Sanibonani! Here are two posts in one. The first I wrote yesterday; the second I wrote today. The division should be clear.
Things are settling back into normalcy for me at site after the whirlwind Weinstein visit and some time in the big city for our PC Swaziland newsletter. While a fellow volunteer/newsletter editor and I worked on this edition, we spent some time discussing challenges at our sites. Both of us have experienced delays with our girls empowerment clubs because of school scheduling (this has been a busy term for sports). Likewise, we both have had challenges teaching life skills at our schools. For me, this was the same scheduling issue. I also hit a snag in working with the women's support group on their chicken project. It felt for both of us as if we were at a lull in our service. Not much seemed to be working the way we expected.
This, bangani (friends), is Peace Corps. We're about a year into our time here, and we've spent that year trying to get various projects off the ground. For myriad reasons, this is not the easiest thing in the world to do. We both expressed frustration and discussed the disappointment that came with these setbacks.
And then something strange happened.
While I was in the city, I received a call from a teacher asking if I was coming for life skills and the girls club that day. I told her no, but I said I'd be there the next week. I called the support group leader, and we arranged a time to meet to discuss how to move ahead with their income-generating chicken project. I attended a results dissemination meeting for a study on the integration of HIV and family-planning services. I discussed the possibility of a meeting with an NGO (nongovernment organization) to work on a mural with the children's support group at my clinic. Suddenly, my dance card was filling up. And you know what? It felt AWESOME.
This was possible because I, like all volunteers, have spent the past year building relationships and working through trial and error. We all experience disappointment and frustration during our service. In this case, it's not because the community doesn't want to work with me -- the people in my village have been great. Sometimes things just happen differently or happen more slowly than I expect. And, it's important for me to remind myself, life here doesn't revolve around me. This community was here long before I got here, and it will remain after I leave. All I can do is try to figure out where I fit into it and do my best to lend a hand.
That said, the year mark is where many volunteers experience a low point. I hope that was mine.
Swazi word of the day: umndeni = family. Umndeni wami = my family.
----
I just finished two books that, coincidentally, dovetailed
quite nicely and could have an interesting impact on my service. The first was
“The Invisible Cure” by Helen Epstein, and the second was “The Tipping Point”
by Malcolm Gladwell. On the second, at least, I’m very late to the party. (This
isn’t unusual. I am not what is known as an Early Adopter of trends. See also:
Dave Matthews Band, Harry Potter, leggings, “Arrested Development.”)
Epstein’s book discusses how HIV and AIDS have progressed in
different African countries. She focuses on Uganda, which has seen the most
dramatic decrease in HIV infection rates since the emergence of the virus.
Epstein attributes this largely to the “Zero Grazing” campaign. This encouraged
Ugandans to decrease their number of sexual partners. Her research suggests
that this decrease in partner numbers probably had more of an effect on
Uganda’s HIV situation than the use of condoms or encouragement of abstinence.
It is widely acknowledged now that concurrent sexual
partnerships are a big contributor to the spread of HIV. Swazis, for example,
are much more likely than Americans to have more than one sexual partner at a
time. They are not likely to have MORE lifetime partners than an American, but
while Americans tend to have serial monogamous relationships, Swazis are
likelier to have long-term relationships with more than one partner
simultaneously. This is a huge concern when it comes to HIV.
People who contract HIV have large amounts of the virus in
their blood – and are much more likely to transmit it – very soon after
infection. This often is a period when people are unaware of their HIV status.
This means that if you have two partners at the same time and one passes HIV to
you, you are much likelier to transmit the virus to your other partner long
before you show symptoms. If your second partner has multiple partners as well,
she or he could spread it to them without knowing it, and so on and so on until
you have a huge ripple effect in a complex network of partnerships. In a
situation of serial monogamy, you’re likelier to be with just one partner when
you’re infected and then to stay with that partner through that early period of
acute infectiousness. By the time you change partners, you’re probably less
infectious (or maybe you know your status). This makes for a much slower spread
of disease. That was where Zero Grazing came in. The campaign encouraged people
to decrease the size of their sexual networks, and this had a huge impact on
HIV in Uganda.
Epstein also looks at southern Africa (with a tiny foray
into Swaziland). She sees a difference in how HIV and AIDS are discussed. In
Uganda, people recognize that family members, friends and neighbors have HIV.
In South Africa, in particular, it appears to Epstein that people are much less
likely to put a personal face on HIV. Few acknowledge their status openly, and
there is less discussion of the realities of living with HIV. Even if people
know the facts about HIV, Epstein suggests, they are far less likely to change
their behavior if they don’t have a personal story about it. I can’t speak for
anyone else, but I have seen this in my community. I have asked people whether
there are nationally known spokespeople who are HIV-positive and willing to
discuss it. I’ve been told that there were some at the outset of the epidemic,
but they seem to be less visible now. Stigma is still an enormous problem.
People don’t talk openly about what people die from. Thus HIV remains more of
an abstract idea.
I can’t say for sure what impact this reluctance to talk has
in Swaziland, but I do think it’s doing some harm. Factors such as gender
relations, limited economic opportunities and a false sense of security because
of treatment options might also come into play.
From here, we go to Gladwell. “The Tipping Point” is a study
of how trends spread in society. These can be trends such as teen smoking or
suicide, or they can be trends like a popular pair of shoes. Gladwell argues
that word of mouth is perpetuated by a few people, those he calls Connectors,
Mavens and Salesmen. If you haven’t read the book, I recommend checking it out.
Basically, Gladwell suggests that getting ideas or goods into the hands of the
right people is what drives change.
I pondered this in conjunction with Epstein’s book and
started to wonder: What is the tipping point for HIV in Swaziland? What can be
done to get the idea of prevention, testing and treatment into the hands of the
right people? Gladwell mentions hairdressers as useful outlets for spreading
breast cancer information in the U.S. Some programs in the developing world
have successfully used hair salons to promote female condoms. Could the
hairdressers in my community be advocates for condom use or shrinking of
partner networks? It’s hard to say, and it’s a bigger question than I can
answer. But the two books together opened my mind as far as what I could be
doing here. In the coming weeks, I’m going to visit some of the hair salons in
my community. Maybe I’ll start by asking if I can put boxes of free condoms –
female and male – into the salons. Perhaps I’ll broach the subject of condom
demonstrations. And I’ll definitely start asking the women I know where they
get their information about sexual health. I might be overlooking some key
difference makers in my village.
Will I find any new answers? Will anything really change? I
have no idea. It’s an interesting prospect, at any rate. I’ll let you know how
it goes.
Salani kahle.
