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Breaking the Silence in Nigeria: An Appeal to Presidents

A courageous speech by a Nigerian man living with HIV/AIDS -- and the response from Nigeria's President and the visiting President of the United States -- made a profound impression on a nation mired in denial of an epidemic that has already spread to 5 percent of its adult population.

IMPACT ON HIV, Volume 2, No. 2, December 2000

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John Ibekwe of Onitsha, Nigeria, never thought he'd meet a president. But on August 27, 2000, in the Nigerian capital of Abuja, he had the opportunity to tell his story to the leaders of the Federal Republic of Nigeria and the United States.

A program officer with the Humane Health Organization, which is a partner in the Family Health International (FHI) Implementing AIDS Prevention and Care (IMPACT) program in Nigeria, Ibekwe was one of four speakers at an event organized for U.S. President Bill Clinton's visit to Nigeria. Ibekwe also introduced President Clinton. Tayo Akinmuwagun, a volunteer peer health educator with the Environmental Development and Family Health Organization, a youth-focused NGO that is also a partner in the FHI/IMPACT program, introduced Nigerian President Olusegun Obasanjo.

As President Obasanjo, President Clinton and an audience of about 1,200 health workers and community members listened, Ibekwe told of the discrimination he faces as a person living with HIV. He urged both presidents to serve as powerful advocates against the pervasive stigma and denial associated with the virus.

Almost two weeks later, at a reception for African leaders assembled in New York City for the United Nations Millennium Summit, President Clinton spoke with emotion about Ibekwe's presentation, calling it "one of the most moving experiences I have had as a president."

"I have been through a lot of interesting and profoundly emotional experiences the last eight years," he added. "But one of the most moving things that's happened to me happened when we were just in Nigeria and President Obasanjo and I went to this event in an auditorium with a lot of people to talk about what they were doing in Nigeria to try to prevent AIDS."

President Clinton recounted Ibekwe's story and told his audience that at the end of the presentation, President Obasanjo had embraced Ibekwe's wife, Angela, who is also HIV-positive, in front of hundreds of people. "It was all over the press in Nigeria the next day," President Clinton added. "It changed the whole thinking of a nation about how to approach this disease -- to treat the disease as the enemy, but not the people who are gripped with it. It was an amazing encounter."

-- Kathleen Henry

"Mr. Presidents, I am an adult living with AIDS. I used to think there was no hope for those of us living with HIV/AIDS in this country. But my perception of the future has changed. For the first time in this country, we have a president who has openly acknowledged that AIDS is a problem and has decided to lead the fight against it.

I wish to applaud the dedication of President Obasanjo in the fight against AIDS in Nigeria. But the size of the problem in Nigeria is huge and looks suffocating.

Distinguished guests, this is my story. My wife and I lived together from January of 1995 after our traditional marriage and got a date in April of that same year for our church wedding. But part of the conditions to be met before marriage in the Catholic Church in Onitsha, where we stay, was an HIV antibody test. Without pre-test counseling, my wife and I took the HIV antibody test, and the result was positive for my wife and negative for me.

First, the church announced the revocation of the wedding. When we insisted, our parents were invited. The priest asked our parents if they knew our serostatus. They said yes. The church took time to explain the implications to our parents, but they still supported the marriage. The church thereafter agreed to wed us.

After the wedding, we became close to the archbishop and all the reverend fathers involved. The archbishop referred us to an Argentine doctor, Suzi Coddazi, who was then implementing Family Health International's community home-based care project in Onitsha, funded by the United States Agency for International Development. Our situation improved with the counseling and home visits by outreach workers from the project. I am today a program officer of the care and support project.

In August 1995, my wife was one of those offered an American visa through the lottery. We were then referred to St. Nicholas Hospital in Lagos by the American Embassy for medical tests that included the HIV antibody test. My wife tested positive again. Here, I tested positive for the first time. We presented our documents at the American Embassy and were informed that we could not be given the visa on the basis of our serostatus.

Soon after this, a national meeting of people living with HIV/AIDS was convened in Ibadan. It was at this meeting that I was elected national president. I granted press interviews, which were widely published in Nigerian dailies. My employers got the information and terminated my appointment, giving me two months' salary in lieu of notice.

During this period, my wife became pregnant. Then came the Twelfth World AIDS Conference in Geneva in 1998. USAID, through FHI, supported me to attend the conference. It was an eye opener. It was at this conference that I learnt more about the possibility of preventing mother-to-child transmission of HIV.

I saved enough money from my food allowance for the conference to buy antiretrovirals for my wife and the baby. In Onitsha, we had a long, drawn-out battle with the hospital staff to provide my wife care. They abandoned her because of her HIV status. It was discouraging, but we persisted. My wife had a caesarian section to further protect the baby. The baby was delivered October 8, 1998. My wife is here with me today, and our baby, at 18 months plus, is still seronegative.

Mr. Presidents, the problems of people living with HIV/AIDS are indeed basic and fundamental. While a lot can be achieved with effective community-based care for people living with HIV/AIDS, this level of care is not readily available. Protecting people living with HIV/AIDS from retrenchment and dismissal from work when diagnosed will go a long way to keep hope alive.

Mr. Presidents, I do not wish to bore you with many requests but only to say that we request your support for advocacy to break the silence and denial at different levels of decision making. We request your support in the area of advocacy to discourage stigma and halt discrimination. And drugs that will prevent children from being infected in pregnancy should be made available, affordable and easily accessible.

Mr. President of the United States, you can do something today that will change the entire course of the AIDS pandemic in our world. With you as an advocate on our side, governments in Africa will do more than they are currently doing. Just as you have touched many homes and hearts in Africa with your good works in the area of health, I call on you today to touch the hearts of all ailing persons living with HIV/AIDS with your soothing hands. The war against AIDS can be won if we all come together."

-- John Ibekwe