HIV/AIDS

A community home-based volunteer counsels a client during her home visits in Mbare, Harare, Zimbabwe. A Mercy Corps-led consortium is is providing HIV services to poor and vulnerable households in urban areas. Photo: courtesy of Zimbabwe Project Trust

Florence Tigere is in bed today. The typically vibrant 55-year-old woman, who serves as both treasurer and secretary of her HIV Sahwira Support Group, is suffering from a piercing headache. The severe pain, coupled with Florence’s swollen face and feet, has community home-based volunteer Mary Musamba concerned.

“Please take your mother to the hospital immediately,” Mary advises Florence’s 17-year-old daughter, giving her 50 cents of her personal money to pay for transport. Mary is worried Florence may have contracted a type of meningitis or possibly malaria. In either case, she needs treatment right away, especially because Florence’s immune system is already compromised by the HIV.

The importance of early medical referrals is one of the many reasons the Joint Initiative for Urban Zimbabwe (JI) — a consortium of ten non-governmental organizations (NGOs) places a strong focus on community home-based care. The consortium, which is led by Mercy Corps, is providing HIV services to poor and vulnerable households in urban areas — including delivery of free home-based care to more than 8,578 clients in six urban areas of Zimbabwe.

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Mullah Salohideen is a passionate public health promoter and active member of his local Village Development Committee (VDC) in Mastcho, Tajikistan. Photo: Samyra Roder/Mercy Corps

“It’s a sin to live a passive life. If you see a blind man walking towards a well, it’s your duty to say something,” Mullah Salohideen said with conviction — looking up from studying a brochure on childhood illness in the village clinic’s only empty room.

The local religious leader continued to speak passionately about the chief health concerns in Mastcho district of Northern Tajikistan, interspersing public health quips with Qur’anic references and poetic proverbs. Within minutes, it became clear that his philosophy of moral responsibility goes far beyond words.

As a locally-respected voice on Islam, tenured history teacher and active community member, Salohideen is the ideal public health educator and community mobilizer. “After the fall of the Soviet Union, I was able to bring together what we always knew as opposing ideologies: secularism and religion,” explains Salohideen. With the support of Mercy Corps field staff, Salohideen was able to fully transform his hybrid beliefs into action when he joined his local Village Development Committee (VDC) in 2009.

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In Baalbek, Lebanon youth leaders organized a run to promote health and well being.

Working with Global Citizen Corps youth around the world, I’ve come to realize that change is possible — and these young people are leading the way. So, for a little inspiration to us all today on World AIDS Day, here's a glimpse at how hundreds of youth from seven countries around the globe are taking action on global health issues. These leaders have gone through global citizenship trainings to design and implement meaningful action projects — that empower not only themselves but their communities.

Events are going as I type and we’ll hear more about the scale of these projects in the coming weeks — but here are just a few activities that leaders have been involved in, in the lead-up to World AIDS Day…

In Baalbek, Lebanon youth leaders organized a run to promote health and well-being. Hundreds of young people gathered in the streets to draw attention to health issues in their community. Only a few weeks back, I was lucky enough to meet these students as they excitedly discussed the event that they had planned. It’s amazing to see that they pulled off their event! Congratulations to this crew, it’s been months in the making to organize local officials and manage the resources to implement.

GCC leaders in Swat ran a training around HIV/AIDS issues with students from a local middle school.

Leading up to World AIDS Day Global Citizen Corps leaders in Swat — a district in Pakistan about 160 km outside of Islamabad — ran a training around HIV/AIDS issues with students from a local middle school. Swat was hit hard by recent flooding and youth have been organizing campaigns locally to gather materials and resources to distribute to the community as well as organizing trainings and events.

In the United States students are organizing awareness events across the country. One group is hosting an exhibit, followed by a dance to raise funds for a global AIDS organization. Harlem Children’s Zone in New York City has been volunteering at a local HIV/AIDS clinic.

And right now, in Iraq, youth leaders are organizing blood drives and trainings for schools on global health issues from diabetes to malnutrition. In Indonesia, Global Citizen Corps leaders are supporting relief efforts and working with local Mercy Corps development projects.

It's amazing to see our youth around the world making today count.

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Some of the caregivers and children from the Good Hope Support Group in Mutare, Zimbabwe. Photo: Richard Nyamanhindi/Mercy Corps

Taking care of children living with HIV, or those who have lost parents to HIV/AIDS, can wear a guardian down. Clinic visits never seem to end. There is never enough food to fill everyone’s bellies. And money on hand never seems to cover all the transportation and medical costs.

But when you have other community members supporting you, the burdens lighten.

While it is not always easy taking care of children whose lives have been forever changed by HIV, members of the Good Hope Support Group — a group of four mothers — in Mutare, Zimbabwe help each other overcome challenges.

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Fatima and her little brother Luke. Photo: Richard Nyamanhindi/Mercy Corps

Across Zimbabwe, 1.5 million children have been affected by HIV/AIDS, with many losing one or both parents to the virus. The majority of these orphaned and vulnerable children — even if taken in by compassionate relatives — struggle to have enough food to eat and to afford school fees.

Those in dire situations face hunger everyday, as well as stigmatization in the communities that they live. When things get this bad, children often drop out of school because they cannot afford the required uniforms and fees, or because they need to take on day jobs selling firewood or sweets to support themselves and their siblings.

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I am just back from a few days visiting Mercy Corps programs in Zimbabwe and it was fascinating. Zim ranks fourth on Foreign Policy Magazine’s annual “Failed States Index,” and having traveled to many of the top “failed states” — Afghanistan, Haiti, Somalia, Sudan — I was expecting a pretty grim scene.

