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.

Meetings, Mattresses, and Moving

(Post by Nicole)

Saturday: Community Meeting

I went with some staff members to one last community meeting before the big day of taking the children, mainly domestic workers, from the slums and transporting them to a vocational school 2 hours away. The goal of this community meeting was to answer last minute questions from the employers, guardians, and children. The process of identifying child domestic workers between the ages of 14 and 17 began in July with community meetings and door-to-door interviews. It will culminate tomorrow when the first group of kids is moved to vocational schools.

The community meeting was a huge success with a much larger turnout than expected. Children, employers, guardians, task force members, the police commander, and a reverend were in attendance. The full spectrum of human emotion was present; most people were happy, some were angry, and others were worried. It was clear that we would have to tread delicately—I watched my colleague talk passionately about the importance of sending these children to school not only because they have a right to education, but also for the future of Uganda. He was incredible and managed to navigate the fine line between stressing the unlawfulness of employers sitting in the audience engaging in child exploitation while winning over their trust. I learned that sometimes killing people with kindness is in fact the best approach.

As expected, many of the employers who had initially refused to talk with our staff out of fear of being arrested, now realize our only motive is to give these vulnerable children a better life. They must have felt a bit guilty about denying their child laborer a chance for free vocational training, because some asked if it was too late to change their decision and sign consent. We explained that unfortunately, at this time, we have made preparations for only the children who had employers who consented earlier and that it would take some time for the school to be able to accommodate more kids, for buses to be arranged, for us to find more funding, etc. This resulted in a bit of chaos, some tears and a few employers trying to sneak their kids onto our already complete lists. I learned quickly that far more work goes into grassroots endeavors than I had ever imagined.

The community meeting also shed some light on reasons why some parents of domestic workers initially refused or were wary of us taking their children. Apparently there was a case of an organization in another part of Uganda that offered children free boarding school and then the children were mistreated and malnourished. Moreover, a few years ago, in this exact community, some men posing as an NGO took money from parents, promising to come back for the children who they promised to place in school and then disappeared with the money. Corruption is rampant and this type of deceit is detrimental to the work of legitimate organizations.

A big issue that needed to be addressed at the community meeting was the inability of many families to procure bedding (a small foam mattress and blanket) for the impending vocational school attendees. It was brought to our attention that many of the kids sleep on mats or share mattresses with other family members and therefore cannot bring bedding to the boarding school. We were told that the boarding school would not accept them without bedding. Our NGO is paying for everything else (room, board, exam fees and the like) but does not have a large enough budget to buy mattresses. We came to the tough resolution that children without bedding would have to wait until the following week—in the meanwhile we would scramble to find a solution.

After the meeting ended, I couldn’t help but reflect back on the whole process and wondered how we could have made this run more smoothly. Perhaps if the guardians had attended more community meetings in the weeks leading up to this one, they would have understood our intentions better and consented to allowing us to take the children earlier. With more notice they may have been better able to provide the children with bedding. As a novice in the community-organizing arena, I just don’t know—maybe getting 68 kids was success.

Monday: Busing Kids to School

Today we picked the children up from the various slums of Kampala and brought them to the vocational school. I imagined we would meet all the 68 kids at one central location, they would be packed, and we would be on our way. How long could that possible take? Surely if we start at 10:30am we’ll be on the road by noon, right? WRONG.

The children were instructed to be ready at 10am. When the six of us arrived at our first stop, the police barracks, the children were packed and ready to go. They wore their best clothes, held buckets for laundry, suitcases, and foam mattresses. Then we were told that several of the kids still had not been able to find mattresses. When we reiterated that they would be left behind until next week, they ran away up into the barracks and most came back with small foam mattresses. They likely begged friends or family and found a way to get their hands on something to sleep on. One employer gave up her own mattress so that her domestic worker wouldn’t miss this opportunity. Others weren’t so lucky. Trying times show people’s true colors—for good or for bad.

Next, we went to gather the kids from the other slums of Kampala. Several were not ready (I think they did not believe we were really coming for them.) They quickly scurried to gather belongings and piled into our van. I got lucky and was in the front seat, but others were not. In the now “clowned” van with kids and mattresses that piled in more like Jenga™ blocks one girl started to vomit (into her handkerchief) as we navigated the rutted roads of the city. As a fellow car sick soldier, I felt very sorry for this sick girl and wished I had brought my sea bands to offer her. Slowly we gathered all of the children. Eventually we had a total of 68 kids, 3 buses and a lot of stuff. For those keeping score, we left Kampala at 3:00pm.

