My Host Family November 16, 2007

My host family has proven to be a huge support to me during my transition into life in Kamuli. I am grateful that I arrived during a holiday period as my host mother is a teacher and was available in those initial, crucial weeks of my adjustment. One day in particular, during my first week, I was really struggling with homesickness and just didn’t want to be alone. My host mother just sat with me for hours just to keep me company so I wouldn’t have to be alone. My host family eats dinner together every night and often sings and prayers together before bed. This, during the first weeks, was a huge sense of comfort as it was a routine that I could depend on. Each of my host parents have an active faith and role in the church which has allowed for much dialogue about faith in our family. I have enjoyed their children and look forward to the evenings of play before dinner. I have a bedroom to myself which has provided me with a place to rest and seek solitude when needed. Overall, I am very happy with my host family and consider it an answer to prayer to be living with them.

Of course there are challenges, many of which arise out of difficultly in communicating. Because of the indirect style common to Ugandan culture, the first weeks were spent trying to convey messages to each other passively while hoping the other would pick up on it. Because there are so many children in the home, no food is kept in public places, it is hidden away so I often feel as though I am completely dependent upon others for my food which is something that is a transition. Lack of fruit in my diet has also been a small challenge but I am learning to address small things before they become big issues later on. I think, though, the biggest challenge I have in my host family is not seeing them very much. Everyone is always so busy, we leave at different times in the morning and return at various times in the evening. Because only the parents are fluent in English, when they are not around my communication with the rest of the family is limited. There are two girls (both around 16) who live with us and serve as maids/babysitters. It is their job to do the cooking, cleaning, and laundry, so my host mother insists they take care of me as well. As a result of this, I still often feel like a guest and not a part of the family as I am not allowed to participate in family chores. All in all, though, I have been so thankful for my relationship with my family and host mother in particular.

AEGY Goals/Objectives/Activities November 16, 2007

1) Goal of my assistance efforts is to AEGY staff in utilizing their capacity to educate, treat, and counsel those in their community who are infected or affected by HIV/AIDS.

2) Specific objectives involve collecting information to develop training manuals for primary and secondary school education programs so that accurate, uniform information is given and program has sustainability if volunteers change in order to educate youth to make behavior change decisions which will prevent them from being infected with HIV.
3) Major activities carried out involve facilitating peer education trainings in secondary schools, conducting health talks in primary schools, and visiting support groups of PLWHA and orphans.
4) Key Changes that will indicate efforts have been successful:
a. Training manual development for primary school health education talks
b. Training manual development for secondary peer education clubs
c. Students making decisions to change their behavior and modeling that for their peers.
d. Training AEGY secretary in computer skills to increase competence

Goals of personal development and learning which I have for this upcoming SALT year are focused primarily around the mission of SALT- I hope to learn, reflect, absorb, and above all, change as a result of this year’s experience. Personal transformation and growth are my main goals as I hope to share and implement all that I learn here with my community at home and wherever the future takes me. I hope to personally develop and be transformed in the following ways:
1) To learn to be more relationship oriented (opposed to task)
2) To be present in the moment, in the here and now (not focusing on past or future)
3) To daily spend quiet time with God by learning to be comfortable with silence and stillness (learning to listen)
4) To not always judge what’s unfamiliar as inferior- be open to change/differences
5) To develop confidence in my knowledge/skill set/abilities
6) To develop mutually supportive relationships here in Kamuli
7) To learn to carry on a casual conversation in Lusoga in hopes to develop relationships

The primary relationships I hope to focus on and plan to seek to develop in this upcoming year are with Beatrice, Esther, Monica, and Michelle. My hope is that each of these relationships will develop into ones which giving and receiving are mutual. Each person, each relationship, represents a different aspect of my SALT Kamuli experience. Beatrice is my host mother and has already proven to be a huge support and mentor as she serves in the church as a lay leader and works hard at home to love and teach her children values. I hope that in our times together in the evening drinking tea we will develop a relationship of encouragement and support as we process through our days together. Esther is a young woman who attends the same church as I and is about my age. She is involved with many activities at church and has just recently finished her university study. Although we are in the beginning stages of forming a friendship, I can see the potential for us to develop an accountability relationship as we are at similar places in life. Monica is the AEGY secretary and is the person with whom I probably spend the most time with. Monica is a single mother who struggles to make ends meet and lacks confidence. Through our interactions, we laugh and pass time by talking about a variety of topics. Monica is Catholic and very skeptical of born-again Christians which has opened the door to dialogue about the divisions between Christians here in Uganda. Monica has become for me like a cultural mentor and has taken it upon herself to teach me things like how to cook, wash, and be a typical Ugandan woman. Michelle is the other relationship I intend to pursue and focus on this year as we share this experience together. Although we are in different locations, Michelle’s prayers and encouragement and empathy have meant a lot. We are in solidarity in this and offer each other our ears to listen and our hearts to understand.

