It was day one of a three-day field training in Budadiri, Uganda. As I waited for my lunch, I looked to the side of where the presentation was being held and saw many farmers carrying on, what looked to be, a discussion generating quite a bit of laughter. As I sat down on a nearby chair, words like “condoms,” “over his thumb,” “still ended up pregnant,” and “wife cheated,” came to the left side of my being. As I repositioned myself to listen and gain the full story, I grew curious of the woman narrating it.
I was later introduced to her as the woman “many at first are shy to come talk to, but later form a line to get a hold of.” And now, allow me to introduce her to you. Meet Mrs. Mariariza Nadunga, a local badass coffee farmer by profession, but also Mt. Elgon’s sex education expert.
Since her training in 2000, Mariariza has been maneuvering through the deep villages of the Mt. Elgon escarpment teaching community members about safe sex practices, condom usage (demonstrating how to use and apply them), administering HIV tests, providing counsel, and even hand-delivering antiretrovirals to those who are HIV-positive but fear the social stigma of being seen obtaining medication.
Oh, and she does this also by walking around with a purse that is loaded with condoms!
In 2015, an estimated 1.5 million people were living with HIV in Uganda, and according to UNAIDS, an estimated 40 percent of adults living with HIV were still left untreated. Though many people living in Uganda with HIV continue to experience stigma and discrimination, ongoing inconsistencies continue to surround those accessing the available treatment.
The earlier story that introduced me to Mariariza was one of her previous facilitations in the field. The lesson proved to be successful. Though just a year into facilitating these sessions with materials obtained from her local government hospital, Mariariza first began advising couples to practice applying the condoms first on their thumb to imitate the actual process of applying it later onto their husbands.
One couple came back to me in a couple of weeks arguing that they were pregnant even after using the condom the way I demonstrated it in the lesson and the man also believed that his wife was pregnant by another man. As Mariariza began to explain to the couple that the condom was not meant for the thumb, but in actuality for the husband’s penis, she began telling the group that “the couple apologized for their mistake in not knowing what to do, as they did it in the wrong way. However when saying they were sorry, they told me that next time, tell them, 'a spade is a spade.'"
Leaving an impression I couldn’t ignore, I sought out to learn more about Mrs. Mariariza Nadung, so I pulled her aside on our final day of training to talk more of her community work in Budadiri. We positioned ourselves a few meters away from the others, and as I fetched my recorder from my pocket, she steadied herself across the plastic arm rails of her chair awaiting my cue with a large smile on her face.
“In the 1980s, Ugandans didn’t know HIV came. We were also at war in the bush fighting, so when the soldiers moved around finding fun — they didn’t know about the use of condoms, and people said that they couldn’t take a sweet in the paper. You must feel it.”
The "paper" I later understood meant condoms. In fact, the general response I get when asking youth throughout my region in Uganda on why don’t they use condoms, they quote the same testimony the soldiers did: they have to “feel it.”
Speaking at a range just above a whisper to each of my following questions, Mariariza kept on with the story of the young soldiers in the bush referring to them as “skeletons due to the AIDS in their body.” Sunken cheeks, starved bodies and sluggish to react, Mariariza recounted several stories to me of the grisly village scenes.
“People would end up scratching themselves, creating scars…people believed them to be bewitched by the voodoo practitioners," she explains. "It was actually because of this, many doctors proceeded into the field to test these community members on syphilis and gonorrhea, to later discover they were HIV-positive instead.”
Mariariza recalled that it was at this point in time that a local NGO, TASO (The AIDS Support Organization) Mbale, stepped in to train community members about safe sex practices, the use of condoms, and how to administer HIV tests using the materials available at the local government hospital and regional offices.
“At first there were two of us, me and a woman named Samjanja. Then the doctors trained the midwives and then the counselors. First, they trained us all on HIV testing, and then others on counselor elements,” Mariariza goes on to explain that the same person administering the test would not be the same person advising on the results. She believed the system was setup in a way to better deliver the news by another than the one administering the test.
When shifting the direction of questions to why she began this community work in HIV in the fist place, Mariariza paused for a bit before mentioning that she “wanted to help the community members who were dying… and some who I tested back in 2000, they are still alive today. Those who [didn't] listen, they have died. Those who did listen, are alive. Today like before [in 2000], those who worry about the stigma, I don't leave them. I make the effort to go and speak to their counselor, I pick for them the drugs and then bring them the medicine to have that person continue living than dying.”
I became overwhelmed. Hearing of her strides, a sole coffee farmer from Budadiri, Mariariza pushed aside the social stigma that continues intimidating thousands from seeking out their antiretroviral drugs, which in Uganda the government supplies at a low cost or even free price at many of their government hospitals and clinics.
Though according to the World Health Organization, with drug supplies increasing in volume, on-going delays within the supply chain management paired with “poor storage and weak quality control methods, stock outs, and a chronic lack of manpower,” batches have to be stretched until the next delivery comes to a clinic to avoid running out.
Despite Uganda's pushing beyond its medical curtains, Mariariza is not fazed by any of it. She keeps moving forward with HIV tests and condoms at the ready. "I don't want my community members to get unnecessarily pregnant, sick, or get HIV. I also don’t want young girls to die from getting unnecessarily pregnant. The [HIV-positive community members] make me proud."
Mariariza never faced stigma herself from the community, partly due to her connections, but overall she owes it to her attitude regarding confidentiality. “I don't fear them. I joke with them, I don't go out telling people that those people are HIV-positive. I keep their secret.”
She also addressed the changes to what an HIV-positive community member now looks like since her work began in the 2000s. “Everyone looks smart (i.e. looking great), and they don't have the symptoms like before or look sick. They look like you and me. They go on with their work, and they are hardworking people and continue to grow and live. That’s why I am happy today. If I showed you one, you wouldn’t believe me.”
Mariariza has kept the confidentiality of thousands, if not more, because as she mentioned to me, the stigma shouldn’t be something that defines who she assists. “I want them to be healthy, and I want them to keep getting stronger and healthy," she says.
Mariazriza also shared that Olam International, the organization responsible for the three-day coffee-farming workshop, celebrated the most recent World AIDS Day by distributing mattresses to the Budadiri community, with the majority directed to the populations within the village that identify as HIV-positive. “That is why we are together, and why I like Olam, they care about the people with HIV.”
I walked away from my field work that day with a brighter temperament in knowing that there is a mountain full of amazing people out here in my little slice of Uganda. People with incredible stories to be told and trudging through the same foothills of Mt. Elgon just like Mrs. Mariariza Nadunga—a mountain home to a history with movers and shakers who may not receive the credit they deserve in keeping their communities together—and growing.
Michał Matejczuk came into the country of Uganda in June of 2016 with no expectations of what he would eventually experience in the Mt. Elgon Escarpment. From daunting taxi vans with curious passengers examining the amount of hair on his arms, or to waking up to a pack of goats chewing up his garden, these are his experiences as a Peace Corps volunteer in Mbale, Uganda.