As the son of a Sri Lankan fisherman—and the first from his village ever to attend university—Fernando knows well what it means to work hard. That has been one of the defining elements of his life. But little did he know that when he left his position as a deputy director in Sri Lanka's Ministry of Agriculture he would soon become Oxfam's point man in Matara helping to revitalize the local coir industry, which turns the fiber from coconut shells into ropes, mats, and other products.
It was the tsunami that changed all his plans.
After 22 years with the Ministry of Agriculture, Fernando had retired at age 55, as many in government service do—to work longer requires permission—and had found another post, a lucrative one, in the private sector. But within days he realized it was not for him: bribery was one of the job requirements.
"I was shocked by it," he said, and, with the blessing of his wife, promptly gave his notice. Home, with its two acres of land in Kalutara district, beckoned instead.
"I started a little farm," said Fernando. "I had plantains, goats, and chickens."
Then the wave hit. His house was spared—it was far enough inland—but the coastal home he had grown up in, and which he had just restored for other family members, was swept away.
"Everybody got out—thank God," said Fernando, including his elderly father who, at 89, was saved by some youths who scooped him up in a plastic chair and carried him to safety in a church.
Right away Fernando jumped into the relief effort, working with a German organization that was assisting children affected by the disaster.
"I was helping them and I was very happy," Fernando recalled, and that's when he saw an ad Oxfam had placed for a livelihoods assistant in Matara—and applied. He had to convince the hiring committee, however, that he was the right man for the job. Why would a man from the upper echelons of Sri Lankan government service with decades of professional experience want to take the post of an assistant?
The answer was simple and unarguable.
"I want to serve," Fernando remembered explaining. "I have come from a fishing village. I'll help the same people."
They are the people, like his mother, whose early influence on his life set the standard that has guided him ever since.
"My mother was very pious and economical and good with saving," said Fernando. "Even though we didn't have money, she had money. Even today I can't believe my mother, on my father's meager earnings, had money."
Now, engaged with the coir workers, Fernando is helping other women in similar circumstances slowly build some financial security for their families—a mission that speaks to the core of who he is. The coir project, known as the Poor Women's Economic Leadership Coir Program, has helped save its members from exploitation by middle men. It has found them new markets for their coir products and introduced labor-saving equipment. Most of all, it has helped women build unity, through self-help groups and a newly formed federation that will make them a force to be reckoned with.
"I have very good job satisfaction working with these people," Fernando said. "I am happy we have empowered them. They can do anything they wish. And their living standards are becoming better."
What about this project makes him the most proud?
"Having the opportunity to work with the women," said Fernando. "They have the courage and interest to do better in society."
]]>"I'm not famous," said the slogan on his T-shirt.
And that's probably why you haven't heard very much about Milongo's problem'or the problem of countless Congolese women caught in a war that has used their bodies as a battlefield. Rape has ruined their lives. And now, it's creeping into their villages, too, corroding what's left of community life after so many years of conflict.
But since it's happening in a place that's far away, in villages whose names we can hardly pronounce, we don't pay attention. We should—because it's a horror that stalks us, too. About 132,000 women a year in the United States report they are victims of rape, or attempted rape, says the National Organization for Women. That's one of the reasons Congress passed the Violence Against Women Act in 1994—to combat sexual assault.
Now, there's a new protection bill set for debate in Washington. This one would take the first steps toward guarding the safety of women everywhere—even in countries where governments are not up to the task. Proposed by US Senators Joseph R. Biden and Richard Lugar, the International Violence Against Women Act would require the development of a five-year strategy—supported by a $175 million annual investment—to support programs targeting violence against women. Among them would be public awareness campaigns and a strengthening of criminal and civil justice systems.
Additionally, through increased training for aid workers and expanded reporting requirements, the bill would tackle the violence women and girls suffer during humanitarian crises and conflict—times when women are particularly vulnerable. Nowhere is this more evident than in the Democratic Republic of Congo. John Holmes, the United Nations under secretary for humanitarian affairs, told a reporter last October that the sexual violence in Congo is the worst in the world.
