A Gift for Life in Rwanda
Helping HIV-positive women get medical attention and tools for self-reliance is a gift needed.
Rwanda’s large widow and orphan populations are part of the ongoing impact of violence and disease in that country. The exact figure will never be known, but the United Nations estimates 100,000-250,000 women were raped during the three-month genocide in 1994. Many women became pregnant or contracted HIV. Adding insult to injury, these women are ostracized by an uneducated and fearful community, forcing them to live on the fringes of society. Too weak and poor to seek consistent health care, these women have struggled to take care of themselves and their offspring. It almost seems like a hopeless situation; however, like the old adage says, where there’s a will, there’s a way.
Since 2005 Rwanda Gift for Life has responded to the hardships and trauma rape survivors continue to face even as they struggle to care for their families while living with HIV. After a yearlong study, human rights advocates at African Rights reported rape survivors in 11 of 12 Rwandan provinces were living with HIV and AIDS, had no economic support or access to medicine and were in dire straights, said Caitlin Lamber, former program coordinator and field worker for Rwanda Gift for Life.
Rwanda Gift for Life was a direct result of the research done by African Rights. Its mission is to get the women the medical attention they need with a long-term goal of helping them regain self-reliance.
“We developed a five-year program to help a select group of women regain their health,” Ms. Lambert said. “We did this by providing them with housing, a living stipend, and because many had given birth to babies from the rapes and taken in genocide orphans, help with their children.”
Rwanda Gift for Life first focuses on helping the women get the anti-retroviral drugs (ARVs) they need. It then addresses consistent access to food, which is important because taking the medications without food causes severe nausea and vomiting, which in turn causes the women to stop taking the drugs or to take them sporadically. Improper use increases the chances of building a resistance to the drug.
“There is a huge disconnect between the rural communities and the urban communities where the hospitals are based,” Ms. Lambert said. “If a woman lives in rural Rwanda and the hospital is in Butari town, she can’t afford the bus ticket to get there. If it's between feeding your child and paying the bus fare, you’re going to feed your child. It’s the cycle of poverty the women get caught up in. They can’t think of the long term. They have to think of the day to day. This is where Rwanda Gift for Life steps in. After we’ve helped them regain their health, we help them with income-generating projects.”
Gift for Life helps 12 women through a five-year process, investing approximately $1,200 annually to help each of them. “I’m sure we could give grants to 200 women, but working individually with 200 women is impossible for one person,” Ms. Lambert said. This individual attention is essential to the success of the program because each beneficiary needs a great deal of time and hands-on support to fully realize the program’s goals of health and self-sufficiency.
By the fifth year, the women are healthier and ready to work on regaining their independence. The program provides each woman with a two-day assessment session and three days of instruction with a Rwandan business trainer. The women are given a grant to help with their new business, whether it’s to rent space in the market cooperative or open a hair salon. Most of the women already own small businesses, and the money is put toward expanding the existing business.
Rather than simply renting a stall in a market, there is an emphasis placed on joining the market cooperative. “They would be lucky to bring in $50 a month if they didn’t receive this grant to join the cooperative,” Ms. Lambert said. “I feel a lot of the women in the market try to break even, and what we’re trying to do is help the women join the cooperative because that gives them a long-term solution to their problems. If they join the cooperative they are part of a bigger community. The benefits are both economic and social.”
Rwanda Gift for Life helps the women develop a plan to grow their businesses. “There is a social worker from the district who works with HIV and AIDS survivors, helping them with a business plan regarding what is realistic as well as individualized help from people who know how to run a business,” Ms. Lambert said. “There is a strong educational component. We don’t want to simply give the women money and say, ‘Good luck!’”
‘They gave me hope’
Aurelie,* a 39-year-old mother of two boys and one girl, received a grant from Rwanda Gift for Life. She was raped during the genocide but did not know she had been infected with HIV until she began to feel ill in 2001, at which point she had herself tested. When she tested positive, she encouraged her partner, with whom she owned a restaurant, to get tested also. He discovered he too was infected; however, unable to accept the truth, he ignored it. He died a year later, and Aurelie was left to earn a living and raise her children while battling HIV.
“I continued to work in the restaurant for two years, but the children were too young, and I had to take care of them,” Aurelie said. “The workers started to do whatever they wanted, stealing money from me, and I had to close the restaurant in 2004 and find cleaning jobs so I could eat.”
Although her health hadn’t completely deteriorated, Aurelie lived in fear of opportunistic infections. She was worried she would die and leave her children orphans. Then, in 2006, she found Rwanda Gift for Life. “Each month they gave me rice, beans, 1 liter of milk, 6,000 francs [about $6] to buy school supplies and a 10,000-franc [about $10] stipend."
