Report to the Board of Directors & Staff of Center on Halsted

November 6, 2009

Dear Board Members & Staff:

Next week, look for a special edition of Weekly Successes: Gregory Gross, the Clinical Manager of our HIV Testing and Prevention Program, will tell us about his travels to Africa this past month. Gregory received an exciting opportunity to be part of an expedition to Mutare, Zimbabwe where he witnessed the tragic reality of the HIV pandemic firsthand. His reports on HIV/AIDS treatment in Zimbabwe are humbling reminders of the challenges before us as we continue to fight AIDS worldwide.

Gregory's sobering observations notwithstanding, we're thrilled that Gregory could have an opportunity to bring his expertise to an area so deeply in need of informed AIDS treatment strategies. The Center's day-to-day focus may be on the needs of our local community, but the work we do here in Lakeview has global implications. We're looking forward to hearing about Gregory's journey, and we know that we will learn a great deal from his insights. Bravo to Gregory, and be sure to ask him about his travels when you see him in person!

Modesto Tico Valle
Executive Director



Zimbabwe
Gregory Gross, AM MDiv LSW, Clinical Manager of the HIV Testing & Prevention Program


In late summer, I was approached about the possibility of joining a delegation of deacons from the United Methodist Church to travel to Zimbabwe to work with the Zimbabwe UMC, Africa University, and Project Tariro in Old Mutare, Zimbabwe. The purpose of the trip would be to learn about the HIV/AIDS pandemic in the country and explicitly to collaborate with Project Tariro (meaning “Hope” in the Shona language), an initiative of UM deacons, in helping persons live positively with HIV/AIDS in Zimbabwe. I was invited and selected to join this twelve-person group based upon my work as the Clinical Manager of the HIV Testing & Prevention Program here at Center on Halsted where I also oversee the HIV+ support groups and provide counseling & psychotherapy.

On October 15th, I traveled to Nashville, Tennessee, where I met the group for orientation & team building for our 15-day journey. I was excited to join this team of persons from across the United States who came with diverse backgrounds, politics, and theologies but with the common purpose of addressing the HIV/AIDS pandemic. While I was the only person on the team who had yet to travel internationally, it quickly became clear that what I brought to the team was the greatest knowledge of and experience with HIV/AIDS.

Before traveling, I had done much research about Zimbabwe and especially about the impact of the pandemic in the region. While I was somewhat familiar about the political climate of the country, I was not as familiar about the history that had lead to the current state of affairs. Zimbabwe was once the breadbasket of Southern Africa – exporting food & resources throughout the region. Literacy rates were nearly the highest on the continent. However, through a complicated series of events including a move from socialism to capitalism, the grabbing of land of and the expulsion of the descendants of colonists, and much political corruption, the economy of Zimbabwe collapsed and inflation skyrocketed. Last year’s election further complicated the situation when it was followed by allegations of a stolen election, extreme violence, and finally a tenuous unity government.

While all of this is taking place, the pandemic is raging. Three thousand people a week were dying as a result of HIV/AIDS. Anti-retroviral medications were impossible to obtain. The average life-expectancy fell to only 34 years of age. Infection rates rose to 25% of the population pushing Zimbabwe to becoming the fourth most HIV-impacted country on the planet.

It was against this backdrop that we arrived in Zimbabwe. I didn’t know what to expect and to be honest I was extremely anxious. I didn’t know if I would be strong enough to see this side of the pandemic. Here in the US, when I must deliver the news that someone is indeed infected by HIV, I am able to offer him or her hope that HIV is no longer a death sentence.

With medication, a person can expect to live into their 70s. But this wouldn’t be the case in Zimbabwe. Yes, ARV’s are now available but there are only enough available for those who are already on them to continue them. Due to the shortage, there is not enough for anyone who is not already taking them.

And it was indeed difficult. We traveled to a

primary & secondary school in the eastern province of Manicaland where we met with and heard the stories of the OVC students. The OVC are the Orphaned & Vulnerable Children meaning that one or both of their parents died from HIV/AIDS. Through this program they are able to remain in their school and community rather than being moved to an orphanage. They will live with their grandparents or aunts or uncles or, shockingly, many serve as the heads of their households! At 10 years old, they may be caring for their own siblings. And yet, they lit up when they broke into song for us or when seeing their own picture on my digital camera. “Again,” came the chorus of small voices. It is likely that many of these children are also infected with HIV, but they have not been tested. Without access to medications and in a society plagued by stigma related to HIV, why would they be?