But what makes these attacks even more insidious is the consequence of speaking out about them: There is danger in challenging Congo's culture of impunity. Justine Masika lives with it daily—behind the barbed wire wall erected around her house to keep her safe. She is the head of a Goma-based group that has helped more than 7,000 women who have suffered from sexual violence. Last year, soldiers punished her for her truth-telling and advocacy. They invaded her house and attacked her daughters.
But Masika is not alone. Others, like Lamia Milongo, are fighting back, too. When the soldier abducted his 12-year-old daughter to claim her as his "wife," Milongo put his own safety aside and went in pursuit. He rescued her and returned her home unharmed. But the daughter of his neighbor was not so lucky. Her rescue came too late. Now, at 15, she is pregnant, shamed, and facing a life of hardship and poverty since in Congolese culture women who have been raped are often cast off by their communities.
Sexual violence is a plague the world should be rid of. Mothers like Masika need our help. So do fathers like Milongo. We took an important step here in the US in 1994. Now it's time to take the next one—into our global community—with passage of the International Violence Against Women Act.
]]>"The project has been very favorable for us, because we have seen ourselves embark on a really positive path within ANAP," Ydalmez Gonzalez says. "And for my personal experience, it has been very fruitful. We learned about gender, organizing, communication, computers, and organic agriculture. We learned a lot and it is very satisfying."
Many women in the rural areas of Cuba are looking for work, but there aren't many opportunities. Oxfam is helping to solve this problem by including in its projects the construction of greenhouses and nurseries where women can work. In addition, ANAP has organized workshops on gender in order to lift women's self esteem and create new leaders. Today, in the municipalities of Roda and Palmiras, there are 60 new women leaders.
"This project has been a base for us to continue working on what we have dreamed about for years. Women have the same rights as men, the law says so. But in the real world, from a social point of view, it isn't so," says Alberto Curbelo, president of ANAP in Cienfuegos. "Today, because of this project, 53 percent of the leaders in this province are women. So, when we saw these excellent results, we decided to develop a gender strategy for ANAP nationally. This strategy allows us to identify the problems that limit women's participation in each cooperative and find a way to resolve it. What's more, the project helps women and men identify their own strengths and potential."
For Carmen Padron, president of a credit and services cooperative, ANAP's gender work has been the key to her development. "I started out in ANAP in an administrative position in a livestock cooperative," she says. "Because of this women's leadership project, I began to feel more confident. I started to take on other responsibilities within the same cooperative. I worked a little in sugar cane production, taking on a little more of the role of a director among my workmates. And my workmates, apart from respecting me as a woman, saw me as a leader."
"Later, I went on to manage a 125-member sugar cane cooperative," she says. "It wasn't difficult. I learned a lot in the women's workshops. I felt confident. I learned to direct, to communicate, how to talk to my workmates, how to get them to do things without offending them, without mistreating them, or imposing myself upon them. I used the power of persuasion. But when I went on, a few months ago, to lead an entire cooperative I thought they might reject me. But they didn't; they accepted me. And since I had experience, it wasn't difficult. The farmer today is not the same as before. He accepts the fact that women lead, that they have opinions, and he takes them into consideration. So it wasn't difficult to be a woman leader. But if I hadn't have had all these training sessions, all this instruction, all this knowledge I had acquired, I wouldn't have been able to do it. I would have stayed behind a desk, scribbling numbers. No one would have been able to get me out of there."
It isn't just older women who are discovering these new abilities and possibilities. Only in her twenties, Yamelis Ferron was a speaker at an official ceremony. She spoke to thousands of farmers.
"It was really exciting, because after I spoke people said, 'I didn't know you were capable of that,' and 'I didn't think you had the courage to stand up and speak in front of so many people,'" she says, remembering her experience. "In school I would panic whenever I had to speak to large groups. But when I got involved in this movement of women leaders, little by little I lost that fear. I feel very proud to have started from the rank and file. I am now deputy in the municipality of Roda and I continue to work. They are small steps, but steps you notice."
]]>Members of Oxfam International have also provided grant support for neighborhood social programs, such as the world-renowned Martin Luther King Center, a leader in popular education.
