Introduction
Ngozi Iwere is the first in Nigeria to develop a model program for HIV/AIDS prevention that targets and involves the entire community instead of focusing on small high-risk target populations.
The New Idea
Ngozi Iwere is challenging the idea that the HIV/AIDS virus can be contained by educating only special high-risk groups in society. While this idea is mainstream in many settings, it represents a radical departure in Nigeria and carries many implications. Working under the assumption that every member of the community is at risk, she has developed a project designed to involve the entire community in HIV/AIDS education and prevention. Her Community Life Project works within existing neighborhood and community networks such as hair salon unions, marketplace and small business unions, mechanics unions and schools to develop and aggressively disseminate prevention and treatment information.This community-in-charge approach is diametrically opposed to the expert-driven, from-on-high character of public health information in Nigeria. Ngozi believes that, because discussion of HIV/AIDS touches on sensitive issues such as drug use and sexuality, the usual impersonal expert-led approach is particularly inappropriate. In Ngozi's program, community members have control over what information is shared, how it is shared and who is responsible for making it available. The Project's community seminars, for example, tend to be familiar and frank.Ngozi recounts how one Project member, a security guard, came forward at one seminar and stated, "Let's be realistic, if my wife delivers and I am asked to wait six weeks to have sex, I won't wait. How many of you men would? I don't say it is right to go to a prostitute. But if you can't help yourself, all I say is: Go, but take your condoms with you." Every male head in the room nodded.Ngozi's intention is to put HIV/AIDS prevention and control on the community agenda throughout Nigeria at the same level of commitment, resource allocation, awareness and planning as well-established issues such as schooling, sanitation and traffic safety. Ngozi hopes that, as the topic of HIV/AIDS prevention becomes more commonplace, more community members will be motivated to change their behavior and take responsibility for their own health.
The Problem
Until the early 1990's, Nigeria's government denied that HIV/AIDS was a problem. Recent surveys showed that whereas a large percentage of the population had heard of the disease, most people did not have an accurate understanding of AIDS–Its spread, symptoms, progression–or how to protect themselves against it. Ignorance was common even in the medical profession.More recently, the government and the general public have become aware that HIV/AIDS is a problem but, in the time-honored response of denial, have tended to attribute the problem to a few high-risk groups such as prostitutes, homosexuals and drug users. Current education and service approaches allow a false sense of security to continue, targeting campaigns on specific populations. No community-rooted general outreach efforts exist, and the government's principal investment, in the AIDS Control and Prevention Center, is primarily one of research.
The Strategy
Ngozi's strategy starts not with a package of information and prescribed behaviors developed by "experts," but with questions directed to all sectors of the community. Piloting her approach in her hometown in Isolo, Ngozi organizes focus groups who meet with community members to find out what they want to know about HIV/AIDS, how they want to learn more about it and how they would like to see the information spread.Next, strategically-located segments of the community are given an opportunity to develop their own methods for spreading information. The Isolo hairdressers' association, for example, joined with the Project to publish a series of leaflets dealing with HIV/AIDS issues that mimicked "romance and true confession" magazines, and distributed them in salons and barbershops. The stylists decided that this was a good way to engage their customers in discussions of the issues, and to get them to see their own vulnerability by reading about real or potential situations relevant to their lifestyles.The Project organizes AIDS education workshops for Isolo's professional associations, participates in public symposia organized by other nongovernmental associations, and brings AIDS education to schools. The Project has reached several hundred teachers and over 5,000 youths both in and out of school with their HIV/AIDS workshops. The programs, which often involve debates and quiz competitions for students, are planned and carried out jointly with Ngozi's Project, school authorities, teachers and students from different grade levels. The Project has also made a special effort to reach out to the women of Isolo. In addition to working with primarily female associations of salon owners and hairdressers, the Project organized a Women's Cultural Day. Community women performed plays on the theme of AIDS, and men, women and children joined in poetry recitations and rap/singing sessions to both entertain and inform the audiences. The Project conducted an HIV/AIDS workshop for commercial sex workers, barmen and brothel owners, who have since helped conduct other mini-workshops for their peers and participated in the Project's general activities.Ngozi has a two-part plan for the Project's expansion. First, remembering the security guard, she plans to broaden the Project's scope of operation to address other health concerns identified by the community groups, especially STDs, family planning and teenage pregnancy. She is working in collaboration with the local government's health education unit to conduct workshops on HIV/AIDS, STDs and drug abuse for workers in area hospitals and clinics.Second, Ngozi wishes to spread the Community Life Project model throughout Nigeria. She is organizing a workshop for local governmental representatives from each state in Nigeria to show them how to establish projects in their respective areas. At the workshop she will distribute a manual, now in development that outlines the process for establishing these chapters. Starting in 1997, she will replicate the project in two nearby sister cities with similar populations and socio-economic conditions, Mushin and Oshodi.
The Person
Born in 1956 to a middle class, Ibo-speaking family, Ngozi was ten years old when the great Nigerian civil war broke out. Her home life crumbled when her family was forced to flee Nigeria and move to a rural village in western Benin. Rural poverty was a shock to a girl who had always lived in modest comfort in the city, but Ngozi says that she learned to appreciate the way the village community was organized. "There was no pipe-borne water or electricity, but the people had ways of discussing and solving their problems. I learned."Ngozi's professional background is in language teaching, journalism and communications. She describes herself as an activist by vocation, and has worked with a number of women's and student movements and on a reproductive health campaign. She attributes her success as community organizer not from any formal training, but out of love of people and faith that the community has an ability to organize, to survive and to solve its own problems. The Community Life Project was born out of her conviction that while empowerment will no doubt bring about development, power is already in the hands of the people. What is needed, she argues, are "catalysts," who can "waken the sleeping creative energy in all communities."