10AM. October 10, 2001 .A moment that is hard to forget for one technical expert in coffee, cocoa and rubber planting, working for ANADER, a rural development agency based inCôte d'Ivoire. It is the day he first learned he was HIV positive.
Aka (this is an alias) was in a hospital in Abidjan, having traveled here to receive medical treatment.
Dr Badou Kouame
"He was one of my first patients to receive anti-retroviral (ARV) therapy, "says Dr Badou Kouame, ANADER's full-time doctor. "When I first treated him, he was suffering from a second episode of typhoid fever," explains Dr Badou. "He was also extremely thin and had a white tongue, diarrhea and a bad cold" he adds.
"When my doctor told me, I didn't react at all," says Aka. Speechless and emotionless, he could not bring himself to tell his wife until three months later. His wife has tested negative. Three years later, he has not yet told his nine children. He is too afraid.
"I must not get tired; otherwise my daughters will have to find other means of earning an income that could lead them to becoming at-risk for HIV infection," he worries.
Being Sick Costs Money
Aka is one of the eighteen hundred out of two thousand five hundred ANADER employees based in rural villages throughout the country at risk for HIV infection.
The 48-year old agricultural technician encourages groups of planters to organize themselves into cooperatives, informs them about new varieties that are more resistant to insects and trains them in techniques such as leaving enough space between each plant. He also teaches women how to work small plots of land with crops such as rice, eggplant, onion and cabbage so they can become more financially independent from their husbands.
At the beginning of his HIV infection when he was often absent from work, sixty agricultural advisers who depended on him for training could not be as productive. As a result, ANADER lost time and revenues.
Agricultural Technician: An at-risk Profession
Aka explains how his job favors having multiple sexual partners. The technician is what he describes a "modern man", who is single and has money to buy things such as televisions and radios. "When they arrive in villages with their motorcycles or 4x4 trucks, they are an immediate target as women think they have money to spend," he says.
ANADER technicians are often sent on long-term projects in villages far from their homes. Fifteen-day training sessions away from their homes and families are common.
"During these times when we are away from our families, we often go out and frequent night clubs and other at-risk places," he explains. "Also, keep in mind that we are in direct contact with women because we are training them to grow crops," he continues. "And they are often beautiful women", he slips in.
Aka was sent on a two-year assignment in a village in a remote area near Vavoua (439 kms in the north of Abidjan) far away from his wife and family. It was here he decided to live with a woman. He is pretty certain it was through sexual relations with her that he became infected with HIV. "I found out this woman died two years ago," he says.
Beneficiary of ANADER's HIV Solidarity Fund
He paid for his own HIV treatment for a year and a half (182,000 CFA or the equivalent of $353) until ANADER helped him out with the cost. The agricultural technician is now one of the eighteen ANADER employees currently benefiting from the fund.
He contributes 300 CFA ($.58) each month, approximately 0.1 percent of his monthly salary of 300,000 CFA ($582), to the HIV solidarity fund. This enables him to have access to anti-retroviral (ARV) therapy and other HIV-related care.
Every day, in the morning and in the evening, Aka takes 4 capsules and one tablet, consisting of a combination of three different ARV drugs.
ANADER covers eighty percent of the cost of any antibiotics he needs.
As of October 2004, if any of Aka's family should test HIV positive in the future, the rural development agency has committed to taking care of them too.
From HIV positive to Role Model
Aka has been participating in HIV/AIDS prevention campaigns on behalf of ANADER since before the breakout of the war in Côte d'Ivoire in September 2002. He was then based in a city in the northern part of the country. Armed with a video cassette on HIV/Aids transmission and a wooden penis to demonstrate to men how to use condoms, he traveled into neighboring villages to spread the message about HIV infection.
"It was difficult to speak about sex in the north since I was working mostly with Muslim people who believe that talking about sex is a taboo," he says.
In November 2002, rebels broke into his room and held him at gunpoint but he was lucky since the chief of the village where he was living negotiated his release. He then escaped by catching a ride with a friend who was a driver for the Red Cross.
Today he is part of ANADER's HIV/AIDS committee responsible for organizing prevention campaigns in a city 80 kilometers north of Abidjan, and its surrounding villages.