Monday, December 24, 2007

ADHERENCE TO TREATMENT AND DOMESTIC VIOLENCE

The Center used to be a home based care and counseling center where people received counseling and testing for HIV. I regret to say that I have only been on two home based care visits due the fact that we can’t fuel our vehicle to make home visits (excuses, excuses). We visited a female client who defaulted from her HIV treatment and was too thin and sick too walk. She had a bed pan and little in a hut that was half way thatched. She did receive food baskets provided by the government but since there is a lot of corruption with food baskets, I speculate that her food was stolen by family members. The other was another defaulter who was in the early stages of the disease.

I respect Botswana’s efforts in providing free TB and HIV treatment to its citizens but without proper adherence these people will develop drug resistance strains. You can’t just throw free drugs to people! A lot of people here in the bush take their drugs at the clinic and once they get home they throw the drugs away due to side effects, lack of food, and lack of understanding on the importance to adherence. Also people can spread drug resistant strains of HIV which is really scary. Care and treatment is not on the priority list of donors which is causing a lot of organizations like ours to close their program due to funding. This is maddening because Botswana has the second highest rate of HIV infection.

A lot of people ask why the rate is so high and the reasons that come to mind are decreased mortality death rates due to life saving free drugs combined with increasing risky sexual behaviors. In ten years Botswana will experience an alarming death toll when the drugs can not extend their lives any further. This is a country with a small population of 1.7 million people and 36% HIV prevalence.

There is a lot of domestic violence in Botswana for reasons that not many people can explain other than it’s just an old practice excepted by the uneducated families. The Bakalanga tribe in my region has the highest rates of domestic violence, also known as “Passion Killing.” Most of the Passion Killings are related to HIV brought on my infidelity. I highly recommend a South African movie called “Yesterday”. It’s a beautiful film and depicts the reality of many families in affected by AIDS in Africa.

Monday, December 17, 2007

CHOBE NATIONAL PARK



A major feature of Chobe National Park is its elephant population. First of all, the Chobe has the largest elephant population in the world. This population covers most of northern Botswana plus northwestern Zimbabwe. The Botswana elephant population is currently estimated at are 120,000.
We camped at Ihaha on the Chobe River for six days. On our way to the camp site on the first day we saw lions eating a wilderbeast, elephans, kudu, chimps, and giraffe. The days were hot, too hot to do anything but sit under a tree and read a book. The afternoons were spent four wheeling around the park seeing animals at our own leisure. Two of the men we were with were former hunters in the Southern African region so they were like an open encyclopedia when it came to animals and their behavior.




























































BEAUTY CONTEST NOVEMBER 11, 2007


Maitengwe Home Based Care Center works closely with Kabelano Pre-School for Orphans and Vulnerable Children. I’ve been directing most of my attention here since the Center is struggling financially. There are 19 orphans and 29 regular children. The Catholic Church supports 12 orphans through funding from PEPFAR/Catholic Relief Services. They support school fees, shoes, uniforms and tracksuits. However, there is not enough money for school meals and teacher salaries, so we have been doing a lot of fundraising to run the school’s daily activities. Last week we had a talent show for the pre-school girls. The practiced so hard on their cat walk and their individual dance moves.


There are parents who don’t pay school fees so I calculated the amount of over due payments and realized it would solve our financial problems of not being able to pay the teacher salaries and school meals. The teachers and I made a new policy that school fees are due on the 5th of every month. If the child has not paid the fee by the last day of that month then he/she is not allowed to attend school the following month until payment is received. Most of these parents are employed and can afford school fees. We wrote a letter with a list of names to the appropriate person at the district government office for registering them for government assistance for those parents who can't afford school fees. Most of my Peace Corps service has been political: gaining support from local government, writing to the Minister of Local Government and to the Ministry of Health about the situation.






Saturday, August 11, 2007

DEATH IN MAITENGWE

There are three to five deaths per week either from AIDS or old age. There are funerals every weekend and I am sorry to say that I have not attended a single one. We were warned about attending too many funerals for reasons of our resilience. It’s is easy to become jaded from attending funerals every week and not feeling like you’re making an impact. Most of the impact that volunteers make are not even seen till years and decades later.

