World AIDS Day Celebration in Shadara Village - Pakistan

This project is based on the idea that HIV/AIDS-related stigma not only impacts the individual living with the disease; it also creates "an atmosphere of fear and deliberate ignorance on part of people who may choose not to take action to protect themselves against the menace. Breaking this cycle of stigma & discrimination is through ensuring that people with HIV are part of this society and they can contribute towards its development". To translate this idea into practice, SACHET invited Shadara villagers to SACHET's free medical clinic to address some of these issues together.

The interactive session began with a street theatre performance by SACHET's theatre group. Young actors demonstrated to rural audiences - in an entertaining fashion - that AIDS is indeed a dreaded disease about which they still may know very little. By starting from an assumed state of ignorance, the play was designed to create an environment conducive to breaking down taboos that close off discussion about HIV/AIDS. The ultimate goal here was to encourage audience members to adopt a positive attitude toward people living with the disease.

The interactive play was followed by a question-and-answer session in which medical experts answered participants' questions. The team from the SACHET Health Program stressed using screened blood, disposable syringes, and contraceptives such as condoms. They also encouraged the creation of an environment of openness in which talking about sexually transmitted infections (STIs) or HIV/AIDS is no longer taboo. They said that restrictions on women's mobility are barriers to information and STI preventive services and that there is a need for peer education initiatives to create awareness and promote healthy reproductive health practices.

In a related, evening theatre performance, community members gathered in the auditorium of the Islamabad Club to watch a play addressing fear, stigma, and discrimination surrounding HIV/AIDS. In this play, characters identifiable in the local surroundings - an athlete, a barber, a truck driver, a eunuch, a drug addict, and a housewife - told a story that encouraged viewers to build "an environment of love, harmony and peace where hatred is for the syndrome and not the victim."

Participation on the part of the community of those living with HIV/AIDS was integral to this programme. A 23-year-old HIV-positive man from Lahore was invited to share his story with the community. He indicated that he was confused and afraid of his family's reaction when the doctor confirmed that he was HIV-positive, saying "It was difficult to acknowledge that I had become the victim of a disease that is still without any cure...now I'm out to sensitize the people with no knowledge of what the havoc their ignorant attitude towards this disease can play with their lives". His presence was meant to stress to the community that "Empathy not sympathy is required to deal with this social stigma".

HIV/AIDS, Stigma and Discrimination.

The interactive street theatre play described above was performed 10 times in total in early December 2003; 700 people between the ages of 10 and 70 years attended. Before each performance, audience members were asked how many knew about HIV/AIDS; only 10% of the 700 people had heard about it.

The Federal Ministry of Health initiated the NACP in 1987. In its early stages, the programme was laboratory-oriented, but progressively began to shift toward a community focus. Its objectives are the reduction of morbidity and the prevention of HIV transmission, safe blood transfusions, prevention of STI transmission, establishment of surveillance, training of health staff, research and behavioural studies, and development of programme management. As of this writing, the NACP is using a multi-sectoral approach to address HIV/AIDS; NGO collaboration is an important part of this strategy.

The World AIDS Day Celebration was conducted as part of SACHET's Dare to Sensitize, Train & Inform (DoSTi) programme. Funded by individual philanthropists, the 5-year project is designed to halt the spread of HIV/AIDS in Rawalpindi, Islamabad, and Attock districts. Programme officials emphasise the need to sensitise rural communities about HIV/AIDS, as awareness of the impact of the disease is low in these areas. SACHET claims that prevalence of HIV/AIDS in Pakistan is quite low (0.1%); however, they say, vulnerability is high due to risk factors such as injected drug abuse, commercial sex, refugees, and unsafe blood transfusion. The most vulnerable group, they say, is adolescents and youth, who make up 43.4% of the total Pakistani population. Due to ignorance and/or despondency marked by poverty or other factors, members of this age group, they say, are more likely to indulge in high-risk activities leading to AIDS.

Each year, World AIDS Day is celebrated throughout the world; a commitment is reaffirmed to protect present and future generations from the threat of the disease. In 2003, under the theme of "Live & Let Live", awareness-raising celebrations like SACHET's were held worldwide.