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."
]]>They were featured speakers on a week-long Oxfam America tour, which passed through five US cities on its way from New Mexico to Missouri. Inspired by Oxfam's Sisters on the Planet initiative—and supported by groups like CARE and the League of Women Voters—the tour focused on the human face of climate change here and abroad, with an emphasis the ways the US can help vulnerable communities survive the crisis.
"Pollution, greenhouse gases, they don't respect boundaries," said Voré Gana Seck, the speaker from Senegal. "This is a global problem that needs global solutions."
Sharon Hanshaw, executive director of Coastal Women for Change and one of Oxfam's Sisters on the Planet, spoke about her personal losses from Hurricane Katrina, as well as the storm's lasting effects on her home town of Biloxi, Mississippi.
Speaking at the Kansas City, Missouri, public library, Hanshaw explained that it's not just past hurricanes that concern her community, but the ones ahead, which are predicted to intensify. "This year we've had four hurricanes in the last six months," she said. "Gustav was called a dud, but it still flooded our houses."
In Biloxi, she said, hurricanes not only wreak physical damage, but also add to the burdens of people already among America's poorest.
"Times were hard pre-Katrina, and now it's even worse; prices have gone up," said Hanshaw. "We still have people living in trailers, no healthcare, no childcare, no public library. We don't need a handout from the government. We need infrastructure to help our community live again."
Seck, Executive Director of Green Senegal and president of the international NGO coalition CONGAD, highlighted the common ground between Senegal and the Gulf Coast. In both places, she said, the poorest families are the ones to bear the burden.
At an event at the Omaha, Nebraska, public library, Seck compared the effects of climate change to those of a war: "You can't produce enough food, you can't harvest. You don't have enough money. You can't send your kids to school."
For local farming families, she said, a decrease in rainfall means that staple crops like rice, millet, and vegetables often fail to reach maturity, leaving families with less food to eat and fewer extra crops to sell. To earn a better living, some of these farmers migrate to already-crowded cities like Dakar, where floods and poor sanitation are leading to an increase in water-borne diseases like cholera.
Others join the ranks of the "climate refugees": teens and young adults who leave their villages for Spain or the Canary Islands, looking to earn money to send to their families back home. Hundreds of these young people have died while attempting ocean crossings in small, fragile boats.
"In Algeciras, Spain, there is a burial ground called the "Cemetery of the Unknown People," said Seck. "These are our environmental refugees. They are the unknown."
Despite these hardships, both speakers' organizations are leading efforts to help their communities survive the crisis.
"The first thing we have to do is be resilient," said Hanshaw, whose group distributes hurricane preparedness kits—containing fresh water, food, insurance papers, and flashlights—to Biloxi seniors and families. They're also offering affordable child care options to help women in the community return to work.
Hanshaw's organization also trains local women to go to Washington, DC, and "tell the stories that are not being told." Their message to legislators: "We're still here. We're going to be here. And climate change affects all of us."
Seck's group teaches Senegalese farmers new techniques that help crops grow in a drier climate, like drip irrigation systems and faster-maturing seeds. Seck showed photos of the successful projects in action: first a riot of green seedlings, then tall plants in orderly rows, flourishing beneath a wide blue sky.
So far, she said, these innovative methods are only in place in a few villages. But with the support of wealthier countries like the US, projects like these could help farmers throughout the region.
Many audience members at these events signed up for Oxfam's online climate change action team, which provides ways to directly influence US legislators on the issue.
For some, the speakers' words brought a change in perspective. "I came here expecting to hear about Africa, but I didn't expect to hear Sharon's story, right in our backyard," said Lillian Pardo, a retired physician who attended the Kansas City speaking event. "You don't see this on the news."
Andrew Jameton, a professor at the University of Nebraska Medical Center, was the last to speak in a question and answer session in Omaha. "I want to fight this, and a lot of people feel the same way, but it will be a tough century," he said, adding that, because of the speakers' words, "I'm not optimistic—but I'm hopeful."
