Women’s Equity in Access to Care & Treatment, or WE-ACTx, aims to provide the women and children of Rwanda with proper access to healthcare and treatment. Nearly 10 years after the Rwandan Genocide, this HIV/AIDS initiative brought much needed aid to communities of women and children in Kigali. Now, more than 12 years later, the organization continues its work, offering not only clinical care and mental health services for people infected with HIV/AIDS, but also youth programs and support with income generation—aimed at addressing both poverty and malnutrition.
I caught up with Mardge Cohen, co-founder of WE-ACTx, and spoke a bit about the organization’s origins, progress and successes, which have allowed this quite exceptional organization to thrive among the people of Kigali, Rwanda.
Tell me, how did WE-ACTx begin?
“The organization was started in 2004. We went to Rwanda because one of the other people who formed the organization, named Anne-Christine d’Adesky, a journalist, had been writing a book about HIV and women. She had been to Rwanda and these heads of associations talked to her about how the women of Rwanda, who had been raped during the genocide and were then infected with HIV, were not getting access to medicines for HIV. But the men who raped them, who were in jail, were getting medicines for their HIV. These women thought that was very unfair, and they asked Anne-Christine to bring a bunch of physicians and advocates to help fast-track medicine for these women because they were getting very sick and dying.
The genocide was in 1994 and this was in 2004, and it takes about a decade, 10 years, after you’re infected with HIV to become very sick. The women were just getting sick and the leaders of these associations wanted to do something about it.”
Do you feel that these at risk populations of Rwanda are ignored by the government, or were ignored?
“In 2004, nobody was getting medications for HIV. It was before PEPFAR (The U.S. President’s Emergency Plan for AIDS Relief). It was before the global fund. It was at a time… you know I’d been working on HIV since 1987, and people were saying things about Africa: ‘Well, we’ll just give them medication for pneumonia, for prophylaxis. We can’t afford… and the people in Africa wouldn’t know how to manage, there isn’t a good enough infrastructure to manage the antiretroviral therapy, so we’ll just ride them off.’ And they were going to ride them off. You know, right now there are 36 million people living with HIV worldwide and 26 million of them are in Africa, and most of them are in Sub-Saharan Africa.
That’s an enormous number of people that people were thinking of just riding off, so the governments of those countries in Africa really had no wherewithal to actually help people. The drugs weren’t there. They weren’t letting the drugs get there, so my feeling is my experience in Rwanda was in fact the government seriously wanted to help people. Once medication became available, they figured out ways to actually control the dispersal of the medicine so that it got out to people, and they tested everybody. I was aware of some countries where tests got outdated, expired, in garages and never got to people—that’s not what happened in Rwanda. In Rwanda, they really tried.”
You didn’t face much resistance from the government?
“Well, our approach was a little bit different from the government’s because our approach was very women-centered and youth-centered, and their approach was more decentralized… sort of a public health model where people would just go to the nearest clinic to where they lived. Everybody would sort of be engaged in the healthcare system that way, but because HIV comes with a lot of stigma people didn’t really want to go to clinics near where they lived. Women sort of liked the idea of going to a place that cared about women and worried about their emotional reaction to HIV, gender-based violence and helping them try to become productive members of society—not just worrying about HIV as it affected the baby or the husband, but rather cared about them as real people. So, people wanted to come to our program even though it may not have been a neighborhood clinic.
That was a little bit problematic for the Rwandan government. They didn’t like that so much, but they then saw that we did very well with connecting women to care and having people with very good retention rates and adherence to medication. Then, after a while, we had a lot of good youth programming because we had so many women who they had kids—a lot of attention to youth friendly programs. Then we got on better with the Rwandan government public health system and now we’re in very good shape. We do a research program with their principal investigators, and we’re principal investigators; It’s much more collegial.”
What did you have to do to overcome cultural differences? I know that specifically in Rwanda, people don’t very much like to talk about things involving sex.
“So, there was a pretty big public health campaign to get people tested. And, you know, in Africa it’s said that one of the major risk factors for a woman having HIV was being in a monogamous relationship with her husband. It’s just that he probably is not in a monogamous relationship with her. Women who had done everything they were supposed to do, get married, have children, they were at risk for HIV. As a result, we didn’t really have to have that many difficult conversations with them, but they were reticent to talk about things… but after a while, we used a model of peer advocacy.
We found some Rwandan women who were HIV-infected who were sort of a bit more leader-ish and wanted to sort of help other women. We utilized them to help us understand what the cultural differences were and for them to sort of share with the other women what efficacy the drug we had and the approach we were taking. That really, really helps—a peer model really got through some of those cultural differences. I think one of the things that I learned was that you have to be very patient; I’m a very impatient person and things are very slow, and change happens over a long period of time. It’s not quick. There was a lot of stigma related to HIV and there still is because we went there 11 years ago and now its 2015 but there’s still a lot of stigma.”
Did you do some advocacy in the community to try to change that perception?
“We did, especially if there were kids in schools or if there were neighborhoods that were giving people a hard time or landlords who kicked people out of their homes. We did legal training of advocates to sort of have the people… you see, there aren’t that many lawyers in Rwanda and the case loads that they have are so great that there’s sort of a paralegal system and we try to train our patients—a significant number of them—to participate that way in dealing with those issues. That sort of helped. We also tried to provide a very joyous atmosphere for the children because their lives are pretty rough, and every year we have this thing called ‘Day of the African Child’—a big party for all the families, like 1,200-1,400 people come and have a big party and its just to celebrate that they’re alive. Those kind of thing help the parents and the patients realize that we were not trying to get away with anything or do anything bad, but really just trying to provide a better quality of life for people who are HIV-infected.”
