Following the guest speakers at the 2017 Irish Aid Professor Father Michael Kelly Lecture on HIV and AIDS, there was a Q&A session, chaired by Irish Aid Director General Ruairi de Burca. Please click below to watch the session.
Dr. Chewe Luo, Chief of HIV/AIDS at UNICEF’s Programme Division, was the second guest speaker at the 2017 Irish Aid Professor Father Michael Kelly Lecture on HIV and AIDS. Please click below to watch Dr. Luo’s speech, and click on the second image to download Dr. Luo’s presentation slides.
Dr. Chewe Luo
Chief of HIV/AIDS, Programme Division, UNICEF
Royal Irish Academy, Dublin, Ireland
28th November 2017
Daphine Abaho, Peer Educator with Mildmay Uganda, was the first guest speaker at the 2017 Irish Aid Professor Father Michael Kelly Lecture on HIV and AIDS. Please click below to watch Daphine’s moving and informative address, and scroll down to read her address in full.
Daphine Abaho, Peer Educator, Mildmay Uganda
Royal Irish Academy, Dublin, Ireland
28th November 2017
Good evening, ladies and gentlemen.
My name is Daphine Abaho. I am from Uganda. I am 22 years old and I live with HIV. I am a volunteer peer educator and I work with Mildmay Uganda. I welcome you to visit my beautiful country and to visit Mildmay. I thank you in a special way for choosing to come here today. Like someone – I do not know who – once said; broken Irish is better than clever English. Thank you – go raibh maith agat – thank you. Thank you.
On behalf of the young people of the world, especially in Uganda and other developing countries where I come from, who live with HIV and so suffer its effects; on behalf of the adolescents and the young men and women with HIV at Mildmay Uganda’s Centre of Excellence for HIV prevention, care, and treatment, and on behalf of all children with HIV especially those born and so live with it not out of their making, I am profoundly honoured to be accorded the opportunity to stand before you. How I wish you could open my heart and see that I am happy! You know, I come from a tribe of a people for whom happiness on their faces and eyes may not easily come naturally! But I am happy. Indeed, it is a privilege for me to address the The Irish Aid Annual Prof. Fr. Michael Kelly Lecture on HIV and AIDS, because, mine – ours, as you know – is a story of an unwavering hope in despair, of solace in the face of animosity, and of resilience and steadfastness in adversity.
Permit me to thank the gorgeous Nadine for inviting me to speak at this most noble forum. You know I am a most unlikely candidate for this; there are thousands of young people living with HIV who have hugely amazing stories and for me to be chosen to speak for them is of a singular honour. Thank you, Nadine, Steve, Nicola and Vincent. I am humbled that Irish Aid invited me to come here. I am indebted to your generosity, to your service for humanity, and to your work. And you know Irish Aid is one of my country’s biggest donor partners. Thank you.
I thank Fr. Michael Kelly for his work on HIV/AIDS. I thank him particularly for his work in Africa. Thank you, Father.
Permit me, also, to express my deeply sincere gratitude to the International HIV/AIDS Alliance who profiled my story. Thank you, Gemma. Thank you, Georgina. Thank you Laura, thank you Lora. Thank you to everybody.
I am thinking in a particular way of my Mildmay Uganda family back at home, without whose continued care, perhaps, I wouldn’t be here, maybe I wouldn’t have a life. Thank you Dr Barbara Mukasa and your team. Thank you. Thank you, above all, for bearing me. Thank you again.
Lastly, but certainly not the least, join me in thanking the global family – governments, organisations, and foundations – for your efforts in combatting HIV. You have given me a life.
We are gathered in this place to think on YOUNG PEOPLE AND HIV. It is a unique moment in the era of HIV. As you well know, young people under the age of 14 years constitute a quarter of the world’s population while those between 15 and 24 years of age constitute almost a fifth. Uganda’s youths are the youngest population in the world; in fact, 77% of our population is under 30 years of age implying most of it is dependent! Now, look, the unemployment rate for young people aged 15 to 24 years of age in Uganda is a shocking 83%! Meanwhile, access to education in my country is still low; for every ten students enrolled into primary school, only one is enrolled into secondary. Uganda’s HIV prevalence is 6.5%. We know that HIV disproportionately affects the female gender; the HIV prevalence among women in Uganda is 3.8% while that among men is 1.9%. In fact, 570 young women aged 15 to 24 years acquire HIV every week! I would like you, ladies and gentlemen, to think very deeply on these numbers. Let us also note, ladies and gentlemen, that a multitude of children are still born with HIV in this age.
