Paul Kasonkomona: A Zambian HIV treatment activist takes on homophobia and silence

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PaulKasonkomona

Paul Kasonkomona in the August 2011

Paul Kasonkomona’s struggle took him from saving up money for his own funeral, to the struggle for treatment access

Several years before police in Zambia arrested Paul Kasonkomona this week for telling a national television audience that the nation  needs to decriminalize homosexuality and recognize its gay population, a widely distributed Zambian government-issued report made observations similar to his.

The Government of  Zambia and National AIDS Council’s Joint Mid-Term Review of the National AIDS Strategic Framework 2006-2010 noted gaps hindering the country’s AIDS strategy: “At the conceptualization stage, some risk behaviour groups (i.e. multiple concurrent sexual partners, discordant couples, uncircumcised men, and MSM) were missed out, therefore, no interventions are specifically targeting these groups . . .”

The report, issued in 2009, noted that “legal issues” hindered collecting necessary information and providing needed services for men who have sex with men, referring the “anti-sodomy” laws introduced by British colonialists and remaining on the books. Repeatedly noting the challenge that this criminalization posed, leading not only to the neglect of a significant part of the community, but to the further spread of disease, the report recommended: “The legal impediment to effective HIV and AIDS interventions and programming for MSM and IDU groups should be revisited so that people in this group are readily identifiable and supported with appropriate HIV and AIDS interventions.”

Time passed. Donors funding conspicuous billboard campaigns urging monogamy, asking Zambians “How Many People Are You Having Sex with?” and organizing tribal chiefs to discourage traditional practices  that included “widow inheritance” and “sexual cleansing,” argued that Zambians weren’t ready to give up homophobia.

By then it was election season, which as in other countries, begins very shortly after the previous one ends. On a daily basis, milingowarnsheadlines in the government-owned newspapers, accurately or inaccurately accused opposition candidate for the presidency Michael Sata, who has since won, of tolerating homosexuality, indicating this was a bad thing.To put this in some perspective, the sitting candidate was being accused of not being eligible to hold office because his parents hadn’t been born within the borders of what is now Zambia. In poor countries and relatively affluent ones alike, the issues that affect voters’ lives tend to get lost around election time.

Zambia’s HIV activist community held on to the decriminalization issue though.

With funding cutbacks having led to stockouts, forcing HIV patients to travel to clinics every two weeks instead of every three months to get their antiretroviral medicine supplies, civil society was growing increasingly concerned that the country’s AIDS strategy be effective. Paul Kasonkomona was the most vocal on the role that human rights recognition needed to play in that.

I met him in the early afternoon at a restaurant on the main road leading to Livingstone. He is a small, wiry man, with a wide smile and a strong handshake. Yes, he acknowledged, people expect a bigger man. Something about his name perhaps, which goes on and on, and his reputation for not going away — he had been threatened with arrest and been arrested while demonstrating for HIV treatment access repeatedly by then.

Behind us, he pointed out, were the shanty slums of Misisi, where people lived in desperate poverty, where health care, education, and food all are luxuries, and where residents scrounge their livings selling whatever they can: groundnuts, charcoal, themselves. In front of us was a road leading to an affluent suburb a short distance away, where teenagers went to private schools, had pocket money to buy things they wanted. The populations of the two disparate places, he said, are not completely divided by their circumstances, he pointed out. “They meet here,” he said. Ignoring one group was not the way to win the battle against AIDS, he said.

He had learned he had HIV about a decade and a half earlier, he told me, and had immediately left for Zimbabwe.

The economy was better there, at the time, he explained. “I thought I could save up enough money for my funeral.”

He didn’t think he could expect anyone else to pick up the tab, with his illness branding him a promiscuous person.

He got some antiretroviral medicine, occassionally in Zimbabwe. He has paid the cost of drug resistance for getting what he could, when he could, sporadically, in a bid to outlive the neglect of poor countries that marked the first decade after treatment became available in affluent countries. That fueled his fight for treatment access. His fight for treatment access in turn fueled his fight for the inclusion of people living not only with HIV but living with HIV in poverty on boards that guide Zambia’s response to the epidemic. He believed Zambians who are affected most by HIV were at least as ready for a response to the epidemic that includes men who has sex with men, as they are for campaigns targeting extramarital sex and obscure, and largely symbolic traditional practices.

He spoke for three hours that afternoon, facing a setting sun, and finally darkness.

He has a feeling the struggle is shortening his life, he said that day, but it doesn’t make sense to stop, because that would shorten his life too. He wouldn’t mind, though, if those with more weight than he has joined the struggle to make the response to HIV more equitable.