PEPFAR

Last week I went up to Kasama for our PEPFAR training. PEPFAR is the President's Emergency Plan For AIDS Relief, and is essentially our HIV training through Peace Corps. The training was for anyone in Northern Province who hadn't gone through the PEPFAR process yet. We had to bring a Zambian counterpart from the village with us so they too could learn about HIV/AIDS. I'm pretty sure most Sub-Saharan African volunteers have to do some sort of HIV/AIDS work. I was really excited for this because most PCVs I've talked to said it's one of the best trainings we recieve from Peace Corps.

I brought a woman from a neighboring village who works with an ante-natal and PMTCT clinic at the Luchembe health post every week (Prevention of Mother to Child Transmission). She doesn't speak much English at all, but thank goodness there was a translator at the workshop. He literally translated every single sentence from English to Bemba for the Zambians.

The HIV/AIDS epedemic in Zambia is pretty staggering. The overall prevelance rate of HIV is about 14% country wide, down from 16% a few years ago. While Northern Province actually has the lowest rate of prevelance out of all the 9 provinces in country, Mpika District has the highest rate in Northern Province (if that makes any sense). Obviously the more urban, populated areas have a higher rate of HIV because there is more traffic there (ie Lusaka and Copperbelt Provinces). LIke the rest of the world, there are more women here with HIV than men, and women are at a higher risk to contract HIV as well.

The workshop involved a lot of in depth discussion about the ways people can contract HIV, and how we can prevent this. There was also a lot of talk about sex, for obvious reasons. Because Zambia is a Christian conservative nation, things sometimes got a little awkward when we had to discuss things like anal sex, prostitution, and circumcision. However, the Zambian counterparts were all willing to contribute to the discussion and gave some very interesting insight into the Zambian view on such issues. We actually had a really informative question/answer session where people could write questions anonymously for our PEPFAR director, Jo to answer (Jo is a British woman who has been living in Zambia for 15 years and working with HIV/AIDS work for years beyond that). The Zambians were really interested in learning about relationship and sexual patterns of America. I must say us American PCVs were equally interested in the Zambian relationship culture as some of the customs seem so outrageous to us. For example, it is believed in Zambia that if a woman performs oral sex on her husband, when he dies and she sees his corpse - she will also die. Therefore people do not participate in this sexual activity for fear of death...

That is just one of the rather bizare beliefs that we learned about during the week. I could go on, but even I don't feel comfortable writing about it on such a forum. I must say that I learned a great deal about HIV/AIDS and really hope to pass on my education to others. My counterpart Lydia, and I hope to hold a big VCT day in Luchembe (Voluntary Counseling and Testing). In fact, VCT was offered at the PEPFAR workshop and almost all of the participants went for testing. There is a stigma placed on getting testing in the village sometimes because people think that if someone is going for testing, they have engaged in risky behavior and therefore think they must already have HIV. If a married woman for example, went to go get tested without her husband knowing, the husband would be upset and think that the woman was doing something wrong in order for her to want to be tested. There are a lot of problems with infidelty in relationships here (men having mistresses or 'side plates' as they call them here), which results in a number of problems.

Then there is the problem of getting and taking ARVs here (Antiretro virals). Most rural health posts do not supply ARVs so people with HIV often have to travel long distances to get them. There again is a social stigma on having to take ARVs since they need to be taken at the same time everyday. Everyone here knows someone with HIV so it's just too bad that they are still stigmatizing those living positively.

HIV/AIDS is a really tough topic to deal with in the village, but I have a lot of resources now to try to tackle the issue. I hope to help distribute condoms, and make people more aware of the simple steps they can take to defend themselves. We actually received a whole bag of resources to bring back with us, including a wooden penis to demonstration how to properly use a condom... not awkward at all!