You will, then, ask how I got HIV and how I did get along. I was born a lone child with HIV two decades ago in a village in the south-western part of Uganda, near the famed Mgahinga National Park with its beautiful mountain gorillas. When I was born I did not know my father for he walked away on us, he has remained, but, a dream. I know he’s dead because I was told that I buried him – although I did not know him. I do not know how he acquired HIV. There were no programs for Prevention of Mother-To-Child Transmission of HIV in my village. Because my father was away, my mother had to work to fend for me. She went off to the city to look for work when I was five. She did odd jobs including vending ill-preserved foodstuffs to travellers, hawking used and damped – or ‘second hand’ – clothes – as we call them back home. She earned about 90 US Dollars per month. This was very little for me to have an education that would be meaningful.
During this time up until the age of twelve I grew up with my grandmother who has since passed on. Later on I did join my mother and went to city schools. We did not own property in the city but mother worked and bought a house in the village. My grandmother lived in the house until she died. Because she had full-blown AIDS, when I was seventeen, mother succumbed to it and died. It was a most defining moment in my life. Just to dwell a bit on what happened after that. In many parts of my country women and girls do not have rights to property because of their gender. Our ‘caste’ society considers them ‘second class’ citizens. Shortly after we buried her, my aunties on my mother’s side took up the property and sold it off. I would learn, later, that mother had borrowed some money from them in order to fend for me. I dropped out of secondary school when she died. I stayed with my aunties for a year until they threw me out.
Life challenged me; because I was very vulnerable, as you may know, life’s challenges hit me head on. To take you back a little bit, I discovered that I had HIV in 2004 at the age of eight when I was brought to the then Mildmay Center in Uganda having suffered a condition that health facilities in my village could not treat. I was enrolled onto treatment – to this day, by the way. I suffered a low self-esteem. I suffered negativity and anguish. I felt isolated from my peers and from society. I contemplated suicide; it was so tough the stigma I faced, you can only imagine. Once, I just stopped taking my medication and wished I could die and be where my mother was. Because of my decision to get off medication, I fell very ill. I failed on first line treatment. I was going to die. At this point I am thinking particularly of Dr. Ivy Kasirye a Paediatrician who was in charge of the Paediatric Ward at Mildmay Uganda. Dr. Ivy treated me and took care of me, I am indebted. More important, though, is that she gave me reason to live, she supported me morally. Once she told me I would be a light to young people who have lost hope due to HIV, and that I would never know where the world and its endless opportunity would lead me. HERE I AM BEFORE YOU IN DUBLIN. You know in the part of the world where I come from we attach a lot of meaning to travelling. Dr. Ivy became a huge model for me. Thank you Dr. Ivy. Life became better for I found reason to live. Not that opportunity came my way, but I began to see life differently. I started taking my medication again. I disclosed my status to other young people, I took a personal decision to live a positive life. The anguish has since gone; the negativity has vanished. Now I live with esteem.
Therefore, I stand here today to share with you my story. I stand here today for the millions of young people who live with HIV to echo their quest for equity. I stand here knowing that my story will be a voice for them who suffer ridicule and reproach. I stand here knowing that there is a brighter day tomorrow.
I stand here to address HIV through bridging gender inequality, through keeping adolescent girls and young women free of HIV, fronting social justice in the face of injustice, creating systems that protect the rights of minors, and addressing barriers to an HIV free world. I am thinking of my friend Mariam, who as a twelve-year-old village girl, was raped on her way from a well to fetch water for the family and infected with HIV over a decade ago. She became pregnant and gave birth to a beautiful baby – girl free of HIV. The authorities, it is alleged, took a bribe from the sexual offender, released him from his prison cell almost as soon as he had been locked up, and left the village to never be seen to this day. Mariam’s family abandoned her and so could not continue with her education. She found work as a volunteer peer educator to young people with HIV, earning about 60 US Dollars per month. She thought she would pay her fees and go back to school but then that would not be enough for her and for her child who is now about 8 years old. She has decided to keep her daughter in school. But then she cannot get a regular job, let alone a well-paying one. Her daughter will certainly drop out if she is not helped.
That, too, is my story; I earn just over 60 US Dollars per month from the work I do as a volunteer peer educator to young people with HIV; it is impossible for me to go back to school, let alone pay for my house rent. I am indebted, at this juncture, to a friend of my late mother – I call him ‘Uncle Brian’ – and his family, in whose house I stay and do not have to pay rent – for now. I am also indebted to Mildmay Uganda where Mariam and I work as volunteer peer educators – for now for we do not know what the future holds.
From these, therefore, we gathered here, should not be blind to the disaffection young people living with HIV go through. They are broken-hearted, they are ravaged, they are suffering. So we, here, must keep hearing them. We must feel for them. We must address their need. We must not wish them away ever. I recommend the following;
I implore governments, NGOs, the civil society fraternity, religious organisations, men and women of good will to press on, to do more. For people who are like me, we need more. In my country, the deficit for life-saving therapy, for behavioural and psychosocial support, for antiretroviral medicines is well over 50%. There is need for support for peer education, for more DAPHINES to do this work. I need to go back to school, I want to be a counsellor. Organisations like mine – Mildmay Uganda – need more support; there is a huge deficit for our HIV programs. The work is enormous.
