HIV / AIDS Stories
Stories about how WFP is assisting people with HIV and tuberculosis.
HARARE - Rogers Makunda is hunched over a canvas, brow furrowed and humming quietly, almost oblivious to the bone-shaking African beats coming from the street outside. He’s painting a set of apartment blocks near his home in Harare’s crowded, low-income neighbourhood of Mbare.
Today, Makunda is not working from home, but from the art school where he completed two diplomas in the late 1980s. The students around him one recent morning are gossiping and brainstorming about their creations – and listening to Makunda’s advice, accumulated over two decades spent working as an artist.
“I used to sell my paintings through the National Gallery (of Zimbabwe) and some buyers took them back to Kenya and the UK,” Makunda recalls in an interview a few hours later. In 1987, his paintings even won a national award.
Those were the good days. Then, four years ago, Makunda found out he was HIV positive, joining the ranks of 1.2 million other Zimbabweans with the virus. This past September (2013), his brother died from diabetes. Weak and strapped for money, Makunda nonetheless took in his brother’s family, swelling his household to seven.
“I was so worried, because I knew it meant more food, more school fees and no one else to help pay,” says Makunda, who began skipping meals to make ends meet. “I knew I had to keep working, but I wasn’t strong enough.”
In October, Makunda enrolled in WFP’s Health and Nutrition programme. Over a six-month period, he receives a nourishing and fortified corn-soya blend to help his recovery. WFP’s programme, which reaches some 180,000 of the country’s most vulnerable people and their families this year, also provides household rations of maize, pulses and oil.
But in the cities of Harare, Bulawayo and Gweru, those enrolled in the programme like Makunda, receive vouchers to buy selected foods they like at supermarkets. They also receive US$5 to purchase additional items they need. About 8,000 vouchers are being distributed each month thanks to support from Switzerland and Canada.
“Last month, I spent the $5 on milk and potatoes. I hadn’t drunk milk for a long time,” he says. “WFP’s food is helping me so much because I’m getting stronger.”
Zimbabwe’s HIV prevalence rate is 15 percent, but HIV cases are decreasing. The rate has fallen by 3 percent since 2006.
In recent years, Makunda has branched out from painting to tie-dying textiles – shirts, skirts, jackets and even wall hangings. He works in a neighbour’s yard, using sliced-off coke bottles as paint containers. Customers are charmed by the textiles’ bright colours.
But Makunda has bigger plans. He wants to export the textiles to other southern African countries. And he wants to get back to painting – once he can afford to buy more paint.
When award-winning Zimbabwean artist Rogers Makunda discovered he was HIV-positive in 2009, he wanted to keep living and working as he had before. But that proved impossible, especially after his brother died and he found himself providing for several more children. Now enrolled in WFP’s Health and Nutrition Programme, Makunda is back at work – and looking ahead.
ROME -- There are many reasons for the presence of hunger in the world and they are often interconnected. Here are six that we think are important.
People living in poverty can't afford nutritious food for themselves and their families. This makes them weaker, physically and mentally, so they are less able to earn the money that would help them escape poverty and hunger. The effects can be long-lasting. Children who are chronically malnourished, or ‘stunted’, often grow upto be adults whose incomes are lower. They are condemned to a life of poverty and hunger.
Similarly, in developing countries, farmers often can't afford seeds, so they cannot plant the crops that would provide for their families. They may have to cultivate crops without the tools and fertilizers they need. Others have no land or water or education. In short, the poor are hungry and their hunger traps them in poverty.
Lack of investment in agriculture
Too many developing countries lack the roads, warehouses and irrigation systems that would help them overcome hunger. Without this key infrastructure, communities are left facing high transport costs, a lack of storage facilities and unreliable water supplies -- all of which conspire to limit farmers' yields and families' access to food.
Investments in improving land management, using water more efficiently and making more resistant seed types available can bring big improvements.
In fact, research by the UN Food and Agriculture Organization shows that investment in agriculture is five times more effective in reducing poverty and hunger than investment in any other sector.
