Peace Corps ages people.
Check out my then and now:
Then/Now
This week, all of us are in Lima for mid-service med checks and meetings. Each of us gave presentations on what we've been up to this past year, and we started to realize something.
Peace Corps ages people.
Check out my then and now:
Peace Corps ages people.
Check out my then and now:
Youth Group Photography Project
My youth group recently did a photography project in our little pueblo. The objective was to take a collection of photos that would make a portrait of how life is in Pampas. No pictures of over-photographed landmarks. No posing.
Here are a few taken by the teens:
Here are a few taken by the teens:
PC Book Club: The Wisdom of Whores
Thanks to PEPFAR, a huge chunk of PC Peru volunteers are finding themselves knee-deep in HIV prevention. It's no surprise that, as a result, books discussing the AIDS pandemic are now appearing on the Peace Corps Book Club list.
In The Wisdom of Whores: Brothels, Bureaucrats and the Business of AIDS, epidemiologist Elizabeth Pisani tears apart the current ideology driving AIDS work worldwide.
Africa is leading the world in HIV-infection rates, and rightfully so much of HIV prevention and funding is going to this part of the world. However, Pisani argues, what's happening in South and East Africa is NOT what is happening everywhere else. And while these parts of Africa have HIV infection in the general population, the rest of the world is discovering the highest risk of HIV infection isn't. In fact, the epidemic is concentrated in pretty condensed at-risk populations: sex workers, males who have sex with males and drug injectors.
An overwhelming amount of AIDS funding, however, is not funneled toward these groups, but toward the general population, where the risk is much lower. Instead of focusing funding for providing and promoting the use of clean needles, condoms and lubricant, money is being spent on development projects, life skills for teens and encouraging abstinence.
Not to say that these programs aren't useful. But as Pisani points out, economic development and individual empowerment are all well and good, but what will really stop the spread of HIV are condoms and clean needles.
I've spent the past year working on HIV prevention projects in my site. We've trained 60 teachers, 40 youth health promoters and over 200 teenagers in HIV prevention. We've shown movies, done marches, and recorded radio spots. We've organized community meetings to educate house wives and conducted condom relays in classrooms.
But has it really made a difference in curbing the spread of HIV?
According to Pisani, it most likely hasn't. And from the data I've seen, she's probably right. HIV infection rates in Tumbes ARE high, but really only in males who have sex with males, and sex workers. In the general population – where all our work is conducted – the rates are actually quite low.
This is kind of disheartening for a girl who has spent a lot of time waving bananas in the air with one hand and condoms with the other.
Perhaps our resources would be better utilized if we focused our energy in the at-risk populations. But in a culture with such fierce machismo, where prejudice and hostility might lurk around any professed outsider, how can we seek them out without putting them at risk?
Our solution so far has been to blanket the entire community with information in hopes of reaching those who are truly at risk, which – let's face it – is a little like throwing seeds across an open field in hopes that a few will start to grow.
As Pisani mentioned, a positive byproduct of our project might be a reduction in teen pregnancy and STIs. Some youth might not cave to growing delinquency because they're kept busy with sessions and project activities. And we're certainly doing a lot to open up lines of communication concerning sex and condom usage.
But what's more, the community is stepping up, working together – getting excited about something.
Call me naive, but I think that's a pretty good step. And even though we're not where we need to be, we're at least moving forward. Hopefully in the right direction.
--
Pisani's evaluation of the problems guiding the HIV pandemic and her solutions (pulled directly from her book):
The Problem (on Planet Epidemiology)
The overwhelming majority of HIV-infected adults get HIV by having unprotected sex with an infected person, or by sharing needles with them while injecting drugs.
People pass the virus most easily when they have lots of it in their blood (i.e. when they are newly infected).
HIV is transmitted most easily when it comes into contact with sores, lesions or foreskin.
The Solution (On Planet Epidemiology)
Cut the exchange of body fluids between infected and uninfected people.
