26 October 2011

HIV Prevention 101

Post by Nicole

Today is the day I give my first HIV prevention presentation.  Of course, there are a few logistical matters to handle before I get my program underway.  The reason behind my visit was that the first 68 children we had placed at the vocational boarding school 10 days ago were due for a monitoring visit, and we were bringing an additional 37 kids.  This second group was a result of my organizations hard work: scouting for eligible candidates in targeted neighborhoods, and resolving issues that had previously prevented many of the children from placement, such as employers who initially refused to let their child laborer go. 

The morning started out as an instant replay of last week.  We arrived at the police barracks where the children were eagerly waiting for us to take them to the school.  However, word must have spread that we were coming and there were an additional 10 kids than expected, packed and ready to go.  These sly youth had never been interviewed by our field staff and were plainly trying to sneak onto the bus.  Worse yet, some didn’t fit our age criteria while others had been brought from outside our targeted communities.  We didn’t know what to do because while these children undoubtedly are vulnerable (one criterion for acceptance to the program), they did not fit the rest of the characteristics and we must maintain the very strict condition set by our donors for purposes of accountability.  If it is later discovered that we accepted children who do not fit the age requirement, or are not domestic workers (though fit all the other criteria) we run into issues of project credibility. 

Once we resolved the confusion of the magically appearing kids, and some arguring, the staff and I took the names of the additional kids and will have a meeting with senior management to figure out a way to accommodate these children.  We clearly all felt strongly about this heartbreaking issue and want to help them.  We shall see what comes of it…


Children and mattresses board the "school bus"

Off we went on our two-hour ride to Jinja with the prescribed 37 kids.   When we arrived one colleague registered the new kids while another gathered the kids we placed last week for my lecture.  In total about 70 teens, boys and girls, were present.  They were so excited and enthusiastic.  Several wanted to hug me before the lecture even started.  I’m still not sure if they were enthralled by my white skin or just thirsty for knowledge.  Probably, some just wanted to feel cool that they were friendly with a muzungu.

I started my lecture by asking for volunteers to define HIV and AIDS and was impressed by the audience participation.  I had a staff member help translate as English is only one of many languages spoken by the students.  Surprisingly the language barrier wasn’t as much of a problem as I had expected.  Things were off to a great start.  Until my intern colleague approached me and whispered that the warden told him I should not talk about condoms and instead only discuss abstinence.  Not this issue again, I thought.  The school is funded by Evangelical Christians and I anticipated such a problem, but I was assured the topic of condom use and safe sex was fair game by the school’s director weeks ago.  I had also consulted with members of my NGO who offered the same advice.  Clearly there are differing opinions within this institution. 

Action shot: me giving the lecture to the students in their classroom

Let me back up for a moment, a little history if I may.  Uganda was on the forefront of combating the AIDS epidemic in the late 80’s and early 90’s.  While other African presidents were denying the problem or offering false information, Musevini has been praised for immediate and effective prevention strategies (which included distribution of millions of condoms and education on how to use them).  As a result, the HIV rates dropped.  They are now sadly on the rise again, with heterosexual females being the most rapidly growing group to be infected.  While the exact numbers are unknown, it is estimated the 10% of the urban Ugandan population is HIV positive.  The rates are slightly lower in rural areas.

Given this trend and my prepared curriculum of condoms and bananas for a demonstration I decided, with the support of the Director (who’s decisions technically trumps the Warden’s) and my NGO counterpart, to go forward with the program.  I feel it is morally wrong to withhold information from inquiring teenagers.  My counterpart and I we agreed that if the kids ask about condoms we would answer honestly.  I was very cautious with my answers.  I stressed that they are too young to be having sex, maybe I said some things that scared the heck out of them regarding the potential of sex jeopardizing their futures, but I believe they need the whole truth.  Finally, a student—bless him!—asked about condoms and I took the opportunity and ran with it.  They were full of excellent questions and seemed to hang on my every word.  And then I broke out the banana.  The class went wild, roaring with laughter and jumping up and down.  Fearing our potential misdemeanor, my colleague and I shushed the kids and did a quick banana-condom presentation, hoping that the warden wasn’t nearby.   

I felt slightly vindicated about my decision to speak to the class honestly when my colleague told me that last year one of the students sent to the school through our NGO got pregnant while there and was forced to leave.  After the session was over many kids came up to thank me.  I handed out teen-focused newspapers produced by a Ugandan NGO called Straight Talk, which the kids went crazy for.  I realized that with kids at this age the Internet becomes a fountain of information, for good or for bad, but these kids only have the little information they get from friends, relatives, and teachers (if they were fortunate enough to have attended school).  Handing out these Straight Talk publications, it seemed as if they were made of gold by the way the kids expressed such a desire to own an issue.  I regretted not bringing more educational handouts.

We also evaluated their progress at school and asked them to tell us what challenges they are facing.  The first thing that came up was the lack of sanitary pads for the girls, and lack o mosquito nets.  Many were sharing cups and bowls with other students.  They don’t have enough pens or paper.  And, some of the kids have been stealing things from other kids.

Still, when asked if they are happy, all replied with an enthusiastic YES.  They are learning a lot, the teachers are good, and they are hopeful that this education will help them in the future.

As I had expected, my little buddy Derrick found me the minute I arrived.  We took a walk and he told me that he loves school and has chosen the catering and hotel management track.  He promises to work really hard in the courses.  He then told me a bit about his background.  His father died many years ago and Derrick was not able to go to the funeral or ever get information about his father’s death since it happened in the city and he was living in the countryside.  His mother eventually had to move to the city with her children to find work and has been supporting the entire family on her modest police officer salary (71 USD/month).  Some of the money is sent back to the village to support extended family members.  Even though he performed well at school, he wasn’t able to finish secondary school, as his mother’s meager wages just weren’t enough for all the children’s school fees.  He said that he feels blessed to have been chosen for this program and promises not to waste this opportunity.  He hopes to get a job in a hotel so that he can earn a better income and help his mother and younger brothers. 

What an incredible feeling to be part of an organization that is truly changing the lives of children.