We visited rural clinics where they are providing medical care and support for the local villages with very limited supplies. In this part of the world, the common co-infections that is seen is HIV and malaria. Unfortunately, the medications for these two deadly infections negatively interact with each other making an already difficult situation even worse. Unbelievably, they are doing all this with sporadic electricity and extremely limited clean water.

We met with home-based caregivers through Project Tariro who travel, most times by foot, to the homes of those living, and dying, of HIV. We traveled with them to the homes of two individuals in the last stages of life. Both individuals were struggling with severe thrush, a fungal, opportunistic infection that had completely colonized their mouths and throats.

We met with the residents of the Gatsi Old Peoples’ Home in the Honde Valley. These beautiful people in their twilight years have been forgotten by their own society. Nursing homes and long-term care facilities are unheard of here in this communal society. But the families of these residents cannot be found. Casualties of war, the pandemics of HIV & malaria, and political corruption. These men & women live in tattered clothes, with limited food, and many blind – by simple cataracts.

Finally, I spent much time at the VCT clinic associated with Old Mutare Mission Hospital and soon to become part of Project Tariro as their funding source will soon be ending. The Voluntary Counseling & Testing Clinic provides free HIV testing & counseling very similar to the HIV Testing & Prevention here at COH. Additionally, they offer a support group for those who are HIV+. I was very humbled as the staff of the VCT were so excited to meet some from the US who does the same job that they do. We spent the afternoon comparing notes of how we both operate, of the statistics of both programs. And I delivered the donated supplies that I had brought with me – an entire suitcase – including the 1000 condoms from COH, and the medical supplies donated by the HIV Staff of COH. The staff was thrilled!!

I was shocked to learn that their positive rate is 30% -- meaning nearly one in three people they test have HIV!?! I asked the staff about what support they receive in the midst of this difficult work and they just smiled. I was so grateful for the time I had with them where we could ask questions of each other and learn from each other. I was then invited to return the following day to join the support group.

In this country where HIV is believed to be a punishment from God or the result of a curse placed by an evil spirit, support groups are vitally needed. At the VCT 80 people – mainly women - take part in two support groups. They sang. They danced. They performed a skit that they improvise in churches & community organizations about HIV to combat the stigma. They worked on their “Income-Generating Projects” to earn money for themselves such as candle-making, sewing, crocheting, and gardening. They learned about healthy eating and then were given seeds to begin their own garden. They received the condoms I had brought and then demonstrated how to use them. It was a wonderful afternoon of being invited into the lives of these brothers & sisters.

The most touching was the stories that they shared with me. I was told how some of the young girls (13 to 17 years old) were infected by older men who believe that it can be cured by having sex with a virgin. I heard from the woman whose husband divorced her when she became infected and how she eventually came to forgive him when he was diagnosed himself.

I heard the story of Tandi. Tandi was 10 years old and her mother had been a member of the support group for the past year. Last April, her mother became extremely ill and needed a blood transfusion. But the hospital did not have the supplies to perform it. It was then determined that folic acid would sustain her; however, there was none in the hospital… or in the province.

So a group took off to travel to the next province. In the meantime, she called Tandi to her bed to tell her that she was dying and that she should go to the support group who would care for her. She and Tandi were outcasts. The group returned with the medical supplies, but this woman had died an hour earlier. And then she laid in the morgue for four weeks because her family would not bury her. Her family would have nothing to do with her or Tandi because she had AIDS. So the members of this support group – who had next to nothing themselves – raised $400 to bury her. And the local pastor, a 26-year-old single woman, took in Tandi as she had with 3 other young girls.

This is community. When their families, their villages, their churches, their society turned against them, they found each other. They care for each other. They support and comfort each other. They combat stigma together. This is Tariro. Hope.

I am late to this fight against HIV/AIDS. I was too young in the 80s & early 90s. But through encounter with the pandemic in Zimbabwe, I feel I’ve had a glimpse of what it must have been life. It’s one thing to hear about it from family & friends. It’s another to be immersed in it.