Was it a bit difficult to break into the community in Kigali?
“Well, luckily, these groups—these women’s groups, these leaders who had spoken to my friend Anne-Christine d’Adesky—they were still there. Initially, it started with 5 groups, and they called us in and told us where to go and they told us what to do, so I never felt like I was . . . bringing our stuff and putting it on people in Rwanda. I felt that the Rwandans had called us in. I thought that we were very lucky to have that approach, and they told us what they wanted from us. That made it, I think, a good way to be in another culture, in another country, and we’ve maintained that. We have partner association meetings four times a year where we review what’s going. We didn’t have to put up a shingle and hope people would come. Basically, those associations keep bringing their members to us, so I think it a pretty good model for being connected to community groups. You know, AIDS groups, women groups, local groups, service groups…
Then there’s the issue of the genocide and I think those are some of the lessons we learned, too. In some of the groups, people didn’t always want to work together, and we had a sort of… We didn’t understand that, or we didn’t think of that as behind some of the problems that we encountered, but it sometimes was. But now, the staff is sort of mixed grouping and everybody have bought into the mission to provide good HIV care for children, women, their partners and their families. And I think everybody does the best they can to make that happen.”
Do you feel that a substantial amount of progress has been made?
“Oh yeah! I mean, HIV is a deadly disease. We now have about 2,600 people—I’d say 90 percent—of those over 25 adhere wonderfully to their medicines and are doing great. A small percentage need a lot more help to take their medicine and keep doing well. The younger people, who have had the disease longer because most of them were born with it, have sometimes become resistant to some of the medicine. So, we have to put them on more complicated regimens.
Some of the good medicines we have in this country are not readily available there. When I first started that was true. Then for a while, the medicines we had in Rwanda and the medicines we had in the U.S. were the same. Now the U.S. is way, way passed Rwanda and a lot of countries in Africa and Latin America. They don’t have the medicines we have, which are really excellent medications. So, that’s a problem, but there is generally progress. I watched, at this ‘Day of the African Child,’ I watched kids who I knew when they were 10 who are now 21 years of age, and they’re confident, they’re strong, they’re going to university—it’s amazing! It’s an enormous amount of progress!”
Was the genocide the main reason why you chose to work in Rwanda?
“It was more HIV, but in the context of the genocide. I had an interest in intimate partner violence because I had seen a lot of that in the care I gave women in Chicago who were HIV infected. We’ve done studies, and there’s just high prevalence of gender-based violence, like 62 percent lifetime—here [in the U.S.]—experience with either sexual, physical, or emotional abuse. Then, we looked at it in Rwanda, in our clinic, post-genocide, and it was 62 percent also. It was the same in both countries—you know poor population, difficult situation of sexually transmitted disease where people go off to try to make a living somewhere else… In the U.S. there was lot of drug use and a lot of difficult relationships with partners. There had been issues [in Rwanda]—people had lost partners during the genocide, people had been raped during the genocide. I was interested in Rwanda because my friend had been here and we had been asked to go, but I thought that because of everything that I had learned related to women with HIV and their experiences, it would be useful in this ultimate experience of gender-based violence, which was the genocide, where about a quarter of a million women were raped. So it was sort of both things.”
What do you think the main difference is between the government in Rwanda and in a country like Zimbabwe, which has seen a lot of resistance to NGOs that are trying to come into the country trying to help people with HIV?
“I think Rwanda sort of benefited post-genocide and by the 2001-2003 people coming in. A lot of Western and European countries that felt so guilty of not helping during the genocide were now giving lots of money. At the same time, there was lots of money going into HIV in a lot of countries, but the difference was that . . . there was money straight to the government and there was NGOs’ money, but what Rwanda did—very importantly—was it controlled the NGOs a lot, or tried to. There was a very strong government presence… very strong. One can’t write anything related to Rwanda without mentioning how wonderful the Rwandan government is. One can’t really be there without somehow being acknowledged by or understand the relationship with the Rwandan government, but its not just that; It’s that there was a lot of government will in Rwanda to do well in terms of the HIV epidemic, and in some sense, I think they wanted to be a poster-child for being able to distribute medicines well and lower the prevalence as opposed to be known for the genocide. It was a way to sort of make history—current history—much more positive as a country. And they were one of the best at utilizing the many millions of dollars that were given to them to help with the HIV epidemic. I think it was disproportionately more than what other countries got, but they utilized it extremely well. The other countries who maybe should have gotten more never used it well, often. There wasn’t the same governmental will, which I think you need.
It’s not just an issue of, are the NGOs disorganized? are they sort of stepping all over each other? and are they not doing what’s right? There are those issues, which I did see a bit in Rwanda and I had seen in a lot of other countries, but what I didn’t see in Rwanda was a government that wasn’t taking the epidemic seriously. They really put energy and resources… they used the resources they got to have a very strong public health system which helped HIV and other things along the way. It really addressed maternal mortality, infant mortality… When I started in Rwanda there were 30 doctors for 10 million people, and now there are so many more physicians and nurses who are trained related to HIV. And I think it’s an issue not just of the government’s relationship to NGOs, but of the government itself, having a strong presence related to the problems that the society is facing. I think that’s different from Zimbabwe and other countries.”
What do you think is lacking in terms of support for NGOs that do the same work that you do?
