Anda di halaman 1dari 64

Kano State, Nigeria

Report of the In-Depth Assessment


of the HIV/AIDS Situation

Assessment Team:
Ekong Emah, FHI/Nigeria
Adamu Imam,FHI/Nigeria
Jummai Bappah, Consultant
Dr. Mustapha Nnamadi, Consultant
Dr. Shehu Umar, Consultant
Dr. Judith Walker, Consultant

FA M I LY H E A LT H I N T E R N AT I O N A L • FEBRUARY 2001
In-Depth Assessment Report

Table of Contents

PAGE

Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
1. Introduction/Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
2. Methodology and Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
3. Kano State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
3.1 Ministry of Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
3.2 Ministry of Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
3.3 Ministry of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
3.4 Ministry of Women Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
3.5 Ministry of Agriculture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
3.6 State Action Committee on AIDS (SACA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
4. Fagge Local Government Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
4.1 Site inventory and mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
4.2 Risk settings and populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
4.2.1 Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
4.2.2 Butchers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
4.2.3 Long-distance drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
4.2.4 Petrol sellers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
4.2.5 Male traders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
4.2.6 Male clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
4.2.7 Vulnerable women – Female traders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
4.3 Health facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
4.4 Care and support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
4.4.1 Public institutions providing care for PLHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
4.4.1.1 Sheik Mohammed Jidda Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
4.4.1.2 Infectious Disease Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
4.4.2 Private institutions providing care for PLHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
4.4.2.1 ECWA Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
4.4.2.2 Light Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
4.4.2.3 Assumpta Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
4.5 Community leaders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
4.6 Organisational assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
4.6.1 Nigerian Labour Congress (NLC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
4.6.2 Nigerian Union of Teachers (NUT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
4.6.3 National Association of Women Journalists (NAWOJ) . . . . . . . . . . . . . . . . . . . . . . . .28
4.6.4 Monitoring, Support and Mobilisation Group (MOSMDG) . . . . . . . . . . . . . . . . . . . . .28
4.6.5 Jam'iyyar Matan Arewa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
4.6.6 Muryar Jama'ar Fagge (Fagge Peoples Forum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

2
Kano State

5. Nassarawa Local Government Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32


5.1 Mapping and site inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
5.2 Risk settings and factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
5.3 High risk populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
5.3.1 Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
5.3.2 Male clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
5.3.3 Long-distance drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
5.3.4 Men with multiple partners – Butchers/meat sellers . . . . . . . . . . . . . . . . . . . . . . . . . .41
5.3.5 Male youth – Black market petrol sellers (Yan Cuwa Cuwa) . . . . . . . . . . . . . . . . . . . .41
5.3.6 Vulnerable women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
5.4 Care and support services in Nassarawa LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
5.5 Public institutions providing care for PLHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
5.5.1 Sir Mohammadu Sanusi Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
5.5.2 Mohammadu Abdullahi Wase Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
5.6 Private institutions providing care for PLHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
5.6.1 Ahmadiyya Muslim Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
5.6.2 Warshu Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
5.7 NGOs providing care and support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
5.7.1 Council of Positive People (COPOP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
5.7.2 Nassarawa Children's Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
5.8 Community leaders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
5.9 Organisational assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
5.9.1 Council of Positive People (COPOP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
5.9.2 Youth and Development Association (YEDA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
5.9.3 Nigerian Red Cross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
5.9.4 Tudun Wada Patriots Association and Gama Self-Help Group . . . . . . . . . . . . . . . . . .46
6. TarauniLocal Government Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
6.1 Site inventory and mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
6.2 Risk settings and factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
6.3 High risk and vulnerable populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
6.3.1 Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
6.3.2 Yan Cuwa Cuwa (Petrol Sellers) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
6.3.3 Men with multiple partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
6.3.4 Long-distance drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
6.3.5 Male clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
6.3.6 Vulnerable women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
6.4 Health facilities and sectoral responses to HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
6.5 Care and support of PLHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
6.6 Public institutions providing care for PLHA –
Aminu Kano Teaching Hospital (AKTH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57
6.7 Private institutions providing care for PLHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
6.7.1 Al Noury Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
6.7.2 Premier Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
6.8 NGOs providing care and support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
6.8.1 Society for Women and AIDS in Nigeria (SWAAN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
6.8.2 Council of Positive People (COPOP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
6.9 Community leaders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
6.10 Organisational assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

3
In-Depth Assessment Report

List of Tables
Fagge Local Government Area
Demographic information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Residential characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Primary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Secondary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Vocational schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Quaranic and special schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Size of target populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Sex workers and brothels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Prices charged by sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Bars and clubs where sex workers operate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Streets where sex workers meet clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Truck and bus companies that pass through this site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Estimated number of trucks and buses entering or leaving site daily . . . . . . . . . . . . . . . . . . . . . . . .18
Estimated number of trucks and buses parking overnight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Places trucks and bus drivers park at night . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Guest houses, hotels, motels and lodgings frequented by truck and bus drivers . . . . . . . . . . . . . . . .19
Bars and clubs frequented by truck and bus drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Places and locations truck and bus drivers find sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Youth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Major marketplaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Number of public facilities in Fagge LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Number of private facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Estimated number of pharmacies and drug stores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Profile of facilities in Fagge LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Profile of facilities by type of HIV/AIDS service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Non-governmental organisations working in HIV/AIDS prevention and
care and reproductive health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Total number in formal employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Religious denominations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Professional and trade associations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Major community groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Guesthouses, motels, hotels and lodgings frequented by mine and oil workers . . . . . . . . . . . . . . . .31
Farms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Construction companies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Media people read, watch or listen to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

4
Kano State

Nassarawa Local Government Area


Demographic information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Total number in formal employment at this site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Residential characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Size of target populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Number of public facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Number of private facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Estimated number of pharmacies and drug stores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
Primary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Secondary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
Tertiary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Quaranic and special schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Sex workers’ hostels and brothels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Bars and clubs where sex workers operate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Streets where sex workers meet clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Prices charged by sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Truck and bus companies that pass through this site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Estimated number of trucks and buses entering or leaving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Estimated number of trucks and buses parking overnight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Places truck and bus drivers park at night . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Guesthouses, hotels, motels and lodges frequented by truck and bus drivers . . . . . . . . . . . . . . . . . .40
Bars and clubs frequented by truck and bus drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
NGOs providing care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
Farms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Construction and other companies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46

Tarauni Local Government Area


Demographic information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Size of target populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Residential characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Religious denominations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Major marketplaces and their locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Social institutions (educational)
Primary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Secondary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Tertiary and vocational schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Total number in formal employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Professional and trade associations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Sex workers’ hostels and brothels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Bars and clubs where sex workers operate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Streets where sex workers meet clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Prices charged by sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Youth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Truck and bus companies that pass through this site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Estimated number of trucks and buses leaving site daily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Estimated number of trucks and buses parking overnight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Places truck and bus drivers park at night . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Guesthouses, hotels, motels and lodgings frequented by truck and bus drivers . . . . . . . . . . . . . . . .54
Bars and clubs frequented by truck and bus drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Number of public facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Number of private facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Estimated number of pharmacies and drug stores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Profile of health facilities in Tarauni LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
HIV/AIDS services provided . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
NGOs working in HIV/AIDS prevention and care and reproductive health . . . . . . . . . . . . . . . . . . . . .57
Major community groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Media read, watch or listen to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

5
In-Depth Assessment Report

Acronyms
AHIP Adolescent Health and Information Project
AIDS Acquired Immune Deficiency Syndrome
AIDSCAP AIDS Control & Prevention Programme
AIDSTECH AIDS Technology Project
AKTH Aminu Kano Teaching Hospital
CBO Community-based organisation
CHEW Community health extension worker
CRD Centre for Research and Development
COPOP Council of Positive People
DOTS Directly observed therapy, short-course (for tuberculosis)
ECR Expanded comprehensive response
FSW Female sex workers
FHI Family Health International
FGD Focus group discussions
GHON Grassroots health organisation
GRA Government Reserved Area
HQ Headquarters
IDH Infectious disease hospital
IMPACT Implementing AIDS Prevention and Care Project
LACA Local Action Committee on AIDS
LDDS Long-distance drivers
LGA Local Government Area/Authority
MSO Muslim Sister Organisation
MTCT Mother-to-child transmission (of HIV)
NACA National Action Committee on AIDS
NAWOJ National Association of Women Journalists
NGO Non-governmental organisation
NLC Nigeria Labour Congress
NNPC Nigerian National Petroleum Corporation
NTA Nigerian Television Authority
NUPENG Nigerian Union of Petroleum and Gas
NURTW Nigerian Union of Road Transport Workers
NUT Nigerian Union of Teachers
PLHA Person/people living with HIV/AIDS
SACA State Action Committee on AIDS
STD/STI Sexually transmitted disease/infection
SWAAN Society for Women and AIDS in Africa, Nigeria Chapter
TB Tuberculosis
TOT Training of trainers
USAID United States Agency for International Development
UNICEF United Nations International Children’s Emergency Fund
VCT Voluntary counselling and testing
VOA Voice of America
WHADNET Women Health and Advancement Network
YEDA Youth and Environmental Development Association
YOSPIS Youth Society for the Prevention of Infectious Diseases and Social Vices

6
Kano State

Executive Summary
Family Health International (FHI) Nigeria conducted an Major Findings
in-depth assessment in Kano State as part of re-designing
its on-going IMPACT project funded by the United States Kano State’s mix of ethnic groups, lifestyles, and demog-
Agency for International Development (USAID). The re- raphy makes it highly susceptible to contracting and trans-
design is intended to develop comprehensive programs in mitting HIV/AIDS. Since Shari’a has been adopted as the
key risk areas for both HIV/AIDS prevention and care. state religion, FSW operate clandestinely. Reaching them
Three Local Government Areas (Fagge, Nassarawa and with information and education might be problematic.
Tarauni) were assessed in Kano State.
In all three LGAs, the general population have access to
The assessment was conducted simultaneously in various health facilities where HIV/AIDS care and support can be
parts of Nigeria 15 - 21 February 2001. Objectives of the provided. Very active NGOs (especially SWAAN and
in-depth assessment in Kano State – as in other parts of COPOP) also operate here, providing care and support to
Nigeria – included: PLHA, and many health workers are willing to be
involved in providing such care.
• Identifying STI/HIV/AIDS risk factors and prevention
and care opportunities in the three LGAs; There is little or no funding from the state government for
HIV/AIDS prevention and care activities. These activities
• Obtaining data for designing a strategic plan for are not considered a priority at any level; this may be a
STI/HIV/AIDS prevention and care initiatives in prior- major reason for the lack of funding. Only one of the
ity communities; and LGAs assessed had HIV/AIDS budgeted for in this fiscal
year. And while there is a NACA at the federal level, there
• Developing a standard assessment tool/methodology are neither SACA nor LACAs at state and local levels in
that planners can use to evaluate risks, identify pre- Kano. Nor is there any standardisation or coordination of
vention and care opportunities and design coordinated HIV/AIDS activities among the public and private organi-
state/LGA level STI/HIV/AIDS prevention and care sations providing care and support here. In addition, drugs
initiatives. are rarely available at those facilities that do provide care.

FHI conducted the in-depth assessment in collaboration Knowledge and skills about current concepts in the syn-
with stakeholder representatives. The assessment utilized dromic management of STDs, tuberculosis or HIV/AIDS
multiple data collection methods such as: care are minimal. This is compounded by the fact that
organisations like SWAAN and COPOP have little effect
• Site mapping on public and private health facilities or the general pop-
• Site inventory ulation.
• Key informant interviews
• Structured questionnaires for collecting information Even though it is apparent that the general population
on care and support facilities and activities –especially STD patients – should be counselled on con-
• Life histories dom use, the cultural and religious circumstances of Kano
• Structured organisational assessment questionnaire State hinder condom promotion. Health workers and
• Focus group discussions with FSW and PLHA facilities refer all suspected HIV cases to the IDH, causing
• Ethnographic survey stigmatisation: anyone going to the IDH is believed to
have contracted HIV. Such referral also discourages a
Information was collected from various sources including comprehensive-care approach at other facilities.
public officers, private healthcare providers and facilities,
NGO executives, community leaders and members of It is pertinent to note that manuals and guidelines regard-
high-risk and vulnerable groups. ing syndromic management of STDs, TB management,
HIV/AIDS clinical guidelines and HIV/AIDS home-based
care guidelines have not been distributed or disseminated
to health facilities and providers. This affects their ability
to function effectively and adequately train new workers.

7
In-Depth Assessment Report

Recommendations

1. Make officials at all levels of governments aware of


the magnitude of the HIV/AIDS problem and existing
strategies for lessening its effects.

2. Improve and strengthen linkages and coordination of


all parties involved in HIV/AIDS control activities.

3. Reorient health facilities towards the provision of


HIV/AIDS care and support.

4. Train and re-train health personnel on syndromic


approach to STD case management, DOTS strategy
for tuberculosis and clinical and home-based care for
PLHA.

5. Improve awareness and encourage participation of


community members to stimulate the formation and
strengthening of community-based care and support
groups for PLHA.

6. Launch information and education campaigns to de-


stigmatise HIV/AIDS in the community.

7. Encourage greater involvement of private practitioners


in HIV/AIDS activities (including STD treatment and
TB management), since they see a significant number
of people with HIV/AIDS, STDs and TB.

8
Kano State

1. Introduction/Background
Family Health International (FHI) is a private voluntary For the proposed comprehensive program under IMPACT
organisation based in the United States. FHI has more re-design and Expanded Country Response (ECR), FHI
than 30 years of experience in reproductive health, partic- suggests a participatory process:
ularly in the areas of family planning and HIV/AIDS.
With funding from the United States Agency for • Rapid assessment in selected states and LGAs
International Development (USAID), FHI has, for over a • Selection and orientation of partners
decade, been working in HIV/AIDS programming in • In-depth assessments
Nigeria (AIDSTECH 1998-1991; AIDSCAP 1992-1997; • Project design
Bilateral Grant Agreement 1997-1998; and the IMPACT • Project implementation and evaluation
Project that began in 1998). Over these years, FHI has
developed excellent collaborative relationships with pub- This overall comprehensive approach strives to establish a
lic- and private-sector organisations in Nigeria, including synergy of effort to ensure the link between prevention
non-governmental and community-based groups. and care and between related high-risk and vulnerable
populations.
In the initial phase of the IMPACT project, FHI worked
with a variety of NGOs and national organisations to In Kano State, FHI identified three LGAs as key risk areas:
develop pilot initiatives for high-risk groups. During the Fagge, Nassarawa, and Tarauni. Rapid assessment was
next phase of the project, FHI – working closely with the conducted in the three LGAs; the findings led to the in-
National Action Committee on AIDS (NACA), state and depth assessment reported here.
local governments – will concentrate on lessons learned in
key high-risk areas in Nigeria. The goal of the second
phase of the project is to develop comprehensive pro-
gramming in key risk areas for both prevention and care.
This will entail working with local governments and high-
risk and vulnerable groups to develop strategic plans of
action and ensure that their care and support needs are
met. FHI will also help them work with national organi-
sations and structures, drawing on FHI’s collaborative
experiences with the military, police, unions and schools.