Cuba's civil evacuation and protection system is widely renowned for its excellence. Oxfam works with Cuba's Civil Defense to help communities prepare for disasters and has helped Cuba significantly reduce its vulnerability to hurricanes. In 2004 Oxfam America, as part of Oxfam International, documented these experiences and lessons in the publication "Weathering the Storm: Lessons in Risk Reduction in Cuba."
Gender equality is a priority in all the projects Oxfam supports. While Cuban women enjoy a wide array of rights, there continue to be gaps, particularly at home. Supporting research and sensitivity training, particularly in regards to violence against women, is a priority for Oxfam in Cuba.
As part of Oxfam International, Oxfam America has contributed roughly $1.1 million to Oxfam International's work in Cuba since 1995. All of Oxfam America's grants were approved by the US Department of State, and mostly supported agricultural transformation projects designed to improve food security.
]]>In the 1980s, 80 percent of Cuba's trade was with the Socialist Block. With the fall of the Berlin Wall, this market disappeared and the economy practically collapsed. From 1990 to 1991 Cuba's imports declined by 73 percent. The agricultural sector, centered on intensive sugar production for export, depended on imported supplies. It hit rock bottom.
Then came the Cuban Democracy Act of 1992 (also known as the Torricelli Law) and the Helms-Burton Act, prohibiting companies that receive US subsidies to trade with Cuba, and excluding ships that dock in Cuba to visit the US for six months. This resulted in Cuba paying more for shipping because ships had to come from very far away and often solely to go to Cuba.
There were shortages of everything: medicine, gas, food, soap, toilet paper, and matches. "My bones were protruding here," says Jose Diaz, a 66-year-old architect, pointing to his ribs. "I had to sell my car because there was no gas. I lost 80 pounds, since there wasn't enough food and I was biking to work. But now I have a pot belly. I eat everything put in front of me."
To confront this crisis, Cuba's doors were opened to tourism and certain economic activities were liberalized, like small restaurants and fruit and vegetable markets. Later on, foreign currencies were allowed to circulate. Today, in addition to the Cuban peso, a convertible peso is circulating and can be used to make purchases in many stores and restaurants. Cuba also started to diversify its exports, focusing on medical services and biotechnology, distance learning, and commodities like nickel and tobacco.
What little foreign currency entered the country was used to maintain basic social services. In meetings with the Ministry of Education and National Institute of Economic Research, representatives were proud of the fact that no educational or health facilities were closed, and the weight of the crisis was distributed in an even manner.
The agricultural sector had to adapt to new conditions, and change from a monoculture, export-oriented model to the organic production of food for local consumption. Cuba is now considered the biggest laboratory for organic agriculture, in part because there are no chemical products available in Cuba for many of its crops.
In recent years, Cuba is slowly emerging from the crisis. In 2005, economic growth was at 11.8 percent; the next year 12.5 percent. During 2007 it grew 7.5 percent, thanks partly to a relaxation of some aspects of the US embargo. The United States is now Cuba's fifth largest trading partner.
The GDP of the country is higher than it was in 1989 when the crisis began. But this doesn't mean that Cuba has fully recovered. There are still great challenges ahead, like transportation, housing, and food security, to name the most pressing. Even though the average diet has increased to more than 3,200 calories per day, there is still much to be desired in terms of variety. There are shortages of milk and beef, and crop yields are lower than they were in the 1980s. The country spends a lot of money importing subsidized food to distribute to the population. But that food only covers half the population's nutritional needs. The buying power of salaries and pensions are insufficient to cover basic needs. Despite substantial increases, an average family still needs the equivalent of three median salaries to cover their basic needs.
]]>These community organizations are the leaders in an epic struggle against HIV and AIDS in South Africa. They are doing what the government cannot seem to do: deliver essential services that directly benefit the millions of people in the country infected and affected by HIV/AIDS.
"If the government of South Africa wants to address HIV issues, then it needs to strengthen community-based organizations," says Gerard Payne, who works for the AIDS Consortium, a national organization that supports thousands of community groups. He says that the HIV/AIDS crisis is the most significant challenge facing South Africa since the transition from apartheid.
