Tuesday, February 19, 2013

Some Things That I Have Learned… “Understanding is the Best Prevention”


I’m just getting back from a prolonged stay in Chipata town that lasted 12 days. I was going a bit crazy being away from my village for so long but I was asked to come in for a series of project workshops. One was a TEFL Counterpart Workshop where all education volunteers in my province came with an English teacher from their respective school… More on that another time. The first workshop I attended was based entirely on HIV/AIDS and how we can sensitize our communities on prevention, care and treatment. Again, this workshop was designed for a volunteer to bring a counterpart from their community so we could learn and plan together. The program was eye-opening and in my opinion, it truly prepared us to address the crisis of HIV in this country in our own small ways.

In the United States we learn from an early age, I think it was maybe grade 5 for me, about sexual health and everything relating to STIs that we never wanted to know. It came up in health class every other year until graduation, it was a part of the curriculum and whenever HIV was taught, I remember thinking of it as something that was not common and could never happen to me or anyone I knew. In the US, less than 1% of the population is infected with HIV. This statistic is partially skewed if you take into account that the rate is higher in densely populated, urban areas and almost non-existent in more rural areas (i.e. where I come from). Either way, before coming here HIV and AIDS was something that never came up in my day to day life and was something I hardly thought about, which is really sad considering how serious this epidemic is in our world. It is a crisis that we all need to face together.

I’ve assembled some information about the prevalence of HIV and included some hard-to-face truths. I don’t know how important it is to site my sources in a blog format but most of these numbers came from http://aids.gov and from the Zambia Demographic and Health Survey. Please remember how important it is that we all understand what is going on in our world and keep in mind that it is something that needs to be addressed.

From the most recent global statistics, 33.4 million people are now living with HIV/AIDS. Of those infected, 97% are living in low and middle-income countries, particularly in sub-Saharan Africa. As I’ve seen now in my everyday life, most people who are either living with HIV or who are at risk have little access to prevention, care, and treatment. In other parts of Zambia and throughout the world there is no help at all.  One of the most important things to understand is the impact that HIV has on a country’s development. “The HIV epidemic not only affects the health of individuals, it impacts households, communities, and the development and economic growth of nations. Many of the countries hardest hit by HIV also suffer from other infectious diseases, food insecurity, and other serious problems.” I can’t stress enough how true that is from what I’ve seen and heard during my last year here.

As of 2008, the prevalence of HIV in Zambia was reported at 14.3%. This number came from a nationally representative sample of over 13,500 Zambians.  That’s about one in seven Zambians, ages ranging from 15 to 49, that are known to be HIV positive. There is a huge fluctuation between rural and urban areas; almost one in four people living in Lusaka, Zambia’s capital city, are known to be infected. A significantly higher percentage of women are known to be HIV positive than men, 16% of women compared to 12% of men in general and 23% of women compared to 16% of men in urban areas. This is largely due to the sexual violence that is common in Zambia. That is a subject all on it’s own, so I’ll save it for another time but the fact is that girls here aged 15-24 are nearly twice as likely to be HIV positive than the boys their age. 

Unfortunately, it’s known that the majority of Zambians have never been tested for HIV although most do know where to get a test. There is a stigma towards it and a general attitude about sexual practice that many Zambians, particularly Zambian men, won’t change. It’s hard to grasp that some of the most common prevention methods are shunned because of how people were raised to think about sex, but with the death of around 89,000 people from AIDS every year and an estimated 630,000 AIDS orphans left behind, more and more Zambians are listening.

The workshop I attended was sponsored by PEPFAR (Presidents Emergency Plan For AIDS Relief), which comes from the American government. The budget that PEPFAR set aside for Zambia alone in 2007 was $216 million for prevention, care and treatment and an additional $25 million to aid in the prevention of mother-to-child transmission. I can’t even fathom how much money that really is or where it all goes to but if the trends continue from the previous survey done in 2001-02, we can expect at least a slight decrease in HIV prevalence. The last survey was done in 2007 so we will have updated statistics available this year. It’s an exciting time to be here, to have substantial evidence that our program is either working or needs work.

As a Peace Corps Volunteer living in sub-Saharan Africa, one of my primary goals is to spread knowledge about HIV and AIDS and to promote safe sex and regular testing. Currently my counterpart, Josephine, and I are planning a Voluntary Counseling & Testing (VCT) event for all residents of Chadiza. Josephine has an Anti-AIDS club and I have my Boys & Girls Club so we are working together with our kids to plan and perform dramas at the school, in the market and at the local clinic. These dramas will help to sensitize the community and to promote the event, which will take place at the end of March. (Side note, all Zambians love dramas. They love watching them but more than anything they love performing. If you’ve ever seen a Nigerian film, and I don’t recommend it, you’ll have an understanding of the acting chops out here. Still, it’s a nice way to teach and to learn.) I’m excited to be forming and expanding my own goals as a Peace Corps Volunteer and am very glad to have a deeper understanding of life here.

Even if this is something that does not affect you directly, there is still a lot to be done, whether by spreading knowledge on prevention, aiding in the care of someone who is living HIV positive or contributing to an organization that is providing relief.





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