While policies and advocacy efforts continue to shape Nigeria’s healthcare landscape, the real struggles of vulnerable individuals battling HIV, TB, and malaria remain largely unseen. At the capacity-building workshop hosted by Lawyers Alert and Media Health & Rights Initiative of Nigeria and supported by the Gender Equality Fund (GEF) in Akwa-Ibom, participants shared heartbreaking stories from the field, revealing the devastating barriers women face that compound the impact of these diseases beyond medical symptoms. So many heart-wrenching scenarios portray gender disparities that need to be addressed:
The Fear of Stigma: Women Hiding Their Medication
Many women hide their HIV medication from their partners for fear of being stigmatized or abandoned. This often leads to missed doses, making their condition worse.
“I know a woman who keeps her antiretroviral drugs in a neighbor’s house, she forgets to take them regularly because she’s scared her husband’s younger brothers who live with them will find out. Her husband is also HIV positive and does not even tell her when he takes his”
Some of these women believe they have more to lose than their male counterparts in the same situation.
Witchcraft Accusations: The Plight of TB Patients
Among these heart-wrenching stories were those of adolescent girls and children accused of witchcraft simply because they have tuberculosis. The night fevers and severe coughing associated with TB have led families to abandon their own children out of fear and superstition.
The Absence of Caregivers: Adolescents at Risk
Many adolescents living with HIV lack caregivers to remind them to take their medication. Without proper support systems, they forget doses, leading to worsening health conditions. A CSO representative noted, “Many young people feel isolated, and this isolation leads to depression and even suicidal thoughts.”
The Connection Between Disease and Gender-Based Violence
The workshop also revealed the harsh realities of gender-based violence (GBV) among those living with HIV and TB. Economic dependence often forces women to remain in abusive relationships, further deteriorating their health. Edith Akueze, a programme manager for one of the grassroots CSOs narrated;
Iyene’s husband would lock her at home after beating her so that neighbours would not see her scars. He didn’t even care that she would miss the check-ins at the primary healthcare center, or that she needed better food for her TB medication. She fell off the TB medication twice and developed Drug-Resistant Tuberculosis after a while. The caseworker from our NGO kept going there trying to visit her until the man threatened to kill her.
Iyene would faithfully pick up her calls once she got better from the violent bouts, and book an appointment with the caseworker who would come to escort her to the health center for new testing and a new round of treatment. She would dedicatedly take her medication until he attacked and beat her again, then it was back to square one. One day, I asked her, “Madam, if you don’t leave this man and come to our shelter, he will kill you. Abi do you want to die?”, Iyene replied, “It is better I die in my husband’s house, so he can take me back to my family and explain that he killed me”. I didn’t understand this logic.
When she died, I heard about it three weeks later from her neighbour. I called the caseworker and we went to her house. Iyene did not get an autopsy, she did not even get a mention at the police station. She was accused of witchcraft by her husband’s family who claimed that their prayers removed her from his life permanently. Her burial was scheduled and her children were released to us finally for TB test after two years of resistance from her husband. All three of them had TB and were immediately put on treatment and moved to their Aunt’s house. Her fate was the saddest thing that ever crossed my path in 2024, the waterleaf seller who believed her destiny was to die in her husband’s house, literally.
The tragic story of Iyene is not strange. Many other participants shared various scenarios of domestic violence preventing their female beneficiaries from accessing treatment and healthcare. As the discussions progressed, it became clear that healthcare interventions must go beyond medical treatment, they must also address social, economic, and cultural barriers to care.