The scale of the problem requires a local, grassroots response, and community organizations are doing their best to deliver it. Many are overcommitted and underfunded. "Whether it is through financial resources, whether it is through training, we need to strengthen them, so we can reduce the rate of HIV in this country," Payne says.
Payne has just been to visit one such community organization, where he stood in the dusty courtyard outside a two-room cinderblock house in South Africa's North West province as a dozen high-energy toddlers played and ran around him. Four of the organization's home-based care givers prepared to make their rounds, visiting patients in their homes to help cook, clean, and remind them to take their medication.
Payne's job at the AIDS Consortium is affiliate coordinator, so he visits the community-based organizations, assesses their needs and capabilities, and recommends a course of action to train the staff. Many must learn and implement procedures for raising and managing money, and develop a strategic vision for what the organization can be and where it can go. This helps the community organizations get past simply reacting to the HIV/AIDS crisis and working towards measures that will help improve the situation.
One example is in the care of orphans and vulnerable children in the community. The government of South Africa estimated last year that there are 1.5 million children under 17 directly affected by HIV: one or both parents are dead, or they are living with the virus themselves. With so many children now in need of a place to live, or at least hang out after school, get a meal, and stay out of trouble, it is the community organizations that are struggling to meet this need, many of them without specialized training or adequate funds. "They may be running a program, but have no idea how to really do it properly," Payne says. "So we will help them get training so they can provide counseling and other services that will help the children. We help them get to a level where they have good infrastructure and are rendering quality services." This can include a curriculum to teach "life skills" to young people so they can learn how to prevent HIV.
Another essential area where community groups can make a big difference is in helping people living with HIV and AIDS to understand what treatment is available and how to get it—a basic level of knowledge known as "treatment literacy." This is particularly helpful for women, who for reasons related to poverty and discrimination may be unable to get to a clinic or hospital—their families may not give them time, they may not have money to pay for transportation, or they may just simply not know that they are HIV positive and need medication.
Gerard Payne says that even if a patient can get to a hospital, he or she still may not understand what they need to do to stay alive. "Patients go there, the staff does a CD-4 count and gives them some medication, but they do not explain anything," Payne says. "Our objective is to educate organizations how to help patients understand the different treatments needed, and their rights to access treatment."
He adds that educating people about their right to treatment is a big step for many groups that are accustomed to delivering food and other care. "Community-based organizations respond to needs: if someone is sick, they go to them once or twice a week and take care of them," he explains. "We are saying they need to take it a step further. That patient is eventually going to get really ill, so they need to understand what care is available, where to access it, and that they must adhere to the treatment."
Seeing organizations grow and become more effective is one of the things that keeps Payne engaged in his work. "Last year I had one affiliate with no money, so I helped them get financial management systems in place," Payne says. "The first 1,000 rand [US $125] they raised was due to the fact that we showed them how to open up a bank account and write some letters to raise money."
"The joy and satisfaction I get comes when someone tells me that the work we do is making a difference," Payne says.
Payne says that South Africa is at a crucial stage in its history. "We have come a long was as a country, and struggled through many hardships," he says. "We are now in a different kind of struggle, and I want to be able to feel that I am contributing in the struggle against HIV."
]]>"He insulted us and beat me up," she says, tears welling up with the memory. Ortiz recounts the ordeal in her dirt-floor house in the department of Ahuachapan, sitting on a simple wood chair, holding her four-year-old daughter Melissa—her youngest. "One of my children said to me, 'Mama, let's get out of here,' so we went outside."
That spring night, outside their blue concrete house, the threats continued. "He insulted me so much... saying I was worthless, I had no future, and that it was better for him to kill me and the children."
Ortiz had to take action because her husband was a police officer and had a firearm. The family took shelter at a neighbor's house, and Ortiz called the police. Her husband was arrested the next morning. She and her children were safe for the moment, but in his drunken rage he had burned all their clothes.
The hills in Ahuachapan are bright green after a rainy summer. Blue and yellow butterflies fly lazily among the coffee trees along the dirt roads, and the sun is warm and comforting. It looks peaceful, making the violent confrontation Ortiz describes seem out of place. But in this small country of six million, widespread violence tends to be particularly deadly for women.