Most people 15-49 years of age die from AIDS because they either did not get test and treatment or they defaulted from treatment. HIV/AIDS in a place like Botswana is difficult to personalize. If you live in a village like Maitengwe where 43% of people tested positive then it is in front of you, it is reality.

I have just realized one of my biggest discomforts with the world and that is the uneven distribution of wealth, poverty and disease. This have always bothered me and has been the driving force for wanting to serve the poor and work on public health projects in the developing world. It’s easy for us to see images of disease and poverty on the television and read about it in the newspapers in between the sitcoms commercials and expensive dinners and wine. The fact that we accept these social inequalities, disease and poverty is saying that their lives matter less than some others; and the idea that some lives matter less is the root cause of all that’s wrong with the world.

PEACE CORPS ASSIGNMENT

Getting to know the Peace Corps
Excerpt from the Peace Corps Act (22 U.S.C. sec. 2501)

The Congress of the United States declares that it is the policy of the United States and the purpose of this Act to promote world peace and friendship through a Peace Corps, which shall make available to interested countries and areas men and women of the United States qualified for service abroad and willing to serve, under the conditions of hardship if necessary, to help the peoples of such countries and areas in meeting their needs for trained manpower, particularly in meeting the basic needs of those living in the poorest areas of such countries, and to help promote a better understanding of the American people and a better understanding of the other peoples on the part of the American people.


The Peace Corps Mission

The Peace Corps was established in 1961 to promote world peace and friendship through the service of American Volunteers abroad. In adapting to changing needs around the world, the Peace Corps remains guided by its founding mission—to help the people of developing countries meet their basic needs and to help promote mutual understanding among Americans and people from other cultures. Since its founding more than 45 years ago, more than 182,000 Volunteers have furthered these goals through service in the Peace Corps and have served in 138 countries.

PEACE CORPS BOTSWANA ASSIGNMENT

Country: Botswana
Program: Non-Government Organization Capacity Building for HIV/AIDS Project
Job Title: Home Based Care and Orphan Care
Dates of Services: 6/23/2007-6/22-2009

HISTORY OF THE PROGRAM

The Peace Corps entered the Republic of Botswana in December 1966 two months after it achieved independence from the United Kingdom. Over the past 31 years, over 2,000 Peace Corps Volunteers served in Botswana. From 1966 to 1997m Peace Corps Volunteers worked in project that touched nearly all aspects of Botswana’s development. Assignments ranged from teacher trainers, to nursing tutors, to entomologists, to game wardens, and small business advisors, and secondary school volunteers.

Since independence, Botswana has experienced remarkable growth. It has gone from one of the world’s poorest nations to achieving status as a middle-income country. The nation’s infrastructure-roads, power generation, schools, health facilities and housing evolved dramatically. In light of Botswana’s economic success, Peace Corps made a decision to withdraw from the country in 1997. In 2000, the idea of a return to Botswana was brought about by the severity of the AIDS epidemic in the region and, most significantly, the potential of the epidemic to derail an achievements that have been made in Botswana.



President’s Emergency Plan for AIDS Relief (PEPFAR)

Botswana is one of the Emergency Plan’s 15 focus country, which collectively, represent 50 percent of HIV infections worldwide. Under the Emergency Plan, Botswana received more thant $24.3 million in Fiscal Year (FY) 2004, more than %51.8 million in FY 2005, and more than $54.9 million in FY 2006 to support comprehensive HIV/AIDS prevention, treatment and care programs.

STATISTICS AND CONTRIBUTING FACTORS OF HIV/AIDS

Botswana has the second highest prevalence of HIV in the world with almost 39% of the adult population (15-49) infected. According to UNAIDS, the current life expectancy of less than 40 years is a significant decrease from the mid-60s in the 1990s. A social impact of AIDS deaths is the increase in the number of orphans. The number is projected to increase by 18,000 annually between 2000 and 2015. The Government of Botswana estimates that 20% of children will have been orphaned as a result of AIDS.