“Well, we have to do a lot of fundraising and I mean that is hard . . . that is one of our issues and it is a lot of work to raise money. I think what we do is really deliver the product we say we’re going to deliver, and I think that’s why we’ve been successful so far in our fundraising. We’ve been sustained for 11 years, so that speaks to our success in itself.
What I think we did that was good is that right now in Rwanda there is a local NGO called WE-ACT for Hope. It’s all Rwandan-run and they now manage the entire clinic, so our job is to fundraise a certain amount that we commit to, along with a few other groups that they get money from, and we do a lot of guidance related to program and other things, research… but they’re responsible—they are running the show. I think if you have local folks running the show, not just in a body, but rather the responsibility of a true locally credentialed NGO, which is also what Rwanda encourages, that’s a good way to go!”
– Jaime Longoria
Sources: Mother Jones, WE ACTx
Photo: WE ACT
Katniss Everdeen in Peru: Women Use Bows and Arrows
Although it is not a method for battle or hunting in America, shooting a bow and arrow is still the weapon of choice for Wachiperi people in the Peruvian Andes.
Traditionally, the bow was designated for male use. For centuries, men used bows to snag monkeys, other mammals, fish, and birds. While men hunted, women gathered medicinal plants and performed household chores. Boys began training in archery and hunting at age five, while girls learned to help their mothers with cleaning and cooking.
Today, however, the traditional practice is evolving because of modern-day influences. Women and girls do not want to rely on men for food, and therefore, want to learn the ancient art of archery.
For the most part, the Wachiperi community supports this decision.
Sergio Pacheco, a skilled Wachiperi archer says, “The world is modernizing, and women are starting to want to use the bow. They say ‘We are just women in the family, so what happens when our father dies? We need to learn this to be able to take care of our families.’”
Pacheco spoke at the Smithsonian Folklife Festival in June 2015. A skilled archer and traditional doctor amongst Wachiperi people, he shared his cultural knowledge, skills, and wisdom with the audience.
Pacheco explained how hunting has become more difficult due to loggers and miners, who have destroyed the natural habitat of former prey. Men are typically gone for longer days in search of game.
He also described the jaguars that often threaten the Wachiperi community. Twice, he has used bows and arrows to kill the animals.
In addition to discussing hunting practices, Pacheco sang healing songs—called esuwas—for the crowd. He says, “Pills hurt your body because they are chemicals. When I’m sick, I cure myself with only plants.”
Despite his persistence that traditional medical practices are better, he does not question the younger generations—male or female—when they ask to learn archery.
Watch out Katniss Everdeen, you might have some competition coming from Peru!
– Kelsey Parrotte
Sources: Amazon Books, NPR, Smithsonian Institution
Photo: Smithsonian Institution
How John Oliver Blends Activism and Comedy
The audience bursts into laughter. However, while John Oliver is all about getting laughs on his show “Last Week Tonight,” when it comes to blending the comedian and the activist, he’s not joking around.
The above quote is from a segment on sweatshops in the clothing industry, particularly modern, cheaper retailers.
“It seems sweatshops aren’t one of those 90s problems we got rid of like Donnie Wahlberg,” Oliver said. “They’re more like one of those 90s problems we’re still dealing with, like Mark Wahlberg.”
Oliver’s use of his comedic platform as a springboard for his activism makes sense. Prior to his television show’s launch, Oliver was known for his role as a correspondent on “Jon Stewart’s The Daily Show,” and famously filled in for the beloved host in June of 2013, while Stewart was overseas filming his directorial debut.
The difference between Stewart and Oliver’s areas of focus is subtle but significant. Stewart focuses on news and current events, approaching them with a fresh spin, an important trait in a daily program. Oliver, on the other hand, focuses on issues. From food waste, which Oliver compares to Rascall Flatts in that “it can fill a surprising number of stadiums even though many people consider it complete garbage,” to tobacco giant Phillip Morris International threatening to sue Togo, a country with a GDP of just 4.3 billion dollars (“when your GDP is only a couple of billion more than the box office of Avatar, a protracted legal case is not really what you need.”) Oliver takes on major topics not just for laughs, but for information.
What is also unique about Oliver is how he encourages his audience to get involved. In his segment on the tobacco industry, for instance, Oliver christened “Jeff the diseased lung in a cowboy hat” as the new face of Marlboro. Oliver spread t-shirts of the diseased lung in Togo and billboards in Uruguay. Oliver also encouraged his audience to support the new icon, which mocked the tobacco industry’s marketing tactics, particularly in the developing world. It is through this type of culture jamming that Oliver achieves the power of comedy as a medium that influences social change.
Ultimately, “Last Week Tonight” could have been another late night television show, perhaps made a bit edgier due to its placement on HBO. But due to John Oliver’s social activism and experience gained while working with the great Jon Stewart, the show has become an informative springboard for activism, something with great impact on both its audience and the world at large.
– Andrew Michaels
Sources: Last Week Tonight: Fashion, Last Week Tonight: Food Waste, Last Week Tonight: Tobacco, Splitsider
Photo: HBO – Last Week Tonight
Native Crops: The Solution to Africa’s Food Crisis?
A 2010 study recently highlighted in Nature found that, in most cases, indigenous plants contained much higher concentrations of key nutrients, such as vitamins A and C, than non-native varieties. In the case of the native Moringa tree, its leaves pack three times more vitamin A than carrots and seven times more vitamin C than oranges.
