“Smoking is bad for your health. But do people just stop smoking because you tell them that? No. It takes time and support from others to really make that change.” This is how Nancy Abwola, senior programme officer of Raising Voices, explained the process it takes to change the power imbalance between men and women in Uganda. It’s not something that can just happen overnight.
Dorothy’s story mirrors quite well what Abwola states. Dorothy was married to her second husband for one year before he died from an Aids-related illness. She did not know he had it until that moment.
“He made all of the decisions. I didn’t have a lot of say in the marriage,” she said.
According to AVERT, an international Aids Charity, there are many power inequalities between men and women in Uganda, as in Dorothy’s situation. Women lack power to protect themselves and are expected to be innocent and submissive when it comes to sex. This is one reason why marriage prevalence rates for HIV/Aids are so high.
Abwola says in a relationship, the man has more power, especially in a marriage.
“Negotiating condoms maybe acceptable while dating, but not in a marriage,” Abwola said. She and the Raising Voices organisation attribute violence against women as both cause and consequence of HIV/Aids.
That is why the organisation started the programme SASA!, Start Awareness Support Act.
SASA! was started to help communities create positive change by preventing violence in families and creating healthy relationships. In 2008, SASA! asked 2,649 community members (1,181 women and 1,468 men) aged 18-49, living in 12 parishes in Rubaga and Makindye about their relationships, their families, and the problems they faced.
Married women face more violence
The results showed that almost half (49 per cent) of women who are currently married or have been married in the past reported having experienced physical or sexual violence from a partner.
Fifty per cent of men said they used one or more controlling behaviours with their partners in the past 12 months.
Abwola says society as a whole values the roles men play more than women. This is a result of social norms that are embedded into society, where women’s contributions to society are seen as less valuable than a man’s contribution.
For example, child bearing, upbringing, and taking care of the sick are not seen as valuable as a man’s role of salaried work. And even if a woman works as a salary worker, the man is still viewed as better than her and will most likely earn more wages.
Another issue is that polygamy is acceptable, but only for the man, and many times there are other “side dishes” men get involved with other than their wives. Wives may have unfaithful encounters as well, it is just more secretive and kept to themselves, whereas the husband can use his to brag.
Dorothy found out she was HIV positive when she was 35 years old. “I felt very bad and I wanted to commit suicide,” she said. Her counsellors had to help her figure it out, and it was her children who convinced her that there was life after being positive.
According to the 2011 Uganda Aids Indicator Survey, women and men who have never married are least likely to be HIV positive. Lillian Mworeko, the Regional Coordinator of ICWEA (International Community of Women living with Aids in East Africa), says there are too few messages directed to after marriage, so people have this false sense of safety, but unfortunately that is where they are the most vulnerable.
Recognising and challenging harmful gender roles are crucial in preventing the spread of HIV.
The National Society of Women Living With HIV/Aids programme manager, Hope Birungi, noticed that in their organisation they were mainly focusing on women. They would give women skills but then their husbands would violate them.
This made them realise that it is just as important to get men involved in the training. They can transform men’s attitudes and behaviour toward their partners, families, and women in general. SASA! found this to be true.
In communities that SASA! had been implemented 76 per cent of women and men no longer believed that physical violence in relationships was okay, compared to 26 per cent in non-SASA! areas.
One male community member reported that from attending SASA! activities he learned that some of the things he used to do were not right.
For instance, whenever he needed sex, he felt like he had to have it without his wife denying him: “I thought whenever I wanted sex, she would automatically want it. So whenever she would refuse, I would get enraged and we would fight.”
SASA! has also given voice to women. One female community member reported that her and her husband now talk about bedroom issues. “Before SASA! when my husband wanted sex it was a must. I had to give it to him, but now if I don’t feel like having sex I will just tell him and he will understand.”
But this is a cultural issue and like Birungi said, “Community support is challenging, and acceptance takes time.” Because of such challenges also, few people are open about their status.
This is the case for Dorothy. Not many know she is HIV positive. She fears if her neighbours find out, they will stop buying her products. However, support groups like ICWEA and NACWOLA are motivating HIV positive women to go door-to-door in their communities to talk about their challenges.
They believe this is the best prevention method in order to drop the prevalence rates. Abwola says the concept is all about power, and you have to ask, “What is power to you? How do you use it? How can you use it differently?” The community has to see power differently; the thinking has to be challenged.
People don’t like to be told what to do.
“Men think that they have to discipline their wives if they misbehave. Telling them not to beat their wife is nothing new.” So give them a healthy option, let them do the critical thinking and come to the realisation on their own.
Let them see the benefits for themselves. If they learn to respect each other, balance power, and think of each other as equals, then they will start appreciating one another as partners, stop abuse, and want to live out a healthy relationship.
Abwola says, “If we can change attitudes/behaviours then we can fix the epidemic.” Dorothy wishes her husband would have talked to her about it, then maybe they could have gone to treatment together, and he would still be alive. It is clear to see that when women have more security and feel empowered, they might make better decisions and help their spouses do the same.