Factors which contribute to the spread of HIV/AIDS in Botswana is the large role in the presences of risky sexual behaviors, gender equality, unemployment, and poverty. For example, the incidence of HIV/AIDS among women between 15-49 years was at 150,000 of 280,000 adults (54%) living with HIV/AIDS. Because of their low socio-economic status, high level of unemployment and poverty among women, the number of women living with HIV/AIDS is expected to rise. The Government of Botswana estimates by 2010 the life expectancy among women will have fallen by 50%. At current risk levels, UNAIDS projects that about 85% of 15-year old boys in the country will most likely contact HIV.

In order to address the epidemic, discussions between the governments of Botswana and the US were initiated in early 2001. By July 2002, the Director of Peace Corps, with the permission of the Botswana government, agreed to re-establish the Peace Corps program. There are four programs where volunteers are placed: Community Capacity Building, District AIDS Coordination, Non-Government Organization, and Life Skills.

FIRST MONTH AT SITE: MAITENGWE VILLAGE

Maitengwe village is located 50km north of Tutume village, which serves as the headquarters of the Tutume Sub District. Tutume village itself is located 100km northwest of the city of Francis Town. The village has an estimated population of 7,194 people according to the 2001 census. It has as junior secondary school, three primary schools, fully fledged clinic with a maternity wing, and a number of retail outlets and food shops with tomatoes, onions, meat, pumpkin, milk, yogurt, juice and shelf food.

The first two days I scrubbed the walls and floors of my house and unpacked. On Sunday afternoon I decided it was time to venture out and meet people and to get a breath of fresh air. I met an older school girl so has big ambitions of becoming a lawyer and she was fluent in English. We chatted about HIV education in her school and she shared her knowledge of what she had learned. She also taught me a few words in Kalanga and mostly laughed at my pronunciation.

The first day at work the community volunteers welcomed me with open arms with tea and breakfast. PCVd are supposed to take two months to integrate into their communities by learning the local language and completing our community assessment, but instead I had to meet a proposal deadline by the end of the week. The organization that I am working with does not have a nickel to their name and the project is more or less just surviving. I had to go to the Social and Community Development (S&CD) office in Tutume to go through the bureaucratic processes of submitting a proposal and getting a compassionate social worker to endorse a letter of support for the proposal as quickly as possible (donors will not accept a proposal without an endorsement letter from an authorized social council).

The second week was filled with feelings of homesickness, loneliness, diarrhea and inflamed bowels, you name it. The hardest feeling is the feeling of thinking that I will not make a difference in the lives of these people so what is the point? One minute you feel inspired and the next minute you feel helpless, frustrated and completely disoriented. The moment that I feel frustrated is when I remind myself that I am not here for my own personal benefit; but that I am here to serve the poor and help build the capacity of this community in their fights against HIV/AIDS. There are extreme high and low feelings; the low being extremely low and they are awful. You cannot feel true happiness unless you can feel true sadness.

Botswana is a really pretty country. Most people think of Botswana has desert with not much in it when actually there is plenty to see. The country covers an area of 581,730 square kilometers, roughly to size of France or Texas. The vast, flat Kalahari Desert covers more than 70 percent of the country. The ecosystem has gently undulating sandy plans covered by bush and grass dominate the landscape, while rocky outcrops, valleys, salt pans, acacia woodlands, and Mophane forest. The Okavango, one of Southern Africa’s longest rivers, flows into Botswana from the northwest. It fans out into a huge wetland, covering 16,800 kilometers and eventually seeps into the desert. 17 percent of land has been set aside for national parks and game reserves while a further 21 percent surrounding these areas has been designated for wildlife management. Chobe National Park has the largest elephant concentration in the world with an estimated 45,000 elephants.