To begin the second phase of the IMPACT project, FHI


conducted a desk assessment of high-risk areas in Nigeria.
Based on the prevalence rates and existence of such set-
tings, FHI identified a number of key states, from which
four were selected for initial assessment: Anambra, Kano,
Taraba and Lagos. Based on findings of this assessment,
FHI decided to proceed with comprehensive programmes
and interventions in the four states.

9
In-Depth Assessment Report

2. Methodology and Objectives


Before beginning in-depth assessment activities, FHI visit- The in-depth assessment’s objectives were to:
ed state and local government officials to discuss the issues
involved; other visits were intended to mobilise stakehold- 1. Identify STD/HIV/AIDS prevention and care opportu-
ers and target groups for support nities.

A pre-activity planning meeting was held in Lagos 4-9 2. Obtain data for designing a strategic plan for
February 2001 to finalise and adopt the research tools to STD/HIV/AIDS prevention and care initiatives in pri-
be used. A training of trainers (TOT) workshop was also ority communities.
organised in Lagos at which key FHI/HQ, FHI/Nigeria
staff and selected local and international consultants par- 3. Develop a standard assessment tool/methodology that
ticipated. The objective of the TOT was to train partici- planners could use to evaluate risk, identify preven-
pants in use of the research tools. After the training ses- tion and care opportunities and design grounded coor-
sions, all research tools were pre-tested in selected loca- dinated state and LGA level STD/HIV/AIDS preven-
tions in Lagos. One objective of this pre-test was to assess tion and care initiatives
the ability of respondents to understand the questions.
Based on lessons learned from this pre-test, tools were
then edited and finalised.

The in-depth assessment in Kano State, as in other states,


was preceded by a three-day training workshop for pub-
lic-sector and NGO field enumerators in the selected
LGAs (12-14 February 2001). This session was intended
to familiarise field enumerators with the instruments and
ensure standard administration of the tools for uniform
data collection.

The enumerators and three local consultants were divided


into three teams, with each responsible for one LGA.
Stakeholder representatives were assigned to teams, based
on their experience and knowledge of the area’s HIV/AIDS
programming. The fieldwork lasted six days (15-21
February 2001).

A plethora of both qualitative and quantitative data col-


lection methods were utilized, including:

• Site inventory
• Key informant interviews with officials of local gov-
ernment and communities
• Mapping
• Structured questionnaires for collection of information
on care and support facilities and activities
• Life histories
• Structured organisational assessment questionnaires
• Focus Group Discussions (FGD) with target groups
(FSW and PLHA)
• Ethnographic survey

10
Kano State

3. Kano State
Kano City in northern Nigeria is the capital of Kano State. the agency maintains that it needs more staff and more
The historical city has several districts, including an indus- women community mobilisers.
trial center (Bompai) and the old city, which is walled and
contains many clay houses. Principal industries include The ministry is also seeking funds from UNICEF and
peanut production and the manufacture of Morocco NACA.
leather goods, metal ware and cotton. Kano also has a
large trade in the farm produce and livestock of the sur-
rounding area. The area’s trading history dates back to the 3.2 Ministry of Education
trans-Saharan era, and remains the commercial nerve cen-
tre of Nigeria. The region was one of the seven original Since the creation of Kano State 34 years ago, this agency
Hausa States, dating from AD 900; Islam was adopted has consistently received the greatest fiscal allocations
probably between the 12th and 14th centuries. The area from government because of its immense importance to
was taken by the Fulani in the 19th Century and held by the growth and development of the society. Along with
them until 1903, when it was seized by the British. the Ministry of Health and other stakeholders, Education
Population (1992 estimate): 699,900. Governance, as in actively participates in public enlightenment programmes
all Nigerian states, is three-tiered. on STDs/HIV/AIDS, especially those undertaken through
the formation of clubs and associations in schools. These
programmes urge protection against AIDS, but have been
3.1 Ministry of Information hampering by inadequate funding. The ministry has been
trying to secure funds through the involvement of tradi-
The Ministry of Information reported that SACA/LACAs tional institutions and communities. The ministry organ-
have not been established in the state. As the voice of state ises seminars and workshops and produces publications to
government, the ministry is responsible for creating aware- enlighten the public about STDs/HIV/AIDS.
ness about HIV/AIDS, and has a strategic or action plan
that addresses STD/HIV/AIDS. This includes touring all
44 Kano Local Government Areas (LGAs) on advocacy 3.3 Ministry of Health
visits and strategies. The latter include public enlighten-
ment campaigns and film shows about the deadly disease. This agency’s main STDs/HIV/AIDS responsibilities are
The ministry is currently producing video documentaries to planning, implementation, monitoring and evaluating
highlight the scourge of HIV/AIDS and other STDs. HIV/AIDS activities in the state. Priorities include infor-
mation, education and communication, safe blood trans-
Execution of these programmes has mainly been hindered fusion, and home-based care. The ministry has logistics
by a lack of funds. However, the agency has included its problems in the implementation of home-based care serv-
AIDS action programme in the current budget. ices, but intends to address them by recruiting trained
counsellors and seeking funds and support for its
The ministry also produces pamphlets to educate the pub- HIV/AIDS programmes. At present, the Ministry of
lic about STDs/HIV/AIDS. As part of their efforts to sup- Health is working through the Ministry of Education,
port HIV/AIDS programs, the ministry’s department of labour organisations and other NGOs in the area of
youth is trying to create awareness among young people in HIV/AIDS.
the state. Youth and information officers for HIV/AIDS
programmes are stationed in all 44 LGAs. At present, the HIV/AIDS programmes are included in this year’s Health
agency has budgeted N800,000 for such programmes. But budget. The ministry has assigned the following personnel
only N350,000 has been released – not enough to run the to the HIV/AIDS programme: two doctors, one nurse, one
programmes. community health extension worker (CHEW) and one
messenger. Additional staff is needed, such as health edu-
This funding (in the form of both money and equip- cators, laboratory technologists, counsellors, social work-
ment)was used to tour and show films in all LGAs, ers and medical records workers.
arrange seminars for LGA information officers and pro-
duce video documentaries. At present, the Ministry of
Information has 44 community mobilisers, 44 trained
counsellors and 29 photographers in the LGAs. However,

11
In-Depth Assessment Report

3.4 Ministry of Women Affairs 3.6 State Action Committee on AIDS (SACA)

This ministry’s main HIV/AIDS activities are public There is no SACA in Kano State. However, there is a State
enlightenment and mobilisation of women. The AIDS Control Programme (SACP) and a State AIDS
STDs/HIV/AIDS campaign is not a priority. Its AIDS Programme Coordinator. The SACP has two doctors, a
awareness activities are channelled through the depart- nurse, a senior health extension worker and a messenger.
ment of women affairs, dealing with NGOs that are main- This staff strength is not sufficient; additional personnel
ly concerned with PLHA or which support HIV/AIDS pro- are needed – especially health educators, laboratory tech-
grammes: SWAAN, GHON, and MSO. nicians, trained counsellors, social workers and medical
record staff/statisticians.
The ministry has not budgeted anything for HIV/AIDS
activities during the 2000/2001 fiscal year, but intends to The coordinator’s main responsibilities are planning,
include it in next year’s budget. implementing, monitoring and evaluating HIV/AIDS
activities in the state and coordinating groups involved in
such activities.
3.5 Ministry of Agriculture
STI/HIV/AIDS priority areas include disseminating infor-
This ministry noted that it is not responsible for health in mation, education and communication (IEC) about these
the state, but acknowledged that the threat of HIV/AIDS infections, ensuring safe blood-transfusion services and
is real and that each level of government should contribute providing care and support for HIV/AIDS victims. Only
to educating people about risks. Respondents said they programmes that address safe blood-transfusion and IEC
believe more efforts should be placed on eradicating the are currently in effect.
disease.
Funding for SACP activities is grossly inadequate: fifty
percent comes from international donors and 25 percent
each from government and local fund-raising/national
organisations. No money was released from the govern-
ment for HIV/AIDS programs for the years 1999/2000.

The state health department meets monthly; HIV care is


discussed only occasionally. The last time was two
months before this survey; the topic was provision of anti-
tuberculosis drugs. There is no training program for
HIV/AIDS care in the state.

12
Kano State

4. Fagge Local Government Area


Demographic information

Permanent stable population 1.4 million

Temporary population 210,000

Fagge Local Government was carved out of Nassarawa


LGA on 4 December 1996. Between 1996 and the election
of the first democratically elected chairman in 1998, Fagge
was governed by a sole administrator. Fagge is largely a
settlers’ area inhabited by people from other parts of
Nigeria and from neighbouring countries such as Niger
and Ghana. It shares a boundary with Ungogo LGA to
the north, Nassarawa to the east, Kano Municipal to the
south and southwest and Dala to the west. The main
wards in the LGA are Sabon Gari, Nomansland,
Kwakwaci, Gama - Kwari and Kurna (Rijiyar Lemo).
Others are Dan - Rimi, Kwacirin Dikko, Kwacirin Jobe
and Alfa. Fagge Central is a large and important ward
from which the LGA got its name. All wards listed above
were covered in the assessment.

Residential characteristics
Residential characteristics Total number of settlements Average number of people
per household

Low-density 5,000 8
Middle density 10,003 8
High density 5,007 23
Slums - -
Rural 6 14

13
In-Depth Assessment Report

4.1 Site inventory and mapping

Fagge LGA is the commercial nerve centre of Kano State.


The largest market in the state – the Sabon Gari market
(also known as Abubakar Rimi Market) – is located here.
Kwanar Singer, Mayanka and Kurmi are also major com-
mercial centres. Fagge has a few rural settlements, such as
the villages of Kwacirin Dikko and Kwacirin Jobe. These
are in sharp contrast to the bustling nature of the Sabon-
Gari area with its many commercial activities.

The population of Fagge LGA, which is estimated at 1.4


million, lives in a relatively small land area. Despite this
high density, Fagge has comparatively few public facilities
(i.e., schools, hospitals and clean water). The dearth of
these facilities is probably responsible for the large num-
ber of private-sector providers. For example, in Sabon
Gari area, there are only three public secondary schools,
but 25 private secondary schools were identified. About
150 chemists and medicine stores were found in the area.
Several vendors sell jerry cans of water drawn from pri-
vately owned taps.

Social institutions (Educational institutions)

Primary schools
Name Type Males Females Total

Fagge Special Primary School Public 3,000 1,800 4,800

Kuka Primary School Public 4,000 2,000 6,000

Muktariyya Primary School Public/Islamic 1,800 2,000 3,800

Kurna Primary School Public 2,500 1,200 3,700

Aunty Nursery & Primary School Private 300 200 500

Danware Private 1,200 1,500 2,700

Zawai Private 1,000 1,200 2,200

Researchers Private 200 300 500

Queens Private 800 200 1,000

Queen Education Private 250 500 750

Fuddiya Primary School Private

Alfa Primary School Public 61 39 100

Kwachinrin Fobe School Public 70 50 120

Famous Primary School Private

Hope Primary School Private 472 300 772

Gobrirawa Special Primary School Public

14
Kano State

Secondary schools
Name Type Males Females Total

Govt. Commercial Secondary School Public 3,000 Nil 3,000

Maikwatachi Secondary School 1,000 2,500 3,500

Tony Cheta 1,500 2,000 3,500

Abbas Maje 1,800 2,500 4,300

Standard Comprehensive 500 1,000 1,500

Maryam Abacha Public Nil 5,000 5,000

Kwakwachi Public 5,500 Nil 5,500

Mamman Vice School Public 6,000 Nil 6,000

Hope Secondary School Private 28 14 42

Army Day Secondary School Private

Vocational schools
Name Type Males Females Total

Sani Abacha Women Public Nil 1.000 1,000

Quaranic and special schools


Name Type Males Females Total

Shahadtul Private 170

Dinil Islamiya Private 100 80 180

Tawirru Islamiya Private 120 180 300

Umar Khattab Private 90 170 260

Taalimu Quaran Private 500

Nahadatu Islamiya Private

Haydu Islamiya Private 300 4,000 4,300

Mai Kwaru Private 1,500 3,000 4,500

Muktariya Private 3,000 2,500 5,500

Samarul Islamiya Private 2,500 3,500 6,000

There are about 35 Islamic schools, with an estimated female


population of 16,000, bringing the estimated total to 25000

15
In-Depth Assessment Report

4.2 Risk settings and populations

The risk settings for HIV/AIDS in Fagge LGA are the


result of overcrowding, poverty (especially among
women), pockets of males with a high level of discre-
tionary income from petrol selling or other such activities
and large numbers of migrants and cross-border traders.
But perhaps the most significant risk cause of this local
government is its historical role as the entertainment and
vice capital of Kano State. Fagge is a veritable zone of
freedom, with the highest concentration of brothels and
bars in the state.

Size of target populations


Target population Population

Commercial sex workers 2,015

Migrant labourers 3,000

Farm workers 2,000

Fishermen/women NA

Construction workers 10,500

Uniformed government employees (Customs, 2,000


Police, Immigration, Defence Forces, Navy,
etc.)

