Whether on foot, camel, dhow, containership, tanker, or truck—traders have likely criss-crossed Djibouti and its waters for as long as there has been trade. Today, the Port of Djibouti, one of Africa’s busiest, lies at the nexus of major shipping routes between Asia, Africa, and Europe.
From Djibouti, most goods travel inland by trailer-truck: some 800 Ethiopian truckers arrive every day. After offloading coffee, cotton, beans and other commodities from Ethiopia, truckers wait 4 to 6 days to reload with imported electronics, spare parts, construction materials, food aid and much else.
This range of activity makes a small community, virtually unknown outside Djibouti, both important and vulnerable. It’s called PK-12 for “Point Kilometre 12″ in French, the official language. Meaning that it’s 12 km from Djibouti town, the capital and site of the port. PK-12 looks like the mother of all truckstops. Colorful vehicles lie like flattened dominoes as far as the eye can see—thousands of them.
Understandably, drivers with several days on their hands also ferry back and forth another invisible item. About 25 percent are thought to be HIV-positive. The number of HIV-positive young women and men from the community is not known, and the stigma is too strong for even the boldest to disclose their status.
As late as 2004, HIV was a taboo subject, along with condoms. Voluntary testing did not exist. A lot of young women in this small roadside settlement were not only getting pregnant out of wedlock, they were also dying. If someone got a positive diagnosis—usually by showing up at a hospital with TB or another disease—they often took their own life.
“I got involved in HIV education because I used to lie awake at night worrying about my two daughters,” says Zahra Daher. ”They were very young then, but what would happen later? There’s so little opportunity here except sex work. It seemed like a death sentence.”
Zahra and I, along with three bearded imams and several peer counselors, are talking on the second floor of a little building made, fittingly, from one transport container atop another. This center for recreation and HIV education is a “SafeTStop”—one in a network of 52 in communities along the main highways of East Africa. The SafeTStops are part of the ROADS II program funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID and implemented by FHI 360.
A decade ago, before the SafeTStop existed, Daher and others here were chased, stoned, and accused of infecting people simply for talking about HIV. In 2004, Daher assembled a concerned women’s association. Hussein Houmed put together a youth association. Together, they sought support and funding. By 2005, they received both from PEPFAR through USAID/Djibouti.
The clerics—initially far from enthusiastic—were invited to join the initial training. They did, and today they preach prevention at community mosques. “Our target,” says Houmed, “was to inspire people to go for voluntary counseling and testing, so if they’re positive they start taking ARVs [antri-retroviral drugs] if needed. That way they can stay healthy and are also unlikely to pass the virus on.”
Peer counselors roam the local bars and restaurants, befriending people in Arabic, Afar, Somali, or Amharic, distributing condoms, and encouraging truckers and community members alike to be tested.
“The progress is very visible,” says Daher. “Before, no one mentioned the disease. Today we see people talking about it. We see people easily asking for condoms, going for testing, then going back for the results. People who are positive approaching us for advice. And undesired pregnancies are much rarer than they were.”
Thanks to a public-private partnership between USAID, the Government of the Republic of Djibouti, FHI 360, and Dubai Ports World, which operates the port of Djibouti, the little container-hut at PK-12 will be replaced by a larger center nearby. The new SafeTStop will feature testing and treatment on the premises, so clients will have a one-stop-shop for recreation, plus HIV and other health services.
“I’m taking this opportunity to thank American taxpayers and the Ambassador,” said Houmed after our interview. “Long life to the U.S. and the Government of Djibouti, who have made this partnership possible.”