]]>My neighborhood was one of the worst affected by the fighting, which went on all last night. About two kilometers from my house, the gunmen went into a compound and killed seven innocent civilians. Our neighbors were attacked by gunmen who came into their compound and robbed them, taking mobile phones and money. We were okay, but I found some bullets in my compound.
I was in the Oxfam office when the panic started yesterday. People saw the national army troops leaving Goma with their tanks and vehicles, and at the same time they saw the UN troops shifting civilians to a safer compound. No one informed the population about what was happening, and they thought the rebels were going to take control of Goma. People panicked.
Many people took advantage of the panic yesterday to make trouble. They looted shops and robbed families. It was a mixture of people fighting, criminals, and undisciplined soldiers, using small arms like AK-47s. But in other areas there was a deployment of national army units who were disciplined and protected the people. I haven't seen UN soldiers anywhere myself.
Today, it's calm and very quiet. Usually the traffic here starts at six in the morning, but I looked out at 10AM and all I saw was one motorbike. The shops are all shut. Life hasn't started up yet.
A lot of people are displaced and are living in the suburbs of Goma in very harsh conditions, and the fighting is making those conditions even worse because there's no access for humanitarian workers.
In particular, one group of displaced people has now been forced to move for the third time in a couple of months. They are living in schools and hospitals, or with host families in and around Goma. They desperately need water, food, and shelter. There's no health care or medicines. People are living in the open air, and if they do get a little food it's not enough to feed the whole family.
This current crisis has made it harder for Oxfam to respond. We are watching the situation and I'm going out this afternoon to check out our work in the camps.
]]>But if the passerby stopped to listen to the conversation, she would know that this is no ordinary gossip session.
"I need to find a better way to show off my natural vegetables next to the others in the market," says Horng Vary, a 51-year-old farmer and mother. "They might not look as good, but I know they taste better. How do you do it?"
Her friend and neighbor. Van Sou Cheun, 52, tells her to show only the best ones and then when people come to buy tell them about the taste.
"I think it is best to tell them, not show them," Van Sou Korn, 54, says agreeing with Cheun.
This very simple act of exchanging information on ways to better market their products is at the heart of an Oxfam America initiative designed to allow farmers to pool their savings and take charge of their futures. Called Saving for Change, the program allows members in rural communities to save, lend, and pay each other interest while also encouraging them to share new farming and livelihoods ideas with each other. In the process, small farmers like these three women will become better equipped to battle the rising costs that recently hit the world, and Cambodia.
A recent survey done by an Oxfam partner shows that in Cambodia, 2.6 million people are facing food insecurity with the poorest people struggling to deal with rising food prices. More specifically, the survey suggests that villages like Kork around the Tonle Sap Lake will be the hardest hit.
Cambodians spend as much as 70 percent of their income on food, as compared to the US where people spend about 10 percent. This means that to cope with the soaring food prices, people are buying and eating less food—adding to existing malnutrition among people and the country's poor economic outlook.
Unlike some African countries that do not grow enough food to feed their people, Cambodia has produced a surplus of food in the past few years—including its staple rice. But rice is now a 100 percent more expensive than it was last year, making it pricey for the poorest 40 percent of the population. The causes of the increased prices are varied—climate change, rising fertilizer costs, insect infestations, and uninformed trade—but the outcomes are the same: instability and insecurity for the poorest families.
But with 80 percent of the people in Cambodia making a living from agriculture, it would seem that higher prices offer the possibility of a better livelihood for farmers. Unfortunately this isn't the case since small-scale farmers individually have little bargaining power in terms of selling their produce or buying things like seeds and fertilizer.
This is where three women working together and sharing information could change the balance of power.
Oxfam America has taken strides in building human connections in East Asia through Saving for Change. The microfinance program has jumpstarted trust and knowledge sharing in rural areas because it allows communities to be in charge of their own futures and promotes the need for them to work together in order to reach individual goals.
All three women are a part of a Saving for Change program and through it have learned of another Oxfam America program: System of Rice Intensification, or SRI. A process of 12 low-cost, simple practices, SRI helps small farmers increase their yields of rice by 50 to 100 percent while allowing them save on seed and water costs.