In-school youth 25,000

Out-of-school youth 8,000

Street youth/area youth 3,000

Petty traders 10,000

Truck drivers and bus drivers 1,200

With the introduction of Shari’a as a state law in Kano, In addition to FSW, other high-risk groups include butch-
many businesses were rendered illegal (their licenses were ers, men with multiple partners, long distance drivers,
revoked) and closed. These include bars, brothels and petrol sellers (Yan Cuwa-Cuwa) and motorcycle drivers
other places where FSW work. Because Sabon Gari is (Yan Acaba). Vulnerable women such as low-income
multi- cultural and a settlers’ ward, it has remained the earners who trade or wash plates constitute another
major area in Kano where beer parlours and FSW work in important group in determining risk settings and risk fac-
large numbers. Bukavu Army Barracks and its women-run tors.
Mammy Market also have many FSW. Still more are
found in the beer and burukutu shops. They come from
within and outside the barracks. These two locations
(Sabon Gari and Bukavu) give Fagge LGA the highest inci-
dence of FSW and risk settings.

16
Kano State

4.2.1 Female sex workers Within the Sabon Gari ward itself, different locations for
This section focuses on women who render sexual favors and types of FSW were identified. The highest density is to
for money, as opposed to vulnerable women who occa- be found in the areas around Weatherhead, Sani Giwa,
sionally have casual sex for payment in cash or kind. The Abedi and Odutola roads. While some FSW are resident in
FSW often proudly assert, ‘I be Ashawo, wetin?’ (I am a motels within the area, others come from the old city
prostitute; what’s your business?). They get paid between nightly and return home next morning. Residents in parts
N100 and N200 per round and N250 or more per night. of Fagge such as Layin Jahannama believe that FSW come
In addition to the Bukavu barracks, beer and burukutu from outside their own area.
shops in the Mammy Market attract sex workers both
from within and outside of the barracks. Their busiest
Bars and clubs where sex workers operate
times are between 7 pm and midnight.
Names Names

Kandara Palace Akija Hotel


Type Number
Gab Hotel Guest Inn – Kano
Permanent sex workers 3,500
Kano Casino Moulin Rouge
Visiting sex workers 600
Uche Best Coolspot Body & Soul

Mingles Exclusive Roxy Amusement Park

Sex workers and brothels Bays Water Hotel Blue Circle


Name Address Jonas Star Paro
Gidan Sauro Fagge D1 Kwarin Gogau Midwest Honeymoon Hotel
Gidan Audu Baki Banza Fagge D2 Kwarin Gogau Briggy
Gidan Tinttinbo Fagge A Embahel Line

Gidan Chamadan Fagge B Ta’al Road

Gidan Bam Fagge A Plaza Streets where sex workers meet clients

Gidan Kalala Fagge A Plaza Ibrahim Taiwo Road New Road

Lungun Macizai Fagge D2 Triumph/Wapa IBB Way Abedie Road

Bays Water Hotel Onitsha Road, Sabon Gari Civic Centre Road Freetown Road

Jonas Star Church Road

Midwest

Bricity
While some FSW are selective and accept only special
Blue Circle boyfriends, others take all clients. The introduction of
Shari’a in Kano State has greatly increased their business
Paro
in popular bars. Many FSW reported being less selective,
Honeymoon but using the demand to raise their rates. Barmen and
brothel owners who were key informants in this research
stated that condom use is low and there is no effort to per-
suade sex workers to use condoms – despite the fact that
Prices charged by sex workers most people know about AIDS.
Round Night
Sex workers expressed fears about having enough money
Jigawala N500 N500 or food and drinks and about eventually leaving the business.
Okoto N100 N300

Hawkers N50 Food and drinks/any amount

17
In-Depth Assessment Report

4.2.2 Butchers LDDs are usually married, with families in other states;
The butchers in Fagge attest to the long-held Hausa tradi- they are between the ages of 26 and 48. They do not take
tion that butchers like to associate with ‘free women’. prostitutes in the motor park, but follow the women to
They pride themselves on their virility and meet FSW in their rooms in Sabon Gari. There seems to be a great affin-
hotels and social clubs. One butcher interviewed boasted ity between the FSW and the LDDs. As one LDD said, ‘We
of having several sexual partners even though he is mar- think that the girls are OK. Just prostitutes doing their
ried. He does not use a condom with any of them and thing like us’. The LDDs interviewed along Galadima
seeks traditional cures for STIs. He does not see his sexu- Road reported that while some people viewed them as ras-
al behaviour as risky, but as evidence of his manhood. cals, others considered them professionals.

If they contract STIs, the drivers say they go to a doctor,


4.2.3 Long-distance drivers (LDDs) but try to avoid such diseases by using condoms.

Truck and bus companies that pass through this site


LDDs are members of the National Unions of Road
Truck Bus Transport Workers. They listen to radio and watch TV when
they can. They hope to make a lot of money but police
Dangote Salisu Adamu Fagge
wahala and armed robbers are their greatest concerns.
Nagero Sakwaya Line

Inland Containers Kokiya Transport Places trucks and bus drivers park at night

Fagge Transportation Lafiya Jarin Taraka Places Places

Salisu Adamu Fagge Gobir Transport Ibrahim Taiwo Road by Galadima Road
Unity Road
Shakka Babu Baba Brothers
Singer Church Road
Chami Cup Mai Yaya Transport
Niger Street New Road
Ekwenibe Motors Ekene Dili Chukwu
Bello Dandago Abeokuta Road
Brothers Group New Tarzan
Ibrahim Taiwo Road Warri Road
Chijioke P.N. Emera by railway

G.U.O. Okeke F.G. Onyenwe Skan Park Aitken Road

The Young Shall Grow

Estimated number of trucks and


buses entering or leaving site daily

1,030

Estimated number of trucks and


buses parking overnight

220

18
Kano State

Guesthouses, hotels, motels and Places and locations where truck and
lodgings frequented by truck and bus drivers bus drivers find sex workers

Name Location Name Location

Akija Hotel Katsina Road Abedi, Sanin Giwa,


Ibadan Road, Gold Coast,
Kano Guest Inn Ibrahim Taiwo Road Free Town etc.

Criss Park 35 Warri Road Plaza Plaza – Fagge

Nova Guest Inn 34 Warri Road Murtala Muhammed Way near camp by Akija Hotel

Motel La Miracle 29 Enugu Road Bukav Gate Katsina Road

Motel De Mikela 9 Church Road Roxy Airport Road

Take Your Choice 8-9 France Road Briggy Hotel 20, Sanyaolu Street

Mairabo Aitken Road Obanta 10, Church Street

Sky World Niger Road Midwest Sanyaolu

Bayswater Onitsha Road

Ogidi Harmony Enugu Road

Bars and clubs frequented by truck and bus drivers Metro Hotel Abeokuta Road

Name Location

Akija Hotel Katsina Road

Kano Guest Inn Ibrahim Taiwo Road

Peoples’ Club 37 Warri Road

Oyoyo 17 Warri Road

Great Nigeria 30 Abeokuta Road

Dallas Weatherhead

Forest Bar Enugu Road

Denco Church Road

19
In-Depth Assessment Report

4.2.4 Petrol sellers 4.2.6 Male clients


Petrol sellers are in the high-risk group, since they pay fre- Because of the high concentration of sex activity in the
quent visits to FSW. In the Fagge LGA the lifestyle of Sabon Gari area, male clients in the Fagge LGA represent
petrol sellers involves drug abuse and visits to cinemas a wide cross section of the men who visit FSW in Kano
(also a place for meeting FSW), a youth-gang culture and State. Their ages, socio-economic groups and occupations
fighting with other gangs. Sexual networking is very wide- vary widely. However, the type of male clients who fre-
ranging, including sugar mummies, girlfriends, sex work- quent a particular bar or motel are similar to one another.
ers and female hawkers.
Condom use is low among FSW and their clients. Men
They do not use condoms although they have heard about with multiple partners and FSW clients (as listed above)
HIV/AIDS. confirmed this assertion. One regular client said that he
would not use condom because it ‘diminishes pleasure’.
Petrol sellers in this LGA have high aspirations and are
optimistic about the future. They are members of informal
Youth
associations and consider sports personalities and musi-
cians as their role models. Estimated number of out-of - 2,000
school youth

Number of employed out-of- 500


4.2.5 Male traders school youth
Male traders in the Fagge LGA are important sellers of
secondhand goods and motor-vehicles. They also import
textiles and engage in money exchange in the WAPA area.
Condoms
The most prosperous ones do not make cross-border jour-
neys themselves, but have trusted young men (runners) Estimated number of places sell- 130
ing condoms
who travel for them. They are the ones most at risk of
infection because of their lifestyle and work. Several of the Estimated number of condoms 5,000
young men report visits to sex workers in the Republic of sold monthly
Niger, Benin Republic and other neighbouring countries.
While they often have enough money to get married, they
continue to see FSW and special girlfriends. Runners also
admit to visiting sex workers in the Sabon Gari area.

20
Kano State

4.2.7 Vulnerable women – Female traders A key informant interviewed was aware of AIDS, but did
Female petty traders make up one of the most significant not know the name of the disease. The women know
groups of vulnerable females in this LGA. While some about STIs generally, and worried especially about gonor-
women are by no means petty traders, others are indeed rhea – a disease which many have had. When affected,
small-scale sellers with no access to capital. They buy and they visit traditional herbalists for cures.
sell low-cost goods such as second-hand clothing and
shoes. Many in this area move back and forth to Kasuwar They are not aware of condoms and may have never seen
Rimi in Yakasai ward of the Metropolitan LGA, where one. The PRO of the women petty traders association in
they have stalls. Hajji Camp says that he does not believe people can get
AIDS through manicures or pedicures; he thinks AIDS can
only be contracted through sexual activity.
Major marketplaces
Name Location
Radio Kano, Radio Kaduna, VOA and BBC are the main
Gadar Karuwai Market Rigiyan Lemo media listened to, in this order. The petty traders are not
fully incorporated into the traders association. Hopes for
Kwari Market IBB Way/Plaza
the future have to do with care for children while fears
Mayanka (Butchers Murtala Muhammed/IBB concern national level politics and the fact that ‘Nigerian
Market) Way leaders are not truthful’. They also expressed fear of
Abubakar Rimi (Sabon-gari) Skiri plainclothes law enforcement agents in the Pilgrim Camp
area (ciwon sanyi).
Yarkina Market Yarkina

France Road Night Market France Road

Rijiyar Lemo

Petty traders interviewed were illiterate, between the ages


of 25-40 and with little capital of their own. These traders
often have casual partners who give them money for sex-
ual favors. They do not consider themselves to be prosti-
tutes but rather see themselves as poor women.

21
In-Depth Assessment Report

4.3 Health facilities

Two public and three private health facilities were covered


in the assessment in Fagge LGA. All these hospitals pro-
vide some form of clinical care to patients with HIV-relat-
ed illnesses. They offer a wide range of services including
a traditional healer in one hospital. Below is a summary
profile of the hospitals:

Number of public facilities


Type of facility Number

Tertiary Hospital Nil

General Hospital 3

Primary Health Centre 6

Others 2

Number of private facilities


Type of facility Number

Hospital 30

Clinic 18

Nursing Home 2

Estimated number of pharmacies and drug stores

279

Many private clinics and chemists were not open at the


time of the exercise. Key informants said the places were
closed following the latest Kano ethnic crisis.

22
Kano State

Profile of facilities in Fagge LGA


Name Status Doctors Nurse Clinic officers Trained Lab. tech.
HIV/AIDS
counsellors

Sheik Mohd Public 7 62 20 2 1


Jidda Hospital (plus 4 part -
time with coun-
sellng skills)

Infectious Disease Public 3 52 10 2 2


Hospital (IDH)

ECWA Hospital Private 4 11 35 3 3


(faith- based)

Light Clinic Private 2 4 1

Assumpta Clinic Private 2 8 4 2 2

Profile of facility by type of HIV/AIDS service

Name of clinic/ hospital Screening Counselling Medical man- MTCT Population Average num-
agement of Prevention of catchment ber of STI/HIV
HIV/TB area patients
(estimated) monthly

Sheik Mohd Jidda _ _ _ _ 750,000 44 (29 males,


Hospital (15,000 15 females) in
needing HIV the month
care) preceding this
survey

Infectious Disease - - - - entire state 90 - 150


Hospital (IDH)

ECWA Hospital - - - - - 5

Light Clinic - - - - - 5-8

Assumpta Clinic _ _ _ _ - 8

23
In-Depth Assessment Report

4.4 Care and support

Care for HIV-positive patients in Fagge LGA is mostly pro-


vided by public hospitals, private clinics and families – pri-
marily close family members. There seemed to be no
organised community action for PLHA support. No Fagge
NGOs were identified as providing care and/or support for
PLHA or for orphans whose parents have died of AIDS.
However, although SWAAN and COPOP are located else-
where in the state, they their services to cover Fagge LGA.
This is a very important factor, and can be an opportunity
have extended for carrying out further HIV/AIDS activities
in the area.

Non-governmental organisations working in HIV/AIDS prevention and care and reproductive health
HIV/AIDS prevention and home care Reproductive health

MOSMOG Forward - Nigeria:


Administrative office but no activity at this site

SWAAN

COPOP

Health in general Others

Development and Peace Initiative

Other factors considered as strengths for HIV/AIDS care


and support include the accessibility of area health facilities
and the willingness of health workers and other communi-
ty members to be involved in providing care for PLHA.

There are however, some constraints which must be


addressed if PLHA care and support activities are to suc-
ceed. These include the absence of SACA and LACAs, lack
of coordination and linkages between care and support
providers and inadequate knowledge and skills regarding
current concepts in the management of STIs, TB and
HIV/AIDS.