Climate and weather
Natural disasters such as floods, tropical storms and long periods of drought are on the increase -- with calamitous consequences for the hungry poor in developing countries. Drought is already one of the most common causes of food shortages in the world.
In 2011, peristent lack of rain caused crop failures and heavy livestock losses in parts of Ethiopia, Somalia and Kenya. In 2012 there was a similar situation in the Sahel region of West Africa.
In many countries, climate change is exacerbating already tough conditions. The world's fertile farmland is under threat from erosion, salination and desertification. Meanwhile, deforestation by human hands accelerates the erosion of land which could be used for growing food.
War and displacement
Across the globe, conflicts consistently disrupt farming and food production. Fighting also forces millions of people to flee their homes, leading to hunger emergencies as the displaced find themselves without the means to feed themselves. The conflict in Syria is a recent example.
In war, food sometimes becomes a weapon. Soldiers will starve opponents into submission by seizing or destroying food and livestock and systematically wrecking local markets. Fields are often mined and water wells contaminated, forcing farmers to abandon their land.
Ongoing conflict in Somalia and the Democratic Republic of Congo has contributed significantly to the level of hunger in the two countries. By comparison, hunger is on the retreat in more peaceful parts of Africa such as Ghana and Rwanda.
In recent years, the price of food products has been very unstable. Roller-coaster food prices make it difficult for the poorest people to get nutritious food consistently - which is exactly what they need to do. Families need access to adequate food all year round. Price spikes, on the other hand, may temporarily put food out of reach, which can have lasting consequences for small children.
When prices rise, consumers often shift to cheaper, less-nutritious foods, heightening the risks of micronutrient deficiencies and other forms of malnutrition
One third of all food produced (1.3 billion tons) is never consumed. This food wastage represents a missed opportunity to improve global food security in a world where one in 8 is hungry.
Producing this food also uses up precious natural resources that we need to feed the planet. Each year, food that is produced but not eaten guzzles up a volume of water equivalent to the annual flow of Russia's Volga River. Producing this food also adds 3.3 billion tonnes of greenhouse gases to the atmosphere, with consequences for the climate and, ultimately, for food production.
Want to know more about hunger? Go to wfp.org/hunger and find out about the Zero Hunger Challenge by clicking on the banner below.
The world produces enough to feed the entire global population of 7 billion people. And yet, one person in eight on the planet goes to bed hungry each night. So why does hunger exist?
BOBO-DIOULASSO - "Sarah" is a 42-year-old widow and, until recently, provided for herself and her children by selling mangos at the local market in the town of Bobo-Dioulasso in southern Burkina Faso. In 2012, she fell ill and went to the hospital. There she learned that she was HIV positive. She prefers not to share her true name. “I cannot reveal my identity,” she said, “the stigma that surrounds people living with HIV is still too strong.”
By the time she learned that she was infected, Sarah had lost a lot of weight and had no energy; the rumours had already begun to spread, and people were avoiding her. Suspecting her illness, her clients stopped buying from her and her mango business suffered, leaving her without the means to sustain her family.
Among its many activities in Burkina Faso, WFP supports some 7,000 people recently diagnosed with HIV as well as 5,000 vulnerable AIDS orphans. Working with civil society organisations, WFP distributes maize, beans, a fortified corn soya blend and vegetable oil which provides a comprehensive and nutritious diet for the most vulnerable people affected by the HIV epidemic. Culinary workshops and nutrition classes are also provided to those who benefit from the programme.
“WFP provides me with the food I need for at least three meals a day. Finally I have peace of mind, knowing that I have the right nutrition to help fight the infection in my body”, said Sarah. “Also, my children don't fight over food any more, and it makes me happy to see them thrive and go to school.”
Untreated, HIV infection causes serious damage to the immune system and often leads to weight loss. Social stigma and rejection add to the difficult food situation and may lead to undernourishment. Some children of parents who die of AIDS are left in the care of relatives, who themselves have to compete for scarce food sources; many children end up on the streets.