Last week I went to Gabarone, the capital city, to attend the National Child Care Forum. It a crash course in training on how organizations, international donors and local governments work in Botswana. The forum discussed the global perspective of orphans and vulnerable children worldwide, Botswana’s National Response to the Orphans Crisis, local youth programs, licensing of child care projects, youth rehabilitation services, child labor, child rights, early childhood development, child abuse, the roles of donors in enabling quality community based child care, and last but not least, district level planning and coordination. There were 150 organizations and a total of 250 people. It was a very informative conference that I wrote the Peace Corps Country Director to advocate that the NGO and Social and Community Development (S&CD) PCVs receive training on the above topics from the Department of Social Services.

Before the conference I met my mom for two days. We went on a short game drive at Mokolodi Nature Reserve. We got to pet a cheetah! It purred so loud, I scratched his ears and put it too sleep. Cheetahs are so regal and gentle. We also saw elephants, rhinos, hippos, kudu, and tons of wart hogs. We mostly just chatted at the lodge and got caught up with issues back home. I noticed that my pace in life has changed being around another American. My mom kept on asking, “What time is the driver coming? What time is it? What time did you call? When is he going to call back?” I was not worried and just wanted to live in the moment. “The Westerners have the watches but the Africans got the time”. Peace Corps teaches you to live in faith; faith that things will be alright and that your community will accept you and that you will be happy in your new environment—they couldn’t have been more right.

My house has two bedrooms, one bath, a living room, front porch and a hallway type kitchen. It’s a really nice new home with electricity and hot water. I live in my counterpart’s compound that has a main house, small huts, granaries and a garden. The compound is gated so it is very safe and private. There is a servant who cooks, cleans, and gardens for my counterpart but I just stay to myself accept when she is cooking topi which is pounded millet and melon cooked to a thick porridge with sour milk drizzled on top. The servant-type life style is normal for most Africans but sometimes it amazes me how Africans can treat other Africans. My host father is a very respectful and intelligent but he can YELL! When his porridge isn’t cooked on time in the morning, then he’s constantly shouting, this is when I pop my head out and say, “Dumelani Tati, Wamuka Tjini?” meaning-hello father, how are you in Sekalanga. It’s my way of saying, “is it really necessary to yell for porridge (pap) every single morning?” He is a man of politics so I give him all my Newsweek magazines and sometimes we talk about the politics of Botswana and globalization. My host parents have a great marriage, I can tell when my host mom leaves for funerals or business that he misses her. They are models for the rest of their community in regards to family, marriage and responsible citizenship.

I don’t have to worry about someone breaking in my house which is a huge relief since other volunteers don’t have that protection. I do have to be careful who I talk to because there are desperate Zimbabweans roaming around in the village and they are the reasons behind most of the petty crime in Botswana. Another volunteer in Tutume was sexually harassed and was transferred just last week. Typically in the urban areas PCVs encounter more harassment and unwanted attention. Volunteers are happier in the bush because they learn more language and have the ‘traditional’ Peace Corps experience.

WHAT IT TAKES TO BE A VOLUNTEER

WHAT IT TAKES TO BE A VOLUNTEER (QUALITIES)

§ Determination
§ Love
§ Care and compassion
§ Reliability
§ Empathetic
§ Spirit of togetherness


As a volunteer you have to be prepared for challenges you may face when performing your service

§ You will have to sacrifice your time to do volunteer work
§ You may not be accepted by your target and also your services might not be appreciated
§ Others may think you the one bringing the disease to them
§ Other members may perceive you as a person living with HIV/AIDS as most of people we care for are PLWHA.
§ Some people may take advantage of you
§ Your time, energy and effort might not be appreciated

We should also take in to consideration the fact that VOLUNTEERS stood up between thousands of people and chose do VOLUNTEER work. This is really not something easy to do. Because of this, VOLUNTEERS need to be respected, given recognition, praised, empowered and motivated as well, they shouldn’t be taken for granted. Motivation can be done in many ways, it doesn’t mean paying them as most of people think.There is a famous quote that describes how valuable volunteers are “THERE IS NOTHING STRONGER THAN THE HEART OF A VOLUNTEER”A volunteer is like a gift because they are offering their services for nothing in return.