As Tanzania's LGBT fear for their lives, HIV will thrive

In one day, everything changed.One day, she could walk down the street like anyone else. ...

Posted: Dec 2, 2018 10:00 AM
Updated: Dec 2, 2018 10:00 AM

In one day, everything changed.

One day, she could walk down the street like anyone else. People still stared and often judged but in their own minds -- not out loud.

AIDS and HIV

Diseases and disorders

Health and medical

Immune system disorders

Infectious diseases

Africa

Continents and regions

Dar Es Salaam

Demographic groups

Discrimination

Eastern Africa

Gays and lesbians

Population and demographics

Sex and gender issues

Societal issues

Society

Tanzania

LGBT rights

But before she knew it, she was dodging abuse and stones thrown at her by strangers, as well as familiar faces.

"Since the announcement was made, things got worse," said the 23-year-old trans woman from Tanzania, who asked to remain anonymous out of fear for her safety.

She was called derogatory names for being trans and one night was slapped by two men who had been following her, but she managed to run home fast enough to prevent further abuse, she says.

"The feeling is unexplainable," she said. She began questioning the world, her life and who she was. "You start thinking, 'what species am I? Where do I belong?' "

The announcement that she says changed her life was made by powerful politician Paul Makonda, regional governor of Dar es Salaam, Tanzania's largest city. At the end of October, he vowed to set up a task force to round up and arrest people suspected of being gay.

She first identified as a trans woman in 2016, having previously considered herself to be a gay man. "It took courage," she said. "Tanzania is a very religious country."

Although she was "very intelligent" about coming out and about going only to known LGBT-friendly settings, she now feels that things have taken several steps back.

Four weeks ago, she fled her home in Dar es Salaam to go to Kenya's capital, Nairobi, with the help of Kenya-based nongovernmental organization Jinsiangu, which is supported by the International AIDS Alliance and its Rapid Response Fund.

"It was so bad, I had go," she said. The organization gave her transportation and money to relocate and start a new life in Nairobi.

"I'm free here," she said.

'If you know any gays, report them to me'

Makonda's call for all gay people to be reported to him initiated a chain reaction in the country, forcing many into hiding.

Stating that his phone number is widely known, "I am announcing this to every citizen of Dar es Salaam: If you know any gays, report them to me," Makonda said at a news conference October 29.

People already faced a 30-year jail sentence in Tanzania for gay male sex, a holdover from colonial-era laws, mirroring severe penalties for same-sex relationships across many African countries. As a result of that law, the LGBT community experienced regular discrimination and marginalization.

Under the administration of President John Magufuli, rights groups believe, the situation has gotten worse, with the closure of LGBT-friendly clinics and prohibition of community organizations that do HIV outreach -- all because of their work on LGBT health and rights.

But the prospect of a civilian task force scouring the streets and giving civilians the power to report people brought a new level of terror.

After intense international pressure, the Tanzanian government tried to distance itself from the controversial governor's plans, stating almost a week after the announcement that Makonda's "views are not the view of the government."

But the repercussions had begun.

Since the announcement, the International HIV/AIDS Alliance says, it has helped 30 people in Dar es Salaam through the Rapid Response Fund, which provides money to people in dire need within 72 hours. In Tanzania, the grants have provided basics like transport, medical help and shelter.

Many of the people supported this month reported suffering serious injuries as a result of violent attacks, the alliance said.

Those unable to flee are instead pushed underground and into hiding, kept from entering the outside world -- which blocks their access to health services, such as those protecting against HIV/AIDS.

'HIV is so much higher in those populations'

Being forced to be "invisible" due to "public antagonism" exposes people to sexual violence and abuse for which they are also not taken seriously by the police, said Christine Stegling, executive director of the International HIV/AIDS Alliance.

"All those things add to the reasons why HIV is so much higher in those populations," she said, explaining that the organization's response grants help get people out of situations where they might more easily become infected.

According to 2014 UNAIDS data, 17.6% of men who have sex with men in Tanzania are living with HIV -- a rate more than four times higher than the 4.5% in the nation's general adult population.

Globally, according to UNAIDS, new HIV infections among gay men and other men who have sex with men are rising.

The region where "HIV rates are highest among men who have sex with men is sub-Saharan Africa, the second highest is the Caribbean, and these are both regions with high social intolerance for same-sex behavior," Chris Beyrer, the Desmond Tutu Professor of Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health, previously told CNN.

"It's impossible to say there is direct causality, but there certainly is a very strong correlation."

Being forced into hiding also means people do not want to engage in any way with health services and will not test for infections or go to collect HIV treatment. People will avoid anything that will link them to being LGBT and subject to identification, Stegling said.

"You have a whole part of the community not engaging in conversations about sex, sexuality and conversations around HIV," she said. "In the last couple of years, there's a really heightened hijacking of rhetoric against gay people as part of local politics, making life very hard for communities ... and to have HIV programs."

Stegling believes that we're far from meaningfully addressing HIV in marginalized communities.

We know what to do, but we can't do it, she said. There needs to be more peer-led outreach and services, as government services will not reach vulnerable people in such political climates.

Tanzania's Ministry of Health and a government spokesperson did not respond to requests for comment.

'They are making us fear, like we are not human beings'

People involved in peer programs in Tanzania risk abuse but believe that in their work to help and educate people about the importance of HIV prevention as well as living with the condition, in addition to ensuring that they know their rights -- keeping them out of prison and away from the risk of infection.

"People are not free," said Faki, whose name has been changed to ensure his safety. The government is "making us fear, like we are not human beings."

Faki has been openly homosexual for just a few years, having gained the courage to come out through attending training and information sessions with local community groups.

Two years ago, he and two fellow activists formed an organization to work primarily with LGBT groups on his home island of Zanzibar, a semi-autonomous region of Tanzania. Though the island's prejudice is not as extreme as in Dar es Salaam, he says, his team has helped many LGBT people get out of prison and fight for their rights against local police. His work has gotten him arrested too, he said.

"We have no support anymore," he said.

Just a few days after Makonda's announcement for local task forces in Dar es Salaam, Faki helped a group of 10 people who had been beaten and arrested for being gay while on local Pongwe beach, he said. They were reported by the driver who took them there. Amnesty International also reported the arrests.

At the same time, Faki had another LGBT friend come to stay with him, in hiding from Dar es Salaam, he said.

Though his goal in life is to make LGBT people aware of their rights to make them confident about their sexuality in public and in the face of aggressive law enforcement, he also worries about the health of this community.

Access is a core issue, and another prohibitive factor is the attitude of health care workers at clinics, he said.

If people find out you're gay, they're not friendly, he said, adding that if people do go to clinics for care, they can't be free and explain themselves or their situation, causing extra problems and "contributing to the spread of HIV."

He is not hopeful about his island's or country's future.

Global outcry in response to Mankonda's announcement has calmed the situation somewhat in Dar es Salaam and nationwide, but not entirely.

"People don't want to change their mindset on this issue," Faki said, referring mainly to government leaders. This means we have to fight, he said, training people to be aware and confident.

"It's not easy," he said. "But it's important for them to have knowledge."

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