Joao "Tamimo" Ali, a maintenance worker at the U.S. Agency for International Development mission in Maputo, Mozambique, began to notice the devastating effects of HIV/AIDS in his community about two years ago. Struck by the untimely deaths of some neighborhood residents and fellow churchgoers, Tamimo was determined to find out all he could about the deadly epidemic ravaging southern Africa.

"I was so curious that I began reading everything I could get my hands on," he said. "I wanted to share my knowledge with members of the community."

After starting informal counseling sessions in his own neighborhood, he saw the opportunity to use more innovative outreach ideas. At a USAID staff meeting where plans for a July 2005 HIV/AIDS health fair were being discussed, Tamimo volunteered to create a theater group to present HIV/AIDS-related skits he had written in a uniquely Mozambican cultural context.

With a growing HIV/AIDS epidemic, Mozambique is one of the 15 focus countries under the U.S. President's Emergency Plan for AIDS Relief and is receiving $94 million for prevention, care and treatment programs this fiscal year.

The latest statistics are sobering: One of six Mozambicans aged 15 to 49 is HIV positive; an estimated 500 people in that same age range become infected daily. With only 650 physicians and a population of 19 million, the country is facing a grave health crisis.

Culture Changes

"Certain Mozambican cultural practices clearly contribute to the spread of HIV/AIDS," said Tamimo, "and I wanted a way to point this out to my co-workers." The July 2005 presentation of Tamimo's skits by a group of USAID and Centers for Disease Control Locally Employed Staff was a huge success, fueling a dialogue about the importance of knowing one's serological status. Mission employees lined up in great numbers at the health fair's onsite testing facility.

The skits touched on controversial themes such as delayed sexual debut (the average age to initiate sex is believed to be 16 in Mozambique), fidelity, the use of condoms in extramarital affairs and speaking with parents about sexual peer pressure.

Popular demand led to the group's second show in late November in honor of World AIDS Day. In his prelude, Tamimo urged mission audience members to go out to their own neighborhoods, churches, mosques and schools to continue sharing awareness and prevention messages in creative ways.

Following on the heels of a successful Mission Speakers Initiative that sent teams of employees out to Maputo-area high schools to discuss American culture, foreign policy and bilateral relations with Mozambique, a new idea was born: to capitalize on the theatrical talents of Locally Employed Staff by sending out the "HIV/AIDS Road Show" to Mozambican high-school and private-sector audiences.

The group's first presentation, held on March 3, unfolded in front of 55 high school students in the suburb of Matola. Among young couples, "proof of love" is a common technique used to pressure young women into sexual initiation. The first skit presented the message powerfully by turning the tables: the young girl asked her boyfriend to wait as his proof of love. A comical interlude followed, as a mother and a father sat down with their teenage children to clumsily initiate a discussion of the risks of sexual intercourse and the importance of condom use.

Serious Questions

After the conclusion of the skits, Clinicto-Community HIV/AIDS Outreach Advisor Dr. Mussa Calu, a member of the USAID health team, answered questions that were unexpectedly technical in nature.

"The students were surprisingly well informed on the biology component of the virus, but it's clear that they need to focus on behavior change and female empowerment," she said.

Gender inequality is a serious issue in Mozambique, where it is often difficult for women to negotiate the terms of sex or turn down sex. The May 19 road show performance in front of 75 factory workers at the Unilever plant highlighted the problem. Men asked questions like "How can I have a child even if I'm HIV positive?" and "When can I stop using a condom with my girlfriend?" while the women's questions centered on asserting control over sexual choices.

One of Tamimo's skits emphasized the issue: A housewife cleaning out her husband's suitcase after his business trip finds condoms and refuses to be intimate with him until he's shown her the results of an HIV test. Smiles, laughter, pensive looks and applause from the audience were proof that the message had been received. Even more remarkably, Tamimo's sign-up sheet for Unilever employees interested in forming their own theatrical group filled up quickly.

Tamimo, Dr. Calu, Branca Cruz, Joana Coana, Euridia Azevedo, Leonardo Ricardo, Adriano Tivane, Silvia Fernandes, Samuel Dzimba and Joaquim Martins " the founding members of the road show " have all shown a remarkable commitment to the fight against HIV/AIDS. Their personal examples demonstrate to their communities that through the steadfast efforts of a few, many and much can change.