Sema Sauti

Sauti means loud or loudly in Kiswahili. Sauti also is the name of a project I had the pleasure of participating in during my time in Tanzania. I spent a month and some change in Moshi, Tanzania looking at the public health system, and I know, I’ve been posting about everything but public health. I’ve found a hard time finding the right words to even begin to describe my experience. Where to start?

Sauti. This is a 3 month old project that was started in Moshi to track the spread of HIV among key populations in rural communities. It is a project sponsored by John Tompkins University and a few other US- based organizations. This project consists of a screening center and teams of peer educators that go out into the field to recruit key populations for HIV screening and testing. The idea behind the name is empowerment. Sema Sauti means to speak loudly/ shout. To speak loudly about HIV, about stigmas, about problems among key populations that haven’t been talked about before. Before Sauti, there was no HIV screening service available.

Key populations are groups deemed by the government to be at risk and include female sex workers, men having sex with men, and people living in the catchment or slum areas where you might find a large population of sex workers. While I don’t always agree with the definitions of how people are labeled, I do like the strategy of Sauti. They do not tell the clients to stop what they are doing, but counsel them about how to be safe. They provide free condoms, lubricant, and birth control along with the screening and counseling services.

Key Pop

Another incredibly important service Sauti offers is the service of a case worker. A case worker will work with women (or men) that have been diagnosed with HIV, are in domestic violence situations, or those who have other serious issues that need more than just a HIV test and a free condom. This is one of the only places people can go to work with the (one) case worker. This service is not available at hospitals, police stations, or wherever else you might end up. The hardest part for the case worker isn’t the large caseload, but the challenge of finding the clients since a chunk of them don’t have valid numbers, addresses, or the ability to read and write.

I’m not going to lie, I struggled with the definition of some of the key populations. Homosexuality is not openly accepted in Tanzania as it is in the West, so it was hard for me to wrap my mind around the understanding that HIV is spread by men having sex with men (we know exactly how it is spread, through certain bodily fluids, not being gay). I also struggled with the woman who was labeled a sex worker because she was receiving goods from a sex partner she’d been with for a year (the only sex partner mind you).

Despite my thoughts about terminology and labeling of key populations, I’m excited to see the development of this project. This is a 5 year thing, and 3 months in they are getting about 15-20 clients a day at the clinic, which is huge since those 100 people each week had no where to go before. I’m looking forward to the research that emerges from Sauti and hoping it empowers some key populations to speak loudly and speak out about social issues they face!



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