While some modified non-native crops do contain much higher percentages of certain nutrients, such as the well-known “Golden Rice” which was created to combat vitamin A deficiency, the harsh climate in much of Africa makes growing non-native crops much more challenging. In addition to having considerable nutritional content, indigenous crops are hardier and faster growing than their exotic counterparts.
With predictions of global climate change causing weather patterns to become more erratic, with sudden rains and long periods of drought, native plants that have spent thousands of years adapting to Africa’s already intense climate could offer a much more reliable food source in the face of such dramatic changes. “Most of the traditional varieties are ready for harvest much faster than non-native crops, so they could be promising options if the rainy seasons become more erratic—one of the predicted outcomes of global warming,” wrote Cernansky, author of the Nature article.
Despite their advantages, native crops make up only a tiny fraction of total agricultural sales. In Kenya, native plants only account for roughly 6 percent of the market, despite the country seeing a 25 percent increase in the land area dedicated to native plants from 2011 to 2013. Much of the lag is due to poor or unreliable infrastructure restricting access to market opportunities. According to Lusike Wasilwa, assistant director of horticulture at Kenya Agriculture and Livestock Research Organisation, more research is needed to address the issues of production, storage and marketing of native plants.
While it is clear that native plants will not be able to solve Africa’s food crisis overnight, they may offer a cheap and elegant solution in the future.
– Gina Lehner
Sources: SciDev.net, Mother Jones
Photo: SciDev.net
Coffeed Chain Helps Charities
Coffeed’s CEO and founder, Frank “Turtle” Raffaele, was a stock trader on Wall Street before the 2008 stock market crash. After the crash, he decided to pursue a new path and started Coffeed along with three other former traders. The flagship café opened in 2012 in Long Island City. Currently, there are six Coffeed stores in New York City, and, to take the company international, a seventh café is planned for Seoul. Each location is partnered with a different local nonprofit, such as Community Mainstreaming Associates or the Refugee and Immigrant Fund.
One shop is located in Chelsea at the headquarters of the Foundling organization, a nonprofit that provides foster care and adoption services. Coffeed donates to Foundling in exchange for reduced rent in this busy location. They also dedicate a portion of the café to displaying information about Foundling’s work and issues related to poverty and inequality. Furthermore, they employ some of Foundling’s clients, including developmentally disabled adults and teenaged foster children.
Coffeed’s flagship café partners with Brooklyn Grange, a small farm located on their rooftop. They source most of their produce from this farm and support the City Growers organization, which educates the community about sustainability and agriculture.
Raffaele operates Coffeed on a number of important principles. They serve only Fair Trade coffee and try to keep business local by sourcing high quality ingredients from local vendors and supporting local charities. The cafes are meant to be safe, comfortable spaces for customers where they can enjoy food and coffee at reasonable prices. They work to promote sustainability by engaging in environmental practices such as composting. They regularly refine their coffee roasting and prep procedures. Staff members are carefully selected and work to educate consumers about their products. But the guiding principle for this company is putting charity first.
Raffaele hopes to open 15 to 20 locations in the next five years by connecting with fundraisers and investors. One of his main objectives for Coffeed is to prove that business can be both charitable and profitable. The model has been successful so far and could inspire more businesses to follow suit as the chain goes international.
– Jane Harkness
Sources: Coffeed, Huffington Post, Inc., Small Business Trends, The Times Ledger
Photo: Daily Coffee News
Good Books Gives Retail Profit to Oxfam
It’s possible through the Auckland, New Zealand based company, Good Books. Just by shopping for books on their website, one can directly help the world’s poor through an automatic donation to Oxfam New Zealand, a partner of the general Oxfam family.
This is possible through a business plan by Good Books, which includes several partners that can donate their time or services to make the operation have zero operating costs.
For example, all the workers directly associated with Good Books are unpaid. The organization’s book distributor, Paperback Shop UK, handles the actual moving of the merchandise and supplies the website and management services. Also, the organization is able to build the company’s brand through media support and customers spreading the word.
But this specific labor is for a great cause since all retail profits are sent to Oxfam, an organization that works on many fronts trying to end global poverty.
Oxfam’s work is varied; the Oxfam America website specifically says the following about their work which is indicative of the organization’s work as a whole:
“No one should go hungry.”
“We all have the right to clean water.”
“All people deserve to live safely.”
“Women and girls are crucial to reducing poverty.”
“We all deserve the opportunity to earn a decent living.”
“People have a right to participate in decisions that affect their lives.”
“We must help poor communities cope with climate change.”
“Poverty is not inevitable.”
“People have the power to end poverty.”
While the purchase/donation cannot be earmarked through the Good Books’ website, purchasing the books matches well with the statements, “women and girls are crucial to reducing poverty,” and “we all deserve the opportunity to earn a decent living.” Both of those ideas hinge on education for the masses to move people out of poverty.
Oxfam New Zealand says that “every extra year a girl spends in school could reduce child mortality by ten percent.” So, much of their good work is built around education initiatives to help the community.
Oxfam and their partners have helped rebuild schools in Pakistan, get clean water for students in Nairobi, teach about women’s rights in Guatemala, and even giving goats to families in Ethiopia where the selling of offspring and goods provides money to send daughters of poor families to school.
By buying books from Good Books, consumers can use their purchasing power to help all the areas listed above. Specifically though, one can use their money to directly aid the fight against poverty while also reading a book that can change the mental attitudes for those in developed countries. Awareness and change concerning poverty can be worked on in two very distinct ways through the purchase of books.
– Megan Ivy
Sources: Good Books, Oxfam America, Oxfam New Zealand
Photo: Oxfaminternation
Can the Infectious Disease Yaws Be Eradicated?