As far as long term goals related to my service with MCC, I hope that this year truly is transforming so that upon my return to the States and my community, I am able to share the stories of my experiences. I am only one person but I can share with many and I hope that by being changed myself during my time here, I will be used as a catalyst for change for others. I hope that wherever I end up, in whatever career path I pursue, I will constantly be surrounded by people seeking to live out Christ’s teachings in their day to day life and embrace peace and social justice issues. I hope to possibly go back to school in my future and work towards a Master’s Degree in public health/nursing and live in an intentional community. Wherever I go, whatever I do, my goal is to live simply, embrace peace, work for justice, love others, and ultimately display my love for God through it all.

Looking Ahead: Where I’m Going… November 16, 2007

This is where I’m heading… or hoping to head at least…

As I look to the next year ahead, my focus as regards to my assignment working at AEGY here in Kamuli is to build relationships which serve as conduits of mutual learning and growth. I come to AEGY with knowledge of HIV/AIDS and a skill set as an American trained nurse but with very little experience. Those with whom I work and encounter at AEGY have much experience with HIV/AIDS but very little knowledge and formalized training. During this next year, my hope is that the relationships I develop at work will prove to be mutually transformative and that I will gain experience and learn from them just as they will learn information and skills from me. I also really intend to focus this year on seeing people and not a problem. HIV/AIDS in America is often presented as this terrible epidemic and that if only the right information and medication would find its way there to Africa, all would be well. As I’ve spent time here in Kamuli and met people living with HIV/AIDS and gained a fraction of understanding to their plight, I am realizing that it really isn’t that easy of a problem to fix. As an American, I have the tendency to want to fix the problem. My focus for this year is to see clients as people to love and not problems to be fixed.

In my assignment, I see myself furthering MCC’s priorities in many various ways. The first priority is that of relief. As I work with AEGY, we are directly meeting the needs of those in the Kamuli District who are infected and affected by the HIV/AIDS epidemic. We provide both material (treatment, beddings, income generating activities, school supplies, etc.) and non-material support (counseling, support, education, referrals, etc.). I have been a part of providing these and am serving as a visible representation of MCC to all of AEGY’s clients as many are aware that MCC provides funding and support for AEGY’s various activities. The second priority of MCC which my assignment is allowing me to further is of capacity building. In my role at AEGY, I am teaching computer skills to the secretary and beginning to undertake the initiative to write and develop training manuals for AEGY’s primary health education talks and their peer education programs in secondary schools. In most of my roles at AEGY, I am always assisting or working alongside others so that when my SALT term comes to an end, there will not be a huge gap to fill, instead we are always working as a team, learning from each other as we go. This also relates to MCC’s priority of connecting. As we work together at AEGY, I am learning so much from my colleagues and we constantly engage in conversation exchanging ideas. I have found that by asking lots of questions and being open to the responses of others, an environment of mutual giving and receiving of knowledge is achieved. MCC also holds peace as a priority which I am encountering as I work with people of different faith backgrounds than my own to fight a common enemy of HIV/AIDS. I have not yet attended the Living with Shalom training held in January, but because of a recent meeting which I attended and the numerous Shalom alumni that I’ve met, I look forward to being a part of that training and learning more about breaking down barriers of stereotypes and prejudices here in Uganda and in my own life as well.

I intend to carry out the following activities throughout the next year of my SALT term to fulfill my job description. I intend to assist AEGY staff in the training and monitoring of peer educators and secondary school clubs and reproductive health education classes in primary schools. I intend to accompany other AEGY staff members and offer the gift of my presence while visiting support groups for people living with HIV/AIDS in addition to orphans in their school setting. I will also assist in administering opportunistic infection treatment with two other AEGY nurses for clients. In discussing my role at AEGY with my supervisor, in addition to the above roles included in my formalized job description, I hope to collect the information necessary to develop training manuals for both the primary school health education talks and the peer education trainings. At this point in time there is a lack of consistency between AEGY volunteers and the information they are delivering so it’s the hope of AEGY to have a uniform document which all volunteers can base their trainings from to ensure that accurate and thorough information is being facilitated into the community. I also intend to assist AEGY’s supervisor in writing proposals for grants and developing an information AEGY brochure.