They are now SRI farmers.
"When I first heard about this way to grow rice I didn't believe it," Vary says. "But when I saw my neighbors growing more rice, I took a small part of my land and tried it. I have had three harvests, each one producing more rice than the one before."
This is especially important now. The survey results show that many rice farmers are facing a 70 percent increase in production costs, so growing more rice while saving on water and seeds can make a big difference.
"Everything is more expensive now," Vary says. "But at least we have more rice than some of our neighbors."
The Saving for Change program requires that group members formally meet each month to go over financial transactions in the community. That meeting also gives them the chance to talk about other issues such as their agricultural practices or selling tactics.
"When one of us goes to another market in another village, we bring back a list of prices to share with the group," Vary says. "It keeps us competitive."
The three women find time each week to talk about how their SRI fields are doing and share practices and experiments with the methodology. They all agree that sharing information on how to grow more rice or how to better sell their products will help them manage during this time of soaring costs.
"It is important for us to do this now because of the prices," Vary says. "We are not worried, though, because we have each other. We feel supported."
]]>This tree once shaded Hanshaw's driveway and mailbox—but now it marks the place where her house used to stand, before Hurricane Katrina struck Biloxi, MS.
As cars rumble past, Hanshaw maps out the landscape of memory. "That's where we found my daughter's bed, afterward," she says, indicating a red SUV a few rows away. "This was my backyard. This was the front porch."
Hanshaw was out of town on August 29, 2005, when Katrina's winds drove the Gulf of Mexico into her neighborhood. Thirteen feet of water crashed through the streets that day, filling her house with mud, scattering her belongings, tearing the bumper off her car. The waters swept inland to downtown Biloxi, flooding the hairdressing business she'd run for 21 years. Months later, all the homes on her block were bulldozed to build this parking lot for the Imperial Palace casino.
Hanshaw says the storm brought her not just destruction, however, but also transformation. As executive director of Oxfam America partner organization Coastal Women for Change (CWC), she has turned her losses into strength—by becoming an advocate and role model for others, her fellow survivors.
"This is a left-behind community," Hanshaw says emphatically of East Biloxi, the close-knit, predominantly African-American and Vietnamese neighborhood where she was born and raised.
You only have to walk the streets here to see what she means. Many houses in this once-vibrant neighborhood now stand abandoned, their boarded-up windows turning a blank face to the street. Some damaged homes, like Hanshaw's, were razed after the storm, leaving behind only vacant lots. Others are flanked by boxy white trailers, where families live cramped together as they await government grants, insurance settlements, or other resources they need to finish rebuilding.
A few restored houses gleam with new paint, "For Rent" signs propped up on the lawn. But rents have nearly doubled since the storm, and good jobs are hard to come by—so many displaced residents can't afford to move back home.
"We need affordable housing—not projects, but homes that people can pay for on a living wage in Mississippi," says Hanshaw. "But the message right now is, "if you're not rich, get back."
Hanshaw points out that Biloxi's beachfront casinos and wealthier neighborhoods began rebuilding soon after the waters receded. But somehow those funds never reached this mostly low- and middle-income neighborhood.
Today, she can recite a litany of things lost and not yet replaced: The public library. Funds for small businesses. Elder care programs. Playgrounds for low-income kids.
By training women, people of color, and low-income people to make their voices heard in the Gulf Coast recovery process, CWC aims to give people the means to speak out about these and other pressing community needs.
The group has convened a public forum to discuss rebuilding efforts with Biloxi's mayor and city councilors. Several CWC members have since been appointed to the mayor's planning commission. CWC has also sent delegations to Jackson, MS, and Washington, DC, to urge legislators to provide more affordable housing for people left homeless by the hurricanes.
Until they see results, Hanshaw says, they will continue to push for change at the local, state, and federal levels. "This is our community," she says. "We want it back the way it was&mdsah;or better."