Yaws is the most common endemic treponematoses, a group of bacterial infections that also includes nonvenereal syphilis and pinta. All of these infections are transmitted through non-sexual contact with an infected person. They can cause skin lesions, bone pain, bone lesions, nose deformities and the thickening or cracking of a person’s hands and soles of the feet. The World Health Organization (WHO) estimates that 75% of infected people are under 15 years of age, with most cases seen in children aged 6 to 10. Gender is not a determining factor of infection.
Yaws is spread through skin-to-skin contact, usually after a small injury occurs, something common when children play. Yet, WHO states that “overcrowding, poor hygiene and socioeconomic conditions facilitate the spread of the yaws.”
The disease is not life-threatening, which is likely why it became a neglected disease in the scope of global disease work. But if left untreated, a person can become permanently disfigured and disabled. Such a diagnosis is bad for anyone infected with the disease, but since mostly children suffer from yaws, it becomes a life-long issue if not resolved quickly. When a child contracts yaws, their ability to go to school is jeopardized. If left untreated, absenteeism rises among children and their future employment, especially feeding their families through farming, is impacted.
It has long since been thought that yaws could be a disease that can have complete eradication since humans are the only carriers of the disease. Previously, initiatives to eradicate yaws were undertaken with almost complete success. But the mass effort was prematurely lifted and the disease returned, though not quite on the same scale as before.
Recently, the idea of complete eradication has come back up. The two most effective antibiotics to treat yaws are azithromycin and benzathine penicillin, both of which can be given with relative ease. Even though no vaccine is available for yaws, if early diagnosis is achieved, treatment with the antibiotics can occur and sanitation can be improved to help stop the spread of the disease. With the steps, the end of yaws is in sight.
There have already been cases of previously endemic countries achieving complete eradication, including India. The Yaws Eradication Programme (YEP) was launched in India in 1996 with the goal to have complete eradication in the country. In 1997, 735 cases of yaws were reported; in 2004, the country was considered to have achieved “Zero Case.” Because not all cases of yaws are reported, only time will tell if complete eradication can be sustained, but right now all signs are pointing to success.
With great things already happening in India and a plan in place to achieve more success globally, yaws should be eradicated from remaining endemic countries by 2020.
– Megan Ivy
Sources: PubMed.gov, WHO 1, WHO 2
Photo: Chacha
Ultimate Frisbee Encourages Prosperity in Chennai
Sports have rules and require dexterity. Ultimate frisbee gives players the freedom to set their rules without referees. It is a leisure sport in the United States, where teams wear matching uniforms and have decorated discs. Often times, events are scheduled at parks, where participants plan day-long activities.
The challenge by Sundance asked for submissions of videos or fictional narratives featuring positive stories about individuals or groups who are beating poverty. There were 90 countries that participated, but a moviemaker in India named Mirle won the competition with his documentary of teens in India’s slums who play ultimate frisbee.
Of the 1.1 billion residents in India, approximately 231,631,442 have been recorded as living in poverty, as of 2010. In coastal areas, fishermen live in depleted conditions. The environment deteriorates because it is vulnerable to natural disasters.
Manu Karan spent time in Boulder, Colorado and returned to Chennai, a city on the coast, in 2007 to complete his MBA program. He had learned how to play ultimate frisbee while in Colorado and brought the game back with him, becoming the founder and president of Chennai Ultimate Frisbee.
The city has 300 players and is home to most of India’s participants in the sport. Children of fishermen, ragpickers and shopkeepers watch other players and eventually join the fun.
Ultimate frisbee cut into bad habits adopted by teens, bringing purpose to lives that had previously felt directionless. These adolescents would often steal mangoes and get into fights on the streets. But all, even those who didn’t have shoes, televisions or enough money to play other sports, were welcome to play ultimate frisbee.
This sport can lift people out of poverty and halt repetitive bad habits. A code of ethics is passed on to both participant and bystander. “175 Grams,” the film created for the Sundance Institute Short Film Challenge, features a team called Fly Wild, where a certain player is determined to continue schooling and maintain a humble reputation.
Teams contain a mixture of social divisions. Many players have different backgrounds, speak different languages, follow different religions and have different amounts of wealth. Men and women are mixed together in teams. There are usually three women for every four men.
Because of this sport, teenagers are learning how to respect others and dress professionally. Nongovernmental organizations such as Pudiyador and IndiCorps are using the sport to educate youth about leadership practices, the importance of unity and gender equality.
Facing separate creeds used to be intimidating, but ultimate frisbee essentially forces others to interact or reconcile, ignoring these differences for the sake of sport. People from the slums and people from upper-middle class families inspire each other. The poor aspire to learn English and desire higher education and opportunity.
Dan Rule, the coach of Australian ultimate players, helped to develop low-cost ways to keep Chennai’s under-23 team players in shape since they do not have access to a gymnasium or other basic equipment. The players of the Australian ultimate team also donated cleats to the players.
It has been seven years since the game was introduced to Chennai. The players of India’s first under-23 team are scheduled to fly to London in mid-July for an opportunity to compete for the World Championship. They have already won 11th place in competition for the World Championship in Dubai.
There are approximately five million people enjoying the sport in the United States. Ultimate frisbee creates family ties, inspires children and gives adults the opportunity to share their excitement for the game.
Fly Wild and U23 are responsible for shaping lives. People in impoverished India are encouraged to rise out of poverty. Teams are inspiring and uniting the youth of their communities through the sport.