24
Kano State

4.4.1 Public institutions providing care for PLHA 4.4.1.2 The Infectious Disease Hospital
This specialist hospital has three doctors, 52 nurses, 10
4.4.1.1Sheik Mohammed Jidda Hospital clinical officers, two trained HIV/AIDS counsellors, 10 TB
This is a general hospital with seven doctors, 62 nurses, 20 staff (full-time), two laboratory technicians/technologists
clinical officers, two trained HIV/AIDS counsellors and and one traditional healer. It provides medical care for
one laboratory technician/technologist. It offers HIV HIV/AIDS patients (including counselling) and TB and
screening and counselling, medical management of admits an average of 3000 patients per year (higher in
HIV/AIDS and prevention of mother-to-child transmission years with epidemics). About 1000 -1800 of them present
of HIV. It serves a population of about 750,000, of whom with HIV/AIDS-related illness.????????????
15, 000 need HIV care. Two to three percent of adult in-
patients here have HIV-related illnesses. The facility needs The hospital serves the entire Kano State and needs more
more staff to cope with the increasing demand for such staff – especially nurses – to meet current demands. IDH
care. Generally, TB patients are not managed here, but are receives written referrals from all Kano institutions and, in
referred to the Infectious Disease Hospital (IDH). turn, refers HIV/AIDS patients to support groups for
home-based, PLHA and traditional care. Their referrals
The Sheik Mohammed hospital treated 44 cases of STDs are usually without letters.
(29 males, 15 females) in the month preceding this survey.
The number of STDs seen at the facility has increased over The respondent interviewed had not seen the national
the last two years. Treatment is based on a combination HIV/AIDS/STI policy; the hospital does not have
of unspecified approaches to diagnosis (probably etiolog- HIV/AIDS care guidelines.
ic and syndromic). Staff had received training on syn-
dromic management of STDs and clinical management of IDH is the major institution providing TB treatment and
HIV/AIDS (organised by the Federal Ministry of Health care in the state and TB cases here have been increasing:
and WHO). They had seen the syndromic management of the number of all forms of TB recorded in 1998 was 1080;
STDs manual produced by the Federal Ministry of Health. by the year 2000 AD, it had increased to 2097. DOTS
strategy –under nurse responsibility – is employed.
Staff does not routinely screen STD patients for HIV but Mortality before completing treatment is high and loss to
refer suspected cases for VCT. They give proper and ade- follow-up during treatment exceptionally high. For exam-
quate advice to STD patients but do not keep a supply of ple, of the 902 smear positive cases of TB recorded in the
condoms at the clinic. The following manuals are avail- year 2,000, only 240 patients completed their treatment.
able at the hospital: HIV/AIDS clinical management Patients pay for their drugs. TB patients are not routine-
guidelines, STD syndromic management manual, home- ly screened for HIV.
based care manual and guidelines for HIV/AIDS coun-
selling. They do not have the manual on TB management. The hospital does not see STD patients.

There is expressed demand for HIV testing – voluntary,


referral, premarital and MTCT prevention – in the catch-
ment area. The facility has four part-time counsellors and
four established staff with counselling skills. The respon-
dent counsels an average eight clients per month. He
knew about interventions to prevent MTCT, but routine
HIV screening is not provided to all new ANC clients.

25
In-Depth Assessment Report

4.4.2 Private institutions providing care for PLHA 4.4.2.3 Assumpta Clinic
This clinic has two doctors, eight nurses, four clinical offi-
4.4.2.1 ECWA Hospital cers, two trained HIV/AIDS counsellors and two labora-
This is a Christian missionary (faith-based) institution tory technicians/technologists. Assumpta offers medical
with four doctors, 11 nurses, 35 clinical officers and three care for HIV/AIDS patients (including counselling and
laboratory technologists. The hospital provides clinical palliative care, antiretroviral therapy and spiritual care).
care (including the medical management of HIV/AIDS and It also treats TB patients. About 15-20 percent of their
counselling services) for people with HIV/AIDS. It also adult in-patients are HIV/AIDS cases. Approximately
offers social support for PLHA. The hospital sees about eight patients with HIV/AIDS-related illnesses are seen
five cases of AIDS-related illnesses each month. They do each month – and the number is increasing.
not supply drugs or manage STDs or TB.
Respondent had not seen the national HIV/AIDS/STI pol-
The facility has three full-time counsellors and one estab- icy, but had received training in clinical management of
lished staff with counselling skills. The respondent said HIV/AIDs. Care guidelines for HIV/AIDS are available in
there is an expressed demand for HIV testing in their the clinic.
catchment for voluntary, pre-marital and pre-employment
reasons. They counsel an average of five clients per Assumpta screens all TB patients for HIV. The number of
month. TB patients presenting has been increasing. The clinic
nurse does the observation for the DOTS strategy. Home
4.4.2.2 Light Clinic visit services are provided TB patients with HIV. This
This facility employs two doctors, four nurses, and one serves a double purpose: it helps the patients comply with
laboratory technician/technologist. The clinic provides drug regimens and also traces defaulters.
medical care for HIV/AIDS (including counselling and pal-
liative care) and TB. Light Clinic admits about 200 The clinic sees four to six STD cases each month; this
patients every year, three to five of these have HIV-related number has remained steady over time. Treatment is
illnesses, five to seven have TB. All TB patients are based on a combination of all three approaches to diag-
screened for HIV. DOTS strategy is not employed. The nosis. The respondent interviewed had been trained in
clinic treats five to eight cases of STDs per month - a num- and seen the manual for syndromic management of STDs.
ber that has remained more or less steady over time. He had also received clinical management of HIV/AIDS
Treatment is based on etiologic diagnosis or sometimes a training at courses organised by the Jos University
combination of approaches. Teaching Hospital (JUTH) and AKTH.

The respondent interviewed had not had training on or The medical director and the matron are trained counsel-
seen the manual for syndromic management of STDs. lors and disclose HIV results and counsel patients who test
Hospital personnel had not seen the national HIV-positive. There is an expressed demand for HIV test-
HIV/AIDS/STI policy and did not have HIV/AIDS care ing for premarital, MTCT and pre-employment reasons.
guidelines. They had not been trained in clinical manage-
ment of HIV/AIDS. Respondent was unaware of inter- The clinic does not offer advice on or demonstration of
ventions to prevent MTCT but said the clinic does screen condom use and does not stock condoms.
all new antenatal clinic attendees for HIV and provides Respondents were aware of interventions to prevent
post-test counselling for those who have tested positive. MTCT, but screen all ANC attendees for HIV. The facil-
ity emphasizes instrument sterilization and proper dispos-
Though not trained as counsellors, the two doctors pro- al of materials. However, episiotomies are still performed
vide this service to patients. There is an expressed demand routinely. Exclusive breast feeding is very common
for HIV testing for voluntary referral and premarital rea- amongst the women who deliver here – formula-only feed-
sons. ing is never practiced. The respondent believes, however,
that if the latter were promoted to prevent MTCT among
Light Clinic does not offer advice on condom use or HIV-positive mothers, it would be well accepted by both
demonstration and does not keep condoms in their clinic. mothers and their relatives– if they are adequately
informed about it.

26
Kano State

4.5 Community leaders 4.6 Organisational assessment

Fagge community leaders agree on the need for 4.6.1 Nigerian Labour Congress (NLC)
STI/HIV/AIDS interventions here. This conclusion was Nigerian Labour Congress is a single trade union organi-
reached based on interviews conducted with three com- sation with 29 affiliated labour groups. NLC is located on
munity leaders (one traditional ruler, a Muslim cleric and Katsina Road, near Bukavu Barracks, Kano. It is regis-
a Catholic reverend). tered with the government as a NGO. The organisation
has a board of trustees, state administrative council and a
The community leaders are already engaged in mobilising state executive council. The NLC mission statement
community members for development activities and initia- declares that the organisation strives to protect the inter-
tives, with priorities for health issues. Until the onslaught est of all workers and the general public. These aims and
of AIDS, malaria and drug abuse were considered the objectives are achieved through its affiliated trade/profes-
greatest health threats to the community. The leaders sional unions. NLC’s main sources of funding are member
believe the immediate solution to the AIDS problem here contributions, union dues, and donations from the state
is good and effective education and enlightenment pro- government, organisations and individuals. The congress
grammes – and they think community leaders and other provides feedback on project/programme progress to the
adults should be involved in the effort. community, beneficiaries, donors and government. NLC
also organises seminars for trade union leaders. The
All leaders expressed willingness to care for male or Nigerian Labour Congress has been involved in many
female relatives who become ill with HIV and said they HIV/AIDS awareness campaigns.
would like to be involved in community STDs/HIV/AIDS
activities and initiatives. They would also like more Members of this association are willing to care for male or
HIV/AIDS information, education and communication, female relatives who become ill with HIV/AIDS. Should a
voluntary counselling and testing services, youth clubs for relative become ill with HIV/AIDS, they said, they would
HIV/AIDS education, community care and support activi- not want the nature of such illness to remain secret.
ties and community orphan care.

4.6.2 Nigerian Union of Teachers (NUT)


Nigerian Union or Teachers is one of the 29 industrial
trade unions affiliated with NLC. Its office is at Plot 3,
Gyadi-Gyadi Court Road Kano. NUT is registered with
the All African Teachers Organisation (AATO), Education
International (EI) and the government. The union has a
board of trustees, whose members can sign all cheques
and other correspondences. Board members are expected
to guide organisational activities. NUT has organised
seminars, workshops and education tours to improve the
status of its members.

The union has a strategic plan that focuses on the general


rehabilitation of teachers’ houses, provision of necessary
infrastructures in schools and selfless service. NUT has
organised HIV/AIDS activities in Kano’s 44 LGAs and has
participated in many HIV/AIDS awareness campaigns,
particularly in schools.

Members say they are willing to care for male or female


relatives who become ill with HIV/AIDS and would not
want the nature of such illness to remain secret.

27
In-Depth Assessment Report

4.6.3 National Association of Women The group is fully aware of STD/HIV/AIDS and knowl-
Journalists (NAWOJ) edgeable about health issues. MOSMOG is therefore rec-
ommended for participation in future activities.
National Association of Women Journalists (NAWOJ) is
housed at 13B Farm Centre, NUT Press Centre, Kano. Members say they are willing to care for male or female
Established in 1989, it is limited by guaranty and is not relatives who become ill with HIV/AIDS and would not
registered. NAWOJ has an approved constitution and a want the nature of such illness to remain secret.
board of trustees. Its mission statement discusses creating
awareness among women journalists. Funding comes
mainly from members’ union dues and grants from donor 4.6.5 Jam’iyyar Matan Arewa
agencies such as USAID and JHU/CCP. The organisation Jam’iyyar Matan Arewa’s office is located at No. 4 Bawo
has been involved in HIV/AIDS campaigns for several Street, Hausawa New Layout, Kano. It was established in
years. 1964 and is registered with the Ministry of Information
and USAID. The organisation has an executive committee
Members say they are willing to care for male or female and patrons. In its mission statement, Jam’iyyar Matan
relatives who become ill with HIV/AIDS, and would not Arewa says that its purpose is ensuring that women and
want the nature of such illness to be kept secret. children are well-looked-after, enlightened, empowered
and allowed to participate in government decision-mak-
ing. The organisation has received funds from USAID and
4.6.4 Monitoring, Support and Mobilisation Johns Hopkins University. Most money comes from phi-
Group (MOSMOG) lanthropists, other individuals and – occasionally – gov-
MOSMOG headquarters are at No. 92 Sarkin Yaki Road, ernment. The group has submitted proposals to donors in
Nomansland, Kano. The group was established 29 the past year.
October 1998, and is registered with the government as an
NGO. It has an approved constitution and board of Jam’iyyar Matan Arewa has been involved in various
trustees. Operations include: (1) reaching out to the pub- HIV/AIDS awareness campaign. Members say they are
lic and propagating MOSMOG ideas, (2) providing willing to care for male or female relatives who become ill
parental advice where and when necessary, (3) settling dis- with HIV/AIDS, and would not want the nature of such
putes between members and providing disciplinary meas- illness to remain secret.
ures where and when necessary and (4) fund-raising for
MOSMOG.
4.6.6 Muryar Jama’ar Fagge (Fagge Peoples Forum)
Its mission statement claims MOSMOG’s aim is to pro- This is a voluntary NGO established in July 2000. It is a
mote unity and peace among Nigerians, discourage anti- limited-guarantee community-based organisation located
social practices, enhance socio-cultural integration and at Fishing Caladium Fagge. It has a board of trustees,
youth empowerment. The statement has not been responsible for formulating financial policies. The board
changed in the last three years. MOSMOG has developed advises the executives on asset valuations and depreciation
a one-year strategic plan for community development, and their general assembly on asset disposal and acquisi-
poverty alleviation and job creation and youth enlighten- tion. The forum’s aim is to provide gainful employment
ment about the dangers of antisocial behaviours. No for unemployed youth in the community through educa-
stakeholders were involved in the plan. MOSMOG is now tion and development and job provision. Muryar Jama’ar
monitoring results of the plan, and making necessary cor- Fagge has taken part in various HIV/AIDS awareness cam-
rections or amendments for future projects. paigns, particularly among youth in the community.

The organisation has received funds from the Centre for Members say they are willing to care for male or female
Research and Documentation (CRD) Kano. MOSMOG’s relatives who might become ill with HIV/AIDS and would
main sources of funding are registration fees, levies, dona- not want the nature of such illness to remain secret.
tions by members, grants, payment for works undertaken,
launchings, etc. The board of trustees is responsible for
fund-raising. MOSMOG reports quarterly to the commu-
nity, beneficiaries and donors on progress of its projects
and programmes.

28
Kano State

Employment statistics
Total number in formal employment at the site: 47,700

Economic sector Number employed

Mine or oil workers Nil

Farming/agriculture 100

Construction 11,100

Uniformed government services 5,000

Other government services 8,000

Retail (shops) 25,000

Shipping NA

Fishing NA

Tourism (hotels/lodgings/motels/etc.) 280

Religious denominations
Names of denominations Number of stations

Christian (churches) 120

Muslim (mosques) 100

Tijjaniya 15

Kadiriyya 12

Izala 40

29
In-Depth Assessment Report

Professional and trade associations


Names of professional associations Names of trade associations

Lishakas (Doctors) - not registered Yantaya Association

Groundnut Oil Sellers Youth Merchants Association

Patent Medicine Sellers Union Kuka Scraps Association

National Union of Road Transport Workers Kunguyar Maaska

Mawanka Association

Yan ‘Itace Association

Spare Parts Dealers

Groundnut Sellers Union

Major community groups


Names of community groups Activities carried out by group

Sabon Gari Coalition Self-help projects

Leaders of Tomorrow Self-help projects

Fagge Sodangi Self-help on education, sanitation etc.

Fagge Youth Same as above

Fagge Forum Same as above

Fagge Modern Security Security

Kwarin Gogau Development Association Development

Agudu Tare A Tsira Tare Self-help for FSW

Dan Rimi Vigilante Security

Patrol Group Security

30
Kano State

Guesthouses, motels, hotels and lodgings frequented by mine and oil workers
Name Location

Obanta 10, Church Road

Midwest Sanyaolu

Ogidi Harmony Enugu Road

Metro Hotel Abeokuta Road

Farms
Name of farm Number of employees Activity Does site have
HIV/AIDS program?

