Meet Hassan: HIV Counselor Reaches the Hard-to-Reach Communities in Nigeria

Hassan riding a donkey to reach hard-to-reach communities (Photo: Jhpiego)

Hassan (right) with Mallam Ginger Isa (left) testing for HIV (Photo: Jhpiego)

Riding donkeys, motorcycles, and bicycles and walking along rugged roads for long distances are just a part of Hassan Mohammad’s daily routine. Hassan is a community health extension worker and team lead of the HIV Testing and Counseling Unit at Tsafe General Hospital. Tsafe is an area located in Zamfara state in northwest Nigeria. It has several remote communities with an estimated population of over 90,000 people who have little or no access to hospital care.

Through PEPFAR and the U.S. Centers for Disease Control and Prevention (CDC) in Nigeria, Jhpiego—an international, non-profit health organization—trains community volunteers and health care providers like Hassan to provide HIV testing and counseling services to hard-to-reach vulnerable communities like Tsafe.

"Before I was trained, I never saw the importance of assisting people to know their HIV status," Hassan said. "I’m grateful to Jhpiego for teaching me how to carry out HIV testing and counseling services in my community."

In a little less than 3 months, Hassan and his small team have provided services to 9,733 people and are motivated to do more. They test clients and ensure that identified HIV positive clients are linked and referred to hospitals miles away. To ensure the clients are able to complete the continuum of care, the team provides escort or "buddy" services that can help prevent and reduce clients’ loss to follow up.

Map of Nigeria with Zamfara state highlighted

Map Source: Federal Republic of Nigeria, House of Representatives

Zamfara (highlighted on map)

Location: Northwest Nigeria
Population: 3,972,135*
- Ranked 21 out of 36 states in population size
- 2.3% of Nigeria’s total population**
Capital: Gusau
HIV Prevalence: 2.1%***

*US Bureau of Census Population Database; Projected 2012 population.

** Nigeria’s Projected 2012 population = 170,124,000 based on US Bureau of Census Population Database; Projected 2012 population.

***UNAIDS Report on the Global AIDS Epidemic, Country Progress Report, Nigeria, National Agency for the Control of AIDS, 2012.

His hard work and efforts have earned him the name "soja," meaning protector of the people, in the communities. Mallam Ginger Isa, is one such person who appreciates the work of "soja." "As a nomad, I have moved from one border town to different communities and have been told about HIV, but never had the opportunity be tested," said Mallam. "Now I know my status as well as my family. I was happy that I and my family members were tested and we all tested negative."

As a result of providing HIV services, Hassan and his team have built relationships with the traditional rulers. These traditional rulers are now working to provide additional health information and resources for their communities: insecticide-treated mosquito nets for pregnant women and their children, health education, family planning services, promotion of access to medical care, and promotion of hospital delivery with a skilled birth attendant.

"It has not been easy, but I am happy to reach many people to give them services that they would not have gotten considering the distances they have to cover before getting to health facilities," said Hassan. "It’s also important to know that many other communities are now sending messages to us to bring the testing to their areas. This is a totally different HIV picture in terms of awareness from these very conservative communities compared to a year or two ago."