– Katie Groe
Sources: Global Post, Fast Company, Rural Poverty Portal, Huffington Post
Photo: Global Post
Wealth and Violence Collide in Buenaventura, Colombia
Colombia has been described by some as a country with two faces: one face is the Colombia of the elite and wealthy, while the other is a Colombia marked by violence, gang lords and a vicious drug trade. Once considered too dangerous for visitors due to a brutal civil war between various factions of the government and paramilitary groups, which began in 1964, Colombia has since cleaned itself up, with major cities like Bogota and Medellin now considered hot-spots for tourism. Despite massive improvements that have benefitted the country in recent years, as of 2013 an astonishing 30.6 percent of the population was living below the poverty line, according to the World Bank. Colombia also remains the world’s largest cocaine producer, supplying 90 percent of the cocaine consumed in the United States.
Buenaventura, a port town located on the Pacific Coast, is a perfect example of the way in which these “two faces” can collide.
On the one hand, Buenaventura struggles with a legacy of violence that continues to characterize the culture of the city today. During the 1980s, the city was a battleground between leftist guerrillas of the Revolutionary Armed Forces, or FARC, and right-wing paramilitary groups. When the FARC were driven out, paramilitary groups established themselves and began to engage in gang activity, helping to carve the city into rival gang territories and the port into an important regional focal point for the export of cocaine. According to a Human Rights Watch report, these groups have taken the lives of many Buenaventura residents, who are often dismembered in so-called “chop houses” for unwittingly crossing between gang territories.
On the other hand, due to its strategic location on the coast, Buenaventura has recently become the centerpiece of a government strategy to increase Colombian trade with Asian and Western countries on the Pacific, such as the United States, Chile, Mexico and Peru. To achieve this goal, the central government in Bogota has invested millions in development projects, such as the construction of a container port and industrial park, as well as the construction of a major waterfront development project that authorities hope will help attract tourism.
Residents, however, have argued that there is a link between the recent rise of violence in the city and the development projects. Locals, for instance, point to the fact that much of the violence has been concentrated in and has affected locals living in areas along the port. Residential habitation of the area obstructs government plans to turn the area into a tourist destination.
In response to protracted levels of violence in the town, which has recently received increased media attention, Colombian President Juan Manuel Santos finally intervened last year, sending in an emergency infusion of cash as well as police officers from the capital.
According to Colonel Marcelo Russi, the police commander in Buenaventura, the added law enforcement has helped to dramatically reduce the murder rate and number of disappearances in the city. Alexander Micolta, the executive president of the Buenaventura Chamber of Commerce, however, has stated that not enough is being done to effectively eradicate violence from the city. “Here, everything that has to do with the port advances. But the city doesn’t advance,” Micolta said.
In order to save Buenaventura, it is evident that money invested in the city needs to be focused on protecting the people who actually live there instead of in efforts to attract foreign investment and tourist capital. Otherwise, the city’s long history of violence and gang activity will continue to perpetuate itself and invade every corner of the city once the police presence leaves. If that happens, then Colombia’s “two faces” will persist to rear their ugly heads in tandem in the country’s small, sea-side city of Buenaventura.
– Ana Powell
Sources: New York Times 1, New York Times 2, World Bank
Photo: War on Want
Interview with Mardge Cohen, Co-Founder of WE-ACTx
I caught up with Mardge Cohen, co-founder of WE-ACTx, and spoke a bit about the organization’s origins, progress and successes, which have allowed this quite exceptional organization to thrive among the people of Kigali, Rwanda.
Tell me, how did WE-ACTx begin?
“The organization was started in 2004. We went to Rwanda because one of the other people who formed the organization, named Anne-Christine d’Adesky, a journalist, had been writing a book about HIV and women. She had been to Rwanda and these heads of associations talked to her about how the women of Rwanda, who had been raped during the genocide and were then infected with HIV, were not getting access to medicines for HIV. But the men who raped them, who were in jail, were getting medicines for their HIV. These women thought that was very unfair, and they asked Anne-Christine to bring a bunch of physicians and advocates to help fast-track medicine for these women because they were getting very sick and dying.
The genocide was in 1994 and this was in 2004, and it takes about a decade, 10 years, after you’re infected with HIV to become very sick. The women were just getting sick and the leaders of these associations wanted to do something about it.”
Do you feel that these at risk populations of Rwanda are ignored by the government, or were ignored?
“In 2004, nobody was getting medications for HIV. It was before PEPFAR (The U.S. President’s Emergency Plan for AIDS Relief). It was before the global fund. It was at a time… you know I’d been working on HIV since 1987, and people were saying things about Africa: ‘Well, we’ll just give them medication for pneumonia, for prophylaxis. We can’t afford… and the people in Africa wouldn’t know how to manage, there isn’t a good enough infrastructure to manage the antiretroviral therapy, so we’ll just ride them off.’ And they were going to ride them off. You know, right now there are 36 million people living with HIV worldwide and 26 million of them are in Africa, and most of them are in Sub-Saharan Africa.
That’s an enormous number of people that people were thinking of just riding off, so the governments of those countries in Africa really had no wherewithal to actually help people. The drugs weren’t there. They weren’t letting the drugs get there, so my feeling is my experience in Rwanda was in fact the government seriously wanted to help people. Once medication became available, they figured out ways to actually control the dispersal of the medicine so that it got out to people, and they tested everybody. I was aware of some countries where tests got outdated, expired, in garages and never got to people—that’s not what happened in Rwanda. In Rwanda, they really tried.”
