Everyday life in Bondo hospital.
Patients hospitalized in the late stages of AIDS and doctors overwhelmed by the sheer volume of sick people they receive everyday from the beaches.
Dr. Morris Juma: “According to our data most of our patients who come from the beach who are fisherman, around 70 percent of them usually test positive.
Q: Why is that?
“According to what we have realized it is because of the activities that go on in the beach”.
Lazarus Ouma: “Every home is affected. You will hardly find any home that had never been affected by the HIV Virus. You will find homes that are left without the parents, children are left alone. You will find some homes that the children are only left with the grandparents. No parents.”
Lake Victoria. Home to one of Africa’s biggest fishing industries and a population devastated by AIDS.
|Play the film in Flash by clicking below|
Here, the men man the boats, but the business is run by women.
Competition between these women is fierce – everything rests on the catch, and whoever manages to get their hands on it.
But an exploitative process of procurement has grown up around the industry – creating a system that has also played straight into the hands of the AIDS virus.
It is called the Jaboya system, and describes the relationship between the fishermen and the women who buy their fish.
Frequently this relationship is sexual.
Women who offer sex to the fishermen stand a better chance of getting fish.
“When fishermen come from the lake I buy their fish, but in order to guarantee that you get fish you must also develop a sexual relationship. Without sex there is no guarantee that you will get any fish.”
Julia is one such Jaboya. Her husband died of AIDS last year leaving her without support and no alternative but to join the Jaboya system.
”The Jaboya system is not a good system, but I am a widow with children. With no other means of income, I am forced to use this system.”
Leaving little room for trust. Julia is yet to tell her lover that she is HIV positive because the consequences would be catastrophic for her and her young family.
“I haven’t told him my status because he’ll leave me if he knows I’m positive.”
And the sexual obligations of these women do not end with the fisherman. The fish must be transferred to market while it is still fresh and competition for space on the roof of the bus can be just as intense as getting hold of the fish in the first place.
This woman is one of the fish vendors. Few know the Jaboya system better than her.
“Sometimes space on the bus is limited, so some women have sexual relations with the driver to make sure their fish gets to market.”
“There are even some women who have a relationship with the fisherman, the bus driver and the vendor at the market.”
These practices serve to create a network of sexual contacts that have allowed the virus to not only take hold in this community, but also to wreak havoc.
Ndeda Island is one of the worst hit communities in the area. From a 1997 population of 6,000 just 2,400 remain.
Ignorance by contrast remains commonplace.
Each morning this woman comes down to the beach to help with the morning catch.
And once the fish have been sold, she’s on the lookout for a different catch.
“I have two businesses. First I go to the beach looking for fish. And if I don’t get a fish I will surely catch a man.”
“Some customers like to use condoms – while others refuse to use them. I can go either way. I’m happy to do whatever the customer wants.
“I do not fear death because death is waiting for all of us. AIDS can infect me or the person I am with at anytime so I carry on and have sex without fear.”
And the impact of this fatalism is clear for all to see.
Fifty metres away, the body of a man who has died of AIDS the previous night lies cold on the floor while his fellow fishermen try to raise enough money to get the body to the mainland - and the mortuary.
All around the lake stand the ruined houses of AIDS victims - victims as much of culture as disease.
In addition to the widespread practice of polygamy – with some men marrying as many as 6 wives - local culture dictates that when a man dies a close member of his family should inherit his wife - making wife-inheritance one of the primary sources of infection.
“On each and every homestead you must find one person or two who died of AIDS.”
“This is the grave of my co-wife who died in 2002 and this is the grave of my husband – he was positive, he had AIDS. And later on my co-wife also died from the same disease.
Margaret Nyadenda’s husband died in 1997, leaving her alone with 6 children, but she thanks her Christian faith for giving her the courage to resist the social pressure to be inherited by her husband’s brother.
And because me myself I’m saved, I decided not to be inherited. And you know, when you are not inherited my community cannot like me because they think I am going against their customs.
But you can stand by yourself and say you, you are a Christian, you cannot accept to be inherited and that is what happened to myself - but my co-wife accepted to be inherited and maybe that is why she is no longer with us.”
Margaret now looks after not only her own children but those of her co-wife as well.
It is a fate shared by many of her neighbours, who often call on Margaret for support.
“Her husband is the one who inherited my co-wife and later on he also died so she is also a widow now.”
Margaret is herself HIV positive and it is thanks to her enlightened attitude as well as the anti-retroviral drugs that she takes, that she is still alive.
Everywhere there is evidence of the ignorance that prevails throughout much of the community.
Mark Onyango is the assistant chief of Ndeda Island.
“This is the home of Mr. George Ociendo who died with this wives. And here are the children and their grandmother. Here is Margaret Ociendo and the children who were left when the whole family died. And the girl here is cooking for the children.
Q: No adults?
No adults. No adults.”
Responsibility for this young family now falls on the shoulders of 14-year-old Beatrice who since her parents died has been forced to drop in and out of school as she struggles to look after her siblings.
Beatrice tries to meet their needs with the little money she earns for smoking fish, putting her in daily contact with fisherman and leaving her vulnerable to the Jaboya system.
Today, lunch for one must be shared by 6.
“My father fell sick in 1999 but only when he was about to die did he tell Mum that he had AIDS.
Sometimes we have no food and we have to sleep hungry. Only when we are lucky to sell fish are we able to buy food.”
Lake Victoria’s fish migrate around the lake and the fishermen follow them – spreading the disease ever further
Lazarus Ouma is an AIDS Awareness Campaigner who travels the lakes beaches and islands trying to hammer home the message of prevention.
But many people still deny the existence of HIV, believing the disease to be a curse visited on those people who break customary law.
Lazarus’ message often falls on deaf ears – except for the occasional moment of humour.
“You cannot get a poor man struggling for a transport, going to Bondo to and fro simply for the test. Now, she or he will just stay here not knowing their health status simply because we are far away from the hospital.
“So they still go on doing their sexual immoralities without any preventive measures because they think they are ok. So the spread still goes on because they are not aware.
Indeed, the only time that most HIV infected people make it from the beach to the nearby town of Bondo comes when they arrive at the morgue.
All of these women have lost their husbands – all of them are HV positive.
Perhaps the only winners of this tragedy are the mortuary owners. This man is a nurse by trade but is working after-hours at the family mortuary because of the sheer number of bodies they are receiving.
Morgue Assistant: “Apparently we have 11 bodies and most of the bodies that you are seeing here are people who have died of HIV/AIDS. Day in day out people come here crying of this killer disease.
It’s terrible, its creating havoc in this community. Most of our people, even the homes around, they are dying of this disease. If we don’t get help or find a proper way to curb this disaster then I think this community will get extinct to say the least.”
Many people here still believe AIDS is a curse - and they’re right.
More than 20 years after lake Victoria was first hit with HIV, children still bury their fathers.
And these funerals look set to continue until the fishing community of Lake Victoria comes to realize that AIDS is a disease that can be prevented.