I will be interacting primarily this next year with the AIDS Education Group for Youth (AEGY) organization and its clients, people living with or affected by HIV/AIDS. My assistance will help to address AEGY’s need for information, organization, and skills. I also am able to offer myself, my youthful energy and optimism to the office. Working with HIV/AIDS can sometimes be overwhelming and traumatizing so it has been encouraging to my co-workers to have a new member to their team who is able to bring a different perspective to the table. In the office, there is the need for more organization of files and training of the current secretary in computer skills, both of which have become projects for me which I enjoy. I will be working much with secondary students doing peer education and my assistance will help convey accurate knowledge and information about adolescence and HIV/AIDS prevention. This need was determined by the AEGY supervisor. In the peer education clubs and primary school health education talks, there is a need for a uniform teaching curriculum that will be sustainable and therefore developed and documented. Both of these needs arouse from discussions with supervisor and other AEGY staff members in conversations about my role in AEGY in this year of service.

Looking Back: Where I’ve Been… November 16, 2007

As required by the MCC (Mennonite Central Committee), I recently had to submit a quarterly progress report and an annual plan of what I’ve been doing thus far in my 2 ½ months of service and what I hope to do in the 8 ½ months ahead. Although the comments to follow may not be the most interesting, I’ve decided to post them to prove that I am doing more here than just sitting on mats, drinking tea, and eating carbohydrates.

This is where I’ve been…

The most significant learning that has occurred for me during the time I’ve spent at AEGY thus far has been in the direct encounter with people living with HIV/AIDS (PLWHA). Prior to coming, I had spent much time reading and researching about HIV/AIDS and the epidemic. I came to Uganda with much knowledge and abstract theories on how to address this problem effectively. Now that I have been living here for nearly two months and am interacting with PLWHA on a daily basis and seeing with my own eyes their experiences, the epidemic has taken on new meaning. It is not just a public health problem, the causes and effects of HIV/AIDS on the community run much deeper. Seeing and meeting PLWHA and establishing relationships with them has made this abstract epidemic a reality for me as I am able enter into their lives in some small act of solidarity.

I am also learning that things are more than meets the eye. When I first arrived and began to learn about AEGY and its programs, I thought to myself that it has no structure and no organization. I was amazed at how it was functioning! Now that I’ve been here for a while, I’m beginning to see the structure of the organization and recognize that because things may not be organized the way I would think best, different does not mean bad.

Another thing I am learning, quite unexpectedly, is what it means to be white and an American. Living in a small town where I am the only “mzungu” has heightened my awareness at the color of my skin. The way people treat and interact with me has greatly caused me to pause and evaluate what it means in this context, to be white and all the privileges it carries. People make assumptions about me based upon my appearance and have certain expectations that follow. I am also accorded much respect and even gifts on occasion which I certainly didn’t do anything to earn.

A highlight during this period has been the development of relationships and really beginning to see Kamuli as home. I traveled to Hoima, the other side of the country, for a weekend shortly ago. While away, I missed Kamuli, I missed friends here. That realization- that I missed my town and family- really stuck me as a highlight to my time here as I am becoming more a part of the community here. I was also able a few weeks ago to teach a few friends from church how to cook hamburgers. This simple act of cooking and sharing with them a part of my culture really brought a sense of belonging.

I also have been greatly enjoying the church which I attend and am a part of here in Kamuli. It is a Pentecostal Church, very different in worship style than what I was used to and comfortable with. I am learning to be more open-minded and have enjoyed stepping outside my comfort zone learning to embrace the diversity of the body of Christ.

The greatest struggle I have been facing since my arrival here in Kamuli has been loneliness. When I left the States, I left behind a solid group of friends and mentors whom supported and encouraged me in all aspects of my life. Being so far from this support network has been a challenge, especially as I did not anticipate the intensity of emotion that I experienced in my first weeks on assignment. The worldviews of America and Uganda are so drastically different, I knew this in theory but when it became my reality, I was not prepared for its effects. Even though we are able to speak the same language and talk, communication has been something that I’ve had to work at to make sure I am understood and understanding others. Kamuli is one of the more rural districts in Uganda and as a result receives very few mzungu (white people). To compound the struggles I’ve faced with feelings of loneliness, I recently had a close childhood friend pass away. Not learning of the news until days after her unexpected death as well as not being able to mourn and grieve with family and friends during this time of sorrow has really caused me emotional difficulty.