You didn’t face much resistance from the government?
“Well, our approach was a little bit different from the government’s because our approach was very women-centered and youth-centered, and their approach was more decentralized… sort of a public health model where people would just go to the nearest clinic to where they lived. Everybody would sort of be engaged in the healthcare system that way, but because HIV comes with a lot of stigma people didn’t really want to go to clinics near where they lived. Women sort of liked the idea of going to a place that cared about women and worried about their emotional reaction to HIV, gender-based violence and helping them try to become productive members of society—not just worrying about HIV as it affected the baby or the husband, but rather cared about them as real people. So, people wanted to come to our program even though it may not have been a neighborhood clinic.
That was a little bit problematic for the Rwandan government. They didn’t like that so much, but they then saw that we did very well with connecting women to care and having people with very good retention rates and adherence to medication. Then, after a while, we had a lot of good youth programming because we had so many women who they had kids—a lot of attention to youth friendly programs. Then we got on better with the Rwandan government public health system and now we’re in very good shape. We do a research program with their principal investigators, and we’re principal investigators; It’s much more collegial.”
What did you have to do to overcome cultural differences? I know that specifically in Rwanda, people don’t very much like to talk about things involving sex.
“So, there was a pretty big public health campaign to get people tested. And, you know, in Africa it’s said that one of the major risk factors for a woman having HIV was being in a monogamous relationship with her husband. It’s just that he probably is not in a monogamous relationship with her. Women who had done everything they were supposed to do, get married, have children, they were at risk for HIV. As a result, we didn’t really have to have that many difficult conversations with them, but they were reticent to talk about things… but after a while, we used a model of peer advocacy.
We found some Rwandan women who were HIV-infected who were sort of a bit more leader-ish and wanted to sort of help other women. We utilized them to help us understand what the cultural differences were and for them to sort of share with the other women what efficacy the drug we had and the approach we were taking. That really, really helps—a peer model really got through some of those cultural differences. I think one of the things that I learned was that you have to be very patient; I’m a very impatient person and things are very slow, and change happens over a long period of time. It’s not quick. There was a lot of stigma related to HIV and there still is because we went there 11 years ago and now its 2015 but there’s still a lot of stigma.”
Did you do some advocacy in the community to try to change that perception?
“We did, especially if there were kids in schools or if there were neighborhoods that were giving people a hard time or landlords who kicked people out of their homes. We did legal training of advocates to sort of have the people… you see, there aren’t that many lawyers in Rwanda and the case loads that they have are so great that there’s sort of a paralegal system and we try to train our patients—a significant number of them—to participate that way in dealing with those issues. That sort of helped. We also tried to provide a very joyous atmosphere for the children because their lives are pretty rough, and every year we have this thing called ‘Day of the African Child’—a big party for all the families, like 1,200-1,400 people come and have a big party and its just to celebrate that they’re alive. Those kind of thing help the parents and the patients realize that we were not trying to get away with anything or do anything bad, but really just trying to provide a better quality of life for people who are HIV-infected.”
Was it a bit difficult to break into the community in Kigali?
“Well, luckily, these groups—these women’s groups, these leaders who had spoken to my friend Anne-Christine d’Adesky—they were still there. Initially, it started with 5 groups, and they called us in and told us where to go and they told us what to do, so I never felt like I was . . . bringing our stuff and putting it on people in Rwanda. I felt that the Rwandans had called us in. I thought that we were very lucky to have that approach, and they told us what they wanted from us. That made it, I think, a good way to be in another culture, in another country, and we’ve maintained that. We have partner association meetings four times a year where we review what’s going. We didn’t have to put up a shingle and hope people would come. Basically, those associations keep bringing their members to us, so I think it a pretty good model for being connected to community groups. You know, AIDS groups, women groups, local groups, service groups…
Then there’s the issue of the genocide and I think those are some of the lessons we learned, too. In some of the groups, people didn’t always want to work together, and we had a sort of… We didn’t understand that, or we didn’t think of that as behind some of the problems that we encountered, but it sometimes was. But now, the staff is sort of mixed grouping and everybody have bought into the mission to provide good HIV care for children, women, their partners and their families. And I think everybody does the best they can to make that happen.”
Do you feel that a substantial amount of progress has been made?
“Oh yeah! I mean, HIV is a deadly disease. We now have about 2,600 people—I’d say 90 percent—of those over 25 adhere wonderfully to their medicines and are doing great. A small percentage need a lot more help to take their medicine and keep doing well. The younger people, who have had the disease longer because most of them were born with it, have sometimes become resistant to some of the medicine. So, we have to put them on more complicated regimens.
Some of the good medicines we have in this country are not readily available there. When I first started that was true. Then for a while, the medicines we had in Rwanda and the medicines we had in the U.S. were the same. Now the U.S. is way, way passed Rwanda and a lot of countries in Africa and Latin America. They don’t have the medicines we have, which are really excellent medications. So, that’s a problem, but there is generally progress. I watched, at this ‘Day of the African Child,’ I watched kids who I knew when they were 10 who are now 21 years of age, and they’re confident, they’re strong, they’re going to university—it’s amazing! It’s an enormous amount of progress!”
Was the genocide the main reason why you chose to work in Rwanda?