I further recommend that we front human rights, both basic and fundamental, for we need a renewed emphasis on these or we risk reversing the gains. Without the right to information, or to health, or to an education, or even to proper nutrition or to a habitat, we cannot end HIV.
To the young people all over the world living with HIV, I say again; I am Daphine and I have HIV. I have lived with it for 22 years. My advice to you is; do not feel disaffected and alienated. I am on treatment. It is not the end of your life. You still have a bright future to live however obscure it may seem.
Ladies and gentlemen, once again I am honoured to be with you here today. I dream of a world free of HIV for the children of the future. I wake up every day to contribute to that life through my work with young people at Mildmay Uganda. I ‘LOVE A POSITIVE LIFE’.
Like Fr. Michael Kelly I ask you to spread the message of strength, dignity, and hope for those affected and at risk and to work to avert HIV. Humanity will celebrate the promise of our work.
Thank you, everybody.
Go raibh maith agat.
May the good Lord bless you abundantly.
Irish Aid Director General Ruairi de Burca was the Chair for the 2017 Irish Aid Professor Father Michael Kelly Lecture. Please click below to view his remarks introducing the speakers for the event:
Following this, Minister of State for the Diaspora and International Development Ciaran Cannon T.D. formally opened the lecture. Please click below to watch Minister Cannon’s speech:
Father Michael then delivered his introductory address via pre-recorded video from Lusaka. In it, he gave his thoughts on the current challenges affecting young people at risk of, or living with, HIV, and also introduced the two guest speakers – Dr. Chewe Luo and Daphine Abaho. Please click below to watch, and scroll down to read Father Michael’s address in full.
Young People and HIV
Michael J. Kelly, S.J., Luwisha House, Lusaka
Chair, Ladies and Gentlemen, Friends:
As in previous years, it gives me great pleasure to welcome all of you to this annual lecture and to thank you for the commitment you have shown by coming to the Royal Irish Academy this evening. Let me also thank Irish Aid, and through them the Irish people, for the far-sighted decision to face the challenge each year of asking what more we can do to rid the world of the great scourge of HIV and AIDS and to help the people that it affects. I want also to thank the Irish Forum for Global Health for its assiduous work in organising this evening’s event. Most sincere thanks to Nadine Ferris France, Nicola Brennan, and all of you for your vision and efforts.
And, as also in previous years, I must apologise for my inability to be with you. I would just love to be there, but age and fragility don’t allow it. I’m sorry about that.
But don’t let my absence worry you. The essential thing this evening is the message that our two special guest speakers will bring about the central importance of doing something to lessen the horrendous impacts that HIV and AIDS can make on the lives of young people. Both are well equipped to do so.
Dr. Chewe Luo is from Zambia. I can tell you with pride that she is a greatly respected and admired friend of many years standing, though it is a long time since we last met. Let me make up for that by greeting her now and welcoming her to Ireland: mulishani, mukwai; mwaiseni, ba-Chewe!
Dr. Luo specialises in child health, especially in a tropical environment. This expertise has fed into the many years she has invested in programmes for children and AIDS, and in turn all of this has led to her position today as the chief of UNICEF’s HIV/AIDS division.
The second guest-speaker is Daphine Abaho from Uganda. I haven’t had the privilege of meeting Daphine, but I have been greatly impressed by a short film about the work she does for HIV education, prevention and care among young people in Uganda. Daphine herself is a young person who has been very open about the fact that she is living with HIV. Her courage in doing so and the way she draws on her condition to inspire young people in Uganda to live an HIV-free life surely deserve our respect and admiration.
When we met for this event last year, we noted some major successes in the global struggle against AIDS. The good news is that some of these successes have been sustained and even expanded. For the first time in the thirty-six years since AIDS began its devastating work among us, more than half the people infected with HIV are now receiving life-preserving treatment, by taking just a single tablet once a day. For millions of people, this has transformed HIV from being a death sentence into a chronic, manageable disease. When properly adhered to, the same treatment has also greatly reduced the risk of HIV transmission and in many places has made mother-to-child transmission a rare occurrence.
There has also been a decline in the number of AIDS-related deaths. These have almost halved, from a peak of nearly two million in 2005 to one million in 2016, with the reduction being more rapid among women than among men. Also between 2010 and 2016, the number of children dying from AIDS fell by more than 40%.
But as we acknowledge the progress that these declines represent, let us also remember that behind the cold statistics there are women and girls, men and boys, toddlers and infants, experiencing the pangs and sufferings of a long drawn-out and brutally agonizing death, watched by their trauma-racked and totally devastated families who don’t understand what is happening but who just know within themselves, “this is evil; it should not be.”