What I found in Zimbabwe was surprising. The physical infrastructure was better than anyplace I’ve been in Africa other than Kenya. The population is highly literate and people speak great English. The landscape is stunning and there are great tourist attractions like Victoria Falls. The land and climate are perfect for large-scale agricultural production and, indeed, Zimbabwe used to be the breadbasket of southern Africa.

The newly-dollarized economy has stabilized after a hyperinflationary period that choked off economic progress. It’s got one of the most dynamic economies in Africa right next door in South Africa. Given these conditions, Zimbabwe has tons of promise.

But there are still some serious obstacles to Zimbabwe realizing its potential. The power-sharing agreement between President Robert Mugabe and Prime Minister Morgan Tsvangirai is gridlocked, and it’s unclear whether the constitution-in-progress and subsequent elections will set the stage for sustained growth and a real improvement in the quality of life for most Zimbabweans.

Beyond that, Zimbabwe has a serious HIV problem. Roughly one in five adults are HIV positive, and there is a whole generation of young Zimbabweans growing up as AIDS orphans. That loss of life is sad itself, but when you look at the ripple effect of those deaths — kids growing up without their parents, grandparents caring for orphaned grandkids well beyond their own working years — the situation is truly tragic.

All in, I thought there was reason for optimism in Zimbabwe, tough as things are. Unlike many of the so-called failed states, Zim has much of what it needs to get off of that list.

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A few weeks ago, I was honored to serve as the Chief Judge at an interschool debate on HIV/AIDS prevention. Under a perfect blue Ugandan sky, youth from two neighboring schools prepared to deliver remarks on the importance of abstinence, safe sex, delayed marriage and healthy life choices.

A young woman delivers her part of the debate. Photo: Tara Noronha/Mercy Corps

I expected some of the young debaters — Peer Educators in Mercy Corps’ Youth Empowerment Program (YEP) — to display at least some signs of anxiety and nervousness over the event. These youth were orating not only before a panel of judges, but also an audience comprised of more than 150 peers and key members of the community. Even though the Peer Educators had organized the event as part of YEP’s life skills program, I anticipated seeing some beads of sweat, perhaps a little stuttering and maybe even a few tears. After all, public speaking terrifies most adults I know!

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Richard Nyamanhindi on the back of a motorcycle, headed to a village near Kitgum, Uganda to conduct interviews during the recent writing and photography workshop. Photo: Thatcher Cook for Mercy Corps

Before I came to Uganda for the writing and photography workshop, I went to collect a success story in Mutare — a border town in southern Zimbabwe where Mercy Corps is implementing a number of programmes. These include cash transfers, youth protection, vocational training, home-based care, water, sanitation and hygiene among others.

However, this day was extraordinary, because I was going to meet Chipo (not her real name) a 16 year old who has been living with HIV her entire life. Chipo is an orphaned and vulnerable child who is a home-based care client getting primary care from Mercy Corps-assisted facilitators.

It’s usually very hard to meet and talk with people that are living with HIV, especially if they are young children such as Chipo, but I always try to put on a smile. Chipo’s parents died while she was doing Grade 7 and since then, she has been leaving on her own without knowing the cause of her ill health. To add pain to injury, her sister deserted her two years ago — when Zimbabwe's hyper-inflation took its toll on household income — to look for greener pastures in neighbouring Botswana.

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In 2001, Mercy Corps hired Carmelina and another woman to serve as "cultural brokers" — go-betweens for the mostly Spanish-speaking staff and the mostly Q'eqchi-speaking visitors. Photo: Nathan Golon for Mercy Corps

On any given morning, the spotless health center in tiny Tucurú, Guatemala is abuzz with activity. Carmelina Botzoc is a big reason why.

In the late 1990s, Mercy Corps was asked to reinvigorate the center by its founders, Jack and Marie Eiting. Not only had it fallen into disrepair, but it had failed to attract Tucurú's overwhelmingly indigenous population.

Mercy Corps immediately made several high-visibility improvements. The grounds were spruced up, and the hospital was scrubbed and equipped with up-to-date technology. Bathrooms were modernized; the pharmacy was stocked full.

But things didn't truly begin to turn around until the hospital, which had alienated many locals, made a change that essentially dusted off the welcome mat.

In 2001, Mercy Corps hired Carmelina and another woman to serve as "cultural brokers" — go-betweens for the mostly Spanish-speaking staff and the mostly Q'eqchi-speaking visitors. The job went beyond translating language. For example, Carmelina found herself lobbying patients to have faith in outside clinicians and exhorting doctors to trust the Q'eqchi people's long reliance on herbal tonics.

"For the local population, seeing people dressed like them and speaking their language gave them more confidence," says Carmelina, 36. "The changes have been great: people are making better decisions about their health, recognizing danger signs and coming here when they need to."

She's also been heavily involved with a Mercy Corps youth program, Jovenes 4 Peace, which has organized a group of indigenous teens to educate their peers and their community about HIV/AIDS.

Carmelina says she's always had an interest in helping people in her community. Even before joining Mercy Corps, she'd worked for 13 years as a volunteer health promoter with the government while she raised her five children, the youngest of whom is now 9. "I enjoy the satisfaction I get from supporting people in the community, from helping them emotionally," she says.

Soon she'll be able to help even more. After starting at Mercy Corps with a sixth-grade education, she's two more years of weekend classes away from becoming a nurse. It's a grueling schedule: She rises at 4 a.m. every Saturday for three hours of buses to the university followed by 12 hours of classes.

But when she graduates, she'll be one of the region's few female Q'eqchi nurses — she knows of only one other. And surely it will be partly because of her that others will follow.

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