The HIV epidemic in West Africa shows large variations, affecting especially marginalised groups of the society. Every year, close to 1.5 million persons living with HIV and AIDS orphans benefit from WFP nutrition programmes worldwide. For Sarah, the situation is now brighter; with the right medication and nutrition, she has regained her strength. Hopefully, with the effect of HIV-sensitive programmes, she might one day be able to take her fruits back to the market, and to support her family again.
Across six towns of Burkina Faso, WFP provides food assistance to people living with HIV as well as vulnerable AIDS orphans. Here is the story of one of the beneficiaries.
PANAMA CITY- According to the memorandum of understanding, Plan International and the United Nations World Food Programme will work together addressing nutritional issues during emergency situations, as well as long term periods, with the purpose of reaching the most vulnerable Latin American populations.
Under this agreement, both organizations will conduct activities focused on food security of children during the first 1,000 days of life, children under the age of 5, pregnant women, breast-feeding mothers, and people living with HIV/AIDS in Bolivia, Colombia, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Panama, Paraguay, Peru, Nicaragua and the Dominican Republic.
The signing of this agreement took place in Panama City at the WFP Regional Bureau with the presence of Roland Angerer, Regional Director of Plan in the Americas; Ingrid Kuhfeldt, Plan's Regional Director of Operations, and WFP Deputy Regional Director and Officer in Charge, Alzira Ferreira.
In terms of natural disasters, Plan International and WFP will work together in early warning systems, in emergency preparedness and response, and disaster risk reduction to diminish vulnerability and strengthen the resilience of the communities who are affected by climatic events, respond to their immediate and critical need, as well as support them in their longer-term recovery.
The WFP Deputy Regional Director and Officer in Charge, Alzira Ferreira, and the Regional Director of Plan in the Americas, Roland Angerer, signed an agreement to work together to fight food insecurity to help the most vulnerable populations, especially women and children, in Latin America and the Caribbean.
Although the prevalence of HIV has gone down in Zimbabwe, it still remains among the highest in the world. Approximately 14.9 percent of the country’s 12.9 million population is living with HIV, reports UNAIDS. Nearly 1,300 lives are lost weekly from HIV-related illnesses, according to statistics from the Ministry of Health and Child Welfare. That the country has nonetheless made enormous progress in combating the pandemic is due in no small measure to a partnership between The Global Fund to Fight AIDS, Tuberculosis and Malaria and the Ministry of Health and Child Welfare. The partnership has enabled many people infected with HIV to live healthy lives, thanks to the provision of special anti-retroviral treatment (ART). High-quality free treatment is now widely available across the country.
“Today many people are alive thanks to this support.” says Tambudzai (27). “More and more people are being treated every day.”
Tambu (as she is known) is a subsistence farmer in Buhera, a dry district 170 kms south east of Zimbabwe’s capital Harare. She lives with her elderly parents and her daughter three-year old daughter, Nyasha, who is HIV-negative. Tambu works as a casual labourer in neighbours' fields but her income is low.
Initially, the high cost of ART and the poor distribution of medicines prevented many HIV-positive people from getting the help they needed. Central to making treatment more widely available has been the Global Fund’s collaboration with the UN World Food Programme’s Logistics unit in Zimbabwe. Together, they have ensured the timely delivery of essential drugs and medicines to ensure the right treatment is provided at the right time to those in need.
“The fight against HIV goes beyond pharmaceutical considerations and the medical ward,” says WFP Country Director Sory Ouane. “It’s a multi-faceted and complex issue which calls for multi-dimensional solutions and equally important is the provision of logistical expertise with procurement, handling, storage and distribution of the medicines.”
WFP has been at the forefront of humanitarian logistics in Zimbabwe, delivering much-needed food assistance across the country. In addition, its role has also been increasingly to provide logistics services to Government, development and humanitarian partners and various UN agencies including the Global Fund. This support helps strengthen the supply chain and stock management to ensure that much needed assistance is delivered on time and at the right place.
