Sunday, August 7, 2011

Project Report: STI & HIV/AIDS Awareness Program for Rural Vanuatu (NAC 149)

On July 11th, 2011, the workshop Wanem Nao HIV/AIDS mo Sik STI began. The workshop would include talks about sexual reproductive health, STIs, and, ultimately, HIV/AIDS. Before this could happen though, I needed to bring in help from the outside. On the 8th of July, I left Naviso, East Maewo and made my 4-hour trek to West Maewo. In West Maewo, I stayed one night before going to East Ambae to bring in fellow volunteer Nancy Miyake, who had worked in North Ambae (now with Save the Children in Port Vila). After leaving East Ambae, we made one more stop in South Maewo, Baitora, to bring Lindsay Templin. With two more Community Health Volunteers (both female), we made our way back to West Central Maewo and stayed one more night. On the 9th of July, the three of us made the walk back to Naviso via a bush road from Telise Village. A little over 5-hours later, we arrived, wearied and dirty, in Naviso.

The following day, July 10th, we collectively went to Church in the morning and afterwards I was able to make my community announcements about the workshop: beginning on Monday and going through Tuesday. Prior to this, I had been conducting a 4-week media campaign promoting the workshop. This involved repeated reminders during community announcements after church, various flyers, and talking with the community. Leading up to the workshop, I could feel a palpable excitement; people were continually asking questions about the dates and times. After announcements, I had to make some final arrangements and later in the day the other volunteers and I would make preparations. I had to make sure the pig, two roosters, rice, and other kakae was ready for the next two days. Additionally, I had to meet with the Youth Committee that was supposed to perform my drama tomorrow during the workshop – this requires some storytelling:

Two weeks prior to my workshop I searched out 8 – 10 people to help me make a drama visualizing the affects of HIV on the Immune System. I finally got a list of names and set two days to meet before I would go to Ambae to get the other volunteers. These two days would be used to prepare and practice the drama. The first day we were supposed to meet at 7 AM. Of course, being American, I arrived promptly at 7:00 only to wait until 8:45 before everyone showed up. After this, the leader of the Youth Committee, Esron Boe, told me that he would be going to Lalaone in North Maewo to make Copra and would miss the next practice, but would be back before the workshop; this was my first problem I ran into – I did not see him again until July 20th.

In his stead, Ephram was charged with leading the group and Ephram seemed motivated and interested in adding to the drama to improve the entertainment quality. The next time we were supposed to meet I did not want to wait a long time; I decided to come late and meet the late ones halfway. I arrived at 7:45 and found no one. I waited until Ephram came down and told me that they had been there at 7:00 and waited, danced, and finally, assuming I was unable to come, left. Well that did not work. Ephram decided that we could meet the next day, in the morning, before I left for West Maewo and Ambae. The next day I showed up promptly at the Nakamal, after Morning Prayer (as stipulated by Ephram) and, again, found no one. Opposed to waiting, I went to Ephram’s house to find him asleep – he had a kava hangover and had missed prayer. He told me that he would grab everyone and meet me at the Nakamal. About 10 minutes later, I was met by Ephram with bad news: ol man oli lus (All the people are gone). Ok, we decided that we will meet after Church on the Sunday before the workshop, July 10th.

This brings us back to the Sunday preparations. After Church, I find Ephram and he tells me that he will find all the people and get me from my house and we can practice. So, I go back to my house and wait. I do not see Ephram again until that night drinking kava. At this point, I tell him, since we had met once, the participants know the drama and I just need them ready to act on the second morning of the workshop.

Jumping ahead, on the second day of the workshop, July 12th, I go and get Ephram in the morning and tell him to get everyone ready. A small time later, Ephram comes and tells me, once again: ol man oli lus. Well, lucky I am used to this and found willing participants to come and act impromptu. Lesson Learnt: Locals can, but I am not allowed to work on ‘Island Time’.

Now, we can get back to the meat of the story. The preparations were finalized on Sunday, as Nancy, Lindsay, and I went over the workshop details and prepared the Reproductive Health materials – at the same time, making sure we understood how the sexual organs worked ourselves. Once we were all on the same page, we were ready for the workshop.

July 11th, 2011: Day 1 – Sex and Ni-Vanuatu

We began the workshop with an opening prayer and the Bananas Dance Ice Breaker. After this we went outside and played a massive name game. By the time we finished this and went back inside, attendance had boomed and we had somewhere around 70 – 80 people of all ages in the Church. We began the day by splitting the groups into two (males and females) and using picture activities to learn about reproductive health. This took up much of the morning, but before breaking for lunch, we had the groups split into two again (after learning this activity would not work with males and females together) to define what ‘sex’ means. This was an eye-opener and a funny activity; I no longer believe that Ni-Vanuatu have reservations about sex.

After breaking for lunch, we came together again and started the STI talk covering: STI i minim wanem, Wanem ol nem blong sik STI, Wanem ol saen blong sik STI, Hao nao blong blokem sik STI, and i gat meresin blong sik STI. Following these talks, we went into a picture activity that involved some critical analysis of family planning methods. Finally, we closed the day out with a talk from the Nurse, Nicholas Bage, about the services offered at the Mamalu Vanua Dispensary (family planning, STI treatment/medicine, condoms, etc.). After, the workshop was closed with a prayer, thus completing day one.

July 12th, 2011: Day 2 – HIV/AIDS and Gender Play

The second day of the workshop began with a fruit salad dance followed quickly by an outdoors activity: Telephone. Yes, the classic game of telephone, where you try to pass a message down a line or in a circle and see what comes of the message in the end. The activity was meant to represent the importance of learning correct information and how toktok blong rod can lead to misunderstandings and problems. Following this we went into the first section of the day.