“It was more HIV, but in the context of the genocide. I had an interest in intimate partner violence because I had seen a lot of that in the care I gave women in Chicago who were HIV infected. We’ve done studies, and there’s just high prevalence of gender-based violence, like 62 percent lifetime—here [in the U.S.]—experience with either sexual, physical, or emotional abuse. Then, we looked at it in Rwanda, in our clinic, post-genocide, and it was 62 percent also. It was the same in both countries—you know poor population, difficult situation of sexually transmitted disease where people go off to try to make a living somewhere else… In the U.S. there was lot of drug use and a lot of difficult relationships with partners. There had been issues [in Rwanda]—people had lost partners during the genocide, people had been raped during the genocide. I was interested in Rwanda because my friend had been here and we had been asked to go, but I thought that because of everything that I had learned related to women with HIV and their experiences, it would be useful in this ultimate experience of gender-based violence, which was the genocide, where about a quarter of a million women were raped. So it was sort of both things.”
What do you think the main difference is between the government in Rwanda and in a country like Zimbabwe, which has seen a lot of resistance to NGOs that are trying to come into the country trying to help people with HIV?
“I think Rwanda sort of benefited post-genocide and by the 2001-2003 people coming in. A lot of Western and European countries that felt so guilty of not helping during the genocide were now giving lots of money. At the same time, there was lots of money going into HIV in a lot of countries, but the difference was that . . . there was money straight to the government and there was NGOs’ money, but what Rwanda did—very importantly—was it controlled the NGOs a lot, or tried to. There was a very strong government presence… very strong. One can’t write anything related to Rwanda without mentioning how wonderful the Rwandan government is. One can’t really be there without somehow being acknowledged by or understand the relationship with the Rwandan government, but its not just that; It’s that there was a lot of government will in Rwanda to do well in terms of the HIV epidemic, and in some sense, I think they wanted to be a poster-child for being able to distribute medicines well and lower the prevalence as opposed to be known for the genocide. It was a way to sort of make history—current history—much more positive as a country. And they were one of the best at utilizing the many millions of dollars that were given to them to help with the HIV epidemic. I think it was disproportionately more than what other countries got, but they utilized it extremely well. The other countries who maybe should have gotten more never used it well, often. There wasn’t the same governmental will, which I think you need.
It’s not just an issue of, are the NGOs disorganized? are they sort of stepping all over each other? and are they not doing what’s right? There are those issues, which I did see a bit in Rwanda and I had seen in a lot of other countries, but what I didn’t see in Rwanda was a government that wasn’t taking the epidemic seriously. They really put energy and resources… they used the resources they got to have a very strong public health system which helped HIV and other things along the way. It really addressed maternal mortality, infant mortality… When I started in Rwanda there were 30 doctors for 10 million people, and now there are so many more physicians and nurses who are trained related to HIV. And I think it’s an issue not just of the government’s relationship to NGOs, but of the government itself, having a strong presence related to the problems that the society is facing. I think that’s different from Zimbabwe and other countries.”
What do you think is lacking in terms of support for NGOs that do the same work that you do?
“Well, we have to do a lot of fundraising and I mean that is hard . . . that is one of our issues and it is a lot of work to raise money. I think what we do is really deliver the product we say we’re going to deliver, and I think that’s why we’ve been successful so far in our fundraising. We’ve been sustained for 11 years, so that speaks to our success in itself.
What I think we did that was good is that right now in Rwanda there is a local NGO called WE-ACT for Hope. It’s all Rwandan-run and they now manage the entire clinic, so our job is to fundraise a certain amount that we commit to, along with a few other groups that they get money from, and we do a lot of guidance related to program and other things, research… but they’re responsible—they are running the show. I think if you have local folks running the show, not just in a body, but rather the responsibility of a true locally credentialed NGO, which is also what Rwanda encourages, that’s a good way to go!”
– Jaime Longoria
Sources: Mother Jones, WE ACTx
Photo: WE ACT
Mobile Family Planning in India
The vans specifically visit regions where family planning is unavailable and where birth rates are exceptionally high, like Bihar and Uttar Pradesh. According to the last India National Family Health Survey in 2005-2006, the average birth rate in Bihar was 4.0 children and the average birth rate in Uttar Pradesh was 3.82 children. Bihar and Uttar Pradesh have the highest and second highest birth rates in all of India. Even so, the mobile family planning project can help women postpone or eliminate the option of pregnancy.
Janani offers IUDs, tubal litigation, condoms, oral contraceptives, injectables and emergency contraceptives for women. Additionally, the project offers non-scalpel vasectomies for men. This project helps promote long-term contraceptives, like the IUD, and permanent methods, like tubal litigation and vasectomies.
Doctors, nurses/midwives, van coordinators, attendants and drivers all make up each team. About four to nine people are in each van to serve Indian communities. The vans have a counseling chamber, audio-visual equipment and medicines and equipment needed for IUD insertion. The nurse/midwives are trained for counseling and IUD insertion in Patna at the Surya Clinic and Training Centre, which is owned by Janani.
The teams in each van serve around 10 to 15 new clients and about five to eight follow-up clients per day. Each team also makes up to 15 days of visits per month. Janani serves between 2,000 and 3,000 new clients and 1,000 and 1,500 follow-up clients each month. While it is important to care for new clients, it is also beneficial to conduct follow-up appointments with previous clients.
Janani aims to help women and men in rural and low-income areas. Improved access to family planning can help individuals who do not want to have children. Additionally, this could help keep more children out of poverty, considering that women may not want to have children if they are in a low-income household. Furthermore, this could help address the issue of overpopulation in India. Solutions such as mobile family planning are innovative and reach individuals who previously may not have access to family planning options.
– Ella Cady
Sources: DKT International, Impatient Optimists
Photo: Needpix.com