Living to die. Dying to live.

Ever since we arrived at site, my fellow PCV Elayna and I have been coordinating the logistics of a PEPFAR funded mobile HIV testing unit that is set to begin operating in September 2007. In order to make the project a success, we've relied heavily (which any good community-based project should) on the input of both new and established stakeholders. One of our stakeholders, a major mining cooperation, liked the idea of a mobile HIV testing unit so much, they decided to provide funding for my organization to set up a mobile testing unit specifically to attend to the needs of people living in the informal settlements popping up around their areas of operation. "Hotspots" (the most under served areas) were identified and a running schedule was constructed. Due to the lack of time between being asked to start the project and the project's start date, there wasn't much time devoted to advertising (Shame)! So, what do you do when something doesn't work out just the way your want/need it to? You improvise! During the first few weeks of operation, VCT counsellors assigned to work on the van walked around the various informal settlements announcing the van's presence in the multiple languages spoken in the area (isiXhosa, Setswana, isiZulu, Venda, Shangan, etc.) Additionally, the van was driven around while counsellors announced the VCT schedule for the respective locations using loudspeakers.

Well, thus far, the project has been a success! The mobile unit is testing more people in one day than any other testing site (i.e. The Department of Health clinics and hospitals, private clinics, NGO-based clinics, etc.). The mobile is even out-pacing my organization's office-based testing service! Clearly, in this case at least, providing alternative testing options is useful when encouraging people to test, particularly when attempting to reach out to people living in economically resource poor communities, who may be unable to afford the cost of transportation to an office-based VCT site. This sounds cliche, but I'm going to say it any way: If people can't come to the service, bring the service to them. (There, I said it!)

So, you're probably thinking to yourself: So where does the title to your post fit into the story? Well, one of the most interesting bits of feedback provided by counsellors is the issue of clients and community members wanting to know more about the "HIV grant (Disability grant)". The South African government has provided a grant for people who are unable to work because of a mental/physical disability. In the case of HIV infection, if one is unable to work because of an HIV-related issue and the CD4 count is below 200, one is eligible for the grant. From my understanding, when the CD4 count rises over 200, the grant is stopped, because theoretically, you will be in a better state to work. So here's the missing link to the story: counsellors have noted that many people stop them to ask about how to get the grant money. People have come in for testing, and when testing negative, become upset because they don't qualify to get the grant money. When testing positive, some people are actually happy, because this means they have an extra income. I'm going to give you time to think about that one .........................................................................................................
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Sad and scary, huh?! I'm sure that many of these people have some level of understanding in terms of the possible implications of what one faces after testing positive: stigma, discrimination, failed health, isolation, being so weak that you can't stand up...and the list goes on. I say this, because the majority of people within South Africa, I would argue, know someone who is or was HIV positive. They've probably seen first hand that HIV in South Africa is not a pretty picture.I guess that it's difficult for me to understand on a deeper level, because I've never been in a situation where I felt the only way I could bring money into the house (to pay the bills, eat, seek medical treatment, put clothes on the backs of me or my family members, etc.) was to contract a disease. It is a level of desperation that I would never want for myself or anyone...but unfortunately, it is someone's...

Poverty, desperation, low self esteem, low self efficacy, oppression, misinformation, gender inequities, and a whole bunch of other issues compound on each other, creating a distorted reality whereby contracting HIV becomes an income generating disease........

8bob-6bob= Twobob

Just a friendly little reminder: The time to start you Twobob countdown has come...10 days and counting, until my Twobob comes home with me! The family that is temporarily taking care of him has been so kind to me. They've sent email updates and pictures of how my little Bob Bob is growing up to be such a hansome big boy. I am, however, slightly concerned by the latest picture. I think my little Double Bob might be leaning towards the ugly side. Now don't get me wrong, I've been expecting a smush face and extended girth, but he's still a puppy. I thought that it was manditory that all puppies are unconditionally cute. My best friend Gerald insists that he's going to grow out of his current ugly phase. My parents tell me that, at the time the picture was taken, he was a bit caught off guard or maybe he hasn't yet learned how to pose on his good side. Whatever the case...I'm keeping my fingers crossed and am beginning to prepare myself on how to build up his self confidence. Wish me luck!

Patience and Persistence Make You Stronger!

The view of John Legend from where I was standing

A few weeks ago, I found out that my favorite contemporary artist (aside from Anita Baker and Stevie Wonder), John Legend was set to perform at the famed Sun City on the 16th and 17th of this month! Needless to say, I had to get a ticket! You won't believe the scraping I had to do, in order to make sure that I could survive (i.e. eat, get from one place to the next, etc.) for the rest of the quarter on my Peace Corps living allowance. Now don't gt me wrong (this is a note to all of the Trainees coming in July and for all those interested in joining the Peace Corps and for all family, friends and concerned citizens), I get well above what "the average" South African makes, so I'm not hurting or anything. Since we got that out of the way, back to the story: After saving enough money (read: missing out on my daily candy bar fix and eating at Chicken Lickin' for lunch), I marched right up to my friendly Shoprite to the Computicket, so that I could purchase my well deserved ticket! To my shock and horror, their computers were down, so I was instructed to go up to the second Shoprite in town. When I got there, I was told that their ticket printer was down. I was instructed to call the main office. Before calling the main office, I went online in an attempt to buy the tickets. No such luck...my American bank card and my Peace Corps issued bank card have the wrong formatting for buying anything through Computicket. The same issue occurred when I phoned the main branch! Time was closing in on me...there was only a week remaining before the concert and the Saturday show was already sold out! Oh My! Finally, after many nights of crying myself to sleep and dreaming of John Legend singing "Save Room" to me as I teach community members about reducing their risk of HIV infection by condomizing, testing, and the need to address the issue of multiple concurrent partnerships, I GOT A TICKET! J. Leg...here I come...

Well, not exactly, but kind of.... So, public transportation in South Africa is remarkable. You can get just about anywhere...particularly to Sun City, as many of the employees live in my local community. Going off of the input from my colleagues, I was encouraged not to use it for this event, because I might not be able to get back (transport into town apparently wouldn't be available from Sun City after the concert let out). In an effort to find transport, I had to bribe everyone I knew with a car or with access to a car. I had to put on my best smiley face, give warm hugs, speak in a gentle voice, convince people that helping me would get them into heaven quicker because of my close relationship with GOD. (Disclaimer: The strategies used are not condoned, supported or encouraged by Peace Corps. The views expressed are mine and mine alone.) You know, things like that. Well, it worked! The father of a certain person agreed to take me!!!!

Picture it: June 17, 2007. Dressed to the nines in a dress not worn down and horribly disfigured from multiple hand washings. Hair newly cropped (read: peer pressure from a certain person, his aunt, colleagues, and friends complaining that I was starting to closely resemble Cousin It). Lipstick and make-up substituting for the usual: Cherry flavored Chapstick and soap and water. Standing less than 10 feet away from J. Leg belting out all of my favorite hits (P.D.A. and Another Again). Swaying along with the ebb and flow of the crowd of fans surrounding me! I was in heaven!

Seeing J. Leg in a live performance: A perfect end to a stressful month!

Lessons Learned:

1. Bribery works
2. J. Leg prefers boxer briefs (That's the kind of info you learn standing so close to the stage)
3. Peace Corps issued bank cards are a no-go when purchasing things online
   
4. Patience and Persistence make you stronger!