To respond to these struggles, I have greatly been blessed with a wonderful support network here in Uganda on the MCC team. The other SALTer has proven to be a great encouragement and empathetic ear. The Country Representatives have always made themselves available to talk if there is a problem and having prayer partners has also been an encouragement. I enjoy journaling and use it as a way to process and reflect the emotions I am feeling and prayer and quiet time in my relationship with Christ has also proven to be a support. I am blessed with much support from family and friends at home so their communication has been rejuvenating in my most troublesome moments. Reading books for pleasure has helped to pass some of that lonely time and I’m generally learning to be more comfortable with silence and stillness. The most significant thing that I’m learning with regards to responding to the ‘struggles’ of life is that my tears are not a sign of weakness. Giving oneself permission to cry when necessary- opposed to my initial desire to hold emotion in- is liberating beyond words and has proven to be quite therapeutic.

I have encountered God everywhere in my assignment. Anne Lamott is one of my favorite authors and in one of her books she says that her two favorite prayers are “help me, help me, help me” and “thank you, thank you, thank you”. As I’ve been constantly uncomfortable for the past two months, these two prayers have become my mantra. Everyday I seem to cry out both of them to God and have really found God to be present in this place. Because I am a foreigner here, my spiritual need for strength is heightened as I know that I cannot rely on myself to get me through the day. I have encountered God much in the people around me with whom I interact. I work with many people who embody what it means to follow Christ as they care for the widow and orphan in their time of need and sacrificially spend their free time caring for those infected or affected by HIV/AIDS. Seeing the Gospel embodied in a living, breathing, active way has really been a huge encouragement and challenge to my faith and has caused me to reflect upon many of my priorities. In my loneliness, I am learning to be silent and still which has allowed my prayer time to be enriched as I am, for the first time in my life, learning that communication with God through prayer is two way- it involves more than me just talking- it involves actively listening and creating space for God to speak.

One of my first field experiences with AEGY I traveled with a colleague to do home visits for PLWHA. At one of the homes, we visited two clients- a mother and a daughter who were both HIV positive. After teaching and counseling them, we were preparing to leave when they insisted on giving me a gift for coming to see them. This woman and her daughter were determined to give me a giant yam from their garden to take home as a gesture of their appreciation for my visit. I was touched that they wanted to bless me in this way yet I really struggled to understand why they were so persistent and the deep meaning behind it. At the time, I remember looking around and seeing their tiny shack and the little food they had, their thin skeletons and sickly appearances made me want to refuse the gift of food just so they would have a meal for tonight. I certainly didn’t need anymore food!

I am learning that this experience meant something different to me than it did those two clients. To me, my visit wasn’t a big deal but to them, while to them, receiving an American was a huge honor. To me, accepting the gift was taking away their food. The little that they had, they were giving away to someone who didn’t have a need. To them, however, they were offering hospitality to a guest. Offering hospitality is a large part of Ugandan culture and to receive visitors and not give them something is a cultural taboo. In this moment, grace became ever more real- learning to receive something that one did nothing to earn.

Two feet – of my own November 14, 2007

So, today marks the first day in which I actually handled conflict in a positive, assertive manner.  I’m quite impressed with myself—my past tendency would have been to shy away from conflict—a.k.a. running in the opposite direction or pretending it doesn’t exist—which makes this confrontation a landmark achievement which clearly must be documented.  (Liz Laribee- you would be SO proud of me- I’m learning to stand up for myself—on my own two feet!).  This past week there were MCC visitors from the Akron office (in PA).  While they were here shooting the documentary, I inevitably became like a third wheel and technical crewmember.  Throughout the time I spent with them, good conversations were had and with their outside perspectives, I was again challenged in many ways by their point of view.  Robin, also working with HIV/AIDS prevention in Bangladesh, was skilled at drawing out of me things I’ve known about myself but often have chosen to conveniently overlook as facing them requires far more energy and motivation and courage than I feel like I can muster.  Also, it requires change on my part and let’s all be realistic, who in their right mind enjoys change that involves leaving your comfort zone?  Most don’t… at least most of the sane, normal people I know don’t.

