DEAD AID

I recently had the opportunity to attend an outreach initiative with the Youth Against AIDS Club (YAAC), a student organization devoted to fighting “the mismatch associated with AIDS”.

The program suggested a full day of events; however we were to leave for the Kumenge Technical Institute at “midday” which is usually around 2pm (we actually left closer to 4pm).

The program initially included a drama highlighting ways to prevent HIV/AIDS transmission, speeches by the chairperson of the club and the patron (right before leaving I was told that I should give a speech which I respectfully declined), followed by a volleyball games (played by the boys), a netball game (played by the girls), and a football game (played by the boys). Since we got such a late start, the drama was cut short and the netball game was cut completely (surprise, surprise, even in Uganda girls’ sports is the first to get cut).

I was most interested to see the drama, because that is most pertinent to the work I envisioned doing with the students here in Uganda. I was pleasantly surprised to see that the audience clearly enjoyed the drama.The student performers portrayed promiscuous students, playing girls who were having multiple partners at one given time period as well as having transactional relations, where they would have sex in return for money, new clothes, fancy material goods, etc…

There were different parts of the drama, portraying sex for love and sex as a transactional act. There were also portions of the drama portraying successful students who abstained as well as students who practiced safe sex. The end of the drama portrayed the promiscuous girls as having gotten pregnant and having become infected with HIV. There was no mention of the male characters and the results of their actions, but I wonder if having the girls be victims to the ill-results is more effective.

I would have liked to see how the students at the technical institute felt about the skit. Afterwards everyone clapped and laughed, but I wonder if they got the message out of it, whether or not they understood that one should abstain, be faithful (as in only have one partner at any given period of time), and use condoms. There wasn’t any mention of needle sharing or the use of dirty needles as a method of HIV transmission, but I am not sure how much HIV is actually transmitted in this matter compared to transmission via sexual routes.

In the end I was fairly pleased with the drama and hope to be able to work with the students in making it better. It was mostly in Luganda so the actual dialogue was hard to follow, but the main idea was fairly easy to understand. Hopefully by working with the students I’ll be able to increase their effectiveness. I think the way they are most effective is that it is Ugandan youth telling other Ugandan youth about issues related to HIV/AIDS transmission. It isn’t the WHITE MAN coming in and dictating what should be done to decrease the infection. I think that allows the audience to relate much more to the participants doing the outreach, because the participants actually see, live, and know what is happening that is causing the HIV/AIDS transmission to continue or even increase.

 

Their Eyes Were Watching God

I’ve spent the past few days in the capitol city of Kampala visiting the Peace Corps medical office (don’t worry, I’m in good health, I have just noticed my eyes have felt strained and wanted to check them out, of course as soon as I got here I decided to eat gluttonously and my digestive system wasn’t too pleased). I realized how much I spend here. In addition to everything being ridiculously expensive out here, it seems that I binge on everything from food to crafts because everything is available here. It’s pretty insane. Once in a few months coming to Kampala would be nice, to get away from site and just be able to relax, but I can see how it can cause a volunteer to really use ALL of their monthly allowance (which isn’t much to begin with so using it all in one go really stinks). At the end of my medical adventure I came out pretty even monetarily and with a new pair of glasses! Lucky for me, my prescription hasn’t changed too much, but hopefully this new pair of glasses will relieve the strain that I’ve felt.

Anyhow, on to more important things…I have a new project idea I’m hoping to implement at my nursing school and possible at a secondary school in my town.

