Unheard Voices, Hidden Lives - Cambodia, India and Ecuador (2006)

Location: India and South Asia, South East and Far East Asia, Cambodia

Project Background

Photography by members of at-risk groups and groups affected and infected with HIV/AIDS in three countries, in collaboration with the International HIV/AIDS Alliance’s wider multi-country HIV prevention programme.

Project photo gallery

Further project info

Cambodia

Project Trainers: Eugenie Dolberg, Jane Martin
In 2006, Cambodia was the country most affected by HIV in Asia, with a national prevalence of approximately 2.6%. Over 250,000 people had been infected with HIV in Cambodia since the beginning of the epidemic and 94,000 people died of AIDS.

However, by 2006 increased political commitment, stronger responses from civil society and a wide range of activities by the Ministry of Health began beginning to stem the tide of new infections. The number of new infections has dropped from 100 a day in 1997 to 20 a day in 2004.

Sex work, sex between men and injecting drug use were the principal modes of HIV transmission in Cambodia and there was increasing recognition among both government and civil society of the importance of recognising and working with these groups to prevent HIV and mitigate its impact.

Two sets of photography workshops were run by PhotoVoice facilitators Eugenie Dolberg and Jane Martin in July and September 2006, with the month’s gap in between allowing participants to work with the cameras in their everyday lives. Among the especially at-risk groups of people represented among the participants were sex workers, men who have sex with men (MSM) and people living with HIVAIDS.

India

Project Trainers: Jenny Matthews, Matthew Lea

India is at a crossroads in its efforts to control HIV. Although adult HIV prevalence is still relatively low at 0.9%, infection is spreading rapidly – the number of HIV-infected people has increased tenfold in the past decade to 5.7 million.

There are a number of things that make India’s HIV epidemic unique. India’s size and diversity have resulted in multiple local epidemics which has made a uniform approach to prevention challenging. Populations that are key to the epidemic across India are dispersed and mobile, making it very difficult to set up programmes. Extreme stigma, apathy and denial work towards keeping the epidemic hidden, allowing it to spread unchecked.

The resources available to fight HIV in India are also far below what is needed. The total annual allocation to fight HIV in India is US$146 million, while a fully funded prevention and care programme in India would cost closer to US$1 billion a year.

In the state of Andhra Pradesh, one of India’s highest prevalence states, the International HIV/AIDS Alliance has been implementing the Frontiers Prevention Project. Focusing on men who have sex with men (MSM), sex workers and people living with HIV, the project is working to expand access to proven HIV prevention programmes.

The establishment of a network of Mythri clinics designed to treat sexually transmitted infections, which are a significant co-factor in the transmission of HIV, has been coupled with behaviour change and condom promotion. Community mobilisation directed at empowering members of key population groups to participate in and lead HIV prevention efforts and challenge stigma and discrimination, is also central to the project.

In September and October 2006 PhotoVoice facilitators Jenny Matthews and Matthew Lea ran two sets of workshops with fifteen members of key groups recruited from various locations in Andhra Pradesh. In the month between these two sets of workshops participants returned to their home villages with digital cameras and took photographs to document their lives and experiences. The resulting frank, intimate and often hard-hitting photographs provide an insight into the lives of groups often overlooked and under-represented in India, and illustrate the way they affect and are affected by the spread and prevention of HIV/AIDS in their country.

Ecuador

Project Trainers: Lynn Weddle, Marcela Nievas

Ecuador is located in the north west section of South America, sharing borders with Colombia, Brazil and Peru. Ecuador’s estimated HIV prevalence rate in adults is 0.3%, with around 23,000 people living with HIV.

As Colombia’s neighbour, Ecuador is caught up in a military and economic response to Colombia’s civil and drug wars. The wars also present a serious migration problem for Ecuador, with an estimated 1,000 Colombians entering Ecuador illegally each month, many of whom stay in Santo Domingo de los Colorados. Many of these migrants, primarily women, become involved in sex work because of the socio-economic pressures they have to deal with as they attempt to resettle in Ecuador.

The intensified economic crisis that Ecuador has been experiencing since 1999 has exacerbated the spread of HIV. Over this period, there has been a sharp decrease in household incomes; levels of unemployment have risen dramatically, and poverty throughout the country has increased significantly – most crucially in communities already highly vulnerable to infection, such as people who sell sex, migrants and urban populations.

The economic crisis has meant that people living with HIV cannot afford adequate nutrition, medical attention and medication. The scarce funds that have been allocated to these areas by government are directed toward the poorest sectors of society and only address their most basic health needs, ignoring the many Ecuadorian citizens whose income is judged to be just above that of the poorest.

In August and September 2006 PhotoVoice facilitators Lynn Weddle and Marcela Nievas ran two sets of photographic training workshops in Quito with fifteen members of key groups already associated with the International HIV/AIDS Alliance’s local partner organisation in Ecuador, Corporacion Kimirina. The selection of participants included sex workers, gay men and other men who have sex with men, and people living with HIV. In the month between the two sets of workshops participants took digital cameras back with them to their homes and took photographs to document their everyday lives and highlight the issues that affect them. The powerful images produced provide a remarkable insight into the lives of groups often overlooked by policies aimed at addressing the AIDS epidemic.