Change is work and transformation doesn’t come easy.  If it did, I wouldn’t be here in Uganda talking with youth about sex and HIV and abstinence and behavior change.  Accurate information would be given, students would hear, and change their behavior appropriately.  And we’d all live in a happy AIDS-free world, right?  Sorry, it’s not quite that easy, my friend.  Anyhow, back to me and my problems.  (this blog is all about me, remember?!) So with Robin & Shaun here, our conversations gravitated to how my SALT term is going and eventually ended in me feeling a bit dejected at the realization that I am still functioning in the same old dysfunctional ways as I’ve always been. 

I am a people pleaser.   Yes, I’ve said it.  I can now let out a sigh of relief.  Phew.  Glad I got that off my chest.  Oh wait, you’re not surprised?  I guess you must be one of the fortunate few to have roomed with me over the past four years at Messiah or grown up with me in the rolling hills and open fields of New Tripoli.  I have to say, as time goes on, it becomes easier to admit this fact about myself, most likely because my friends tell me its true all the time and don’t stop there.  They must proceed in suggesting that I get over it or else I may have permanent tread marks on my back from people constantly walking over me.  Okay, perhaps they’ve never come right out and directly said this but I’m fairly sure this is what they’re thinking. 

I’m not sure where it started, I’ve seen a few counselors over the years who could probably speculate and offer a fairly good explanation but I’ll chalk it up to a combination of factors of my past and personality.  Having this weakness of mine highlighted this past week, for whatever reason, took me back to my days in middle school when I had a little incident with some fruit punch flavored Kool-Aid.  Of course, it wasn’t my fault that my mother never told me not to dye my hair with Kool-Aid. So when I did (thinking it was the coolest thing to do ever- picture me, all of 13 years old kneeling in the kitchen with my hair soaking in a basin of red liquid with the oven timer set for 20 minutes) only to discover that the bright red, sugary-sweet juice doesn’t wash out quite as easily of golden blonde hair as I had initially expected.  At first I was just embarrassed by the seemingly permanent fruit punch highlights but as time went on, the realization set in that I should have been old enough to see the foolishness in using artificially flavored fruit juice to temporarily color my hair all along. When first enlightened to my people-pleasing nature, I was embarrassed.  After years of knowing about it and doing very little to change my behavior about it, I feel foolish that its still the same-old-same skeleton in my closet causing me problems. 

To spare you the details (I’m trying to be considerate in spite of my long-winded elaborate explanations!) and respect the confidentiality of a few co-workers, I won’t go into details about the conflict other than to say that it involved a cultural misunderstanding of hospitality, gift giving, and acceptance of the like from our clients- people who live out in the village- much like you see on those awful late night/early morning sponsor-this-child-and-send-us-your-money-before-the-flies-eat-him-to-death infomercials.  My ‘white-ness’ played a role, which it inescapably seems to have become a baseline for all my interactions.  .  My supervisor and discussing directly with him some of the discomfort I felt caused by a series of recent unsettling events—it  was a helpful conversation but still tough because I’m living in a culture that uses indirect means to communicate— it’s a struggle to get someone to say what they actually mean.  People and relationships are valued over the truth sometimes and learning how to fit into this has been a challenge—and still is!  I started off today, however, with a determination to at least take one-step forward standing on my own two feet. I’m trying this whole being more assertive and authentic thing (two qualities which I’m attempting to focus on in hopes of taking the first—difficult and slightly painful—strides towards change and transformation from people-pleasing to a more balanced mindset of loving God, others, and myself.  Much like the artificial flavorings of Kool-Aid, constantly seeking to please people lended to an authenticity on my part in the new relationships I’m developing here in Kamuli and my lack of assertiveness only further adds to damaging effects.  Although small and seemingly insignificant for others, today marks a huge milestone in my assertively authentic pursuit of striping myself of my people-pleasing ways.

All I want for Christmas November 14, 2007

So, the Christmas season is right around the corner- here in Kamuli we’ve already begun fattening up the cows and goats for our Christmas feast.

As the holidays approach, I know that many of you are already brainstorming about what gifts to buy for your families and friends, but in the spirit of giving, I must put in a shameless plug… when shopping for your little brother or significant other, instead of buying another sweater which will inevitably be worn a couple of times and then take up permanent residence in the back of their closet—why not buy them a goat or a cow—or an AIDS Kit if they are more of the vegetarian type?