It all started when a PCV in Jordan emailed me (which is ironic because I’m going to Jordan in a few months) asking me if I would be willing to participate in his World Cultures Project at the school he is teaching at. The whole premise of the project is to get people from different countries to write letters to this class in Jordan, describing the culture, the work the individual is doing, and any experiences they have to share in whichever country they are in. After thinking about it I realized how valuable this kind of project could be to any school, whether it’s a primary, secondary, or even a nursing school. The students at my nursing school often ask what it is like to live abroad, what it is like in America, and what it is like to travel around the world (everyone that knows me knows I have an itch to travel and I love experiencing new cultures, sights, sounds, foods and everything that goes along with traveling). I think this project will really open the students’ eyes and show them how much there is to see and do in the world (not that I assume they are ignorant of this, but having a real example of things going on outside of Uganda can make the picture a bit clearer). I wrote my first letter to the PCV in Jordan and look forward to our correspondence. I hope he is able to also write me letters about Jordan. I also hope to be able to visit his students when I visit Jordan in a few months, I think that would only add to the project’s appeal. I also thought of painting a world map in the library at my nursing school and attached the letters and possibly pictures corresponding to the countries we get letters from. I guess we’ll see how it goes, at the moment I have only just thought of implementing the project in my school and have yet to discuss it with my supervisor. I think he will go for the idea, seeing as how I don’t do much in terms of working at the school.

HAPPY BIRTHDAY MOM!

 

The Invisible Cure

I recently finished reading The Invisible Cure by Helen Epstein (Book #34, yes, my “great sacrifice” isn’t always that, so all those people who are always telling me how proud they are of me can begin questioning that statement). I have to recommend it to all my public health interested friends and colleagues, and anyone who is interested in the AIDS epidemic in Africa.

Epstein writes about her research investigating possible vaccines for HIV, the virus causing AIDS. The story takes a turn, when she begins observing her surroundings in Uganda and other countries around East and Southern Africa. She makes special note of Uganda’s initial success in decreasing the HIV incidence rates compared to other countries in the region and countries around Southern Africa. So, what was the difference between what Uganda did and what the rest of the effected African countries did? Epstein poses this question many times to many different people throughout the Eastern and Southern regions of Africa and comes to one conclusion. Uganda addressed one of the factors actually putting people at risk of contracting HIV, concurrent sexual partners. While in countries like the U.S., we practice serial monogamy, where we, usually, only sleep with one person at a time, in countries like Uganda, it is very common for people to have a handful of partners at the same time. This isn’t even considered cheating or being unfaithful. Think about it, if person A is sleeping with person B, A doesn’t even have to be sleeping with more than one person at a time. B can be sleeping with person C, who is sleeping with persons D, E, and F, who are each sleeping with at least one other person. Think of the vast sexual network that creates, putting everyone in the network at risk if even only one of those people is infected.

So, what does this have to do with me and my work here in Uganda?

Well, I’m glad you asked.

For some time, when Uganda was successful in their initiatives to tackle the HIV infection rate, there was a “Zero Grazing” initiative, where NGOs and CBOs would focus on communicating the dangers of concurrent partners, advising and counseling on decreasing the number of sexual partners at any one time. This was all in a program that also conducted HIV testing, condom distribution, and peer counseling. However, it seems that the initially successful program was phased out after religious conservatives deemed it inappropriate because it seemed to promote promiscuity and early sexual debut.

I noticed in most of the outreach initiatives I’ve participated in, there is this “ABCD” initiative for HIV infection prevention, that is Abstinence, Be faithful, use Condoms, and Do not use dirty needles. While this initiative seems to be addressing concurrent couples, it really doesn’t because in the minds of many Ugandans, having concurrent partners isn’t being unfaithful. It seems to be a non-issue with most couples, in fact many people seem to assume that the person they are sleeping with is sleeping with someone else at the same time. Even in the media, there are stories of very important people having multiple wives, even sleeping with women outside of these multiple marriages. I’m curious as to what the youth of Uganda think about this, whether or not they are taught the dangers of concurrent partners at any stage in their lives and whether or not they actually see the dangers of it. I wonder if anyone I talk to will admit to having concurrent couples, if this is still a common practice for the average person.

This also has changed my views on outreach. It makes me want to talk to the student groups I’ll be working with and see how they address the issue of concurrent partners, if they do at all. I’d be most interested to see what the health workers here think about concurrent couples, because at the end of the day it is my view that you must practice what you preach. If a health worker if having concurrent couples how can they advise others not to do the same?

Sorry for the super serious post, I didn’t have any other ridiculous stories to tell, plus I thought it was about time I got a little more serious about my work here…okay I’ve always been serious but in terms of my expression of my work here.

*Cue foot in mouth*

HAPPY BIRTHDAY DAD