It is good that in the shadow of so much suffering and pain we can acknowledge that considerable progress has been made. We all need to have our spirits lifted by positive news in this field of enormous human tragedy. We also need some good news so as to strengthen our resolve in dealing with situations where the reports are not so good. Last year our theme at this gathering was “Hands up for HIV prevention: Leaving no one behind.” Unfortunately, the story about HIV prevention remains fairly bleak. The number becoming newly infected with HIV remains stubbornly high; indeed, instead of going down, it is actually increasing in some parts of the world.
And while great efforts are being made to leave no one behind, one group that has effectively been disregarded, not receiving the attention it requires and deserves, is that formed by young people – adolescent girls and boys and young women and men, all those between the ages of 10 and 24.
Adolescents are at the age when puberty occurs with all its physical, psychological and social changes. This is a time of enormous vitality, innovation, discovery, questioning and hope on the part of young people. It is the time when romantic and sexual relationships begin to occur, when the young person takes risks and enjoys doing so, when the views of colleagues and friends become central and must be conformed to, often regardless of the cost. This is the time when the young person wants to assert personal independence and is prepared to face dangerous situations with the naïve belief that “it won’t happen to me.” This is a time of challenge for young people who are looking for understanding, encouragement, affirmation, information and the skills they need so that they can safely travel the rocky road to adult status.
But the tragedy is that the qualities that make these young people so very charming and endearing also make them vulnerable to infection by HIV and other sexually transmitted diseases and put girls at high risk of early and unintended pregnancies. And compounding this danger is the fact that our adult world is not doing enough to help them. The deplorable situation is that while deaths from AIDS are decreasing in every other age group they are increasing among adolescents. The number of adolescent deaths from AIDS has tripled this century, something that has not happened with any other age group. The estimate at present is that every ten minutes somewhere in the world an adolescent will die from AIDS, while globally more than a third of all new HIV infections occur among young people aged fifteen to twenty-four.
This is simply unacceptable. Adolescents and young people deserve better of life than that. They need information. They need services. They need commodities. They need treatment and care. And their need is that these should be available in an environment that is open and welcoming to young people. But much that they need may be in very limited supply, if available at all and, where available, may be offered in a setting that is far from being youth-friendly, that in fact is youth-hostile and reeks of disapproval, censure, stigma and discrimination.
In addition, all sorts of legal, policy and social barriers may prevent young people from accessing such health information and services as are available. In some countries young people must have adult consent, usually from a parent, before they can access HIV testing and counselling. It’s easy to see the almost insurmountable barrier this places on going for an HIV test and related services. Can you imagine a worried youngster in the mid-teens saying, “Mum, is it alright if I go round to the clinic for an HIV test?” Or even worse, “is it okay if I go to the clinic to get some condoms?” Clearly, legal and social norms must protect children and young people from abuse. But they should not be so restrictive that they prevent them from accessing services that would help protect them from HIV infection.
And Friends, there is one other thing of great importance in this area. I am speaking to you from Zambia which is in the heart of Africa. One of the things people don’t always realise about Africa is that it is a continent of very young people. In many countries young people under the age of 25 make up two-thirds of the population. And the youth population in our countries is expected to increase by an additional thirty percent in the coming fifteen years. In other words, while the rest of the world is aging and growing older, Africa is rapidly becoming younger.
This presents great promise for economic development, with a large working-age population that could lift the continent from its present poverty-ridden state into a more prosperous future. But it also presents the great challenge of confronting and overcoming HIV and AIDS among these increasing numbers of young people. The human rights and dignity of each of these young persons demand that they get all the help they need to keep themselves HIV-free, and that they get the treatment and care they need to remain vibrantly alive even if infected with HIV. If HIV is not successfully addressed in African countries, the growing population of young people could well turn into a ticking time-bomb, spelling disaster for the region. But if HIV among young people is brought under control, the prospects for Africa, and likewise for other regions, are bright. This challenges us to ask: what can we do about it?
Dr. Luo and Daphine will surely take up these and similar matters with you this evening, in greater depth than I can do in these few introductory words. They are delicate issues, but ones with far-reaching consequences for the good of a large proportion of the human race. I feel sure that both will stimulate a great desire in you to see an improvement in the response to HIV among young people. And maybe even some among you might come up with the thought, “if that was my own daughter or son, would I not move heaven and earth to make sure that there was the necessary protection, care and treatment?”
With these few opening remarks, I thank you again for your presence and support this evening. I wish every one of you an interesting although challenging evening; and when it is over, I wish each one of you a safe journey back to your homes.
Thank you and may God bless all of you and those who are dear to you.