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Theatre as HIV prevention tool in native communities

HIVPoverty, lack of access to education and taboos about sexuality have hampered campaigns for the prevention and control of HIV/AIDS among indigenous communities in Guatemala. These constraints have led to the development of new ways of communicating vital information, like theatre, writes Danilo Valladares.

14 August 2011

"We put on a show with clowns, because young people fall asleep at PowerPoint presentations," Walter Contreras of Ak' Tenamit, a non-governmental organisation (NGO), told IPS. "We perform theatre skits in the Q'eqchi language and in Spanish, to reach out to local communities."

More than 3,500 cases of HIV infection were diagnosed among the native peoples of Guatemala between 2004 and 2010, equivalent to 23 percent of the country's total HIV-positive population, according to statistics from the Ministry of Public Health and Social Assistance.

In the rural provinces, the highest rates of HIV/AIDS are in San Marcos in the northwest, Alta Verapaz in the north and Suchitepéquez in the southwest, according to the results of the first official survey of the HIV/AIDS pandemic in the indigenous population since 1984, the year the first AIDS case was diagnosed in this Central American country.

"Indigenous communities are highly vulnerable because they do not have access to health care in their own language, they receive no information about the disease, and they have no access to HIV testing – apart from a general reluctance to talk about the illness," Contreras said.

Official statistics indicate that in 2006, eight out of 10 indigenous people were living below the poverty line in this country of 14 million people, and that 40 percent of Guatemalans are Amerindians, although NGOs and indigenous people themselves put this figure at 60 percent.

Ak' Tenamit, which means "New Village" in Q'eqchi, a Mayan language, was founded 10 years ago with the goal of disseminating information and promoting preventive action against HIV/AIDS. Now it operates in 29 communities in Livingston, a municipality on the Caribbean coast of Guatemala that has a high proportion of Maya Indian people.

"The key message to get across to young people is how to use a condom properly, and to make sure they have an HIV test when they turn 18," Contreras said.

Ministry of Public Health statistics indicate that from 1984 to 2010, 22,647 cases of HIV/AIDS were notified in Guatemala. However, NGOs say this figure is an underestimate because a large number of cases are never reported.

The Pan American Health Organisation (PAHO), for instance, estimates that over 65,000 people are currently living with HIV in Guatemala, which makes prevention and treatment of those affected a matter of urgency.

Stephane Gue, of Proyecto Payaso (The Clown Project), an NGO offering workshops and theatre performances about HIV in Guatemala, can personally vouch for the effectiveness of theatre as a means of communicating information about the HIV/AIDS epidemic in rural areas.

"Neither the health centres nor the schools know how to tackle the issues, or have great difficulty in doing so," Gue, an artistic performer from France, told IPS. The Clown Project can serve to open a door and provide continuity of efforts for HIV prevention, with a playful, recreational approach, he said.

Their 40-minute show includes clowns, acrobats, jokes, juggling and information in Mayan languages and in Spanish about HIV: the ways it cannot be transmitted and the ways it can, and how it can be prevented, as well as messages of solidarity for HIV-positive people.

"The greater the poverty level, the less access people have to education and health care, as well as to land. Everything conspires towards greater vulnerability of indigenous communities to HIV infection," Gue said.

The Clown Project now covers the northwestern provinces of Huehuetenango, San Marcos and Quetzaltenango, and Suchitepéquez and Retalhuleu in the southwest, all of which have large indigenous populations, as well as the nation's capital.

Vinicio Pérez of the National Centre for Epidemiology (CNE) told IPS that "theatre is better" at getting across information about the AIDS epidemic than a long presentation, "because it uses a more open approach, and encourages more dialogue, in the audience's own language."

Pérez, a doctor, admitted that so far the government has virtually no accurate information about the prevalence of HIV among indigenous peoples, in spite of this knowledge being essential for adopting specific targeted measures.

"Our meagre health budget limits what we can do," said Pérez. According to the authorities, the ideal working budget would be about 800 million dollars, but in fact the budget available is 500 million dollars.

Meanwhile, the HIV epidemic is spreading, partly because of the difficulties indigenous people have in tackling it.

"There is a taboo against using condoms, and gathering a group together to talk about sexual matters is frowned on, especially in the Mayan villages, where this is not accepted because of the conservative nature of their traditions," Pérez said.

At the Millennium Summit organised by the United Nations in 2000, Guatemala and the other U.N. member states made a commitment to fight HIV/AIDS, adopting concrete targets to be met by 2015, but in some cases the results are disappointing.

"Only one in four people say they have some knowledge about HIV," according to the third report on progress towards meeting the U.N. Millennium Development Goals (MDGs), presented in 2010 by the government of President Álvaro Colom. Thus, Guatemala is unlikely to meet the goal of curbing the spread of HIV/AIDS by 2015, the report adds.

The year 2015 is the deadline for achieving the MDGs, which are based on indicators from 1990. The goals include reducing poverty, guaranteeing universal primary education, promoting gender equality, reducing maternal and infant mortality, and fighting HIV/AIDS and other diseases.

José Yac, of the Association for Research, Development and Integral Education (IDEI), a local NGO, told IPS "a critical path for tackling HIV/AIDS is needed so that the indigenous population can participate actively in its prevention and treatment. Also needed is the decentralisation of services and resources."

This article first appeared on IPS.

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