9.28.2014

Fido Doesn't Give You HIV/AIDS


I’m a workaholic, so being on consolidation has been rough. Consolidation wouldn’t be as mind-numbing if there were other health volunteers I could collaborate with on their projects, but alas, I’m the only East region health volunteer, which left me high and dry in terms of work. After getting a call that it would be two months before my house would be finished, I desperately picked up the phone and began cold calling the numbers of health centers in the Bertoua area that I had accumulated over time, in hopes to find some form of work in the meantime. Sadly, none of them answered, despite my repeated attempts. Thankfully though, Lauren and Sarah, two of my East region Youth Development and Education region-mates, came to my rescue!

It’s an East region tradition to do HIV/AIDS sensitization murals in each village where volunteers are posted. Murals have been thus far completed in Mandjou, Batouri, Abong Mbang, and last February, my old post, Lomié. During the week of 4th of July, Sarah and Lauren continued the tradition and did a Diang HIV mural. Sadly, that week I was busy writing my beekeeping grant in Lomié so I wasn’t able to make the long trek to Diang to help out, but ever since the mural was painted, they had never held an ’official’ opening ceremony or sensitization. That’s where I come in.


Last week Lauren and Sarah deemed it was time to hold an official mural revealing and do a sensitization campaign to go along with it. Lauren and Sarah came to Bertoua and we prepped for what we would each teach. The next day Lauren and I got in a bush taxi along with Lauren’s counterpart, Blanche (yes, as in La Blanche!), and began the 40 minute quasi-paved journey to Diang. Diang is a small village of 2,000 that reminded me a lot of Messok, a village I visited 2 hours further southeast of Lomié. It’s small, muddy, and quiet and in need of a lot of help and education. To get to Diang you take the road that goes due North of Bertoua towards Bélabo, where the Sanaga Yang Chimp Rescue is located. Midway to Bélabo we turned off onto a bumpy, muddy road that was grave, but still no rival to the road to Lomié. One annoying checkpoint, a few hundred bumps, and one headache later, we arrived in Diang.


The Center of Diang

Lauren played tour guide and showed me Diang center, the market, the post office, the very nice health center, and of course, her gorgeously decorated house. After washing up, we made our way to the market center where the HIV mural is located to begin the sensitization, which we made sure to clearly state on all advertisements that will start at 9:30am sharp. Of course, we got there at 9:15am and Blanche was still in the process of acquiring chairs, and the only people gathered around was a group of 10 drinking buddies chugging the last drips of palm wine. Lauren and Blanche walked around the village center and tried coaxing people to come learn about HIV. Meanwhile, I tried to convince the drunks to stay and listen to what we have to say, since after all they are probably the most at risk group.


Slowly but surely a group began to form. The proviseur of the local lycée showed up dressed in a suite, bowtie, and cufflinks - clearly I missed the memo we were to be photographed for the cover of Vogue. After the provieseur arrived, Roman, who is the lab tech at the Diang medical clinic, arrived. Roman was there to help us answer more technical and scientific questions. After him, one of the delegates at the Sous-Prefets office arrived. Lauren and Sarah have explained to me in detail the problems and annoyances they’ve had with Diang’s delegates and government officials who think they are all grandes -  and they said this particular man was the worst. When he arrived he immediately approached us and said “I thought this was supposed to be started at 9:30? Your flyers say ‘Please, respect the starting time‘, but here we are at 10:00 and you haven’t started?!”. We bit our tongues, choosing not to point out the fact that he himself had not obeyed the flyer, given that he had arrived 30 minutes past starting time. Finally, when we had about 30 people gathered around, we began.


Cows Who Sat in the Middle of our Presentation

This sensitization was pretty run of the mill, but it opened up some interesting insights into local perceptions and misconceptions of HIV/AIDS.  We all began by introducing ourselves and then Lauren began with a myth or reality activity. While a lot of people didn’t participate because they didn’t want to express their opinion and be public viewed as ‘wrong’, overall those who participated knew a good deal about HIV/AIDS. However, one misconception that holds true throughout Cameroon is that HIV is spread through mosquitoes, and Diang was no different in sharing this belief. 

While to us it seems silly to think that HIV is spread my mosquitoes, the misconception is easy to understand. If HIV is spread through blood, then why can’t a mosquito suck the blood from someone who is HIV+ and give it to someone who is HIV-? It’s not completely unbelievable. I stepped in and attempted to clarify by explaining that while yes, mosquitoes do suck blood from you, they do not, however, go to another person and inject that blood into them - no, instead the blood is the food for the mosquito and therefore is consumed and not re-injected into another human. Much of the audience had ‘AH-HA!’ moments, finally realizing that yes, that is true, but some people still seemed skeptical. To win them over I explained that HIV is only a virus spread among humans, hence human immunodeficiency virus, and therefore, mosquitoes cannot acquire it. At that point, everyone laughed and smiled and mumbled things such as ‘Why, of course!!! Obviously!’. With that misconception cleared up, we moved on.
The HIV Game