Okay, so I don’t mean for you to literally go out and buy livestock but all I want for Christmas this year is everyone, around the world, to have a moment of peace and love in the midst of whatever it is they are facing in life, be it HIV/AIDS, famine, poverty, or broken relationships. All I want for Christmas is, in the spirit of giving, you expand your horizons to consider giving a gift to someone a bit outside your family, perhaps on the other side of the world…

And this is where I throw in yet another shameless plea…Check out www.mcc.org and click under donations link. If you’re not interested in buying livestock in someone’s honor, you could always write a check to support MCC Uganda’s programs (which would have more of a direct impact on AEGY- AIDS Education Group for Youth- the organization I work with which MCC supports). Another option would be to compile an AIDS kit (instructions on the website, too!) and send it off to Akron, PA en route to places in Africa, Asia, and South America.

As holidays approach, I miss home more than ever—this is my first holiday away from home! —And yet, I am still grateful for this new experience of traditions and customs and culture. May this holiday season be one of peace and grace and love, because at the end of the day, these are the only things that matter.

Me, Me, Me November 12, 2007

This past week, there was an MCC communications team- Robin & Sean- visiting AEGY (AIDS Education Group for Youth) and Kamuli.  They have been spending the past three weeks traveling to various countries- Nepal, Swaziland, Zambia, and now finally Uganda- shooting a documentary for the MCC.   It was nice to have company in Kamuli- it was a welcomed break from being the only “mzungu” in town. It was nice spending time with them and assisting in the making of the documentary- their goal was to show a day in the life of a child affected/infected by HIV/AIDS and to tell his/her story.  We spent time with various orphans until one was identified to follow and film, but I have to admit that throughout the “interviewing” process of orphans, I found myself becoming a wee-bit depressed. 

 

Seeing all that poverty and hearing stories of all that suffering… I don’t know, it’s hard to wrap my mind around sometimes… And at the end of the visit, without fail, there is always some kind of request- a desperate plea- for assistance- for food, for shelter, for clothing, for school fees (education)—you know, all those ‘basic needs’ essential to survival you learn about in elementary school. 

 

I hate this part of the visit, I hate that I have to say, “no sorry, I can’t help you” – I hate that I turn my head and avoid their eyes—I hate that I know that if I only would abstain from my chewing gum addiction, I could pay school fees for one child for a year (I chew a lot of gum!)—I hate that I leave these beautiful, precious children knowing full well that I’m going home to sleep in a comfortable, warm bed and eat a plate full of food that far exceeds my daily caloric needs.  Most of all, I hate how everything I hate involves me. 

 

Me, me, me.  I’m an American, through and through. 

 

All this is hard to get used to… but maybe that’s a good thing…Maybe we’re not supposed to get used to it.   I’m not sure that I’d ever want to be “okay” with looking injustice in the eye and turning away.  I’m slowly learning that to engage in the world is to SEE injustice, is to SEE suffering, and is then to sustain the gaze because its then that the tiny hints of hope can break through.  

ABC…if it were only that simple. October 30, 2007

In preparing for my work with AEGY, the past months have been full of reading books, journals, and articles about HIV/AIDS education and prevention. Below is what I’ve learning- so if not interested in healthcare and HIV/AIDS, the following may be a bit drab- consider yourself warned!

If you’re at all familiar with the topic of HIV/AIDS prevention, then the letters ABC should ring as bell as they are the current foundation of many current prevention methods. As I’ve read, I’ve soaked up a bunch of knowledge; here in Kamuli, living and working with people who are HIV+, I’ve seen reality. I will try my best to explain the ABC approach and offer my critiques of it as I go- and of course, I must emphasis that this is strictly my perspective- I am not an expert nor years of experience under my belt- so take all that I say with a grain of salt.

The ABC approach to HIV/AIDS prevention is based upon three core public health teachings- A stands for abstinence (delay of sexual debut- geared towards youth), the B for be faithful (fidelity in relationships- focus on adults), and C is for condoms (correct and consistent use- with message directed at high risk/vulnerable populations). All elements of ABC are necessary, the emphasis of which method of prevention is based upon the targeted population. It is important to mention that this approach encompasses much more than just ABC- if it were this simple to prevent the spread of HIV, there wouldn’t be nearly so many heart wrenching stories of those affected. ABC also includes the following areas: voluntary counseling and testing (VCT), treatment of STDs, opportunistic infections, and HIV (with antiretroviral drugs), destigmatization of people living with AIDS (PLWA), reduction of poverty, increased political openness, effects of gender inequalities (increase in women’s status and education, violence, discrimination in sexual behavior).