This helped Aurelie get back on her feet, so she could plan for the future. Encouraged by the support she was receiving, Aurelie began working again. Today she sells milk, bread and donuts as well as tea and porridge from her home, earning roughly about $4 a day.
“I also have a salon,” she said. “I’m happy for my business because I don’t have to ask for money. I’m independent. I can give my children what they need.”
With the money she earned, Aurelie was able to save and put electricity in her house. She also used a portion of her savings to buy a piece of land, pay a cultivator and plant crops.
Aurelie said community members often don’t understand basic information about how people become infected with HIV or how they live with AIDS. “First, they told me I was no longer accepted by the society, harassing me and my kids. Other people would beat my kids, telling them to stay away from their kids,” she said.
Because very few members of the community are formally educated, they rely on personal beliefs rather than scientific facts when they learn a neighbor or community member is infected with HIV or has AIDS.
“Some people don't know how the disease is transmitted,” said Shemsa Uwase, Rwanda Gift for Life’s logistics manager and field worker. “Even if you tell them they can share drinking water and HIV will not be transmitted, they don’t understand. If you have HIV or AIDS in Rwanda, it’s not easy to get a job, or if you are in business, some people will not come to buy things in your house.”
Even family members shun their relatives, Ms. Uwase said. “Your own mother will refuse to give you food. And if they allow you to stay, they give you your own cup, bed and room, but if you want to eat you can’t eat at the same table,” she said.
Once when Aurelie had been feeling very ill, she called her sister who lived in a nearby village to ask for help. “When my sister came, she saw that I bought some furniture and told me I should’ve saved my money because I was going to die and should’ve put the money in the bank for my children,” she said.
In fact, so strong is the stigma surrounding HIV and AIDS in Rwanda only the women’s first names are used in this article, and their faces were not photographed to protect their identities. What compounds the issue is that HIV and AIDS education is provided in the big city but not in the rural areas where the problem is most serious.
Even with all these misfortunes, Aurelie continues to thrive. “Gift for Life was a resurrection for me,” she said. “Before there was no hope. They gave me hope for tomorrow and the courage to face life and start working again. Before they came, all I thought about was the day. I didn’t plan for the future. Now I have hope for tomorrow, and that I will live well with my children. If I am successful, I will save for my children so when I’m tired and can’t work anymore, I will have enough saved for my children to survive. I hope those who started the program will come back and see how my life has changed.”
‘A gift from heaven’
Josiane,* 39, is another Rwanda Gift for Life grant recipient. Severely beaten and raped during the Rwandan genocide, Josiane has suffered spells of amnesia-like symptoms as well as having contracted HIV from the militiamen who raped her. Like many of the women who were raped, she became pregnant and delivered a baby girl who was also born HIV positive.
It was difficult for her to accept the fact that she was HIV positive. “I became like a fool,”said Josiane, whose two small children were killed during the genocide. “I lost my mind, crazy. It was difficult. I was also poor, almost always sick along with my child and became more crazy. I would leave my home to go to church and forget the way and find myself crying in the middle of nowhere. I hated everyone — even my daughter because she was the child of rape. I felt responsible for her sickness and the loss of my older children.”
Josiane was so distraught she refused to feed her daughter so that she would die sooner and not live in pain. “When she called me Mum, I would tell her that my children, who would’ve been able to help me, were dead. I told her she was of no importance to me at all. I was very aggressive toward the poor little thing,” she said.
Before joining with Rwanda Gift for Life, Josiane lived in a hovel with her daughter and three orphans in her care. Two of the orphans are nieces, and the third one belonged to a friend killed during the genocide. All girls, their ages are 13, 16 and 17. Although physically and mentally incapacitated, Josiane decided to take the children because there was no one else. Her family had been decimated by the genocide.
Rwanda Gift for Life first helped Josiane with food, milk and a stipend. Food was important as both Josiane and her daughter feared taking their ARVs without eating because of the side effects. ARVs taken without food caused her daughter to have a severe skin reaction. They had so little food that Josiane weighed only 88 lbs. She now weighs 154 pounds and looks as healthy as any well person.
With her health restored, Rwanda Gift for Life helped Josiane start a business. “I started selling sorghum. I buy the sorghum and turn it into flour, then sell it to Gift for Life,” she said.
The program gave the milled flour to other beneficiaries of the program, until Josiane was able to build a customer base of her own. She no longer has to sell to Rwanda Gift for Life, but, rather, sells to buyers who come directly to her. This business has allowed Josiane to provide for her family. She plans to expand by selling palm oil and fish along with the sorghum.
Confident that there is enough food to eat and able to provide for her family, Josiane sees a brighter future. “I feel strong because I know there are people who care about and love me,” she said. “Gift for Life was a gift from heaven.”
Gabriel Ramos-Rocchio, is a writer who lives in New York City and Nile Sprague is a photo journalist based in Mendocino, Calif.
*First name only used for privacy concerns.