I find hope that while we have a long way to go here in the US in the fight against HIV/AIDS, we have made progress. Out of the trials of the 80s & 90s, Center on Halsted has immerged. I believe, out of the current struggles, Project Tariro stands as a beacon that people can live positively with HIV/AIDS in Zimbabwe. We may be late to the fight, but we aren’t too late.

To read more about my journey in Zimbabwe visit my blog: http://Chi2Zim.blogspot.com.

You can also view a video of the children singing at: http://www.youtube.com/watch?v=goLQSi9Xuwc.

For more about information about Project Tariro visit www.projecttariro.com.

Slowly

Beginning to find the words again. 

Slowly.

The re-entry has been difficult.  Reverse culture shock.  How to live in a society that has so much and yet, ungratefully so?  So bitter.  So hostile.  So cold and calloused. 

Such disconnect.  Two worlds.  One people.  One people?

Thank you for the phone calls and emails.  I've not yet returned many (most).  I will.  In time. 
Trying to process.  So much to process.  All I've seen.  All I've experienced.  All I met.  All who've embraced me as brother, friend while yet a stranger.  In a foreign land. 

Such Dichotomy.

How?  WHY? 

WHY?!? 

Trying to find the words. 

Trying to make sense. 

Slowly. 

In Time.

To Vote or Not to Vote?

There were elections this week across the United States.  Some were quite heated with harsh words and accusations thrown about.  Bitter rivals.  Strong emotions on all sides. 

And yet, as far as I know, no one was killed for voting "the wrong way" -- being against the party which prevailed.  No one was killed for speaking out against the prevailing party or against the results. 

There were also elections in Zimbabwe last year.  Robert Mugabe was running for re-election.  Mugabe former hero of the 1980 revolution, head of the ZANU-PF party, and president ever since.  His opposition was Morgan Tsvangirai, head of the MDC party. 

Mugabe "won" again.  The people rose up in revolt.  Eventually, a unity government was formed. But in the meantime, many people who voted the "wrong" way were hunted down and executed. 

As we formed relationships with the people we met, we asked about what it was like during the uprising.  We spoke with P, the woman at the hotel who cleaned our rooms.  She told us who during this time, three of her brothers were killed.  She is now caring for their 7 children in addition to her own.  She works extra hours trying to earn enough money to buy a home large enough for them all. 

We heard stories like this too horrifyingly often.

They were executed for the mere fact that they voted against the ruling party -- ZANU-PF -- and for the MDC (Movement for Democratic Change.)

Zimbabwe, once the breadbasket of Africa, is now a failed state.  The economy has collapsed.  Inflation has soared.  The ZimDollar is now worthless (even printing a 100 trillion dollar bill which meant little), and they now only accept the US dollar. 

Zimbabwe, once having the highest rate of literacy on the continent, is now a police state.  One day we had free passage on the main roads.  The next, a security check point appeared, stopping each and every car.  Police with AK-47s stood in the intersection.  More stood just off the road amidst the trees with more weapons.  We didn't have a problem since we were traveling in vehicles from Africa University. 

Except one time:  we were stopped.  The guard looked in the van and asked our driver "how many citizens?"  "Seven," came the answer and we were waved thru.  In actuality, only the driver was a citizen. 

We were instructed -- repeatedly -- do not take pictures of police or government buildings.  This is a picture I snuck on our last day -- not even in Zimbabwe, but in Botswana:

How many exercised their right to vote this week in the US?  

I'm known for being very involved and very vocal about my political views (et tu, Maine??)  To live in a country where that small comment could result in death...

More Songs of Hope from Manicaland Province, Zimbabwe

A song of welcome by the OVC primary school students to the Deacon Caravan in their classroom in Manicaland Province, Zimbabwe.  A welcome reception we received several times thru out our visit in Zimbabwe.



Another song of hope & faith by the OVC primary students

The Songs of Tariro

The songs of the OVC students we met at a secondary school in the Manicaland province. OVC stands for "Orphaned & Vulnerable Children" -- meaning one or both parents have died as a result of HIV/AIDS. Some of these children are now the head of their households.