The American funded, PEPFAR (President’s Emergency Plan for AIDS Relief) initiative has adopted the ABC method as its prevention focus and has received much criticism worldwide. Those from the religious right are upset that condoms are being encouraged and those on the left claim that there is too much emphasis on abstinence. Each side has their views and their own statistics to back it up and yet, from the general perspective here in Kamuli, ABC seems to be quite sufficient in educating the public, especially youth, on how to protect themselves from infection.

Placing too much emphasis on only one letter is to neglect the needs of the others- for example, if only the C is focused upon, HIV would continue to spread rapidly in Uganda as many of the cases of transmission are a result of infidelity with multiple partners in rural places where accessing condoms is virtually impossible. Besides, culturally speaking, advocating the use of condoms is absurd. For condoms to be effective (mind you, only 80-90% effective) in preventing the transmission of HIV, they must be used consistently and correctly which again, is unlikely due to the environment that is rural Uganda. Also with too much emphasis on C, a community is vulnerable to risk compensation- condom promotion can lead to greater sexual risk taking which is a result of a perception of reduced risk making the risk taking seem more attractive (sort of like wearing a seat belt makes you feel safer when driving a car and therefore you’re more likely to speed). Of course, though, encouraging the use of condoms to those individuals who are at risk is extremely important and mustn’t be ignored. It’s a matter of risk reduction opposed to risk elimination (A and B).

Often in literature, Uganda is praised for its early efforts in combating the AIDS epidemic with this approach. The government was quick to admit that there was a problem and openly addressed sexual behavior (interestingly enough, many Ugandans I’ve encountered believe that their leaders responded so promptly to HIV/AIDS was because that a majority of the military was becoming infected- if the government didn’t act, there would be no army left- just one thought…). Much of Uganda’s success is attributed to letter B- being faithful. Ugandans were bombarded with messages of “zero-grazing” and “love faithfully”- with much focus being upon men. It is quite common to attend an AEGY support group and find it mostly comprised of women. Women are not ashamed to admit their status, as many were infected by their husbands. These women abstained from sex until marriage, were faithful to their spouse and but still were infected- unfortunately by the infidelity of their partners.

As a bit of an aside, I’ve been learning about laws here and thought it appropriate to share a few pertaining to this topic. Interestingly, here in Uganda, homosexuality and underage sex are both illegal. According to Ugandan law, sexual responsibility for males is at age 14 and for women, age 18 (note the difference between genders!). This means if a teenage girl becomes pregnant and is under the age of 18, her partner, if over the age of 14, is arrested, fined, and imprisoned. Abortion is illegal as well, leading to many to seek the procedure in unsafe rural clinics performed by untrained lay people. Clearly, these laws effect the youth of Uganda and need to be considered in prevention efforts.

Factors like poverty, illiteracy, instability, displacement, gender disparities all are present and very real here in Kamuli making any prevention strategy difficult to implement. Nothing is ever as simple as ABC…

Home. October 17, 2007

Home. 

Being far away from home and going through an emotional time as this, I’ve been missing it a lot.  It’s caused me to think home in a new way, too, and what follows are my thoughts. 

I got a letter from one of my lovely, dear friends shortly after my arrival here in Kamuli.  I could attempt to paraphrase her words, but I fear they’d lose their value would be lost in translation- so I’ll just quote her directly as her thoughts capture something so deep, so profound, they’ve become questions I ask myself and reminders I say each day.

“It has been a few weeks and you are still in Africa.  A new place that I hope smells and feels more and more like home each day.  I hope that you feel yourself growing and stretching in ways you never before thought possible.  All this in the same of Jesus and because you know that life is best lived when lived in love and for the sake of others.

If we really believe that our home is with Jesus, then should we ever feel totally content where we are? This is the question I have been asking myself recently.  When we wake up, what goals and desires do we have for the day? Are we aware that God is everywhere and thus we have nothing to worry about? Even when no one understands us, the culture we are in does not match up to what we are used to… we still have a home in Jesus.”