Like many single mothers who have been outcast after testing HIV positive, Tambudzai has had a tough time. She was born to poor parents and has lived much of her life on the margins of society. But one day an outreach worker knocked on her door and advised her to seek help. She now receives free anti-retroviral treatment and counselling at a clinic in her village.
Like old friends recounting an ordeal, the two women compete to relate their story.
"Before I started getting food support, I suffered a great deal and would cry a lot,” says Marble. “But once I got special food, life took a turn for the better.”
Marble married early but, shortly before giving birth to her second child, her marriage fell apart after her husband took another wife. She left taking her two children with her.
“I haven’t seen him in years,” says Marble who returned to live and farm with her parents in her home village.
As she was suffering ill health, her family sent her to the local clinic where she tested HIV positive. Grossly underweight, she was referred to the Health and Nutrition Promotion programme and now receives a monthly ration of 10 kg of Super Cereal which can be made into a fortified porridge. She is now stronger and able to work on the family farm again.
Essential food items
The Health and Nutrition programme started in 2007 and is run collaboratively by WFP, the Government and local aid agencies. It currently supports close to 180,000 people countywide with essential food items. During registration, adults’ weight and height are measured to determine body mass while children have their upper arm circumference measured to see if they are malnourished.
Malnourished people on anti-retroviral (ARV) or TB treatment, pregnant and nursing women and children under 5 years are provided with Super Cereal at clinics where services include nutrition assessment, education and counseling.
Clients whose households are shown to be food-insecure are provided with rations comprising maize meal, beans and vegetable oil for the duration of their treatment.
“Food assistance has proved effective in the treatment of clients,” says WFP Acting Country Director Abdurrahim Siddiqui. ”WFP is committed to promoting nutritious diets which help save the lives of people especially women and children.”
For Marble, she is well on her way to start the new life she has always dreamt of on her family farm where she grows tobacco and cotton, and looks after her two children.
For the last four months, Marble's mode of transport was a wheelbarrow pushed by her elderly mother. It took two hours each way from their village to the nearest clinic but Marble’s illness gave them few alternatives. Now she is walking again. Under the shade of a lemon tree in the clinic's courtyard, whilst waiting their turn to collect her monthly food rations from WFP, the two women recount their trials and eventual triumph as Marble’s health improved.
Abidjan – Attimi, 44, has been on the programme since 2007. "We just cannot discharge her and most of the other patients," says Koué Bi Marius César, the coordinator of Renaissance Santé Bouaké, the local NGO that WFP is partnering with to deliver nutrition support to malnourished people living with HIV. "If we discharge them after six months, they will immediately fall victim again to malnutrition. Worse, they will go hungry as most have nothing at all.”
The redeeming power of food
Until about two years ago, WFP was able -- thanks to adequate funding from generous donors -- to provide Attimi, and 300 other people living with HIV in Bouake, with enough food for them and their families. The monthly ration - typically for a family of five - consists of 24 kg of cereals, 7,5 kg of pulses, 5 litres of oil and 15 kg of Super Cereal– a fortified blend of corn and soya flour that is used to prevent malnutrition.
"There was a time when I was so well-fed and strong that I was oblivious to my HIV condition," says Attimi, who first found out about her HIV condition in 2003. "I was not worried. I didn't have to think about my disease. I used to bring home lots of food every month. My family used to eat well and were content. This is why they were so understanding and kind to me. It's as if they didn’t mind that I had HIV."
Through this full family ration, WFP and its local partner Renaissance Santé Bouaké, made sure that the patients got the right quantity and quality of nutrition support they needed to accompany their anti-retroviral treatment and live an active, healthy life. The full family ration was a safeguard against the patient having to give up much of their food to the rest of the family and going hungry as a result.
Many families seemed to hold no prejudice and have no resentment against their HIV positive relatives. They seemed tolerant and even supportive. The secret? It's the redeeming power of food! The full family food ration has helped remove the stigma surrounding HIV.
Medicines on empty stomachs
Not any longer. Financial constraints have forced WFP to scale back its nutrition support programme to people living with HIV in Côte d'Ivoire. Instead of a full family ration, the patients now receive a reduced individual ration of 7 kg of Super Cereal and less than a litre of oil per month.