Getting people to give up sex doesn't work very well, so in terms of sexual transmission, our best bet is to persuade uninfected people to use condoms with any partner likely to be infected with HIV. In East and Southern Africa and in many gay communities that means any new sex partner. Bombard the places people go to meet new partners with condoms and lube. Remember that men have sex with another in prison.
For heterosexuals in most of the world, the highest-risk sex is paid for. Create incentives to use condoms every time sex is bought or sold.
Methadone and other oral drugs can help people stop injecting, so make them widely available but recognize that they don't always work. Make it easy as possible for people who are still injecting to do it safely. Make clean needles available, make them free or dirt cheap. Give them to people in prison if they need them. Make sure no one winds up in prison just because they're carrying needles.
Don't forget to make sure that all injecting equipment used in health services is sterile. Screen all blood for HIV before transfusion.
Cut the amount of virus in the blood of people who are infected. The most obvious way to do this is to provide people who need it with antiretroviral treatment. Test for infection where you're most likely to find it. Bundle prevention services with AIDS drugs at every opportunity. Treating other infections (such as sexual transmitted infections) promptly will reduce spikes in the amount of virus, even among people who are not on anti-HIV drugs.
Close all the potential "open doors," so the virus can't get into the uninfected person.
In communities where there is lots of HIV, circumcise men. Screen for sexually transmitted infections and treat them among women, men and transgenders who sell sex, and among their clients and regular partners. Make sure you use drugs that work. Promote the use of lubricant in all anal sex and for female sex works, too, to minimize tears and lesions. Package it with condoms. Get it into gay bars.
In The Wisdom of Whores: Brothels, Bureaucrats and the Business of AIDS, epidemiologist Elizabeth Pisani tears apart the current ideology driving AIDS work worldwide.
Africa is leading the world in HIV-infection rates, and rightfully so much of HIV prevention and funding is going to this part of the world. However, Pisani argues, what's happening in South and East Africa is NOT what is happening everywhere else. And while these parts of Africa have HIV infection in the general population, the rest of the world is discovering the highest risk of HIV infection isn't. In fact, the epidemic is concentrated in pretty condensed at-risk populations: sex workers, males who have sex with males and drug injectors.
An overwhelming amount of AIDS funding, however, is not funneled toward these groups, but toward the general population, where the risk is much lower. Instead of focusing funding for providing and promoting the use of clean needles, condoms and lubricant, money is being spent on development projects, life skills for teens and encouraging abstinence.
Not to say that these programs aren't useful. But as Pisani points out, economic development and individual empowerment are all well and good, but what will really stop the spread of HIV are condoms and clean needles.
I've spent the past year working on HIV prevention projects in my site. We've trained 60 teachers, 40 youth health promoters and over 200 teenagers in HIV prevention. We've shown movies, done marches, and recorded radio spots. We've organized community meetings to educate house wives and conducted condom relays in classrooms.
But has it really made a difference in curbing the spread of HIV?
According to Pisani, it most likely hasn't. And from the data I've seen, she's probably right. HIV infection rates in Tumbes ARE high, but really only in males who have sex with males, and sex workers. In the general population – where all our work is conducted – the rates are actually quite low.
This is kind of disheartening for a girl who has spent a lot of time waving bananas in the air with one hand and condoms with the other.
Perhaps our resources would be better utilized if we focused our energy in the at-risk populations. But in a culture with such fierce machismo, where prejudice and hostility might lurk around any professed outsider, how can we seek them out without putting them at risk?
Our solution so far has been to blanket the entire community with information in hopes of reaching those who are truly at risk, which – let's face it – is a little like throwing seeds across an open field in hopes that a few will start to grow.
As Pisani mentioned, a positive byproduct of our project might be a reduction in teen pregnancy and STIs. Some youth might not cave to growing delinquency because they're kept busy with sessions and project activities. And we're certainly doing a lot to open up lines of communication concerning sex and condom usage.
But what's more, the community is stepping up, working together – getting excited about something.
