ivoire for the Swiss Centre for Scientific Research, there are resources for issuing prevention messages, providing testing and managing HIV/AIDS. Rural regions, however, only have sporadic campaigns with little follow-up.

"Today, the rural regions remain a place of HIV illiterates, as prevention campaigns are virtually non-existent there," Bassirou told IPS.

According to the most recent study on the pandemic in Côte d'Ivoire, conducted and published in 2005 by the Ministry of Health, overall HIV prevalence is higher in urban areas (5.7 percent) than in the countryside (4.1 percent). The study estimates that the national prevalence rate for HIV is 4.7 percent.

But, "If nothing is done to reduce the disparity of information about HIV/AIDS between urban areas and rural areas, the pandemic could progress in certain poor countries," warned Bassirou.

The experiences of Magloire Kouamé, a history student at the University of Cocody in Abidjan, the Ivorian commercial capital, and farmer Serges Adou illustrate the inequalities.

Kouamé says he "is very informed of what is said about HIV/AIDS" because living in Abidjan, also the biggest city in the country, he has newspapers, television and radio stations at his fingertips.

"Volunteers from NGOs (non-governmental organisations) often walk in the streets, and distribute leaflets about the pandemic to us," he adds. The Joint United Nations Programme on HIV/AIDS (UNAIDS) puts adult HIV prevalence in the country at 7.1 percent.

Adou, who lives in the southern village of Oglawpo, says NGOs give out pamphlets on AIDS and speak about the pandemic perhaps once every two or three months in his area. In addition, it's difficult to get information about HIV from other sources: "Newspapers, radio, television -- we rarely have access to these," he told IPS.

There are no centres for voluntary HIV testing in Côte d'Ivoire's rural areas, noted Bassirou. And, in the rare instances where testing centres have been established in towns located in the interior of the country (only a half-dozen, to date), the facilities are most often too far away from surrounding villages.

He believes these rural regions are made even more vulnerable to the pandemic by widespread illiteracy. Government figures indicate that the rate of illiteracy amongst rural inhabitants is close to 60 percent, while the national average is 40 percent.

Senegalese researcher Maria Fatou Dramé makes similar observations about her country.
"Even in Senegal, everything is focused on urban areas, while rural areas such as the north-east of Senegal, for example, have extensive need of it (HIV/AIDS assistance)," she told IPS.

This disparity has elicited protests. In August 2006, says Dramé, the regional committee to fight against HIV/AIDS in Tambacounda, a village in southern Senegal, alleged "the marginalisation of the region in a selection of projects to fight against AIDS" that saw 16 programmes financed with about 255,000 dollars.

According to UNAIDS, adult HIV prevalence in Senegal stands at less than one percent, one of the lowest rates in Africa. Concerns about the country's rural-urban divide in AIDS programmes aside, Senegal is broadly seen as one of the success stories of the continent in fighting HIV.

Dramane Sawadogo, a Burkinabé researcher, believes that badly informed and poor rural inhabitants in search of a better life are easy prey for HIV/AIDS when they arrive in towns.
Differences in the information provided in towns and villages should be addressed by training rural educators in the fight against AIDS, he says, so that they can raise awareness among farmers. In addition, the number of voluntary testing centres should be increased, even if this necessitates putting mobile clinics into operation, something international organisations like Retrovirus Côte d'Ivoire, an American NGO, are already doing.

UNAIDS puts adult HIV prevalence in Burkina Faso at two percent.
For his part, Bassirou recommends agricultural support measures for rural youths to ensure that they remain in their home regions -- this to avoid a cycle of infection between urban and rural areas.
An initiative of this sort, which involves providing young people with seeds, is already being test driven in certain parts of Côte d'Ivoire, he said: "We try to offer youths in rural areas the means needed for agricultural production, to keep them in their place of origin."

Of African governments, Bassirou added, " they will not attain their (HIV/AIDS) goals, in the long term, while there is this disparity in communication between towns and villages."