El Salvador is still recovering from a 13-year civil war that saw 75,000 people killed and nearly 8,000 "disappeared." It is a politically polarized society, torn between a small business elite, which dominates commerce and the government, and the majority struggling in poverty. Socially, men are dominant: It is a machista culture that holds many women in submissive roles in the family, raising children and doing other work in the home. Roughly half of Salvadorans live in poverty, and women head about 25 percent of households, so the abuse of and discrimination against women contributes directly to keeping them poor and in their subservient role in society.
There is a paucity of data on violence against women in El Salvador, but what few details are available tell a brutal story: In a country about the geographic size of Massachusetts, the rate of "femicide" in El Salvador was 11.15 per 100,000 women in 2005, far exceeding Guatemala's rate (population nearly 13 million) of 7.96 for that same year, according to a 2006 report by the Inter-American Institute of Human Rights. The same report shows the numbers of women murdered in El Salvador inching up slowly from 2001, when there were 211 women killed, to 260 in 2004, before jumping to 390 in 2005. The 2006 total was 437, according to Yanira Argueta, director of the Association of Salvadoran Women. "The situation is critical," she says at a meeting in her office in San Salvador. "Public officials are not sensitive to the problem, and there is no good application of the laws."
Part of the problem is public perception. A 2006 poll by CS Sondeo found that only about 83 percent of people in El Salvador believe that rape is a crime—which means that more than 15 percent don't consider it a criminal act.
Whether rape, murder, assault, or even psychological abuse, violence against women is more than an injustice or a human rights violation: it is an investment in the social status quo that keeps men on top and women below them. And it prevents women from fully contributing to the two changes El Salvador desperately needs: an end to poverty and the building of democracy.
]]>Molina de Vasquez worked hard to get the group established because she wants women to have opportunities to work outside their homes so they can broaden their horizons. "So many women are mistreated by their husbands," she says. "They need to know about their rights and feel capable of doing things."
"I would like to get women to know about their rights and duties, and to increase their self-esteem. We can help ourselves and our families, care for our children, and earn income to change our lives."
When asked why helping other women is so important to her, she says, "Let me tell you a little about my own life; then you will know."
The details come spilling out; she's like someone who walks away from a serious car accident, describing how lucky she is just to be alive. Mistreated by her father, her mother abused, Molina de Vasquez was married at 14 to a soldier. "I thought it was a way to escape," she says, "but my life got worse." Her husband was violent, and his family "used to tell me that my job was to have children and take care of my husband." When she failed to deliver a child for the first three years of their marriage, "I was useless to them," Molina de Vasquez says with a sigh.
But others could see that she was a leader. When their first child went to kindergarten, she was chosen to be the president of the parents' board at the school. "When I told my husband, he was angry. He told me I was not capable of it. I accepted this; he always told me I was good for nothing. For 11 years it was like that."
Eventually they moved to a rural area and things started to improve. Her husband became an agricultural laborer. They had a son. But Molina de Vasquez wanted to do more activities outside their home, like joining a health training program. Although reluctant to allow her to participate, her husband said she could host training sessions at their home. As part of this training, one of Oxfam's partners, AGROSAL, taught the women about their rights and how to prevent domestic violence. It was part of the Vida Diferente campaign to prevent gender violence.
"I started to listen to talks about preventing violence in the home," Molina de Vasquez says. "I learned about my rights." Since her husband allowed her to hold the meetings at their house, Molina de Vasquez took a risk: "I invited him to the talks and training sessions, and he became more sensitive." Together, she and her husband questioned the gender roles and attitudes in the machista culture in El Salvador, and they recreated their relationship. "Now my husband and I solve problems through dialogue, not violence," Molina de Vasquez says. He now recognizes how important it is for her to use her leadership skills. "If someone asks me to do something, I will do it because I know my husband will not say no."
