TUPO PAMOJA KUUSHINDA UKIMWI!

(We are together to fight AIDS.)

For all intensive purposes, this is the slogan of SIC. But it's more than just something drilled into our heads to memorize during Orientation, or something we write on T-shirts and banners.

This weekend I spent 7 hours traversing 3 villages to visit 4 HIV+ patients. The villages were like jungles, with tall, green banana trees and rich dirt, animals and people everywhere. Four of us met in the morning with a man name Ephrem, who has been working with SIC since the beginning, one of the 4 founding members, one of the 2 on the Tanzanian side. Ephrem is, simply put, probably the most amazing man you've ever met in your life. He is technically an SIC staff member, but more so he is simply a friend to HIV positive people all over Arusha. He helps them get vitamins and medicine, he brings them visitors, he connects them with each other. Just because. Sometimes he'll wake up with a feeling that one of his patients needs help, rush over to their house, to find them about to pick up the phone to call him. Or perhaps, about to die, and in need of loving arms to put them to rest. He has an intuition, he calls it a spirituality, that connects him with these people and enables him to help them more than almost anyone else could.

From the very beginning of our journey, Ephrem continuously said, "Tupo Pamoja." We are together. We are together walking across town. We are together to help each other. We are together to bring happiness to the people we are visiting. We are together in the villages, in the classrooms, in the eyes of the government, in our philosophies. Tanzanians and Americans. Tupo Pamoja.

The first woman we visited has been living with HIV since 1999. She is 29 years old. When her family discovered that she was positive, her husband left her, taking her two daughters away and leaving her to fend for herself, without a way of making money. Her husband has since died (he refused to get tested) and her children live with their grandparents, go to school, and live happy, healthy lives. Albina is moderately healthy, is on two ARV's (they are all taking Nevarapine and another drug - you have to take at least two for the drugs to be effective - I'll explain later if you're wondering why; also if you are on drugs in Tanzania, it means you have AIDS...not just HIV - the government provides ARVs to anyone with AIDS), and has become a spokesperson for the HIV positive in her community. She recently moved into a concrete room (many live in mud huts), which she keeps clean with the help of her brother's son, who has come to live with her and care for her when she is sick. She made us porridge, and said it was a blessing to have visitors. We sat, the six of us taking up every spare inch in her room, and talked to her for over an hour, asking her questions, and her asking us questions in return.

Albina is a rare case. She lives a healthy life because she has an immensely positive attitude. She helps to create support groups in her communitites (although many of her new neighbors don't know yet that she's positive), and tries to eliminate stigma by seeking out other HIV positive people and telling them that they are not alone. In essence, she is a Community Health Worker. She does counseling and provides support and advice to other patients around her. We bought her some gifts, some sugar, soap, rice and peanut butter, but it was surprising when she asked us if we could give her money to help put her daughters through school.

It's ridiculous what the cost of an education is here. Sure, it doesn't cost more than in America...but in America we have that kind of money (however much we complain about the cost of college). Some families can't even support a child going to primary school because it costs about $3/month. People her, for the most part, value an education, they just can't afford it. It's horrible. And what do you do when some asks you for the semi-large amount of money that it costs to send a child to college for a year. How can you put a price on education? We are so lucky that we all have the oppornuity to go to school, one way or another. Kids here either have to help herd the animals and work on the farm, or can't afford the uniform and supplies. And even if they attend school, many end up parents at age 19 anyway, attempting to make enough money to get by.

Anyway, Albina was great. She showed us pictures from her daughter's communion and happily walked with us around town for a while. She was such an inspiration; we know that at least some people realize that they can live happily with HIV - and they can help others do the same. Two of the components of a healthy lifestyle that we teach in our classes, both for HIV positive and HIV negative people, are having a social support network and having a positive attitude. Albina's positive attitude comes from the fact that she prays for her own happiness and health. She asked us to pray for her, too.