Alh. Uba Tofa NA Cattle Ranch NO

Construction companies
Names Number of employees

Phototec Lab. 12

Ugo Lab. 15

Mummylin 10

Ossily Company 3

Media people read, watch or listen to


Newspapers/magazines TV Radio

Triumph CTV BBC – Hausa

Gaskiya NTA VOA – Hausa

Albishir Germany – Hausa

Weekly Trust Taska - Radio Kano

This Day Kwabanati Da Jamaa Radio Kano

The Punch FRCN Kaduna

Champion Radio Jigawa

The Guardian

31
In-Depth Assessment Report

5. Nassarawa Local Government Area


Demographic information Total number in formal employment at the site - 19,700

Permanent stable population 1.2 million Economic Sector Numbers employed

Temporary population 300,000 Mine or oil workers

Farming/agriculture 200

Nassarawa LGA was carved out of the old Kano Construction 6,000
Municipal LGA. Its current population is estimated at 1.2 Uniformed government 4,500
million. It is bounded by Ungogo to the northwest; services
Gezawa to the northeast, Kumbotso to the southeast;
Other government services 5,500
Tarauni to the south and Fagge to the west. Nassarawa
LGA has 13 wards: Brigade, Badawa, Dakata, Gama, Retail (shops) 2,500
Giginyu, Gwagwarwa, Hotoro North, Hotoro South,
Shipping -
Kaura Goje, Kawaji, Kawo, Tudun Murtala and Tudun
Wada. Fishing -

Tourism 1,000
This LGA can be described as urban with a multi-ethnic, (Hotel/lodgings/motels, etc.)
multi-religious and multi-national population of Hausas,
Fulanis, Yorubas, Arabs, Nigerians, Malians, Ghanaians
and several other groups. Nassarawa is a commercial cen- Both pubic and private health care facilities serve the peo-
tre with the following major markets: Gwagwarwa, ‘Yan ple living within and around Nassarawa. Six NGOs pro-
Kaba, Tudun Wada and Kasuwar Allah Sarki situated vide HIV/AIDS related services and numerous community
respectively at Brigade, off Hadejia Road, Tudun Wada groups work in the LGA. Some of these community
Road and Dakata areas. There are also seven overnight groups are essentially vigilante groups; others are involved
parks located at ‘Yan Kaba market, ‘Yan Kaba motor in community development and self-help projects. There
park, Hotoro NNPC petrol tanker depot, Dan Marke, are numerous primary and secondary schools and two ter-
Dakata market, Bompai Road and Tudun Wada bus stop. tiary institutions in the LGA.
Several truck and bus companies operate from
Nassarawa. More than 2000 trucks and buses leave the The LGA has no plans to conduct HIV/AIDS activities,
LGA for various destinations; about 1,200 trucks and but is quite willing to participate actively in and support
buses remain there overnight. There are also many indus- programmes and projects that address this infection.
tries and construction companies, which – together with
the markets and transport businesses– generate substantial Community leaders, both traditional and religious, have
revenue for the LGA. expressed their willingness to support HIV/AIDS-related
activities in their community – as long as such activities do
There is a substantial entertainment industry for both not conflict with the beliefs and customs of their people.
high-income and ordinary persons in this LGA: several
cinemas, outdoor snooker clubs, hotels, bars and clubs.

A large number of high-risk and vulnerable groups can be


found in Nassarawa. These include FSW, long distance
truck, tanker and bus drivers, out-of-school youth,
migrant labourers, construction workers and uniformed
service employees (including the armed forces, customs
and immigration).

32
Kano State

5.1 Mapping and site inventory There is no definite HIV/AIDS policy in most industries –
nor is there machinery in place to prevent workers from con-
Nassarawa LGA can be divided into three demographic sub- tracting HIV/AIDS. Most employers cannot provide treat-
areas. The first covers Tudun Wada, Gwagwarwa, Dakata, ment for infected employees. It is important to note that a
Kawaji, Gama and some neighbouring wards; these are poor significant percentage of workers in this sub-area are not
and densely populated. This sub-area has very few public unionised.
facilities, but many privately run quaranic schools and
mosques. The second division covers the Government Many women from northern ethnic minorities also live here.
Reservation Area (GRA) Nassarawa and parts of Hotoro.
This is a low-density sub-area with wide streets and general-
ly cleaner environment than the first described above. The
third sub-area includes Bompai, home to many industries. It
is the oldest industrial estate in Kano State.

Residential characteristics
Type of residence Total number of settlements Average number of people per household

Low-density 3 4

Middle density 3 7

High density 7 12

Slums

Rural 4 12

Size of target populations


Target group Population

Commercial sex workers 1,600

Migrant labourers 3,150

Farm workers 2,900

Fishermen/women

Construction workers 13,000 (many are casual and temporary)

Uniformed employees (Customs, police, immi- 4,500


gration, defence forces, Navy etc.)

In-school youth 17,856

Out-of-school youth 9,000

Street youth/area youth 1,500

Petty traders 5,200

Truck and bus drivers 7,450

33
In-Depth Assessment Report

The LGA has many active NGOs and CBOs. COPOP, There are 13 public and eight private secondary schools
SWAAN and Rotary Bompai are among the organisations and in the LGA. The Local Education Authority puts the
that concern themselves with HIV/AIDS prevention and number of primary schools at 63, including private Islamic
home-based care. schools that receive some public funding or support.
There are no firm estimates of the number of in-school
There are two general hospitals, one tertiary hospital, youth and out-of-school youth. This LGA has a dispro-
eight PHC centres, seven health posts and two major dis- portionate number of public facilities located within its
pensaries. There are 30 private health facilities in this boundaries.
LGA. About 200 medicine stores and pharmacies were
identified during the mapping exercise. Like many other
areas of Kana State, Nassarawa LGA also has several
chemists.

Number of public facilities


Type of facility Number

Tertiary hospital 1

General hospital 2

Primary health care 8

Others 7 health posts,


2 dispensaries

Number of private facilities


Type of facility Number

Hospital 8

Clinic 24

Nursing home 1

Estimated number of pharmacies and drug stores

221

34
Kano State

Primary schools
Name Type Males Females Total

Peak Kiddies Centre Private

ECWA Private

PAJEC International Private

Police International Private

Gawuna Model Public

Tundun Wada Special Primary School Public

Gwagwarwa Special Primary School Public

Dakata Public

Gama Special Primary School Public

Shababul Islam Public 1,000 1,100 2,100

Bennie Primary School Private 570 460 1,030

Hamdala Private 300 219 519

Wish. Progress Centre Private 180 100 280

Holborn Child Friendly Private

Kawo Public

Hotoro South Public

Hotoro North Public

Race Course Model Primary School Public

Gingiyu Primary School Public

Rakad International Private 120 80 200

Malam Nuhu Private 200 150 350

Dangana Primary Public

Excel International Private

Brigade Public

Liman Datti Public

Gawuna Public

Kewaji Public 300 230 530

Ideal Nursery & Primary Private 113 100 213

Da’awa Nursery & Primary Private 200 125 325

Badawa Public 280 153 433

Empire Nursery & Primary Private 60 70 130

Lilly Nursery & Primary Private 150 115 265

Irshadul Muslim Private 80 37 117

Seat of Wisdom Private 200 350 550

35
In-Depth Assessment Report

Secondary schools
Name Type Males Females Total

G.S.S. Kawaji Public 2,880 2,880

G.G.S.S. Dangana Public 1,440 1,440

G.G.S.S. Giginyu Public 1,440 1,440

G.G.S.S. Dakata Public 600 600

G.G.A.S.S. Kawaji Public 1,800 1,800

G.A.S.S. Gwagwarwa Public 360 360

G.G.J.I.S. Gama Public 360 360

St. Louis S.S. Public/private 840 840

G.S.S. Tarauni Public 1,080 1,080

Ahmadiya S.S. Public/private 1,080 260 1,340

Da’awa Comprehensive Private/public 360 360 720

J.S.S. Hotor Public 180 180

Kano Capital Public 720 360 1,080

Basic School of Commerce Private 500 350 850

Sunney Day Private 300 220 520

Bennie International College Private 70 60 130

Greenfields International Private

Hands on Computers Private

Holy Trinity Secondary Private

Islama Commercial Secondary School Private

Kano Model College Private

Prime College Private

Salsa College Private

St. Dominic International Private

St. Michael Grammar School Private

Samadi International Private

Dinop International Private

Excel Staff Private

First Grade Private

Fatima International Private

Hamdala Private

36
Kano State

Tertiary schools
Name Type Males Females Total

Tarbiya Women Private 45 45

Yeda VTC Private 20 30 50

Tertiary schools
Name Type Males Females Total

Madrastul Bilal Private 300 100 400

Tsauni Liman Private 315 210 525

Gidan Liman Private 80 72 152

There are also many smaller quaranic schools in the LGA, At other locations – such as the Yankaba motor park, the
but enrollment information could not be obtained during Tudun Wada bus stop and Dan Marke at Hotoro – truck
the short period of site inventory. and bus drivers park overnight. Sex workers operate here
as food sellers or plate washers, but also offer sex services
should the moment of opportunity arise. FSW have also
5.2 Risk settings and factors recently been observed attaching themselves to pimps for
protection and residential accommodation. A few FSW
The risk setting for HIV/AIDS transmission in Nassarawa are still present in Dakata, Yankaba, Gwagwarwa and
LGA is created by the zones of freedom which still exist Tudun Wada – the major markets in Nassarawa LGA –
despite the introduction of criminal Shari’a law. This situ- but they are now accompanied by leading figures who
ation is compounded by the presence of high-risk men and offer them protection.
vulnerable women who seize moments of opportunity to
engage covertly in high-risk behaviour. FSW are still found In short, the cosmopolitan nature of the LGA, combined
in a few entertainment locations within the zones of free- with the availability of men away from their families (with
dom. In Tudun Wada, Gama, Badawa and Kawaji ready cash) and vulnerable women makes the setting ideal
Quarters, FSW service lower-income clients in brothel-like for commercial transaction sex. Nassarawa’s mix of ethnic
establishments. More prosperous clients seek entertain- groups, lifestyles and demography increases the chances of
ment spots such as King’s Garden, Kano Polo Club, transmitting and contracting HIV/AIDS.
Kawaji Guest Inn, Rendezvous, Nigerian Airways Club,
Customs Staff Club, Jingo Jazz and Central Hotel. The
urban and cosmopolitan nature of the LGA creates a situ-
ation where sex workers also feel free enough to walk the
streets looking for men – despite the introduction of
Shari’a. These women can be seen around the State House
area, pretending to be waiting for public transportation
late in the evening.

There are also numerous unoccupied properties owned by


wealthy men and guarded by mai-guards or soldiers and
policemen. These houses often provide a safe haven and
zone of freedom for FSW who service guards and clients.

37
In-Depth Assessment Report

5.3 High risk populations Bars and clubs where sex workers operate
Name Name
5.3.1 Female sex workers
It is estimated that more than 1000 women earn a living Rendevous Kano Polo Club
from sex work in this LGA. The least educated among Jingo Jazz Kano Club
these women are usually found in Kawaji Quarters and in
the Gama, Badawa and Kawo areas. The better educated King’s Garden Central Hotel Bar
are located in entertainment spots in the GRA, where men Gidan Zaituna Gidan DPO (Kawo)
come for alcohol and entertainment. Central Hotel is per-
haps the best known of these establishments. FSW also Duala Hotel, Bar
cross LGA borders (which were highly artificial); they may
operate in as many as four different locations in one night.
The street walkers – on streets such as Hadejia Road, Streets where sex workers meet clients
Ahmadu Bello Way, Bompai Road, Tudun Wada Road, Name Name
Racecourse Road and Murtala Mohammed Way – follow
clients in their cars. Key informants report that while the HADEJIA Road, near Daula Race Course Road
risk is great, these FSW can earn more that N1000 per BOMPAI Road Murtala Muhammed Way
night.
Tudun Wada Road Agangara, Badawa

Sex workers King’s Garden (in road)


Type Number

Permanent sex workers 280

Visiting sex workers 105 Prices charged by sex workers


Round Night

Permanent: N150 – N200 N300 - N1000 (mostly N500)


Sex workers‘ hostels and brothels
Visiting: 100 N300
Name Address/location

DC 10 Kawaji Quarters

Kawaji Guest Inn Kawaji Quarters

Agangara Badawa

Gidan Jimmai Danbuzu Tudun Wada

Gidan Ta Balarabe Sani Street, Gama

Gidan Turai behind Gama Area Court

Gidan Danshori Hotoro, behind Police


Station

303 Lodging Gidan Amina Kawo, opposite Bus Stop


Mai Bakin Kare

38
Kano State

5.3.2 Male clients 5.3.3 Long-distance drivers (LDDs)


The FSW’s male clients include men residing in the LGA About 1,200 buses enter or leave various markets and
(for example, petrol sellers and civil servants) as well as motor parks in the LGA daily. This brings in not only
men who are in the area for business (e.g., LDDs, con- many transport workers, but women engaged in related
struction and rail workers) or – on rare occasions – activities like hawking and touting. Drivers sleep in their
tourists. Key informants at the Central Hotel report that vehicles (for security reasons) or, during the hot season, in
businessmen and construction workers from Italy, China the open. If the season is harsh, such as during the har-
and India are eager to find young sex workers from the mattan, many visit FSW in hotels and clubhouses located
north. The informants say these clients often believe in Nassarawa and neighbouring LGAs to sleep and have
young northern girls are less exposed and therefore have a sex. One driver interviewed said that he tends to go to
lower rate of STI nfection than women who live in the FSW more during the harmattan instead of sleeping on his
capital. It was also noted that these men often request two own, since he is sure to get warm water and pomade in
or three girls in a single night, since FSW here are cheaper addition to sex.
than in more central locations such as Abuja and Lagos.
Truck and bus companies that
Key informants state that while some of these clients use pass through this site
condoms, the younger the girl the less likely it is that she Truck Bus
will insist on condom use.
Idrisiyya Transport Kano Line

Nigerian male clients include men staying in Nassarawa ASAH Sakwaya Line
LGA hotels while attending workshops or conferences.
A.A.Girgiri Bababa Line
Wealthy young Abuja-based men often become clients
during weekend visits to their homes in Kano. The yan A.S. Nagero Kwajafa
cuwa cuwa, in-school youth of rich families, motorcyclists
A.A.Mudallabi Babban Gawo
and office workers are other clients in this area.
A. Sani Yaro Ahmed ‘Yan Tsaki Transport

Dangote A.a.mai Yaya

Shafka Gangara

Estimated number of trucks and


buses entering or leaving site daily

2,1000

Estimated number of trucks and


buses parking overnight

1,200

39
In-Depth Assessment Report

Places truck and bus drivers park at night Guesthouses, hotels, motels and
lodges frequented by truck and bus drivers
Places Places
Names Location
Yan Kaba Motor Park Dan Marke
Palm Grove Badawa
Yan Kaba Market Dakata Market
Gidan Gayu Sauna
Hotoro NNPC Depot Bompai Road
Gidan Hajiya’Yan Biyu Gwagwarwa
Tudun Wada Bus Stop
Gidan Zaituna King’s Garden

Jingo Jazz Dakata, near Isyaku


Rabi’u Estate
Long-distance drivers park their vehicles here in the
evening and pass the night visiting places such as Marhaba
Cinema, Murtala Mohammed Way and Central Hotel
area, where much networking with commercial sex work-
Bars and clubs frequented by truck and bus drivers
ers occurs. Some drivers join regular girlfriends.
Names Location
Pharmacies and patent medicine stores provide STD-care King’s Garden off Airport Road
services to drivers in the LGA. The latter have heard of
AIDS, but say they are not too worried about becoming Peacock NTA Kano
infected: God will protect them - Allah zai kiyaye. Sports Club Race Course

However, many drivers said they used condoms, although Daula Hotel Murtala Muhammed Way
those who reported having had an STI did not report con- Central Hotel Bompai Road
sistent condom use. The reason usually given for not using
condoms was that it reduces pleasure. Drivers who report-
ed using condoms with FSW also said they relied on the
women to supply the condoms. They said they did not
carry condoms because it is embarrassing and they were
afraid the rubber would melt in the lorry.