"That's too little," complains Attimi who has to share out the food with 11 other members of her family and has often no choice but to take her anti-retroviral medicines on an empty stomach. "Today I had nothing to eat all day. Neither did my 8-year-old daughter. People in the community are fed up with me asking them for food. But what can I do? My husband has been unemployed since he had all his fingers cut off in an accident at the textile factory where he used to work. Today I had to borrow money to be able to pay for transport coming up here.”
At 3.4 per cent, the prevalence of HIV in Cote d'Ivoire is the highest in West Africa. WFP's aim for 2013 is to support over 5,500 Ivorians like Attimi. However, the level of assistance WFP will be able to give to these vulnerable people will depend on the level of funding it will receive for its nutrition support programme.
Attimi is only too well aware that help cannot continue indefinitely. "I know that there comes inevitably a time when your benefactor will tell you the truth,'" she says.
"But what we need from WFP now is to restore the full family ration for a while until we can find some work and start relying on ourselves. We don't want to live on hand-outs. My hope is to get just enough support so I can start a small trade. I want my daughter to go to school and build a future for herself.”
WFP's nutrition support programme for malnourished people living with HIV in the region of Bouaké, central Côte d'Ivoire, runs for six months. After this, the patient is normally expected to grow out of malnutrition and regain his or her ability to lead an active life. However, many patients are so poor and vulnerable that they cannot be discharged.
NAZRET, Ethiopia - In a shop ran by the local consumers’ association in Nazret, Alem buys rice, peas, vegetables, wheat flour and cooking oil. A few months ago, she traveled to a large WFP food distribution to queue for her monthly ration. Today she just heads to a local shop not far from her house with a WFP voucher to collect it.
Alem is part of the WFP urban HIV/AIDS programme aimed at improving the nutritional status and quality of life of food-insecure people living with HIV and AIDS.
“Using a voucher is like buying from the shop with cash for me. Nobody points at us,” says Alem, who came with her two young children.
“The HIV/AIDS programme was implemented in urban areas where markets function well, so we decided to switch to vouchers in several cities. The food that people get from vouchers is produced locally, and the people can get it closer to their homes through local shops” explains Abdou Dieng, WFP country director in Ethiopia.
Using vouchers as a new tool supports local food production and gives people more control over their food choices, but in some areas food assistance is still needed because of low market capacity. Before the vouchers were introduced, the HIV/AIDS programme had already had a significant impact for people living with HIV/AIDS, through direct food assistance.
One of the goals of the programme is to support people seeking treatment at health clinics, including those taking lifesaving Anti-Retroviral Therapy (ART). Monthly food rations or vouchers serve as an incentive for people to regularly take their medications, and improved nutritional status helps the drugs work better.
In 2011, 52% of adults on ARTs had an improved nutritional status after six months of food assistance. School enrolment of orphans and vulnerable children living in households receiving food assistance increased from 80 percent in 2006 to 99 percent in 2011.
“When my husband died I was left with nothing, and I had to look after his two kids from his previous marriage as well as my 5-year old daughter,” explains Tsehay, from Hawassa in Southern Ethiopia.”
“After a year I started feeling unhealthy; I gave up hope, simply counting my days,” she added.
Tsehay heard about WFP when she started taking ART. After a check-up, she was enrolled in the programme and started receiving a monthly ration of vegetable oil and a fortified blend of maize and soy meal. After six months, the nurse said that her health was improving and she was able to graduate from food assistance and begin a business skills training programme.
“They gave me 4,000 birr [about US$220] to start up my own business following the training. Now I grow vegetables and sell them to big hotels in town,” she says.
The WFP HIV/AIDS programme was established in 2003 in three major Ethiopian cities: Addis Ababa, Dire Dawa and Nazret. It has since grown to include 23 additional towns. Once the nutritional status of people stabilizes, they are linked to income-generating activities through local and international NGOs.