When we arrived at the vocational school, the warden held an orientation for the kids. We registered them, photographed the remaining children, and got them settled in their new homes. While the new class was coming in I received a glimpse of their future. Behind us a group of current students were singing and dancing to gospel music while an instructor played the organ. They looked and sounded amazing. Some of our new students watched them in awe, too. It seemed the future, for now, was bright.

Just when we were ready to head back to the city feeling that the day had been a great success, six children sheepishly confessed that they did not, in fact, have mattresses. Knowing full well the rule that they were not supposed to board the bus without bedding, one began to cry. These kids certainly realized the potential this opportunity could offer them. Fortunately when we told the matron about this issue, she had a kind heart and figured out a way to accommodate all these six children. I cannot describe the relief my colleagues and I felt when this was resolved.

After all the children had hurried off to get settled in their dorms, one boy, Derrick, lingered. Eventually he approached me and said, “this place is really cool. I think I will like it.” After answering some of his questions about what I am doing here in Uganda and explaining that I would be back, likely next week, to talk about health education, Derrick said, “When you come back, I would like to share something with you. It’s personal about my life and my family.” I told him that I had time to talk now, but he insisted that it must wait until next week. I’m very curious.

We got home at 830pm—what a long day! Who knew it would take SO many hours to mobilize 68 children? I got home tired, but happy.

A Day in the Field

Post by Nicole

As we come to the end of our second week of work here is Kampala I’m getting more comfortable at my NGO and falling into a nice rhythm.  First, a little about the office environment I’m working in, my first office environment in a long, long time.  The office consists of approximately 11 people, many of whom are Ugandan interns or volunteers.  Since the job market is dismal here, it is common for well-educated locals to volunteer at offices in exchange for transport and lunch. The office is small with modest furnishings and a pantry area where people eat lunch and can help themselves to coffee or tea. I work in the “resource room” which also serves as the meeting room.  Electricity is intermittent and the generator seems to be on the fritz.  I might have contributed to this fritz when the other day the power returned I plugged in my computer, felt a slight electrocution, and heard a loud bang.  Two computers and a copy machine went kaput.  When electricity goes off and the computers die, people are seemingly un-phased, they turn to chat with their neighbor or pull out a newspaper.  I’ve been advised to “roll with it”—very wise words.

I spent the first several days learning about the NGO, which advocates on behalf of marginalized people in the workforce.  They do quite impressive work with few resources and are currently on a big campaign to ban child exploitation.  It is very common here for families—even poor families—to “hire” orphaned or poorer children from the villages as domestic workers.  Although there is a law prohibiting child labor, and technically primary school is mandatory for all Ugandan children, I have learned quickly that there is a major disconnect between the written law and the enforcement of legislation.

After a week and a half of learning, reading, editing documents and helping create web content for the organization, I finally had the opportunity to get out “in the field.” I joined a group of three young men who are recent college graduates and interns in the Child Labor and HIV Education Department of the NGO.  Since July they have been creating mapping tools, holding community meetings and working on a task force to identify children in one community between the ages of 14-17 who are working as domestic laborers.  The NGO has a grant to pay the boarding school fees and uniforms for these children to attend a 6-month vocational program about 1.5 hours outside of Kampala.  The team had identified approximately 100 children and they collected important information about each child (name, age, where they come from, what, if anything, they are getting paid, living conditions, medical problems, job description, guardians, etc).  Each child was asked if he or she would like to go to school and each employer was then asked if he/she would grant permission for the child to be taken from the home and placed in schools. 

On the day that I joined the team, each of the children had been spoken to already.  This was a second go around with the intention of getting verbal consent from the guardian (at times a parent or relative and at other times an employer).  The twist to this story is that the first community targeted is the police barracks.  This warrants some explanation:  all types of officers in Uganda live with their families in the police barracks, which is essentially a slum. It is a huge community of small concrete or tin homes—one on top of the next, none larger than two rooms and each housing many people. Toilet facilities are communal. They do have intermittent electricity and running water. In some of these homes, as many as eight people live in one room. Each family is large, in part because a mother’s  “children” include her biological children, her husband’s children from prior marriages, her brother’s orphaned children who she is looking after since he died, etc.  It is what we could call “blended families” to the max. Officers, on average, earn 200,000 shillings a month, which is the equivalent of 71 USD.  Obviously this is a very low wage and stretching it to cover and family of ten often leaves parents with the inability to pay school fees (approximately 50 USD per child per year).  Often the eldest child is responsible for caring for the younger kids while no parent is around—sometimes the parent is on duty far away for upwards of two weeks at a time.  In other cases, a relative has taken a child in because her own parents were too poor to feed or clothe her.  In reciprocation for food and shelter, the child is put to work.  This usually involves washing the clothing, preparing meals, cleaning the small home and looking after the other children. Still other times a child is sent from the village to the city under the guise of going to school and is instead exploited as a child laborer.