Molina de Vasquez is committed to the new women's organization: "First I would like to get women to know about their rights and duties, and to increase their self-esteem." She says there are practical reasons for this, which leads to the second goal: "We need jobs for all the women. We can help ourselves and our families, care for our children, and earn income to change our lives." For Molina de Vasquez, respect for women and fighting poverty are part of the same struggle.
The changes in Molina de Vasquez's family are hard to compare to the earlier, oppressive days. "I have overcome it—so why can't I help other women? That is my goal: to help many other women."
]]>One of the goals of the campaign is to increase the number of women who understand their rights and can effectively defend them as Adelina Ortiz did. To help educate the next generation, the campaign developed a program for teachers and schoolchildren in 2007 that teaches young people about how to prevent gender violence and what to do if they are attacked.
"We used to talk about gender equity here," says Patricia Jovel. "But never gender violence." Jovel is the director of a school participating in this new initiative in El Progreso, a village perched on the impossibly steep Quetzaltepeque volcano outside San Salvador. The school, where 850 students from 6 to 16 years old attend classes in two half-day groups, is a collection of six cinderblock classrooms topped by metal sheet roofing on either side of a terraced concrete courtyard sloping down the mountainside. It is a beehive of activity after classes, as without any level area for a playground, the students play tag around the central courtyard in the brisk mountain air. Jovel says the young women who sometimes have to walk home in the dark after school are now better equipped to fend off the young men offering drinks and cigarettes to them. "Thank God there have been no rapes," she says.
The students have learned their lessons well: Karla Sanchez, 15, says it is a matter of her basic rights. "Everyone must respect our rights as children, girls, youth. We all have the same rights, and no one can violate them. And if something should happen, we know we can tell our parents, our teachers, or adults we trust. They are here to help us," she explains patiently. And if these people can't help, she knows where to go. She lists a number of institutions where she can turn for protection: the Human Rights Office; the National Police; and the Salvadoran Institute for the Advancement of Women, known as ISDEMU. As she leaves, Sanchez articulates one essential idea about reporting gender violence: "We should not be afraid of what people say."
In 2007, this pilot project in 53 schools exposed 25,000 students to the key messages of the campaign and trained 1,000 students and 1,000 teachers. The teachers now have incorporated violence prevention into their curriculum, and they work with the trained students. The pilot was supported by the Ministry of Education and was such a success that the minister decided to incorporate it into the public school curriculum nationwide.
Sustained pressure to change societal attitudes toward women is a slow process. One effective way to question long-held ideas and beliefs is to educate those entrusted with defending the rights of women, protecting them in the community, and helping them if they are attacked or injured. These include public officials like police officers, judges, public health officials and doctors, and social workers. The campaign organized a formal training program at the University of Central America (UCA) in 2005, and 45 people attended.
Maritza de Vasquez, a psychologist at the family court in the city of San Marcos, just outside San Salvador, says this training has helped her assist the many women who come through her office. De Vasquez says that women are hearing the messages of the campaign and are taking action to protect themselves. In the steady stream of domestic violence and divorce cases she sees, there is a different attitude. "Women take the opportunity to come here and talk about their situation they come here right away to denounce it," she says. "They are expressing their rights more openly now."
Back in Ahuachapan, Ortiz grows corn and raises sheep to support her children and grandchildren. He husband is in jail awaiting a hearing. "I'd rather see him in prison than anywhere else," Ortiz says. It was her participation in a sheep-raising program run by one of Oxfam America's partners, Association of Salvadoran Agriculturalists (AGROSAL), that exposed Ortiz to the human rights training that helped her defend her own life and protect her children. She points out that in all her training to become a health worker, no one ever educated her about domestic violence or how to prevent it. "The training taught me that women have rights and people are obligated to respect them," Ortiz says. "This made me act, to look for help, and thank God I found it."
]]>Mogale, 37, is open about her status: she has been HIV positive for two years, and she is living with it. After all, she is doing better now and hopes the worst is behind her. "Now I am really fit compared to when I was sick—I can go a long distance walking now," she says. She regularly walks about one and a half miles to the headquarters of Pholo Modi Wa Sechaba, a community organization where she is part of a support group for people living with HIV/AIDS in her village of Welgavel.
