Irene* is petite, with almond-shaped eyes and a brillant smile. She is married with one child and an eighth grade education. Irène is HIV-epositive. These facts alone are enough to make her story brave, exceptional. Many women in northern Cameroon are told than an HIV diagnosis is a death sentence and are rejected by their families.

In 2006, Irène connected with EFA International, where she met with other HIV-positive individuals and learned how to stay healthy and live positively. She underwent EFA’s comprehensive 6-month peer education training and now teaches her village about the importance of HIV prevention. That they can protect their children and families from the scourges of AIDS in a country where one in 20 adults has HIV. That they too can defy stigma and face an ominous diagnosis to manage what has become chronic disease: requiring daily awareness, discipline, and resources, but something that does not keep them from following and fulfilling their dreams.

Then I learned that Irène was suffering from a uterine tumor. The unmonitored tumor had grown to such extent that she could feel its presence by pressing on her abdomen. If Irène was not operated on immediately, then she would not survive. She did not have the money to receive the operation. Could we step in to save the life of a woman in whom we had invested so much, and who had given so much in return?

Some colleagues warned that if EFA officially stepped in, it would open a floodgate of medical requests. Most of EFA’s youth empowerment network members do not have the luxury of insurance or extra income to cover health emergencies and rely on family and friends. But I could not stop thinking about Irène’s smile, her energy and willingness to give back to something greater.

A week passed. I received an update from EFA’s regional office. Irène’s community, family and friends had collected the money she needed for the operation. EFA saved Irène because its programs had empowered her. Her village valued the hope and knowledge that Irene was giving to young people. Irène is more than her HIV status. She is a change agent within her community.

Unfortunately, we cannot pay the hospital bills of each individual. Our Circle of Love project has just been launched on GlobalGiving to fill financial gaps so HIV-positive individuals can afford medical tests. But EFA’s peer education empowers HIV-positive individuals to mobilize and know how, when, and where to seek medical care. By staying healthy and practice safe behaviors, they are less likely to transmit HIV within their communities. This positive prevention is one of EFA’s core values.

* Name has been changed to protect individual’s privacy.

With a generalised HIV epidemic (prevalence of 5.5% in adults aged 15-49 years old), the conference host country of Cameroon has led the way in decentralizing its AIDS response. Now almost all health districts are equipped to manage mother-to-child HIV transmission. Around 46% of people with an advanced stage of HIV infection were receiving antiretroviral therapy in 2009 compared to 39% in 2008.

Read the full article here.

PEPFAR’s VAST program is a funding resource for small-scale HIV/AIDS projects initiated by communities and organizations partnered with Peace Corps Volunteers. The program is funded by PEPFAR on an annual basis. The VAST program provides PEPFAR funds to support HIV/AIDS outreach and training in communities where Peace Corps Volunteers live and work.

From the field, Caitlyn reports that they will do one elongated session per month throughout July, August and September.  We will be able to reduce transportation because there are fewer (longer) sessions. In addition, the Maroua youth group trainees are contributing to reducing lodging expenses by hosting the out-of-town trainees. We tried that for Men as Partners [training, held in February 2010] and with the more recent Peer Education sessions and found great success.

Congratulations to Caitlyn and the Cameroon Regional Office!

While they may currently be minors, they are not a minority. According to the 2004 Demographic and Health Surveys, 65% of the Cameroonian population is under the age of 25. This is nearly 2 in 3 people in Cameroon!

Here are a few numbers to represent the challenges that Cameroonian families and communities face in meeting the needs of children and young people in order to shape a better tomorrow:

- 16% of primary school-aged children are not enrolled in school

- 30% of all children under 5 suffer stunted growth

- 30% of Cameroonian households lack access to clean drinking water. In rural areas, 53% of households can’t access clean drinking water.

- Only 1 in 3 young women (aged 15-24) has a comprehensive knowledge of HIV/AIDS.

- An estimated 300,000 Cameroonian women (aged 15+) are living with HIV, emphasizing the importance of mother-to-child transmission.

- There are over 45,000 cases of pediatric AIDS in Cameroon.

- An estimated 300,000 children have been orphaned after losing one or both parents to HIV/AIDS.

Read all of UNICEF’s latest indicators on Cameroon’s children and youth.

These numbers are daunting. ”Il y a du travail” is phrase heard in many conversations about the future. Indeed, “there is work to be done.”

But Cameroon is young, it is resilient, and the solutions are out there.

We hope that governments and organizations can work together with the Haitian people to persevere and rebuild their beautiful country.  We recognize that the road to recovery will be long, and that longer term investments are necessary to ensure sustainability.  EFA International supports Partners in Health and its sister organization – Zanmi Sante — who have had a positive presence in Haiti for decades and are well equipped to work effectively and efficiently to reach those in greatest need.

We are together. On est ensemble, Haiti.

I traveled to Maroua to interview and photograph AJEPS’ members to mark the debut of our work with such youth groups. The last day of Ramadan had just been celebrated and AJEPS members were proudly dressed in their best clothes as they arrived to the whitewashed compound that would become their office headquarters. Under the shade of the quartier’s neem trees, we sat on plastic woven rugs exchanging celebratory greetings in Fulfuldé and admiring everyone’s festive attire.