Hanshaw's personal transformation—"from cosmetologist to activist," as she calls it—began three months after Katrina. She was shuttling between relatives' houses and a FEMA trailer, which gave off formaldehyde fumes that made it hard to breathe. Though more people fled Biloxi every day, she says she couldn't abandon her lifelong home.
Then a friend asked her to join local women who were meeting together wherever they could: a funeral home, the local NAACP headquarters, a church. The women talked about rebuilding, both their community and their lives. "Those meetings were part of our recovery, emotionally," says Hanshaw.
Among the women was Oxfam's Safiya Daniels, who encouraged them to voice their concerns about the pace of recovery in East Biloxi. Equipped with training and startup funds from Oxfam's Gulf Coast recovery program, the women formed CWC in early 2006. Soon after, Hanshaw was appointed the group's executive director.
These days, about 20 core CWC members still come together at regular evening meetings. They still borrow space—a beige cinderblock room in the Church of the Redeemer, a few blocks from the waterfront—but their discussions now center on community outreach and upcoming advocacy opportunities. Members of Oxfam's Gulf Coast staff often join in to provide advice.
Hanshaw believes that all women in the community should be able to attend the meetings. With prices rising at the pump, and few options for public transit, she'll even buy members gas cards so they can afford to drive over.
"I'm going to train you if it kills me," she says, explaining her passion to empower those around her. "You're all going to be powerful women."
Advocacy remains at the heart of CWC's activities. But as the group evolved, members realized that in addition to advocating solutions, they had to create their own.
"We find ourselves still doing direct service," Hanshaw says. "That's not our mission, but we see there's no housing going up here that's affordable, no library, no activity center, or anything for the children. ... So I have to do what's in my face right now."
Among other activities, CWC founded its own in-home child care program to address a shortage of affordable day care. It sponsors senior appreciation dinners and computer training for East Biloxi's elderly residents. And it's taking steps to help locals prepare for the next, inevitable storm.
Meanwhile, Hanshaw speaks out about the fight against climate change in Oxfam's Sisters on the Planet and served as an official timekeeper at the 2008 Democratic National Convention. But if you ask her what she's most proud of about her work, she'll say that it's "women stepping up," whether in Biloxi city council meetings or on the national stage.
"Throughout this whole process," she notes, "we've created more leaders."
With additional reporting by Steve Greene.
]]>"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.
]]>But it wasn't until an 80-year-old woman from Walikale in North Kivu was brought to Masika that the full weight of what was happening became clear, galvanizing her resolve. In the war that was sweeping the region, rape was being used as a weapon not only to degrade women, but to humiliate their husbands and whole communities, too. Masika realized the women and girls of eastern Congo needed organized, pro-active help—and Synergie des femmes pour les Victimes de Violences Sexuelles was born.
Its mission, says Masika, its director, is threefold: to raise awareness about sexual violence toward women, to take care of those who have been sexually abused, and to push for the perpetrators to be brought to justice. Since 2003, the organization, an Oxfam partner, has worked with 7,018 women—women like the one from Walikale, who so desperately needed help and for whom there was none available. Raped and left dumped in a field, she was rescued by a hunter and eventually brought to Goma, the capital of North Kivu. But she was penniless, and despite her serious injuries, the hospital would not treat her. And there she died.
Hers is just one of too many stories of sexual abuse and abandonment—of violence that is still rippling through the remote hills of the eastern provinces, that continues to torture its victims with shame, and that now, in a newer twist, has begun to corrode the core of traditional communities, too.
In a small mudbrick building propped on the edge of a dirt road in Kilungutwe, a crowd of villagers has gathered. It's dark and sweltering inside, but every inch of every bench is taken, and more people crowd at the door and window. They have come to discuss the troubles in their village—the extortion they face at the hands of soldiers, the difficulty they have in getting enough to eat—and now the talk has turned to sexual violence.
With anger still in his voice, Elisha Ezigobe, one of the local chiefs, describes the abduction of his 12-year-old daughter. A soldier took her for his wife—without Ezigobe's consent. As soon as he learned what had happened, he headed for the soldier's camp, dismissing any concern about the repercussions he might face in confronting armed men. He was determined to rescue his daughter.