Wanem nao HIV/AIDS?
The day started with the Immune System talk and the Drama, showing how HIV attacks the white blood cells and how other diseases can enter the body without resistance. After this we went through the activity: Laef Laen blong Sale (Sale’s Life). I used a clothes line with different signs to indicate age groups and life events. I demonstrated how HIV/AIDS can cut your life short; this was emphasized by cutting the clothes line and having every sign fall to the ground. This part turned out to be surprisingly dramatic as the signs hit the ground. The next activity covered the meanings of HIV/AIDS. We closed this section with an activity called ‘Finding the Ball’. In this activity the participants made two lines (males and females), shoulder-to-shoulder, and passed a ball back and forth up and down the line. After the facilitator said stop, the other group would have to guess where the ball was in the opposite line. This activity was meant to demonstrate how HIV does not have any signs and you cannot just assume anyone has or has not contracted the virus. After this we went into the next section of the day.

Hao nao yu serem HIV/AIDS?
This section was complete with picture activities that allowed the participants to explore the answers to each question. This developed great climates for discussion. The two activities explored what waters of the body HIV could pass through and what were the chances of sharing HIV in different activities. Following this we had a talk about the different general activities that would share HIV based on the waters of the body: Sex, Breastfeeding, Blood Transfusion, Bloody wounds, and Having HIV and being pregnant/giving birth. At the completion of this section we broke for lunch.

Hao nao yu save blokem HIV/AIDS
After lunch we began with another Bananas Dance and a game entitled: Juggling My Life. During the game participants stand in a circle and throw different objects around. The facilitator continually puts in more objects (the objects meant to represent life’s responsibilities), after a small time, the facilitator introduces a bigger object and three smaller objects meant to represent sex, pregnancy, STIs, and HIV/AIDS. The activity is supposed to demonstrate the difficulty of juggling your responsibilities and how sex, a bigger responsibility, can lead to different consequences that individuals might not be able to manage. Following this we went into a pictures activity to explore different ways for blocking HIV transmission. After this we touched on the poster with different ways to block ‘sik STI’ from the previous day. After this came the String Activities that used string and circles of participants to show the ease of possible HIV transmission between groups and islands throughout Vanuatu. Finally we went into condom steps and practice, using male condoms only, as female condoms had not reached Lolowai Hospital in East Ambae when we had last passed through. The condom work closed out the section blocking transmission.

Closing Activities
After the last activities, that were done in separate groups (male and female), we came together again to participate in a Gender and Development activity called: The Thing Game. The males and females were set-up as teams on either side of the Church and told that, exchanging turns, people from each group could come grab from the pile of ‘things’ and women would “act like a man” and men would “act like a woman”. While they did this we would record each activity. These resulted in a great amount of laughter with men pretending to breastfeed and give birth and women pretending to act drunk and rowdy, put on male condoms, and drink kava. The activity was followed by a debriefing session that touched on the multiple responsibilities that men and woman shared and how using a condom was a responsibility of everyone: Yumi Evriwan gat Raet blong karem Kondom. Finally, we finished the day’s activities with a talk about the difference between treatment and cure and how testing worked in Vanuatu.

As a group, the other volunteers and I answered all the questions from the ‘question basket’ that had been collected throughout the workshop (the first day’s questions were answered in the morning). Following this, the workshop was ended with a chorus and a closing prayer. Afterwards, the community made a ‘Thank you’ ceremony/lafet and killed another pig for kakae. The volunteers and I were presented with Salusalus and drank kava with the Chief. The village performed a small custom dance and everyone brought in local kakae too. The celebration was a big one and made for a great ending to the NAC-funded workshop in Naviso, East Maewo.

Success Story
In a small tangent, I can tell you the story of one Auntie of mine who, following the workshop, approached Nancy and explained to her: after going to the workshop, she discussed with her husband and they had decided to start using condoms. She asked Nancy if she could get her some condoms and Nancy passed the information to me. Later, I was able to get her the condoms she had asked after. This is explicit proof of the need to make these workshops with facilitators of different sexes and the importance of volunteer collaboration.

NAC-Funded HIV/AIDS Workshop: North Ambae July 17th – 18th

Summary: The Benefits of Volunteer Collaboration
After the workshop in Naviso was completed, I followed Nancy Miyake back to her site in North Ambae to assist in facilitating her workshop. The workshop was designed similar to the workshop in Naviso and Nancy and I changed sections based on what worked and what did not work in Naviso. Moreover, we added new sections to test in North Ambae. Nancy’s workshop involved three different villages in North Ambae. The experience was rewarding and the community opened up well to me during talks about sex and other sensitive issues. Nancy’s workshop was benefited by the presence of Rolingson Tari, the PENAMA Provincial STI, HIV/AIDS Officer, and his counterpart, VSO, Eric Ochieng, a volunteer from Kenya.

The workshop in North Ambae was very successful and I believe without the collaboration between Nancy and me before the workshops, at a PEPFAR-funded workshop for Village Health Workers, and before/during the workshop in Naviso, the end result would have been quite different and nowhere near as successful. I believe collaboration between volunteers is necessary for growth and this can be seen explicitly in my work with Jennifer Blount, the education volunteer in Naviso, and my work with Nancy on the HIV/AIDS workshop. These things could not have been possible without PEPFAR and NAC Funds and the backing of Peace Corps Vanuatu staff. The next collaborative workshop will take place on September 18th in Baitora, South Maewo. With the cooperation of so many volunteers these workshops can only improve and with them, the collective understanding of Ni-Vanuatu regarding all aspects of Sexual Reproductive Health, STIs, and HIV/AIDS.          
          

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