Ethiopian Burial Societies Join Fight Against HIV/AIDS

21 November 2008

(U.S. charity, government support the groups as they expand the mission)

By Phillip Kurata
Staff Writer

Addis Ababa, Ethiopia — Burial societies, which have helped people through the expense and grief surrounding death for centuries here, are expanding their missions to keep people alive as the HIV/AIDS epidemic exacts its toll.

Some 200,000 burial societies, known as idirs, are found throughout Ethiopia, and almost every Ethiopian is connected to one, either personally or through family.

The Tesfa community association in western Addis Ababa, an idir that has adopted a new name and broader mission, helps 4,300 orphans and vulnerable children as well as the elderly people who have become their caregivers.

“Many grandparents take care of their grandchildren because [the children’s] parents have died from AIDS,” said Tesfa chairman Berehnu Abera. “The demand for our services is rising because of the epidemic. The problem of orphans and vulnerable children is getting huge.”

Typically, idir members make small monthly payments to a communal fund. When a death occurs, the group arranges and pays for funerals and the traditional three- to seven-day mourning period.

Getting idirs involved in the war against the HIV/AIDS epidemic did not occur easily or instantaneously. “Many community elders opposed participation because of the stigma attached to the disease,” said Tesfa program officer Yonas Zewdu. “Now, in our district, there are very few HIV-positive people who are bedridden. Because the stigma has been lifted here, they have revealed their status and gotten medication and support.” He said, however, that the stigma remains strong in some rural areas.

Experts estimate that the epidemic has created millions of orphans and vulnerable children in Ethiopia. In urban areas, AIDS patients occupy about 60 percent of hospital beds. The U.S. Agency for International Development has partnered with organizations, such as Save the Children and local idirs, to involve them in home-based care for the patients. Through the President’s Emergency Program for AIDS Relief (PEPFAR), the United States provides $20 million from 2004 to 2009 to finance anti-AIDS programs in Ethiopia.

Idirs identify the orphans and elders in their communities most in need of assistance and organize educational programs to train families in how to care for the sick. They reduce the cost of home-based care by contributing their own human and financial resources, such as providing transportation to health care centers.

Tesfa organizes “community conversations” once every two weeks, where residents identify problems related to HIV and look for collective solutions. “This is a unique and highly effective approach that we are using in Ethiopia,” Zewdu said. “Elderly people who provide care to orphans are able to voice their concerns and receive community support in the form of counseling, food donations and financial assistance.”

Zewdu said that when trouble occurs in households with adopted children, Tesfa provides counseling to both caregivers and children.

“We try to keep children in homes and stop them from taking up life on the streets. We teach the children to respect elders and elders to be more self-reliant,” Zewdu said. He said that Tesfa also provides legal support for orphans who are exploited by adults.

Tesfa helps the community improve its finances by providing microloans and business training. For example, a small loan might go to help a woman buy hens, which lay eggs. The woman sells the eggs, makes money and repays her loan. Tesfa provided education and funding for an orphan who got training as a beautician and went on to open a beauty parlor in the neighborhood. Another received funding to build an oven in which to bake bread that gets sold to hotels.

“We found that giving money to very poor people who had no notion of saving and repaying loans was not useful,” Zewdu said. Extending loans to groups has been successful because neighbors pressure each other to repay the debts. Once a loan has been paid off, then people can qualify for new loans.