3.14.2015

Spreading the Word (HIV Campaign: Phase 1)

Sensitizing Nyongock Village on Transmission of HIV

After three months of being deplacé because of a myriad of medical problems, I’m finally back at it in Ngatt: Eating gombo sec and couscous, talking about HIV, and kicking butt. My PEPFAR grant money finally arrived (it took a few months longer than expected). I went to Ngaoundere last week to pick up the nearly $2,000USD from the bank, and then I went on a huge shopping spree where I dropped nearly that entire sum, but not on anything fun like pagne or leather wallets, but rather on condoms, 1,550 HIV tests, syringes, gloves, and seeds for the community garden that the future HIV Support Group will create.

My testing campaign will be a protracted campaign, not a large 1 day event like the annual Race of Hope testing day in Buea that happened on Valentine’s Day. My campaign will go to 8 villages around Ngatt, and we’ll test about 2 villages a week over the course of 3 weeks. My campaign is more of a no-thrills villageouis campaign since none of the villages will have electricity and resources here are limited. There sadly won’t be music or videos to pump people up and get them excited about testing themselves for HIV, no, instead they are stuck with me, who will be trying my best to get people excited through low-resource games and a dozen hand-drawn pictures about the immune system, transmission methods, prevention methods and stigmatization. 
 
A Group of Fisherfolk and Gica
My campaign will start with a 2 day testing event on March 26-27 in Ngatt, and given the 26th is a market day and the 27th is a prayer day, we are hoping for a big turnout. Thankfully, Spencer is coming up to help with the testing in Ngatt, but his secondary job will be to keep me sane. Then on the 28th we’ll head to the somewhat large fishing village of Wandjock, which sits at the edge of Lake Mbakaou. The lake is currently dammed, so all the fishermen throughout the Adamawa come to catch tilapia, mackerel, and capitaine, and hope to not get eaten by a hippo in the process. But the influx of fishermen also means the influx of femmes libres and bordels - yes, prostitutes.  Women come from near and far to sell gin, vodka, and whiskey sachets to the fishermen (and women) during the day, and then other women come out at night and sell a very different service to the inebriated men.

Wandjock is the largest fishing village, but it isn’t the only one. We are also going to test Mbizor, a village a little further to the west on Lake Mbakaou, Nyongock, a bit to the east of Wandjock, and Ngaoumere, which is right near Nyongock. In addition to these at-risk fishing villages, I’m also doing a testing day in Kandje, a village between Ngatt and Danfili, and a cluster of Mbororo encampments that have a history of rampant STIs and HIV (Gan Laka, Mayo Solla, and Djaro Garga).

It’ll be an exhausting campaign and I receive mixed reactions when I tell locals about the campaign. Some people reply with “Yes! We need this! I’ll be the first in line!” to “Nobody will show up to that, especially if they know they are at risk of being HIV positive!” This gives me the difficult task of convincing everyone that it’s better to know your status, get started on the free ARVs, join my support group and increase their chances at a long healthy life, and to remind them that not  knowing their status will only make their lives more costly and short. While I’m hoping for the best turnout possible, I’m also trying to be realistic and remind myself that this is Cameroon, and things never quite go according to plan. Thankfully, in a two hour long village wide door-to-door survey my translator conducted yesterday, we got the names of at least 200 youth who will show up on the Ngatt testing day, not counting adults and children.
 
Lake Mbakaou in Mbizor
Even if all 1,550 tests don’t get used, we are leaving them at the hospital so that people can come on their own and get tested. I also figure that at the very least, if not everyone gets tested, at least the conversation about HIV and STIs has been started and is hopefully less of a taboo subject, which, I hope, will  encourage people to talk about risk factors and prevention methods.

In order to get the word to each village that they have a free testing day coming up, I traveled to Wandjock, Mbizor, Nyongock and Ngaoumere to give a brief education session and to inform them on the date of their testing day. I traveled by moto with Gica, the security guard at the hospital who I have a love/hate relationship with. I love Gica because he can translate for me and does good work when he is motivated. But far more often I get frustrated with Gica because he whines about not being compensated, is a bit too over-the-top for most Fulbe to appreciate, and he is 80% of the time drunk.

After scheduling our sensitization day for last Friday, Gica blew me off to get drunk at 8am. We rescheduled for Saturday and headed out to Mbizor. Mbizor is a small fishing village, with a mostly Gbaya population. Our sensitization went well. We had about 60 total men, women and children show up to learn about HIV/AIDS and the importance of being tested. After our presentation, we headed down to the Lake where I watched the fishermen as Gica pounded back some Gin sachets, claiming that he drives the moto best when under the influence of alcohol.

After a brief lecture by me about how I don’t want to be driven around by a drunkard, Gica finally decided to stop drinking and get back on the road. Our next stop was Nyongock, a small little fishing village of only perhaps 2 dozens people. We educated around half the village, and they got quite a kick out of my condom demonstration on my wooden penis. The by now tipsy Gica tried to help me convince people they need to get tested by sharing his own personal story, which went something like this: “HIV is like playing a game of chance. I’ve had sex with over 10 women who’ve died from HIV and I still haven’t gotten infected! I’m starting to lose faith in my blood now, so we’ll see what my HIV test says in a few weeks! If it’s positive, then I’ve lost the game of chance. If it’s negative, I would argue that I can’t catch HIV!”
 
Amadou teaching about HIV
It wasn’t exactly the message I wanted spread. First of all, Gica was somewhat promoting risky behavior by claiming he has had sex with 10 HIV+ women. Secondly, he was making it seem as if certain people are immune to HIV, which is also not the message I want to be spreading. When one man asked why he knew a man with HIV who died, but his wife never became infected, Gica told the man that some people are immune to HIV. I quickly tried to backtrack from Gica’s damage by explaining that we don’t know if the married couple was having sex, or if they were using protection, etc. But Gica kept interrupting me telling them that she must’ve just been immune.

After I scolded Gica a bit about doling out false information, I talked with the village health mobilizer about getting the word out about the testing dates. He agreed, wished me luck, and sent us on our way to Ngaoumere.

Ngaoumere is a village that is nearly non-existent in non-fishing season, but now it is a bustling little fishing town. Gica and I stopped to say Sanu to the female chief of Ngaoumere before heading to the education sessions. Gica by this time was pretty inebriated, and started to take off on the moto before I was on, resulting in me getting my right calf a little burnt. After a far more serious lecture from me about how I have no faith and confidence in him anymore, we took off far more slowly.

In Ngaoumere we had a very large turnout. I met with the women first in a small little room. There were about 20 females overall, with about 10 being adults. When I finished the meeting with the women, I went outside and educated the nearly 25 men milling about before prayer. The message was widely received, although one man tried to argue with me telling me that the condoms I was using for my demonstration were not the “originals” and therefore less effective…whatever that means.  

It was an exhausting day of educating somewhat difficult populations in the hot dry season sun, but overall it was a good start to my campaign. We educated nearly 200 people on the transmission and prevention of HIV as well as the importance of voluntary testing. While Gica was more of a nuisance than a help, I’ve recently found more motivated and sober men to translate and work with. Here’s to an exhausting but hopefully successful month!
Part of the Men's Group I Sensitized in Ngaoumere

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