"I took my girl and left," Ezigobe said through an interpreter. "I had my machete. I was going to fight back." His outrage scared the soldier off, and Ezigobe returned his daughter—unharmed—to their home.
But the man sitting next to Ezigobe was not so lucky. His daughter, too, was taken by a soldier. A night passed before he was able to find her and bring her home. Now, at 15, she is pregnant.
There are many stories like this, says Ezigobe, and some fathers are afraid to stand up to the soldiers.
But it's not just military men who are the perpetrators, say others in the roadside hut. Community members have turned into culprits, too—with few serious consequences for their crimes. If the abused girl is 17 or 18, the solution is often to have her marry the rapist. If she's younger, the local chief could order the man to make some kind of reparation—such as a goat—to the girl and her family.
Why is all of this happening now?
"They're asking themselves that question," says Jacqueline Tshilemba, a community educator for APIDE, one of Oxfam's local partners that is working with the people of Kilungutwe. "What they can see is this culture has happened since the war. It happens all over the place and no one gets punished."
At the root of the problem, says Josee Lotsove, is a society that views women as inferior. Lotsove is the coordinator for a local women-based organization called Association des Mamans Anti-Bwaki, or AMAB, an Oxfam partner headquartered in Bunia. Along with those traditional attitudes about women, she says, is the Congo's weak judicial system, which often fails to hold offenders accountable.
When perpetrators are arrested, adds Marie Kanyobayo, it's possible for them to pay a little money to the authorities and buy their freedom. Kanyobayo is the head of another women-based organization called Union des Femmes pour le Developpement, also an Oxfam partner.
It's at this foundation of impunity that Masika, the head of Synergie, is chipping away. Part of Synergie's work involves educating village chiefs and other local opinion leaders—teachers, pastors—about the nature of what has been happening to women, about the catastrophe that it has become, and about the importance of villagers accepting survivors back into the community fold.
But the work comes with great risk.
For speaking out about a problem that has devastated the lives of so many women, Masika and her family have themselves become targets. Last September, six military men came to her house in the early evening and tortured her two daughters, 22 and 20. Masika has since sent them to live in Nairobi, and an aid organization has paid to surround her house with barbed wire to protect her.
Masika admits that sometimes the challenges are so daunting that she's not sure she can continue with her advocacy. But she knows that her voice—and the voices of all the volunteers who work for Synergie—are essential in helping to protect the rights of women who cannot, or dare not, speak out for themselves.
In the Congo, the consequences of rape are far-reaching and affect whole families. Rape heaps shame upon its victims. Women often find themselves cast off by their husbands, and forced into complete self-dependence. Young girls who have been raped lose their chance for marriage and for having a family of their own—and the position of honor that being a mother brings.
At a medical center in Goma where Synergie carries out some of its work, women who are recovering from sexual abuse confront its ugly legacy: possible HIV infection and lives of hardship, including the need to find ways to support themselves. Here, they are learning to weave baskets from long strips of plastic, a skill that will help them earn a living when they are well enough to return to their villages.
But for some, the psychological wounds are so deep they don't want to leave the security and support in which Synergie has wrapped them. For others, the road home is crowded with obstacles that may prove insurmountable. One 36-year-old woman tells of in-laws who are trying to turn her children against her, accusing her of being promiscuous after she was abducted and held as a sex slave and later, in a second round of horror, raped and left pregnant by a government soldier.
For Amina, a volunteer who has been working with Synergie since its founding, the stories she hears from women and girls who have been abused weigh heavily on her. Many of them have become her friends, and she knows that Congolese culture will dictate the future they face—likely one of great difficulty.
Given how sweeping the problem of rape and sexual violence now is, might that culture become more understanding, and even forgiving?
Amina sits quietly for a moment before she replies. A weariness seems to frame her answer. Women are speaking out more, she says. In the past, they kept silent. But as for real change, she can't say when that will come.
]]>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."
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