On the way to visiting the patients, we actually ran into another of Ephrem's patients. She was drunk... He had told her not to drink multiple times, but she keeps drinking. This sort of goes back to an idea we have talked about, but never seen or experienced first hand: when many people discover they are HIV positive, they drown their sorrows in alcohol or drugs. They are legimiately, always depressed. Not only is alcohol bad for hte body, but it is bad for the mind.. it keeps her negative, both her status and her view on life. But anyway...the second woman we visited was slightly older, but had a similar story of stigma in her past. Her husband all shamed her for being HIV positive, and she also hardly ever sees her children. She uses Albina as a support network. She has more visual illness, one of her eyes looks pretty nonfunctional, she is sick in bed much of the time, she lives in a mud room that she can hardly afford, and she has no business to make money (Albina sells second hand clothes - some days are good, some days she sells nothing). However, she was still very happy to have us, and we learned a lot from her.
The third patient was just a quick hello, who lives with another HIV+ woman who we didn't meet. Once again, the support network is so important. That is why SIC teaching against stigma and providing support in the local villages is so crucial to these people's survival.
The fourth was a 9-year-old girl named Irene. Though she had been very sick when she was young, she looks healthy, has a beautiful smile, and loves to play. She has two sibilings, an older sister and a younger brother, both who are negative. Their parents died from AIDS. Irene has medications for opporunistic infections, vitamins, and ARVs that she takes every day. The children live with their grandmother who is very old and weak, so two ladies who live next door take care of them a lot. The place is perfect for the children to play, they are attending school and loving it, and it, once again, seems like a very supportive environment. Much thanks to Ephrem.

Some patients I've heard about in the past:
- One woman's CD4 count reached 0, so they took her to the hopsital to die. Technically, she was dead. 6 months later, after all her family and friends thought she had passed away, she came back, alive and well. She now has a higher CD4 than many AIDS patients.
- A woman with a very high CD4 has two children she can hardly support. Even though she's technically less ill, her negative attitude leaves her bed-ridden on many days. Her childrren are forced to take care of her, and they can't even eat many days.

(As you notice, women tend to much more open to having visitors when they HIV positive. It's harder for men to take the step to get tested, and do something about it.)
So that was an interesting day, for sure...

- - - - - - -

This week was quite an eventful week. The days are going faster and faster. And its absolutely insane that we only have 8 1/2 more days in our first villages...then we're done and will probably never see these people again (check out my photos for pics of my family!).

On Tuesday we had a testing day in one of our subvillages. We thought that SIC didn't have the resources to have both a testing day and a community day in our village, but last minute they figured it out, so we were able to have one! Because our village is so spread out in itself, only people in the Kaloleni subvillage showed up. Many of them had attended our teaching on monday, during which we taught another almost 130 people! It's so rewarding when these men ask questions that really challenge us, because it means that #`1) they care and #2) they're actually listening.

The testing day was held at the subvillage, and despite a few complications and frustrations with SIC staff and resources, we managed to test 86 people. We know that 3 were positive. And we think that one was a little girl who was brought by her really, really old grandmother. They were in the results room for a really long time.

Surprisingly, most of the Masai men who came to our teaching did not show up to our testing. Actually, a lot of men in general didn't come because they were working. But the morning was pretty dominated by men getting tested. Just no Masai. We realized that it was beacuse the Masai believe they have a cure for AIDS. Actually, Jess and Laura's Baba believes he has a cure for AIDS. It is a simple mixture of herbs. We would like to tell them that they could sell this cure and be the richest men alive.
This week we also did some cool projects with our kids at school. We played a jeopardy-like game (sort of modeled after the way we did in O-staff training...thanks to me), to review all the material. And we also did an art project after teaching some life skills. We are here to teach HIV/AIDS education, but SIC also encourages its teachers to take the opportunity to teach about goal setting, being able to make life decisions, have power over one's own future, etc. These are lessons that they never learn in school or from their parents otherwise. Kids aren't asked, "what do you want to be when you grow up?" Kids don't think they have power over their futures, but we teach them that because they DO, they also have the power to keep themselves healthy and HIV free. We had them draw pictures of "I want to stay HIV free because..." It was a very powerful activity. Most kids know, especially girls, that they are going to be parents...they are going to be mamas and men are just workers to raise a family. P.S. We saw a father who looked about 19 with his 1 year old working at a store. Wow. I am NOT ready for kids.

This week we also finished up our condom surveys, providing about 17 stores in our village with male and/or female condoms. Woohoo!

Meanwhile, we are preparing for our huge community day on tuesday, working to begin training our peer educators, and becoming more and more convinced that our group is the most functional and productive group of the program. Our group is awesome. You should hear some of our conversations...

This week I also saw kids beaten at school by the head teacher, did laundry in a bucket at my house, was caught in several wind/dust storms that reached the sky and continued our runs (and took some pictures - the kids were so excited!).

I think that's all for now, folks. Thanks for reading, I hope everything is ok there in Cali...fires and all. I just need to stop hearing people say "Jimbo la california...moto, moto" (the state of california is on fire!). :(

Best as always,
Devon