Ironically, these officers who employ child domestic workers are either unaware of the law prohibiting child labor or have complete disregard for the law (usually the latter).  Some are cases of clear exploitation while other cases are far more complicated. As you can imagine, this becomes a tricky process.  

My First Day in the “Field”

I got in the car, super excited for this adventure with my three new intern friends who took me in as if we’d been buddies forever.  As they sang along to some Snoop Dogg, we exchanged stories and had some good laughs. We arrived at the police barracks and my young intern friends suddenly became very professional as we met with the commander of the police department. He is a middle aged, happy and engaging fellow who expressed full support for our project.  He offered to assist us if we ran into trouble with the employers (other officers).  He was hoping our interaction would remain friendly and that after we explained to the other officers that the organization will be paying for the school fees and this is an important opportunity for these young people, they would quickly consent.  Turns out, it was not quite that easy.

Our team consisted of myself, two invaluable women from the community who are the task force member leaders, and the three interns.  Our goal was to, over the course of two days, reach all 98 of the children and obtain consent from them and their guardians, answer questions, and ensure that each child has a mattress and bed sheets to bring. The vast majority of the targeted students are girls since domestic work is largely the job of women in this community. 

I was immediately struck by how shy and respectful these young girls were. Many curtseyed to me as they shook my hand.  One child, just shy of 2 years old, got down on her knee to greet me as a sign of respect. A couple of girls brought tears to my eyes when I saw the joy and appreciation in their faces at the prospect of going to school. “Thank you, thank you, thank you,” they whispered.  They told me that they feel blessed to have been chosen.  It was incredible to see how eager these kids are for even a small fraction of a formal education.  Many aspire to be hair dressers, tailors, or shoemakers and are hoping to learn those skills in vocational school.

I was equally impressed by the way my intern colleagues worked in the community and the way in which they were able to connect with the children and their families.  They were professional, respectful, caring and non-confrontational. I think this is partly Ugandan culture and partly the nature of these young men.

I was a novelty in the village and soon children appeared form every corner shouting “muzungu.”  I was feeling the love.  “My muzungu,” one girl told her friend.  No, “My muzungu,” the friend argued.  We all had a good laugh as I assured them that there was plenty of me to go around.  A little further into the day, a gentleman on a motorcycle screamed, “Muzungu I love you!!!”  I probably can’t take credit for all the love I received today as they associate muzungu with donor funding and movies.

But, not everyone took to me so quickly. One small boy burst into tears when he saw me. The grandmother cradled him and began to laugh, explaining to me that he had never seen a muzungu and that I should not be offended. Smiling at the child only made him cry louder so eventually I accepted that not everyone was ready to make the muzungu their friend. Maybe next time.

For other young girls who were being given the opportunity for school, today’s story did not end happily.  Many of the employers refused to let the children be taken because they have nobody to look after the other kids. Other employers were not around to give their consent.

And then there is the complicated issue of the villagers hoping that since I have white skin, I can fix their problems.  I was brought to the home of a family with a child who is disabled. “Please see her,” the community task force member asked.  “This girl, she cannot talk or walk and it is so hard for her family, ” she explained.  I met the mother and child who clearly has cerebral palsy. My heart broke for this family who cannot afford therapy for their severely disabled child.  Since the mother must constantly tend to the child, her earning ability is nil and thus all 7 other children also suffer. I’m now on a mission to find free or heavily subsidized therapy for this child. Fingers crossed.  At the end of the day the task force member asked if I knew of anyone who would sponsor her children.  Sometimes being white here is a tough cross to bear.

Of the 60 homes reached today, we managed to get consent from 22 families. Another 26 are pending and the remaining employers refused.  The next step is to develop a strategy to convince these other employers to release the children. We are all hoping that after mediation and some more counseling, we can convince the employers. If not, legal action will likely be taken.

Ultimately, my role here will be to educate these lovely adolescents after they are settled in the vocational school.  I’m developing a basic health education curriculum and plan to discuss nutrition, pregnancy and HIV prevention, and how to make healthy lifestyle choices.  I have also been asked to counsel these young women and teach the interns some basic counseling techniques.  This will be quite the learning experience for me, as I do not have formal training in counseling.  If anyone reading this blog has ideas, please share!

I am starting to feel that there is a higher purpose for me being here. I am overwhelmed by how much I have learned on only my first day out in the community.  I can only hope that as time goes on I can reciprocate in this incredible process of knowledge sharing across the globe.