Pholo Modi Wa Sechaba helped get Mogale out of bed and back on her feet. The organization sent a home-based care worker to nurse her, help her get to the hospital for treatment, teach her how to take her antiretroviral medication and manage her diet, and file for a government support grant—a source of money for disabled people.
Pholo Modi Wa Sechaba—meaning "health is the root of the nation" in Setswana, the local language—has about 21 caregivers serving 240 patients in four villages. They ensure that patients are taking their medication; they cook and clean, and disinfect and dress wounds from the many infections that bedevil those with an immune system compromised by HIV. In some cases they deliver food parcels to help families survive.
Pholo Modi Wa Sechaba is just one of thousands of local community based organizations helping the roughly 5.5 million people living with HIV/AIDS in South Africa. They are on the front line of the struggle, and play an essential role in providing services. "Community-based organizations are key in the fight against HIV/AIDS," says Gerard Payne the affiliate coordinator at the AIDS Consortium, an umbrella organization for the thousands of such community groups around South Africa. "Without them the fight against HIV and AIDS is a mere media campaign. They provide essential services in the community, they speak the language, and they understand the cultural issues in the communities."
Oxfam America is working with the AIDS Consortium to provide training and other support to community based organizations like Pholo Modi Wa Sechaba in South Africa's North West Province, one of the poorest areas of the country, with a high incidence of HIV/AIDS. The AIDS Consortium is working with 47 local community based organizations in the North West, and with funding from Oxfam it can expand its efforts to some of the 150 others struggling against HIV/AIDS in the province.
Pholo Mode Wa Sechaba helps patients get tested for HIV and, when patients test positive, counsels them on their treatment options and on how to "live positively." In addition to its home-based care program, it has a daycare for young children and an after-school program for orphans and others who need a place to do their homework and learn valuable life skills including how to prevent HIV.
Learning that you are HIV positive forces you to think about everything differently. Just having to share your status with your family is enough of a crisis for many newly diagnosed people. They then must struggle with how to live with what may at first seem a death sentence, how to make ends meet if they are too ill to work, how to endure the side effects of the medication, and how to manage the stigma of being HIV positive.
South Africa's health care system, while free, is overburdened and does not provide adequate social support for people living with HIV/AIDS. They can be tested, learn the result, and get a CD4 count (a measure of the blood cells that support their immune system). Many get free antiretroviral medication. But then they are really on their own—and if they lack a support system of family and friends, as many do in communities already ravaged by the disease, these patients are in crisis.
Pholo Modi Wa Sechaba helped Maria Mogale with these struggles, and helped her understand her treatment options. These are the most important lessons the organization teaches people in the community, particularly valuable to women who are sometimes excluded from health care options owing to poverty and discrimination—a violation of their right to health care. Family members may insist on traditional medicine, which frequently delays treatment, and can often hasten death.
Mogale learned this from Pholo Modi Wa Sechaba: "If people are sick, they need to go to the hospital, and not just stay at home and say they are bewitched," she says at her home, a three-room house made of metal sheets outside Welgavel. "I tell people, 'AIDS is there, but you can get better.'" She smiles as she speaks.
Mogale is a strong, positive example for members of her community—and this strength, tragically, is also a good example within her own family. Her daughter Portia, 18, learned she was HIV positive two months ago, and her 60-year-old mother Priscilla, who lives nearby, is also in treatment. Both are now thinking about their lives differently as well, and look to Mogale for advice on how to live and think about their future. Portia is in her second to last year of high school and is considering higher education, even as she is still learning what it means to be HIV positive.
For Maria Mogale, her future may involve helping others on a more formal basis: she wants to work with Pholo Modi Wa Sechaba. "I want to become a caregiver, and teach others what I have learned."
]]>Each season is slightly different than the previous one, but having anticipated the changing conditions, generation after generation learns to adapt.
But what happens when the seasons become less predictable and the conditions more difficult to manage? What happens when human activities, like burning coal, oil, and natural gas, change the climate—not just for a season, but for the long-term? Then, lacking the information or resources necessary to understand, prepare for, and respond to increased hazards, many of the world's poorest communities experience unprecedented stress.
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