As two months have passed, Kamuli is becoming more and more like home.  This truly is an answer to prayer but it also has implications to my connection with those of you at my “other home” as I call the States here.   As this is becoming more and more my community, I’m coming to face the reality for this to occur, the community I left behind must inevitably become less and less. This of course, certainly does not mean that my love for any of you there is any less or that I’ve completely disregarded all thoughts about the people and places left behind.  Of course, I think of you often.  Of course, I love you.  Don’t be ridiculous!  What this does mean, though, that for this season of my life, I’ve made a decision.  I’ve chosen to make a commitment to the people here in Kamuli, to intentionally be focused here, now.  This is my home. 

Now please don’t jump to the conclusion that this means that you should no longer email, snail mail, or call me. Quite the contrary, I still do want to hear from you, very much!  I feel the need, however, to clarify expectations of responses on my end.  I assure you, don’t lose sleep thinking I’m not reading the emails you send- I read them, I really do!  It’s the replying to them that is the problem.

That’s the tension in which I now live, the balance of past and present and future, too.  Gosh, I wish I could remember what our Baccalaureate was about right now- it had something to do with this theme… actually, it might have just been “BE”.   Maybe someone can help me here and refresh my memory… after all, it was only 4 months ago!  Anyhow, I’m not there, but if I’m not all here either.  I’m torn in the middle.  Learning to nurture relationships from afar is tough while putting forth effort into building new ones here. 

I will communicate when I can, if you don’t hear from me, please don’t worry! It probably just means that I’ve been busy developing relationships or riding on motorcycles or running through rainstorms. Or the electricity has been off for a week.  I’m here, no worries.

mpola mpola October 17, 2007

            Mpola mpola  (slowly by slowly) I’m learning to live one day at a time. Take for instance this moment, I am breathing- the air goes in, fills my lungs, and then goes out.  My heart, likewise, is beating, I can feel it, lub-dub it goes.   My eyes, too, are blinking- open, close.  I’m alive and well and I’m beginning to recognize and celebrate this for the amazing gift that it truly is.  When death becomes real, life inevitably takes on new meaning… This year takes on new meaning… in someway, somehow, living here in Kamuli, Uganda is about so much more…  I won’t lie, the pain of losing Krysta is still fresh but hope is found in each new day.  I can’t quite explain it, but this year has become a way for me to remember and honor Krysta’s life… it’s somehow a tribute to her and all that she was and could/should have been.  It’s a year to intentionally love others and offer them the life that she so tragically lost.  If one student listens to the message I share and chooses to change their behavior and thus avoids exposure to HIV, this year was worth it.       

            Before coming here to Uganda, I made a decision, a commitment to myself.  At the end of everyday, I vowed to ask myself one simple question.  No matter what the day was like, as the sun sets and the stars begin to fill the night sky, I pick up my journal and write a response. “What has Jesus taught me today?”  Having this deliberate awareness of Jesus’ workings has challenged me to look for Him and enabled me to see Him moving in places, in people, in ways I never expected.  As I’ve been answering this question over the course of this past week, it’s been a bipolar mix of responses.  But tonight, as I write, I am overwhelmed with one thing and one thing only.  Actually, it captures quite well my entire experience thus far in Uganda, and well, my life.   In everything, no matter what the circumstance has been, God’s grace is sufficient for me.  Even (and especially) when I think I can’t handle it anymore- that’s when His grace is extra sufficient. 

            When I was in kindergarten, I used to come home from school and watch Mr. Rogers on the television- I loved that program and his closet full of sweaters!  In his book, “The World According to Mr. Rogers”, Fred writes,

“Confronting our feelings and giving them appropriate expression always takes strength, not weakness.  It takes strength to acknowledge our anger, and sometimes more strength yet to curb the aggressive urges anger may bring and to channel them into nonviolent outlets. It takes strength to face our sadness and to grieve and to let our grief and our anger flow in tears when they need to.  It takes strength to talk about our feelings and to reach out for help and comfort when we need it.”

            God’s grace is sufficient for me even though life can, at times, be difficult beyond explanation.  We live in a world where there is so much possibility- for great beauty and terrible pain- for sickness and health- for grace and terror- for life and death.   I’m learning that tomorrow is always uncertain.  I’m learning the importance of remembering who we are, where we’ve come from, and all the people along the way that got us here.  I’m learning its important to talk to people and reach out for help and comfort when needed.  I’m learning that it’s important to hold tightly onto all that’s true. 

            Love, in all its different forms, seems to me to be the one true thing there is.  I pray that you may know it now, and always.

            At the end of the day, I have to believe that someday, somehow, it’s all going to make sense and it’s all going to be made right.