The next part of the sensitization was led by Sarah and it was a game where everyone is handed a folded card. Inside two cards, ‘HIV’ is written. In one card, ‘protection’ is written. The rest of the cards are blank. Everyone is told to not open their cards, and instead write down the names of three other people in the audience. After much confusion (much of the audience began writing names of family members and friends who were not in the audience), they finally all wrote down names. Everyone was then told to open their cards and Sarah told the two people with ‘HIV’ to stand up. The first person was Blanche, Lauren’s counterpart. She came up with us and we asked for the other person with ‘HIV’ to stand up. At this, on older man with an opened button up shirt, which bared his hairless, skeletal chest, raised his hand. Sarah said, ’Okay, so you have HIV, come on up with us in front’ - the man’s face looked completely crestfallen and in shock. We then realized that, oh my God, this man thought he actually had HIV. After much reassurance that he did not in fact have HIV, we finally coaxed him up with us. We then made them each call out the names of the three people they had written on their cards. Those people came up and were ‘infected’ and they then called out their names, and so on and so forth until everyone was called up except the person who had ‘protection’ written. The game was meant to demonstrate how easily HIV can spread when one doesn’t know their status and doesn’t use protection. Overall, the audience appreciated the demonstration and in the end realized it was just a game…I think/hope.

After the game, however, somewhat of a chaos broke out, which is pretty dang typical for the East. The game riled people up and made them a bit more talkative and outspoken, which was the point, but it also incited a bit too much excitement and participation among those who were already inebriated - which was a good portion of the audience. It was now my turn to begin my lesson, which was teaching about the methods of transmission and the methods that do not transmit HIV. The mural was the backdrop of our presentation, and it clearly stated the methods of transmission, and when I asked the audience “What are the four fluids which transmit HIV?”, I had hoped they would look at the mural and tell me the correct answers. Everyone was able to get blood and semen, but nobody could guess breast milk and vaginal fluids. After clarifying, I  then explained how each of those fluids transmits HIV and in what circumstances you might acquire or transmit HIV (unprotected sex, birth, breastfeeding, and transfusions or intravenous drugs). I then asked the group if you can acquire HIV through kissing - “no!” they responded. I then asked about toilets - “no!’ they replied in unison. How about sharing food or living with them? - “no!”, and then I asked about mosquitoes and thankfully they all responded with a firm “no!”. Check! They all learned something! This group clearly learns much faster than those in Lomié! 
Me Explaining the Origins of HIV

But as I mentioned, the group at this point had gotten a little raucous. It then spontaneously broke into a free-for-all Q&A. The older man who had previously thought he had HIV when he opened the game card raised his arm and said indignantly, “This is very nice, but HIV was created by Americans and brought to Africa!”. Ugh. I had confronted this widespread belief when I taught about HIV/AIDS in Sierra Leone way back when. Lauren and Sarah were at a loss of how to convince this man that this rumor isn‘t true, and the doctor had no answer because he too believed it was an American creation, so I stepped in and launched into the history of HIV, how to started in the East region of Cameroon (yes, guys, the East region of Cameroon!) and originated from a chimp when a hunter butchered it, then spread down a river and ended up blowing up in Kinshasa and other Central and Southern African nations before making its way to America where our fancy doctors put a name to it. I repeated, “America identified HIV/AIDS as a new disease, but it didn’t create it.” 

This seemed like a good enough answer for them, so then they broke out some more conspiracy theories. I hear one lady mumble, “it’s from China” - I turned to her and said “What did you say?”. Then she repeated, “It comes from dogs”. In French, the word for China (Chine) and dog (chien) can sound pretty similar. When I clarified that she was indeed talking about dogs, I told her to explain, and she said that only people who raise dogs contract HIV. How the heck to these rumors start?


Condom Demos
After my brief explanation, we had a male and female condom demonstration. While Lauren explained the steps of proper condom etiquette, Sarah and I yanked out our penis (…um, the wooden prop penises, that is) and demonstrated. After the male demo was completed, I attempted to show, as best I could without a vagina model, how to insert and use a female condom. After our demonstrations we asked for volunteers to show us how it’s done. The groundskeeper for the Diang lycée raised his hand and came to the front. He was already more than a few drinks into his day, and in a very drunk but sing-songy voice he recited the steps and went through the motions, all the while making the audience laugh. There we have it, our condom demo was tested by a drunk man, and if he can properly demonstrate how to use a condom after having too many drinks, then it goes to show that anyone can.

The sensitization ended and people began slowly meandering back to their houses. We three cleaned up and quickly debriefed what just happened. After counting the whole experience as a success, I hopped back on a moto and returned to Bertoua, but not without passing the beautiful Hausa women from Niger who ride in spectacularly colorful clothes and ride on donkeys through Diang. I was refreshed by a successful sensitization and in awe of the diverse groups who live in Cameroon. Perhaps, indeed, I can have a wonderful last year of service. 

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