40
Kano State

5.3.4 Men with multiple partners – 5.3.6 Vulnerable women


butchers and meat sellers Vulnerable women in this LGA include women and young
Drivers, petrol sellers and butchers who reported having girls selling food, washing plates at restaurants and work-
multiple partners were often very boastful and claimed to ing as housemaids. Divorced and widowed women earn
have charms which made any woman they desired agree very little –approximately N40-N50 per day from wash-
to their advances. In-depth interviews were done with ing plates or children’s clothing. These women can hard-
butchers – who are renowned for having multiple partners ly afford food, and usually have the added responsibility
and being boastful about it. Their ages range from 18-25 of caring for their children. They sometimes receive help
years; the men are usually married. They meet with young from married men in the neighbourhood in exchange for
girls sent to buy meat from them as well as divorced and sex. Children are sent off to the yan kaba market at an
widowed women and hawkers (yan talla). At each loca- early age to work as loaders or to scavenge for scraps to
tion, butchers usually have a leader, referred to as ‘Sarkin sell and to cook.
Fawa’ (literally, chief of butchers).
These women are aware of HIV/AIDS and are afraid of
Though awareness of HIV/AIDS is high, there is a general becoming infected – primarily because of the stigma and
belief that even people with ‘modest’ lifestyles become discrimination associated with HIV/AIDS in the commu-
infected: a person destined to be HIV/AIDS-infected can- nity. There is one famous case in the community where a
not escape. young girl and her boyfriend were believed to have died
from AIDS; the community practically ostracised surviv-
ing family members.
5.3.5 Male youth – black market petrol sellers
(Yan Cuwa Cuwa) Widows in the Dakata Kawaji ward of Nassarawa LGA
Members of this group come from a wide cross section of are organised by Hajiya Aisha of the Women
states in the north, including Jigawa, Kogi and Yobe. Development Association. Approximately 1000 widows
Several of the petrol sellers in this area were found to have and divorced women are said to be members of this organ-
dropped out of school after two or three years in second- isation. They are more interested in obtaining micro-cred-
ary school. Some had never been to school. They are now it than they are in HIV/AIDS interventions.
responsible for educating younger brothers and sisters
with the money they make from petrol selling. Before the
introduction of Shari’a law in Kano State, petrol sellers in
the Badawa area congregated by the bus stop to sell their
product and later socialise and to buy gifts for girlfriends
in the neighbouring shops. Key informants suggest they
also bought drugs. The petrol sellers in this area sell main-
ly on commission and claim to make only about N300 per
day on a good day. They also say that because this money
is not adequate for them to keep girlfriends, they visit
FSW when they are able to save up enough money.

They are worried about getting married and do not think


that they will ever have enough money to do so. The men
are not members of any organisation.

They do not use condoms and, in some cases, have never


seen one. They engage in substance abuse and enjoy enter-
tainment activities such as sports, cinema and billiards.
They have multiple partners.

41
In-Depth Assessment Report

5.4 Care and support services in Nassarawa LGA 5.5.2 Mohammadu Abdullahi Wase Hospital
This is a specialist hospital with 15 doctors, 96 nurses, 15
There is no LACA in place in the LGA and essentially no clinical officers, and nine laboratory technicians/technolo-
plan to address STI/HIV/AIDS. Nor was there any budg- gists. The hospital has been providing medical care for
et for HIV programs for the 1999/2000 fiscal year. There HIV/AIDS patients (including counselling) and TB.
has been no collaboration between the LGA and other
departments, agencies and NGOs for HIV/AIDS pro- The respondent interviewed had seen the national
grams. Home-based care is the only HIV/AIDS service HIV/AIDS/STI policy, but could not make a copy for the
considered high priority; VCT, clinical and orphan care interviewer. The hospital does have HIV/AIDS care guide-
are ranked low priority by LGA authorities. lines, which were shown to the researcher.
The LGA has 21 public health facilities, including one ter-
tiary hospital, two secondary hospitals, seven primary The hospital had between adult in-patients per annum in
health care centres, nine health posts and two dispen- the years 1998-2000. During the same period, they saw
saries. There were 33 private health facilities in the LGA in-patients with HIV-related illnesses.???????? The num-
(eight hospitals, 24 clinics and one nursing home). ber of AIDS patients seen at the facility has been increas-
ing: four or five such patients are now seen at the hospital
Neither public nor private care providers have adequate each month. The number of TB patients has also been
knowledge or skills in the syndromic management of increasing in the last few years. DOTS strategy is not
STDs, DOTS strategy or clinical management of PLHA. practiced in the institution. All patients are routinely
Training and retraining is needed. The facilities them- screened for HIV. Patients pay for drugs in treatment.
selves are not properly oriented towards providing ade-
quate care to PLHA and may require re-orientation. The facility treats [how many?????] females on average
per month. The hospital sees about 30 cases of STDs
among equal numbers of males and females. Treatment of
5.5 Public institutions providing care for PLHA STDs is based on all three approaches to diagnosis. The
respondent interviewed had received training on and had
5.5.1 Sir Mohammadu Sanusi Hospital seen the manual regarding syndromic management of
This is a specialist hospital with four doctors, 39 nurses, STDs. He also had been trained in the clinical manage-
16 clinical officers, two trained HIV/AIDS counsellors and ment of HIV/AIDS at sessions organised by the State AIDS
five laboratory technicians/technologists. The hospital Control Programme in 1999.
has provided only HIV screening and counselling services
since 1999. The estimated population in its catchment
area is 1.5 million, of whom 100,000 need HIV care.

The hospital had 103 adult in-patients in the year 2000, none
of whom had AIDS-related illness. Generally, TB patients are
not managed in this facility, but are referred either to AKTH
or IDH –except for incidental genito-urinary TB. (The hospi-
tal MD is an urologist.) When treating such patients, the hos-
pital uses short-course therapy, not DOTS (i.e., patients were
not observed taking their medication) – the reasoning being
that patients comply with a short-course therapy.

The hospital treated 44 cases of STDs (29 males, 15


females) in the month preceding this survey. The number
of cases has been steady over the last two years.
Treatment is based on clinical and etiologic diagnoses.

Staff has had no training on syndromic management of


STDs or clinical management of HIV/AIDS. They had
never seen the manual on syndromic management of STDs
produced by the Federal Ministry of Health. The respon-
dent interviewed had never seen the national
HIV/AIDS/STI policy and there are no HIV/AIDS care
guidelines in the institution.

42
Kano State

5.6 Private institutions providing care for PLHA 5.6.2 Warshu Hospital
This hospital has three doctors, 20 nurses, one clinical
5.6.1 Ahmadiyya Muslim Hospital officer and two laboratory technicians/technologists. It
This Islamic missionary (faith-based) institution employs provides medical care for HIV/AIDS patients (including
two doctors, nine nurses and two laboratory technolo- counselling, antiretroviral therapy and palliative care) and
gists. The hospital provides clinical care (including med- also treats TB patients.
ical management of HIV/AIDS and tuberculosis, palliative
care and counselling services) for PLHA. The population Respondents had not seen the national HIV/AIDS/STI pol-
of the catchment area is approximately million, with icy or been trained in clinical management of HIV/AIDS.
about 50,000 people needing HIV care. The hospital has The hospital does not have HIV/AIDS care guidelines.
an estimated annual in-patient turnover of between 364
and 500. The hospital estimates that five of these were Respondents did not supply the number of annual in-
HIV/AIDS patients each year. The demand for HIV/AIDS patients, but indicated that one percent of them were usu-
clinical care has been increasing over the last few years. ally HIV/AIDS patients. The number of AIDS patients
seen at the facility has been increasing; about three such
The hospital provides social support for PLHA only in the patients are being seen at the hospital each month.
form of religious and psychological counselling and nutri-
tional talks and cookery demonstrations. There is no The number of TB patients has also been increasing over
space to ensure privacy during counselling sessions; HIV- the last few years. All patients are routinely screened for
positive patients are referred to SWAAN for counselling. HIV. The patient pays for treatment drugs. DOTS is not
The facility does not provide home-based care or orphan practiced because staff are not familiar with the strategy
care and support. and have not been trained in it nor have staff received the
TB management manual.
Patients with TB are treated at the facility; patients pay for
the drugs. An average 30 cases are managed yearly, with The clinic treats about three cases of STDs per month,
an increasing number over the last few years. DOTS strat- based on a combination of the etiologic and syndromic
egy is employed, but about a third of the patients are lost approaches. The respondent interviewed had not had
to follow-up before completion of treatment. training on or seen the manual regarding syndromic man-
Tuberculosis patients are not routinely screened for HIV. agement of STDs. He also had not attended the training
session on clinical management of HIV/AIDS organised in
Although respondents are aware of interventions for the 1999 by the State AIDS Control Programme.
prevention of mother-to-child transmission of HIV, such
services are not provided at the institution.

An average of ten (seven male, three female) STD patients


are seen monthly; their treatment is based on all three
approaches to diagnosis of STDs.

The staff had neither received training on syndromic man-


agement of STDs nor seen a copy of the current NASCP
manual for STD treatment. They had received no training
on HIV/AIDS clinical management. Advice on condom
use is not given patients because the facility does not want
to be seen as encouraging promiscuity.

43
In-Depth Assessment Report

5.7 NGOs providing care and support 5.7.1 Council of Positive People (COPOP)
This is an NGO of people living with HIV/AIDS (PLHA).
Various organisations provide a number of services, It was formed two years ago by PLHA to support one
including care and support for people living with another. The group provides counselling services (post-
HIV/AIDS: test and on-going/follow up and nutritional counselling),
outreach services to homes and other social support serv-
NGOs providing care ices to each other and to newly diagnosed HIV-positive
people. They have one full-time counsellor and eleven
HIV/AIDS prevention and Reproductive health
home care part-time counsellors. SWAAN Kano trains COPOP
members on HIV counselling. Members of COPOP are
COPOP PPFN frequently invited to assist in counselling newly diagnosed
BASICS Nigeria HIV patients to assist them in accepting and coping with
their situations. The organisation provides monthly visits
Rotary Bompai to members and offers such services as vocational training
PPFN for income-generating activities and pain management.
COPOP also supplies drugs – when available – for oppor-
SWAAN tunistic infections. All services are free; local donors
Grassroots Society (SWAAN) are their chief source of funding; COPOP
works closely with this group. COPOP also derives a
Health in general Others
small amount of money from dues or stipends from work-
BASICS Nigeria Tundun Wada Patriots shops and seminars. The organisation’s main challenges
are financial (lack of adequate support from government
Gwagwarwa
Ambassadors and a general shortage of funds) and societal stigmatisa-
tion and rejection.

5.7.2 Nassarawa Children’s Home


This is part of the Mohammed Abdullahi Wase Hospital.
Funds come from the government (90 percent), interna-
tional donors (five percent) and philanthropic individuals
in the community (five percent). Main activities include
care of orphaned children, fostering children and educat-
ing children in the home (both Islamic and western educa-
tion). At the time of this survey, 13 girls and 23 boys were
cared for in the home. The children live here for an aver-
age of two years before being fostered or adopted.

44
Kano State

5.8 Community leaders 5.9 Organisational assessment

Four respected leaders of the community were inter- Many civil society organisations in the LGA – NGOs,
viewed, using the community leaders' questionnaire. They CBOs, trade unions and associations – are actively
were the traditional ruler of Nassarawa (the Dan Buram involved in human development activities. They focus pri-
of Kano), two Islamic religious leaders and the principal marily on community development, environment and
of a Catholic missionary school. Given the influence social welfare services; only a few work on HIV/AIDS
wielded by traditional and religious leaders in Kano, their issues. These groups include: Council of Positive People
opinions carry substantial weight with members of their (COPOP), Tudun Wada Patriots Association, Nigerian
community. The leaders are important when considering Red Cross Society, Gama Self Help Group and Youth
appropriate community interventions. Environmental Development Association (YEDA).

In general, these leaders were willing to support


HIV/AIDS activities in the LGA, including IEC on 5.9.1 Council of Positive People (COPOP)
HIV/AIDS, voluntary counselling and testing services and The Council of Positive People (COPOP) is an NGO of
other HIV/AIDS-related care and support activities. Some PLHA established with the aim of improving the quality
had worked on previous STD/HIV/AIDS public enlighten- of life for PLHA in the state. They are registered with the
ment activities in the state. government and have a constitution and a board of direc-
tors. They collaborate closely with SWAAN as well as
They said that they are willing to visit and provide care for with FHI/USAID. Their main sources of funding are
relatives with HIV/AIDS, but most believed that the dis- FHI/USAID, SWAAN Kano, and the Centre for Research
ease should be kept secret. This suggests a level of and Documentation (CRD).
HIV/AIDS denial among them.

