About World AIDS Day

I wanted to write something about World AIDS Day on the actual day but I didn’t quite know what I wanted to write. I have heard all of the statistics before. (Although in recent news, those statistics are a little less dramatic that previously thought.) Being here has started to humanize those statistics that you read in the newspaper.

Yesterday I completed a small translation project for an NGO here. The director of operations is giving a presentation in Nairobi on one of their programs. The program featured in the presentation focused on youth and adolescents and HIV/AIDS to provide them more comprehensive health care, from prevention to treatment. They created what they called youth-friendly health services in the central hospital here in Maputo and a community health center in Xai-Xai. The program is innovative for a variety of reasons. Not only did these health service organizations provide a central location for youth to go for learning about prevention and testing, they also provided a support network for youth who learned that they were HIV+. The support network was composed of both trained counselors and other HIV+ leaders helped them with coping with news and ongoing psychological and medical support.

These youth leaders led support groups and formed 1-on-1 relationships with new youth to join the group through home visits. These relationships helped support adhesion to treatment. There is still a very strong stigma here about people living with HIV/AIDS. Often they are rejected by friends and family and some are kicked out of their homes. As a consequence, many adolescents hide their status but this can compromise their ability to adhere to the treatment regimen. In response, the youth leaders are continually developing techniques and incentives for adolescents to follow their treatment schedule.

As I was working on the presentation, it was amazing to see the results that have elicited by placing youth at the forefront in this manner. One of the unexpected byproducts was the self-organization of many of the youth in both sites for advocacy and income generating projects to help support youth who are rejected by their families. The NGO also launched a communications campaign aimed at changing the norms about revealing one’s positive sero-status. The visibility encouraged many youth to take the same step to free themselves from the burden of hiding.

When I met with the director, I told him how much I enjoyed learning about the project. He then started telling about all the things that could have happened if they were given the freedom to structure the program as they wished, without bureaucratic interference. I told him that at least these initial strongly positive results might help to reduce the reluctance that some felt about the program. It really amazes me how much is possible in this country despite the numerous and sizable challenges and obstacles, some of which are of the country’s making.

Here are some headlines about yesterday:

President Calls for Routine HIV Testing

Mozambique: Government Reviews HIV/AIDS Strategy

World AIDS Day: Educational Breakthrough

The Lancet Student: Two Things for World AIDS Day

On a completely unrelated and personal tangent, happy birthday to my little brother. You may be a pain in the ass, but I love you anyway.

Cholera? Now? Here?

While the United States has worried about outbreaks of salmonella and E. coli over the past year, there has been an outbreak of cholera here in Mozambique. And not just in a rural, remote part of Mozambique. Here. In Maputo, both in the city and the province. I learned about the outbreak from this allAfrica news article.

Now I know that some of you only associate cholera with playing Oregon Trail. Cousin Claire dies in the Rocky Mountains while you are out hunting buffalo. But this is not a minor disease nor is this a minor outbreak. Four people have already died and 222 people have been identified as infected since October. The Ministry of Health is trying to disseminate information about improving food hygiene but it lacks the proper infrastructure to quickly and thoroughly educate the public. It will take some time before the behavior changes help to end the outbreak.

On a slightly brighter note, the UNDP’s Human Development Index has noted that climate change may not be as detrimental to Mozambique’s future as previously thought. The country is in the somewhat paradoxical situation of facing both more periods of drought and floods in the future. After the floods of 2000, the country put early warning systems in place that helped mitigate the damage and human cost of the 2007 floods, both caused by tropical cyclones in the Indian Ocean. Radio Mozambique also educates the public about disaster preparedness. Considering the rate of change for many other things in this country, this is a remarkable turnaround that is having and will have an definite positive impact on people’s live here.