MINNA, NIGER STATE - Khadijah still cannot tell how she contracted the human immunodeficiency virus (HIV), which causes AIDS. She was diagnosed with it two years into her marriage in 2000. The discovery made her husband, Usman, desperate to know his own status. As it turned out, he, too, was positive.
"He started seeing a herbalist in Gwagwalada [in Abuja] that used to give us abalake (herbs). He also visited others across Niger State (Nigeria), but nothing happened," Khadijah said.
Usman died in 2007. "Anxiety, which gave rise to high blood pressure, led to his death," said Khadijah, a cleaner at the Federal University of Technology in Minna, the Niger State capital.
Khadijah is one of 1.8 million Nigerians living with HIV/AIDS, data from the National Agency for the Control of AIDS show. That represents 7% of the 25.7 million people living with the virus in Africa and 4.7% of the 38.4 million global prevalence, according to the World Health Organisation. Summarily, Africa alone holds 67% of the worldwide burden.
Shortly after Usman's death, Khadijah started seeking medical help at the general hospital in Minna. By this time, her health had begun deteriorating, coupled with stigmatisation and discrimination - including from family and friends.
One day at the general hospital, she saw a banner by an HIV/AIDS support group stating their meeting days. When she dialled the phone number on the banner, the receiver directed her to Divine Mercy Hospital in Dutsen-Kura Gwari community, where [HIV/AIDS] patients meet regularly for counselling.
"That meeting was the first counselling class I attended after knowing my status since 2000," 42-year-old Khadijah said. "The day I went for the meeting, I saw many others like me. That gave me some relief. I said, 'ah, it's not only me.'"
The support group was Friends of the Poor Foundation in Africa or FOTP, a localised version of Friends of the Poor, a nonprofit in the US providing funds, food, and medicines to the very poor and suffering.
Co-founder of Friends of the Poor (US), Jean Colarusso - a devout Californian catholic - had made 15 trips to Nigeria in the early 2000s. Each time, she initiated programs that empowered poor women economically, gave scholarships to needy children, fed low-income families and orphans and paid their medical bills, especially in Niger, Kogi, Delta, and Anambra states. Colarusso was later nicknamed "Mama Africa" for her contribution to lifting the poor in the continent.
Part of Colarusso's work in Nigeria was supporting HIV patients at the Divine Mercy Hospital owned by the Diocesan Health Initiative (HDI), a project of the Catholic Diocese of Minna providing free health services to underserved communities, including giving birth kits to under-resourced health centres.
Reverend Father Chiedozie Ezeribe, a Catholic priest with the Catholic Diocese of Minna, was the director of the DHI at the time and worked closely with Colarusso, who has since returned to the US to continue her work with Friends of the Poor there.
In honour of Colarusso, Father Ezeribe started FOTP in Nigeria in 2014. Once a month, FOTP offers psycho-social support to people living with HIV. It invites HIV survivors who have overcome stigma and, with the help of antiretroviral drugs, happily pursue their careers and live healthier to counsel HIV/AIDS patients who feel downcast and condemned.
FOTP has between 80 to 100 patients during each counselling session. The counselling aims to help people with HIV know that having the virus is not a death sentence. They explain to patients that with the right attitude, emotional balance, and regular intake of antiretroviral drugs to reduce their viral load, anybody with HIV can live long enough to pursue their dreams happily.
Free but not accessible
In 2016, the federal government started the free distribution of antiretroviral drugs to HIV/AIDS patients receiving treatment at tertiary health centres across the country. But sometimes, the drug is unavailable, or patients do not get the needed monthly quantity to keep their viral load below dangerous levels.
Besides, most HIV patients in rural communities do not have access to tertiary health centres, mostly located in urban centres.
In the end, if HIV patients with partial or zero access to free drugs must keep their viral load below fatal levels, they must pay for the medicines out-of-pocket. An HIV/AIDS patient would have to spend at least N100,000 ($231) annually for the drugs, and that is beside the cost of medications for other illnesses related to HIV/AIDS in a country where nearly 40% of the people live in extreme poverty.
But FOTP gives antiretroviral drugs to patients free of charge and supports their other health expenses. Thanks to continued financial support from Colarusso and her US partners. For HIV patients with suicidal thoughts [like Khadijah once had], FOTP takes an extra step to use psychologists to talk them out those thoughts.
"This [support] was probably all my husband needed to be alive," Khadijah said. "The psycho-social support programme takes care of our mental, physical and spiritual wellbeing [because they pray with us]."
Fr. Ezeribe said his encounter with poor HIV patients at the DHI and Colarusso's commitment to helping the poor inspired him to start FOTP in Nigeria to help HIV patients.
"The essence of introducing the Psycho-Social Support Initiative is to help them regain hope and confidence in themselves because they feel once you test positive to HIV/AIDS, your world has come to an end," said Victoria Matthew, DHI's projects coordinator.
"Now, I really don't care what those who know my status say or think about me anymore," said Khadijah, adding that her hope for a happy life is revived.
In 2010, Khadijah remarried Ahmed Isa (not his real name), a vehicle inspection officer in Minna who is also HIV positive. Together, they have three children - all HIV-negative. Thanks to their parent's regular intake of antiretroviral drugs.
Fighting Child Marriage
Besides support to HIV patients, FOTP runs the Stella Maris Educational Foundation (SMEF), a school with primary and secondary sections into which FOTP admits poor children, including those whose parents are living with HIV. But there is another intention for the school.
Gloria Anyisadaje Male, desk officer of Orphans and Vulnerable Children at SMEF, said the school is used to fight child marriage. It gives special consideration to girls (especially those resisting early marriage) in a conservative Muslim north where parents give out their out-of-school girls as child brides for a dowry.
"From experience, marriage is what most families here know, especially the unexposed ones. They believe once a girl child is up to 13, the only thing to do is to get married," Nwadinobi Ifeoma, the school's principal, said, explaining why the school gives attention to young indigent girls.
However, the school (with its 40 staff) is also open to regular students whose parents can afford the tuition fees and other expenses. This allows the school to raise funds for sustenance besides donations. The school currently has 221 pupils and students, including 109 on full scholarship and another 27 on a partial scholarship.
Fifteen-year-old Achinanya Immaculate, a senior secondary school two student, lost her parents at age eight. Since then, she has lived with her parent's relatives, who want her to get married early, but she keeps resisting the pressure.
"I have a friend. She is already married and with a baby, but she is not happy in the marriage, and I feel for her," she said. "If I didn't have the opportunity to go to school, I would prefer learning a skill than being forced into marriage. I have an ambition of becoming a pilot in the future."
Yet, besides regular financial shortfalls, FOTP struggles to manage rising discrimination and stigmatisation from some students against those whose parents are HIV positive. They believe those with HIV-positive parents are positive too, and they disassociate themselves from them. FOTP tries to educate them that none of its students is positive, and even if some are, mere interaction does not transmit the virus.
This story was produced with the support of Nigeria Health Watch through the Solutions Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems.