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Preventing domestic violence and HIV in Uganda

Ugandan dancers - 560

The woman was terrified, as she had just come from the hospital, where she discovered she was HIV-positive. It wasn't so much the virus she feared, as the reaction from her husband. If he were to find out, he would surely beat her and throw her out of the house.

As predicted, the husband arrived home and seeing his wife in distress, forced her to confess what she had learned. "Either I cut you in two pieces and throw you in the ditch or leave the house," he yelled, his arm raised in threat.

Fortunately, the wife wasn’t harmed, for the drama was merely that - a work of street theatre designed to break the traditional patterns of domestic violence and HIV in Uganda. The drama is one of the creative strategies being used by the nonprofit Center for Domestic Violence Prevention in Kampala, Uganda to effectively reduce incidents of domestic violence by more than 50 percent in the communities it serves.

In the process, group also aims to reduce the incidence of HIV, which affects 7.2 percent of adults in the East African nation, according to the latest figures from the United Nations Joint Programme on HIV/AIDS.

The organization works by mobilizing local men and women and training them in various interventions, like the street drama, address pervasive problem of violence among intimate partners. According to its figures, 59 percent of women between the ages of 15 and 49 say they have experienced physical or sexual violence by a husband or partner at some point in their lives.

"We are talking about an epidemic," said Tina Musuya, a social worker and a women’s rights activist who directs the organization.

I was fortunate to see the street theatre program in action during a recent trip to Uganda with the American Jewish World Service, an international development organization that works to end poverty and promote human rights in the developing world. Fifteen of us, all Global Justice Fellows with the organization, visited CEDOVIP's offices in Kampala and then fanned out to see the group's work in action in the streets of Kampala one sunny afternoon.

A crowd had already begun to materialize by the time we arrived in one of the city's poor neighborhoods, where three drummers had lured people from their homes with a lively beat. Two female dancers in colorful red outfits (pictured above) then entertained the crowd, whose curiosity was heightened by the presence of us five white foreigners. By the time the drama began, more than 100 people had gathered in the dirt road - youngsters who tugged at our hands, older women who sat on wooden stools to watch and groups of men who stood on the sidelines, quietly assessing the unfolding drama.

The story begins when the woman returns from the hospital to cry on a neighbor's shoulder. The husband then arrives and suspects something is up. He falls into a rage on learning the wife's news, threatening to "break her bones" and ordering her to leave the house. But the wife says she has nowhere to go. Besides, she tells him, she acquired the virus from him.

A narrator, dressed in an orange shirt, periodically freezes the drama, soliciting suggestions from the crowd on what the couple should do. One observer tells the woman to call the police. Another urges bystanders to intervene to help save the situation.

"We have so many instances of violence in our neighborhood," the narrator concludes, speaking in Luganda while our host translates. "See what happens in violent situations when the woman becomes HIV-positive. Be supportive. Support the victims, but also support the man. Change the behavior. Break the silence."

The drama is just one of many activities CEDOVIP uses to help raise awareness and effectively change attitudes and behaviors that perpetuate violence in intimate relationships. The group recently conducted a randomized controlled trial, involving nearly 2,650 men and women in eight communities, which showed a change in attitudes among men and women, as well as women’s experiences of violence.

In the study, done in collaboration with researchers at the London School of Hygiene and Tropical Medicine and the Ugandan nonprofit Raising Voices, the number of women who reported inter-partner violence declined significantly. And far fewer men said they believed violence against a partner was acceptable.

Moreover, the study found that men reduced their number of sexual partners as a result of the intervention. That is an important finding, Musuya said, as unequal power relationships between men and women may make men feel they have the license to seek out multiple partners.

“The men realized that a crowded relationship fuels violence and increases the risk of HIV infection,” she said.

Charlotte Watts, PhD, director of the Gender Violence and Health Centre at the London medical school and the lead author of the study, said it validates a community-based approach of this kind.

“The key is that we are seeing impacts at a community level both on the acceptability of violence and levels of partner violence,” Watts said. “The findings are exciting, showing that community mobilization programs like this one can achieve substantial impacts over time.”

The researchers now plan to disseminate their findings at regional and global meetings so that others may learn from the experience.

CEDOVIP was recognized in 2010 with a UNAIDS Red Ribbon Award for its innovative work in prevention of violence and HIV.

Previously: Sex work in Uganda: Risky business, In Uganda, offering support for those born with indeterminate sex and No clowning around: How clown-educators are increasing HIV awareness in Guatemala
Photo by Ruthann Richter

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