Call me naive, but I think that's a pretty good step. And even though we're not where we need to be, we're at least moving forward. Hopefully in the right direction.
--
Pisani's evaluation of the problems guiding the HIV pandemic and her solutions (pulled directly from her book):
The Problem (on Planet Epidemiology)
The overwhelming majority of HIV-infected adults get HIV by having unprotected sex with an infected person, or by sharing needles with them while injecting drugs.
People pass the virus most easily when they have lots of it in their blood (i.e. when they are newly infected).
HIV is transmitted most easily when it comes into contact with sores, lesions or foreskin.
The Solution (On Planet Epidemiology)
Cut the exchange of body fluids between infected and uninfected people.
Getting people to give up sex doesn't work very well, so in terms of sexual transmission, our best bet is to persuade uninfected people to use condoms with any partner likely to be infected with HIV. In East and Southern Africa and in many gay communities that means any new sex partner. Bombard the places people go to meet new partners with condoms and lube. Remember that men have sex with another in prison.
For heterosexuals in most of the world, the highest-risk sex is paid for. Create incentives to use condoms every time sex is bought or sold.
Methadone and other oral drugs can help people stop injecting, so make them widely available but recognize that they don't always work. Make it easy as possible for people who are still injecting to do it safely. Make clean needles available, make them free or dirt cheap. Give them to people in prison if they need them. Make sure no one winds up in prison just because they're carrying needles.
Don't forget to make sure that all injecting equipment used in health services is sterile. Screen all blood for HIV before transfusion.
Cut the amount of virus in the blood of people who are infected. The most obvious way to do this is to provide people who need it with antiretroviral treatment. Test for infection where you're most likely to find it. Bundle prevention services with AIDS drugs at every opportunity. Treating other infections (such as sexual transmitted infections) promptly will reduce spikes in the amount of virus, even among people who are not on anti-HIV drugs.
Close all the potential "open doors," so the virus can't get into the uninfected person.
In communities where there is lots of HIV, circumcise men. Screen for sexually transmitted infections and treat them among women, men and transgenders who sell sex, and among their clients and regular partners. Make sure you use drugs that work. Promote the use of lubricant in all anal sex and for female sex works, too, to minimize tears and lesions. Package it with condoms. Get it into gay bars.
Small Victory
We invited two women living with HIV to come to Pampas and give their testimonies, and we made a whole event of it. The youth health promoters performed a skit and gave a small presentation on what HIV is, how it spreads and how to prevent it. And a couple people came from the Ministry of Health to present on the situation of HIV in our department.
Over 100 people showed. More than double any other event we´ve ever done.
Yay for small Peace Corps victories!
Over 100 people showed. More than double any other event we´ve ever done.
Yay for small Peace Corps victories!
Pasa La Voz
Twice a year, Peace Corps Peru puts out a volunteer magazine called Pasa La Voz*. Though not technically the official PC-Peru publication, PLV is a compilation of articles, creative works and commentaries by volunteers, and put together by three PCV** editors. It also includes a special section devoted to profiles of PCVs completing their service.
This next issue is set to hit volunteer mailboxes around Peru soon, and focuses on the GEOGRAPHIC adventure on a NATIONAL level *cough* among volunteers here in Peru.
Special insert, El Ají (a copycat of The Onion), is back and hotter than ever. One volunteer explains the significance of photography in site while others question what the future will bring to Peru's campesinos and if hiking really is the sport of fools and masochists. A case is made for going where the wild things are in the Peruvian Amazon. Miracles of meditation are revealed. And I debate the merits of Twitter.
Amidst the passion, excitement, thrill and intrigue, there's nostalgia and analysis with, at times, a touch of lunacy. This Pasa La Voz promises page-turning fun that you can't put down.
"I'd recommend this issue to all my fellow volunteers in Peru," wrote one reviewer. "The personal account of one volunteer's resolution to embrace, rather than exterminate, the rodents and insects in her bedroom was truly inspiring."