5.9.2 Youth Environmental


Development Association (YEDA)
The Youth Environmental Development Association
(YEDA) is registered with the government and collabo-
rates with USAID implementing partners and CBDD. It
has a constitution and a board of trustees. The organisa-
tion has received funding from the Centre for Research
and Documentation and FHI.

5.9.3 Nigerian Red Cross


The Nigerian Red Cross Society focuses on first aid, dis-
aster relief and emergency preparedness. It is registered
with the government and has its own constitution and
board of governors. Funding is mainly from the
International Federation of Red Crosses and Red
Crescents.

45
In-Depth Assessment Report

5.9.4. Tudun Wada Patriots Association


and Gama Self-Help Group
These two groups are also involved in development proj-
ects in their communities. They have registered with the
government and have their own constitutions and boards
of trustees. Funding comes from revenue-generating activ-
ities, individuals and governmental organisations.

Farms
Names Does Site Have HIV/AIDS
Program?

Jakara Ordiad No

Construction and other companies


Names Number of employees

Iliya Blocks Industry 150

Dantata & Sawoe 185

Hassan Plastics 240

Dangote Textiles 530

Short Industries 200

Poly – Bags 25

Air Liquide 2

Gaskiya Textile 1065

Asada 60

Individual Contractors 180

46
Kano State

6. Tarauni Local Government Area


Demographic information

Permanent stable population NA

Temporary population NA

Tarauni Local Government Area was carved out of Kano


Municipal in 1997. The LGA is comprised of 10 wards:
Tarauni Gabas, Babban Giji, Darmanawa, Unguwa Uku,
Unguwar Gano, Kauyen Alu, Hotoro, Rimin Mammage,
Tarauni, and Dan Tsinke. Tarauni LGA shares a common
border with Nassarawa in the north, Kumbotso in the
south and southeast, and Kano Municipal in the west. The
population of Tarauni LGA is estimated at over 600,000.
Only two areas can be described as rural. The population
is largely indigenous to Kano State and predominantly
Moslem. There is no physical structure for worship by
non-Moslem minorities. Heavy demand for water and
electricity in high-density areas such as Zoo Road con-
tribute to the erratic and inadequate nature of infrastruc-
ture in this area.

Size of target populations


Target populations Population

Commercial sex workers 150

Migrant labourers 100

Farm workers 29

Fishermen/women -

Construction workers 160

Uniformed government employees (Customs, police, immigration, defence forces, etc.) 232

In-School youth 3000

Out-of-school youth 1500

Street youth/area youth 500

Petty traders 1000

Truck drivers/bus drivers 2123

47
In-Depth Assessment Report

A significant number of the inhabitants have relocated


from other local governments such as Kumbotso, Dala,
Gwale and Municipal due to population pressures and
displacement for road construction in the 1980s. The LGA
also has a substantial number of middle-class workers
from the banking sector, tertiary educational institutions
and civil service who live in government-built low-income
high-density housing estates. Workers from the factory
areas in Sharada and Bompai also find accommodations in
this LGA.

Residential characteristics
Type of residence Total number of settlements Average number of people per household

Low-density Maiduguri Road 5

Middle density Kundila Road 6

High density Unguwa Uku 25

Slums - -

Rural 2 12

The traditional district head, ward heads and Islamic reli-


gious leaders are important gatekeepers in the Tarauni
LGA. The authority of traditional and religious leaders is
unquestionable, despite the fact that some inhabitants are
not originally from this community. The mosque is an
important socialisation point for men in the community
and most imams have a community-based following.
Prayer, ceremonies, community welfare projects and
mosque beautification are the main issues around which
men gravitate. The women socialise at the numerous
Islamyyia night schools.

Religious denominations

Islam 110 mosques

48
Kano State

6.1 Site inventory and mapping There are two public and 12 private secondary schools in
the LGA. Ten of the 39 primary schools identified during
There is only one major market in this LGA – the Tarauni the in-depth assessment exercise are public, the remainder
market – located in Tarauni Gabas. There is a smaller one private. More than 300 schools were also identified in the
in Kundila and a livestock market (Kasuwar Awaki) in area between Tarauni and Unguwa Uku. There are sever-
Unguwa Uku. With no major industries and most workers al Islamyyia night schools for married women, which
who reside in this area working elsewhere, the LGA gener- operate out of government primary and secondary
ates little income and therefore cannot meet its obligations schools. The population of in-school youth is about 5000,
and that of out-of-school youth approximately 2500.
Numerous almajiria can be seen in the marketplace, in
Major marketplaces and their locations
motor parks or at the middle- class housing estates wait-
Name Location ing to render small services, such as washing clothes or
Kasuwar Awaki Unguwa Uku carrying load in the hope of raising money. Female street
hawkers can be found selling food, kola nut and ground-
Yanawaki Market behind Unguwa Uku nuts. Almajiria can also be found begging. The large
Motor Park
NNPC depot installation and the mobile police barracks
Kundila Market inside Kundila located on the border of the Tarauni LGA contribute to
the local risk settings.
Tarauni Market Tarauni Gabbas

Social institutions (educational institutions)


Primary schools

Name Type Males Females Total

Essence Nursery/Primary School Private 45 75 120

Intercontinental Nursery/Primary School Private 900

Daurawa Primary School Public

Ladybird Nursery/Primary School Private 250

Sure Way Nursery/Primary School Private 34 18 52

Danmarke Primary School Public

Emphatic Nursery/Primary School Private 29 76 105

Prudent Nursery/Primary School Private 40 73 113

New Era Nursery/Primary School Private

Dinop Private

Ebony Private

Kristal Private

Kundla Primary School Public 280 320 600

Fatima Lamido Private 60 53 113

Unguwa Primary School Public 390 180 690

Salsa Nursery/Primary School Private 200 180 380

Pandaudu Nursery/Primary School Private 150 120 270

49
In-Depth Assessment Report

Secondary schools
Name Type Males Females Total

Intercontinental College Private 120

C.g.& S. Kundila Public

Salsa Secondary School Private 300 220 520

Excel College Private 250 200 450

Oxford Private 200 250 450

Kano Business School Private 400 450 850

Tertiary and vocational schools


Name Males Females Total

Kundila Women

AHIP

There are more than 300 sewing shops in Tarauni. Several Total number in formal employment
are run – though not owned –by migrants from neigh- Economic sector Number employed
bouring West African countries such as Mail, Gambia and
Mine or oil workers -
Senegal. Young men and women from other LGAs and
other states come here to become apprentices, hoping that Farming/agriculture 1,000
they may someday open their own shops. The young
Construction 2,000
apprentices often experience immense hardships in finding
housing, earning enough money or even feeding them- Uniformed government services 300
selves. There are numerous flats and rooms for rent.
Other government services 5,000
Gidan hire is common and, unlike some of the more tra-
ditional local governments such as Dala and Gwale, work- Retail (shops) 2,000
ing women, widows and independent women can secure
Shipping -
accommodation.
Fishing -
With only one public health facility, the LGA is served by
Tourism 50
numerous private facilities that include patent medicine
(Hotels/lodgings/motels, etc.)
stores, private laboratories and pharmacies. Most phar-
macies sell condoms; several itinerant drug vendors also
discreetly sell condoms.

There is a small but active NGO community in the LGA


Professional and trade associations
involved in many development activities.
Names of professional asso- Names of trade associations
ciations -

NUT NURTW

50
Kano State

6.2 Risk settings and factors Before the declaration of criminal Shari’a in Kano State,
many FSW operated in areas where male clients resided.
A large number of factors – and the coping strategies of These included the major motor park and the livestock
vulnerable/low-income groups – contribute to HIV/AIDS market at Unguwa Uku, the neighbouring Na’ibawa and
transmission in the Tarauni LGA: absence of industry or Kauyen Alu parks and areas close to Maiduguri Road
high-income generating activities in the LGA, high levels of (where large numbers of young petrol sellers congregated).
youth unemployment, a large group of vulnerable and low- ‘Roasted meat (suya), women and motorcars follow the
income earning females who must meet their needs and petrol sellers’, one young petrol seller said as he proudly
that of their children, the bustling Unguwa Uku motor discussed his prosperity.
park, many workers from outside the LGA, significant lev-
els of urbanisation, reduced social controls over youth and Since the introduction of criminal Shari’a, FSW activities
a thriving black-market petrol industry in this area. have been greatly reduced. Most have moved to neigh-
bouring states where Shari’a has not been introduced.
These predisposing factors contribute to multiple sexual Others who remain have largely transformed themselves
networking, sex for money and kind and exploitation of into respectable but independent women employed in
younger girls and vulnerable women by men with discre- some low-earning activity such as food selling. This is not
tionary cash. Unlike some other LGAs that have remained to say that there are no FSW in Tarauni LGA; what this
a veritable ‘zone of freedom’ with full-time FSW in broth- means is that they are now more inclined to use sex work
els, the current risk setting in Tarauni mirrors that of met- to augment their income from other activities.
ropolitan local governments in Kano State, where a wide
range of sexual networking takes place – but only when
moments of opportunity arise.

Low-income and vulnerable women offer sex for cash and


kind to augment the merger incomes they derive from
petty trading, sewing apprenticeships, food selling and
plate washing. These women do not work in brothels or
walk the streets. However, in the course of their work as
food sellers or petty traders, they may respond to the
advances of men with money. As a response to the intro-
duction of criminal Shari’a, some of these women cannot
return home late at night after they finish work. Other
women report that they have lost their housing because
they are not married. Some have sought the protection of
men who assist with temporary accommodation in closed
shops or rooms in neighbouring villages. This has been
particularly true of plate washers and food sellers in the
Ungwu Uku area, where women have been forced to seek
the protection of union members. In such situations, risk
of infection rises: vulnerable women are at the mercy of
men who may or may not keep them as their exclusive sex
partners.

51
In-Depth Assessment Report

6.3 High-risk and vulnerable populations Sex workers‘ hostels and brothels
Name Address/location
Specific target populations that constitute those at high
risk and vulnerable to HIV infection include butchers, Layin Kokino Tarauni Tarauni Local Government
Area
long distance drivers, petrol sellers, and motorcycle driv-
ers (yan acaba). Low-income women working as female Gidan Yammata Unguwa Uku
traders, food sellers, housemaids and plate washers also
Gidan Isamiya Unguwa Uku
fall within this vulnerable category.
Dofin Café Naibawa

6.3.1 Female sex workers

Type Numbers Bars and clubs where sex workers operate

Permanent sex workers Nil Name Name

Visiting sex workers 50 Lungun Liman

Naibawa Guest House

These are women who render sexual favours for money, as


opposed to vulnerable or low-income women who occa-
sionally have casual sex for payment in cash or kind. Streets where sex workers meet clients
Given the new context of Shari’a, there are few locations Name Name
where women do nothing but render sexual services for
money. Sex workers have either migrated or transformed Zaria Road by Kauyen Alu
themselves into self-employed petty traders or food sellers. Unguwa Uku Motor Park
In the Unguwa Uku motor park, FSW also work as food
sellers.

Prices charged by sex workers


Round Night

N200 N500 - N2000

52
Kano State

6.3.2 Yan Cuwa Cuwa (Petrol sellers) Youth


Tarauni LGA is famous for having the oldest and perhaps
Estimated number of out- 2,500
most lucrative community of petrol sellers in the state. of-school youth
There are now generations of petrol sellers within area
families. While many sellers only come into this area to do Number of out-of-school 500
youth in employment
business on a daily basis, most reside here with their fam-
ilies. Some families have relocated from other states, in
particular, Yobe, Borno and Kogi.
Condoms
Youths between the ages of 14 and 25 – largely unem- Estimated number of 40
ployed school dropouts – are involved in the highly lucra- places selling condoms
tive practice of black marketing petroleum products on
Estimated number of con- NA
street corners around the LGA. They are part of a distinct doms sold monthly
youth subculture characterised by drug abuse, extravagant
spending, flamboyant behaviour and entertainment that
revolves around sports, cinemas and playing billiards. The
pattern of sexual networking of this group is particularly
complex: it involves visits to FSW where they pay for sex
as well as special regular girlfriends with whom they have 6.3.3 Men with multiple partners
sex in exchange for some demonstration of support. Many This group of men include the young yan cuwa cuwa,
youth in this area also report having sex with young street married men trading in the Tarauni markets, long distance
hawkers (yan talla), widows (zawarawz) and older eco- drivers, butchers and motorcyclists. They frequent hotels
nomically independent women – ‘sugar mummies’. The for shakatawa (relaxation) and women, but also meet sex
yan cuwa cuwa say that they respect their elders, do not partners in their day- to-day activities. When the moment
belong to any formal associations but congregate for cer- of opportunity arises, some of these men report engaging
emonies. in sex in dark corners or semi-public places. In most cases,
men with multiple partners report having regular sex with
They know about condoms but do not use them. They special girlfriends, whose food and shelter needs they
report having had sexually transmitted infections and seek meet. But these men also have other partners.
treatment through peer referrals to chemists.
Not all men with multiple partners report having had a
They listen to radio and watch videos. Yan cuwa cuwa in sexually transmitted infection. Gonorrhea is the common-
this area are particularly optimistic, as they feel that the est infection and bilharzia is often mistaken for a sexually
booming petrol business will continue. Their only fears for transmitted infection. When they have infections they ‘go
the future concern money. to chemist to get injections’ or seek native doctors. Some
men with multiple partners (especially drivers) occasional-
The life history of Musa from Yobe State is illustrative of ly use condoms, but do not like them. They have a liberal
yan cuwa cuwa. He is a 21-year-old indigene of Yobe lifestyle and are very afraid of HIV/AIDS (kanjamau),
State. He lives with his parents in Daurawa Quarters in because there is no cure for it.
Tarauni LGA. He was formerly a mechanic, but was con-
vinced by his friend Sani that selling petrol was more prof-
itable. Musa pays for sex and has four to five partners at
any given time. He has developed a relationship with one
special girl. Maybe she can become his girlfriend, he says;
he is not sure. He occasionally has sex with other women
whom he meets outside of the hotel – when he has money
to pay for it. Musa has never had a sexually transmitted
disease and has never used a condom. He listens to the
radio and watches TV. He respects his elders and listens to
music for entertainment. His major worry is about not
having enough money.