By Stephanie Savariaud, with additional reporting from Meherete-Selassie Menbere
Last year, WFP introduced vouchers into its urban HIV/AIDS programme in Ethiopia on a pilot basis, in place of traditional food assistance. People benefiting from the project can redeem vouchers for locally produced food. It’s just one part of a programme that helps people living with HIV and AIDS to get back on their feet.
Sister Valeria Amato runs the Nutritional Assistance Services of the Catholic Mission of Cumura, the largest reference nutritional centre for people living with HIV and tuberculosis in Guinea-Bissau. The Centre provides nutritional assistance to an average of 3000 patients per month.
In Guinea-Bissau, the second smallest country in West Africa, the prevalence of HIV at around 3 percent makes it among the highest in the region. The incidence of tuberculosis is also high and the co-infection rate with HIV is around 36 percent.
“WFP Nutritional assistance is important for two reasons. First because it focuses on the most vulnerable people who are not able to proceed with their professional activities. Nutritional assistance increases the quantity and quality of food they can eat,” said Sister Valeria Amato. “Second, it helps to monitor patients. The nutritional assistance is an incentive for the patients to complete their treatment, helping minimize the default rate.”
Sister Valeria Amato explained that she made a life choice to assist people living with HIV and tuberculosis.
Nutritional assistance is essential to help people living with HIV to take their anti-retroviral medication. In addition to nutrition support, the centre provides education and counselling pre and post-treatment and supplementary food support for beneficiaries’ households.
Working with its five partner organizations and NGOs, WFP is reaching more than 11,000 beneficiaries across the country.
25 years ago Sister Valeria Amato moved from Sicily to Guinea-Bissau and has since dedicated her life to providing nutritional assistance to people living with HIV and tuberculosis.
GUATEMALA CITY -Eight days after the birth of Jonas, his mother passed away due to complications related to HIV. After his mother's death, Jonas' aunt, Reina Mendez, 48 years old, has been taking care of him so he would have love and a home. Little Jonas has already received 18 months of a anti-retroviral treatment and now at 4 years old, the results of the laboratory exams revealed he is HIV negative.
But taking care of Jonas has not been easy for Reina, a woman who did not know anything about HIV and its impact. She did not know any work skills to support herself and also a small child.
Fortunately for Reina, the World Food Programme (WFP) in Guatemala, through the non-governmental organization APEVIHS (Association for the Prevention and Study of HIV/AIDS, in Spanish) is training a group of 70 mothers who are the head of households or are in charge of their homes partially so they learn new skills so they can earn a living and improve their families' economy in communities of the departments of Retalhuleu and Coatepeque.
“The support that I have received from the Health staff of Coatepeque and the trainings provided by APEVIHS have helped me with Jonas's treatment, and taught me about the importance of the health controls, nutrition and hygiene so that my little Jonas would grows up well,” said Reina, who added that “the productive projects are a good opportunity to cover the health and education needs of our children.”
In addition, these women receive training and guidance on how to get organized, to market their handcrafts and to create of a special fund for the purchase of raw materials with the goal of promoting the production of handcrafts.
Improving the Economy and the Way of Life
“In these trainings I have learned to make piñatas, candles, sowing and to work with recyclable material such as plastic and paper," says 35-year-old Flor de Maria Soriano, a mother of 7 children who lives HIV. "With the sales from these crafts I have managed to give my children the opportunity to study and to also help my husband who currently has no job,” she says.
WFP Nutritionist, Martha Salazar, explains that this project goes beyond helping these women improve their family economy and their lifestyle. The project also creates a space where they have the opportunity to meet and know other women living in similar conditions, which helps them feel accepted and supported. This sharing creates a solidarity bond among them and allows for them to live at least once a week without worries.
“These women are aware that maybe one day the sickness may catch them, but in the mean time they take a positive attitude towards life and they do what is necessary to better their conditions so that their children may move forward,” says the WFP Nutrionist.
Thanks to this initiative a group of Guatemala women living with HIV learn about their condition, to give emotional support to one another and to develop new skills that will allow them to earn a living and put food on the table for their families.