"This is one of the best reads I've had all year!" raved another. "Anybody with any personal interest in the whacky world of PC Peru (and significant amounts of inside knowledge) will love this issue."
Others could not even speak for fear of shedding joyful tears beckoned by the photocopied pages.
Pasa La Voz. In Serpost mailboxes everywhere in 3-4 weeks.
* Pasa La Voz means Spread the Word
**Peace Corps Volunteer (PCV)
This next issue is set to hit volunteer mailboxes around Peru soon, and focuses on the GEOGRAPHIC adventure on a NATIONAL level *cough* among volunteers here in Peru.
Special insert, El Ají (a copycat of The Onion), is back and hotter than ever. One volunteer explains the significance of photography in site while others question what the future will bring to Peru's campesinos and if hiking really is the sport of fools and masochists. A case is made for going where the wild things are in the Peruvian Amazon. Miracles of meditation are revealed. And I debate the merits of Twitter.
Amidst the passion, excitement, thrill and intrigue, there's nostalgia and analysis with, at times, a touch of lunacy. This Pasa La Voz promises page-turning fun that you can't put down.
"I'd recommend this issue to all my fellow volunteers in Peru," wrote one reviewer. "The personal account of one volunteer's resolution to embrace, rather than exterminate, the rodents and insects in her bedroom was truly inspiring."
"This is one of the best reads I've had all year!" raved another. "Anybody with any personal interest in the whacky world of PC Peru (and significant amounts of inside knowledge) will love this issue."
Others could not even speak for fear of shedding joyful tears beckoned by the photocopied pages.
Pasa La Voz. In Serpost mailboxes everywhere in 3-4 weeks.
* Pasa La Voz means Spread the Word
**Peace Corps Volunteer (PCV)
Portraits Project: Cecilia
Cecilia, age 40, mother
"ROW-bean!" A voice squealed. "ROW-bean!"
I put my hand up to shield my eyes from the sun, but I didn't need to see the face to recognize the voice.
"Hola Ceci!" I called. She waved me over – lifting her hand, wrist up, and pushing it down toward her, as if she were in a boat without an oar.
"ROW-bean! Come here!"
I walked over to the short, stout woman with the wide smile buying cilantro from the corner store. She gripped my shoulders and gave me an eager kiss on the cheek.
"Row-bean, how are you? What are you doing? Where are you going? Come to my house!" She said in one breath.
"I'm well, señora," I replied. "How are you?"
"Good, good. Row-bean, where have you been? You haven't visited me in so long. You have to come to my house. Let's chat."
"Oh, thank you, Ceci, I would love to, but I can't. I'm sorry," I said, bulking up the sound of my regret. "I have to get back to work."
"Nonsense," she waved my words away. "You have to come over and have some dessert."
I looked at my watch. It was 9:30 a.m.
"Really, thank you, Ceci, but I don't think I can," I said, then added, " you know, full chamba" for emphasis.*
Ignoring my response, she put her hand on my arm eagerly.
"Row-bean, Row-bean. You know what we need to do? You have to come with me soon to visit my mom in the country. I tell her all about you. What are you doing this afternoon? Let's go this afternoon! We'll make ceviche and go for a walk on the paths along the hills. You'll meet my mom. Yes, that's what we'll do this afternoon. Come over around 3."
"That's really kind of you, Señora. I would really love to, but I have another engagement." Her smile was not deterred. "But that sounds really fun. We should definitely plan on doing it sometime soon."
She nodded vigorously, and her smile brought crinkles to her eyes.
"Yes, Row-bean. Soon, soon. When can you come with us to the country? You let me know."
"Of course, Ceci. I will let you know as soon as I can."
She took my hand with both of hers and brought me in to kiss my cheek.
"Take care of yourself, Row-bean. We'll see each other soon. You'll come over, and we'll chat."
"Yes, of course, Señora. Take care. We'll see each other soon."
*full chamba is Peruvian slang for "super busy working"
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