53
In-Depth Assessment Report

6.3.4 Long-distance drivers Places truck and bus drivers park at night
These men visit girlfriends when they come to Kano State. Places Places
Some (who find themselves with cash) go to hotels and
bars; others stay in the motor park where they also find Unguwa Uku motor park Kasuwa Awaki
women. They are considered big spenders on women and Maiduguri Road by NNPC C.n. Okoli parking lot
are seen to be womanisers. When they contract STIs, the
literate ones go to clinics; the illiterate obtain treatment Naibawa Young Shall Grow
parking lot
from chemists.

They report condom use.

They are members of the National Union of Road Guesthouses, hotels, motels and
lodges frequented by truck and bus drivers
Transport Workers and like to listen to radio. They fear
insecurity, police abuse and political instability that may Names Location

affect their livelihood. Rumfar Maigadi Motor Park Unguwa Uku

Gidan Tsamiya Unguwa Uku


Truck and bus companies that
pass through this site Guest houses in Naibawa Naibawa
Truck Bus

Idrisyya Trucks Young Shall Grow

Individual Trucks Mohd. Girema


Bars and clubs frequented by truck and bus drivers
Talaniz Motors Salisu Adamu Fagge Names Location

A.A. Girigiri Bendel Line Dofin Café Naibawa

MIC – Mera Yobe Line Naibawa Park Naibawa

Kano Line C.N. Okoli

Jigawa Line Blessed Chidi & Sons

Kanuri Line

Estimated number of trucks and


buses entering or leaving site daily

3,500

Estimated number of trucks and


buses parking overnight

1,000

54
Kano State

6.3.5 Male clients 6.3.6 Vulnerable women


Most men in the high-risk group interviewed admitted Vulnerable women are largely unmarried, widowed or
having sex in exchange for money, but did not consider divorced low-income earners. If these women were once
themselves to be male clients. Information on male clients married, it is likely that they were originally from outside
was therefore obtained from FSW, observation and key the LGA and were brought here by their husbands. If
informants. The male clients argued that if the women did divorced or widowed, these women become especially vul-
not like them, the women would not have sex – even if the nerable. They cannot be reabsorbed into their families and
men promised to pay a million naira. This argument was are often left with children for whom they must care.
heard especially from the older and married male client – Remarriage is their only hope, but few men are ready to
like the long distance driver who claimed he could take take on ready-made families. Vulnerable women therefore
girls as second or third wives. Younger petrol sellers and join the ranks of low-income women as they engage in
motorcyclists understood that they were paying for sex plate washing or petty trading. They often have sex with
and had no expectation of marrying sex partners. Detailed men they encounter in their day-to-day work.
information was obtained about male clients in the
Unguwa Uku motor park. These drivers come from all Housemaids who gravitate to the Tarauni LGA area can
over the country and are mostly mature married men also be viewed as vulnerable women. They are between
whose families live outside Kano State. the ages 15 and 24. Some are migrants from southern
Kaduna State, Niger, and Plateau states. Their vulnerabil-
These men usually meet their regular sex partners when ity is worsened by the fact that many are brought from
the women are selling food, trading or undertaking other their rural homes to Tarauni by commission agents and
economic activities. Only a few women do nothing but sell are now at the mercy of their employers. Housemaids are
sex; these FSW come to the motor park in the late reported to engage in casual sex with houseboys or other
evenings to return next morning. The drivers report patro- boys in their neighbourhood for financial and material
nising them if they are beautiful, but prefer women whose gains.
marital status they know. Drivers worry that some FSW
who migrated to and from the motor parks might be mar- Condom use is usually low or non-existent among this
ried – and under Shari’a, such sex is a serious offence. group. Some Christian housemaids are warned about STIs
They are happy that some women now spend nights in the in church. When infected, they patronise patent medicine
motor park; the drivers view this as proof that the women stores. Although these women do not belong to formal
are not married. organisations, they meet informally on weekends for
social and religious activities.
Many LDDs report using condoms, though it is not read-
ily available in the motor park.

55
In-Depth Assessment Report

6.4 Health facilities and sectoral Number of public facilities


responses to HIV/AIDS Type of facility Bus

Tarauni LGA has one public hospital and a number of pri- Tertiary hospital 2
vate hospitals, clinics, chemists and medicine stores. The General hospital Nil
Nigerian Medical Association is located here. Most medi-
cine stores are foundd in Darmanawa and Babban Giji Primary health centre 4
wards. Condoms are generally available in pharmacies
and patent medicine stores and from numerous itinerant
vendors of patented and non-patented drugs. Both public Number of private facilities
and private facilities provide some form of clinical care to
Type of facility Bus
patients with HIV. They offer a wide range of services
including religious and psycho-social support. Tables Hospital Nil
below give a profile of the hospitals and the services they
Clinic 45
provide.
Nursing home Nil

Estimated number of pharmacies and drug stores

171

Profile of health facilities in Tarauni LGA


Name Status Doctors Nurse Clinic officers Trained Lab. tech.
HIV/AIDS
counsellors

AKTH* Public 139 245 1 5 29

Al-Noury Hospital** Private 6 10 2 0 1

Premier Hospital** Private 4 11 35 3 3

*Public ** Private

HIV/AIDS services provided

Name of clinic/ hospital Screening Counselling Medical manage- MTCT Average number
ment of HIV/TB Prevention of STI/HIV
patients monthly

AKTH* Yes Yes Yes Yes 20

Al-Noury Hospital** No No Yes No 20

Premier Hospital** No No Yes No 0

*Public ** Private

56
Kano State

6.5 Care and support of PLHA 6.6 Public institutions providing care for PLHA –
Aminu Kano Teaching Hospital (AKTH)
Public hospitals, private clinics and families provide most
of the care for HIV-positive patients in Tarauni LGA. The This is a tertiary hospital with 139 doctors, 245 nurses,
main public health facility, the Aminu Kano Teaching one clinical officer, five social workers and 29 laboratory
Hospital, offers care and support services (clinical, HIV technicians/technologists. AKTH has provided clinical
counselling and care). Social support for PLHA is provid- care (including the medical management of HIV/AIDS and
ed: the hospital has a general policy of support to all tuberculosis, palliative care and counselling services) for
patients, irrespective of the type of illness. Home-based people with HIV/AIDS since 1994. The facility’s catch-
care and orphan care and support, mother-to-child trans- ment area includes Kano and neighbouring states. It
mission (MTCT) prevention services are not now provid- serves a population of at least 11 million; an estimated
ed, but plans are underway to begin doing so soon. STI 250,000 of them need HIV care. The annual in-patient
services are strictly etiological. turnover was between 2,700 and 6,000 during 1998.
Respondents estimated that they see, on average, 30 cases
per week of HIV/AIDS (of which about six are new cases).
Non-governmental organisations working in HIV/AIDS
prevention and care and reproductive health
The demand for HIV/AIDS clinical care has increased in
the last few years.
HIV/AIDS prevention and Reproductive health
home care
The hospital provides social support to PLHA only if they
AHIP are indigent – a policy applied to all patients of the hospi-
tal, irrespective of their illness. The hospital does not pro-
STOP AIDS
vide home-based care or orphan care and support. At
Health in general Others present, they do not provide MTCT services, but plans are
underway to start doing so soon.
Ilumaja Health Project Muslim Sector
Organisation
TB cases seen at this facility range from over 700 per
JMA annum to 1300 and have clearly increased over the last
few years. All TB patients are routinely screened for HIV.
Anti-TB drugs are paid for and DOTS is practiced only
when the patient is in hospital (about four weeks); there-
after, the patient takes his medications without supervi-
sion.

All STD cases are seen in the General Outpatient


Department (GOPD) or, occasionally, at the gynecology
clinics. Difficult cases are referred to the skin and venere-
alogy clinic. About 20 STD cases are recorded each
month; treatment is based on clinical and etiologic diag-
noses. The staff has not received training on syndromic
management of STDs or seen the current NASCP manual
for STD treatment.

57
In-Depth Assessment Report

6.7 Private institutions providing care for PLHA 6.7.2 Premier Hospital
Premier Hospital provides clinical care (including medical
6.7.1 Al Noury Hospital management of HIV/AIDS and tuberculosis, palliative
This is a missionary (Islamic faith-based) institution with care and counselling services) for people with HIV/AIDS
six doctors (two full-time and four part-time), 10 nurses, in the LGA. The mean annual turnover of in-patients in
two clinical officers, one laboratory technologist and 15 adult wards has been about 150 in the last three years –
volunteer health workers. Since 1990, the hospital has between five and 15 percent of them with HIV/AIDS. The
provided clinical care (including medical management of hospital sees five to 10 patients with AIDS-related illness
HIV/AIDS and tuberculosis, palliative care and coun- each month and demand for care is increasing.
selling services) for people with HIV/AIDS in the LGA.
The catchment area population is around five million, of Patients with TB are treated at the facility and pay for
whom an estimated half million need HIV care. The hos- their drugs. All TB patients are screened for HIV after
pital had an annual in-patient turnover of between 420 counselling. The hospital does not use DOTS strategy.
and 630 patients during the1998-2000 period; HIV/AIDS The total number of TB cases managed at this facility
patients probably constituted 0.5 to 1.1 percent of the ranges from five to16 per annum. Respondents from this
total. Demand for HIV/AIDS clinical care has been institution said nothing about STDs, except that they had
increasing in the last few years. seen the national policy on STI/HIV/AIDS.

The hospital provides social support for PLHA only in the


form of religious and psychological counselling and
through nutritional talks and cookery demonstrations. It
does not provide home-based care or orphan care and
support.

Patients with TB are treated at the facility and pay for


their drugs. Those who cannot afford to pay are referred
to the Infectious Disease Hospital (IDH). The total num-
ber of TB cases managed at Al Noury hospital ranged
from 28 to 41 per annum and has been increasing over the
last few years. Tuberculosis patients are not routinely
screened for HIV. DOTS is not practiced.

An average of 20 STDs are seen monthly (240 per


annum), with treatment based on etiologic diagnosis. The
staff had neither received training on syndromic manage-
ment nor seen a copy of the current NASCP manual. Nor
had they received training on HIV/AIDS clinical manage-
ment.

Advice on condom use is not given to patients because, as


a religious institution, the hospital does not want to be
seen as encouraging promiscuity.

58
Kano State

6.8 NGOs providing care and support 6.9 Community leaders

It is important to note that certain constraints must be Three community leaders, one traditional ruler and two
addressed before PLHA can be successfully cared for and religious leaders, were identified as gatekeepers. They
supported. These include: the present lack of coordina- indicated varying degrees of acceptance of the challenge
tion/linkages between care and support providers of posed by HIV/AIDS in the community and willingness to
HIV/AIDS activities, inadequate knowledge and skills actively participate in interventions. The leaders are
regarding current concepts in the management of STIs, TB involved in awareness activities and in decision-making
and HIV/AIDS, no SACA or LACA at the state and LGA for local health actions – most importantly at the imple-
levels and scant availability of drug availability at the mentation level. While two of the men indicated interest in
facilities. caring for a relative with HIV-related illnesses, the third
said he would refuse to participate in intervention activi-
Efforts must be made to improve community awareness ties. He even questioned the methodology adopted in pro-
and participation and to encourage the formation and gramming and donor intentions.
strengthening of community-based care and support It is important to note that secondary school principals
groups for PLHA. Advocacy at all levels of government, (who were supposed to be interviewed under community-
training and re-training of health personnel and re-orien- leader category) were unwilling to participate in the exer-
tation of health facilities to provide HIV/AIDS care and cise. This could be attributed to the lack of sensitisation
support would greatly improve the present situation. and advocacy on the part of agencies responsible for
Better coordination of all parties involved in HIV/AIDS HIV/AIDS programmes.
issues would doubtless aid care and support programs in
the LGA.
Major community groups
Names of Community Groups Activities Carried Out by
the Group
6.8.1 Society for Women and AIDS in Nigeria (SWAAN)
SWAAN provides free services for PLHA: counselling, Kundila Youth
home-based care, some support for motherless babies and Development Association
orphanages and a weekly HIV/AIDS clinic service run by
Vigilante Group Security
a member physician. The organisation began its
HIV/AIDS-related activities in 1996. Funding for
SWAAN is mostly through international donors (75 per-
cent), with individual donors, local fund-raising activities
and membership dues making up the rest. The group had
95 PLHA registered with them (57 males, 38 females) by
December 2000. They have one full-time trained counsel-
lor and 21 part-time counsellors. Most were trained by
SWAAN Lagos or at the Kano branch. Services offered
include pre- and post-test counselling, on-going, family
planning and nutritional counselling.

6.8.2 Council of Positive People (COPOP)


Although this group is sited in Nassarawa LGA, it works
with SWAAN to aid PLHA throughout the metropolitan
area (see COPOP under Nassarawa LGA).

59
In-Depth Assessment Report

6.10 Organisational assessment

There is a small but active group of civil society organisa-


tions in the LGA –trade unions, NGOs and community-
based organisations(CBOs). These include: Nigerian
Union of Road Transport Workers (NURTW), Women
and Youths Support (WAYS), Nigerian Union of
Petroleum and Gas (NUPENG), Women Health and
Advancement Network (WHADNET), Adolescent Health
and Information Project (AHIP), ILMATA Health
Organisation, Grassroots Health Organisation of Nigeria
(GHON), Society for Women and Aids in Nigeria
(SWAAN), YOSPIS, and Nigerian Union of Journalists.
Most of these have approved constitutions and boards of
trustees. They have indicated interest, support and will-
ingness to work in HIV/AIDS-related activities. SWAAN,
GHON, and WHADNET have all been involved in such
activities in the past.

This suggests that they might be willing to cooperate and


participate in Tarauni, even if activities were initiated by
an organisation other then their own.

Media people read, watch or listen to


Newspapers TV Radio

Triumph STV BBC

Weekly Trust NTA VOA

Daily Trust GERMANY

This Day KADUNA RADIO

Others KANO - TASKA

60
Kano State

Notes

61
In-Depth Assessment Report

Notes

62
Kano State

Notes

63
Family Health International implements the USAID IMPACT Project
in partnership with the Institute of Tropical Medicine, Management Sciences for Health,
Population Services International, Program for Appropriate Technology in Health
and the University of North Carolina at Chapel Hill

Family Health International


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