While a larger organizational meeting took place, I invited consenting AJEPS members to sit with me in a quieter corner of the compound, where I would ask them about themselves, learn the story that each wanted to share and take photographs. Magloire arrived in a red and white plaid shirt, his gaze timid but thoughtful. His smile came easily, but his face showed honest determination. Since learning of his HIV-positive status, Magloire told me that he had found solace in being part of AJEPS’ support group. He scooped sand from the ground, gently passing grains through his hand to the compound floor. He said that while he excelled at art and sculpture, his true ambition was to become a politician, “maybe even the President of Cameroon.” I congratulated Magloire for his ambitions, knowing that his participation in the group was essential to living positively: social support, helping one another follow the complex ARV (anti-retroviral) regime, and encouraging economic success through income generating activities. We were both grateful for what AJEPS could offer him and were hopeful for the future.

I finished my Peace Corps term the following month but continued to correspond with AJEPS executive office members over the next two years as EFA International was officially established as a nonprofit in both the U.S. and Cameroon. I returned to Cameroon in June 2007 to host the Cultural Exchange with University of Maryland students. I am not sure who was more excited about the reunion: AJEPS members, the U. Maryland students, or me.

But perhaps it was Magloire that was the most energetic of all. He was in excellent health and his enthusiasm for the group and its activities with the American visitors could hardly be contained. Magloire, which literally means “my glory”, burst with eagerness as he ran errands and pick up supplies for each day’s activities. Since I’d seen him last, Magloire had started working at ACDEV (Action for Development), a local non-profit organization that educates the population about nutrition. In particular, they produce spirulina, a highly nutritious blue-green algae, to further support the health of malnurished children and those living with HIV. Magloire worked to produce and process the spirulina.

During this Cultural Exchange, Magloire led the group in stenciling t-shirts bearing AJEPS’ name and helped paint the colorful mural on the outer wall of their headquarters. I will never forget the smile that came to his face as he witnessed his artistic labor come to fruition: each of his peers, AJEPS members and U. Maryland students alike, proudly wearing the t-shirts that he’d painstakingly stenciled.

At the end of the two-week visit, we all shook hands and wished each other well, saying “sey yesso” (see you later) and exchanging small gifts. Magloire presented me with a wooden bird that he had carved himself. He explained that this small sparrow represented hope. With many thanks and heartfelt words exchanged, we parted ways, not knowing when we’d see each other next.

I never saw Magloire’s timid smile again. He passed away this past March in Maroua. Despite the moral support that he received from AJEPS, it did not reach him soon enough. Despite the measures that he took to maintain his health: anti-retrovirals (ARVs) to slow the course that AIDS took in his body, antibiotics to prevent infections that his immune system could not fight, and healthy foods to keep his body strong, there were not enough resources at his disposition to prolong his life.

Magloire’s enthusiasm and energy will be deeply missed by AJEPS and all of us at EFA International. We express our deepest sympathy to his family and friends. EFA International continues to support groups like AJEPS so that promising youth like Magloire can build healthy and successful futures for themselves. This loss shakes us to our core, but it reminds us of the work that still lies ahead. We must strive to reach HIV-positive youth as soon as possible, so that they can access the resources that they need to disrupt the cycle of the AIDS epidemic and live longer, happier, more productive lives.

Que ton âme reste en paix, Magloire. May your soul rest in peace. And like a sparrow in the sky, may our souls continue to soar with hope for a brighter future for youth affected by HIV and AIDS.

-Rachel Hoy, MPH

National health systems must be reinforced to provide sustainable HIV/AIDS prevention, treatment and care for its people. One way to ensure sustainability is to invest in laboratories, national health science researchers and medical personnel.

Inadequate laboratory services prevent the effective treatment of HIV and AIDS because they prevent people from knowing their status. It also hinders doctors from effectively treating AIDS patients, as they must monitor different components in a person’s body, such as red and white blood cell counts, in order to prescribe the right ARVs (Antiretrovirals).

-Rachel Hoy, MPH

For too long, South African politicians have held on to unfounded beliefs about HIV and AIDS.  For example, President Jacob Zuma said he “showered after having sex”‘ to avoid HIV.  The appointment of Barbara Hogan as Minister of Health may be promising if she succeeds in guiding the country to embrace more effective care for HIV-infected South Africans, who currently represent 17% of the world’s HIV-positive population.

-Rachel Hoy, MPH

• Individual: Helping HIV+ people to understand their disease and its implications means that they can live longer and healthier lives.  EFA’s work includes sharing information to help people make healthy choices concerning their reproductive health, and encouraging individuals to get informed about their serostatus.
• Family: Informed family members can provide better support to HIV+ individuals, help fight stigma, and have a better understanding that HIV is a disease like any other.  EFA’s work helps to prevent future HIV infections by preventing partner transmission, as well as MTCT (mother to child transmission).
• Community:  Knowledge of HIV prevention can help stop its spread in high risk populations.  EFA’s work also aims to reduce stigma in communities.
• National:  A better understanding of the epidemiology of HIV and a commitment to applying evidence leads to better focused and more effective public health programming. EFA’s work includes sharing information about the importance of national research and the need to reinforce laboratory capacity to manage individual cases as well as advance research. By improving local, regional, and national health care centers (primary, secondary, tertiary), HIV/AIDS prevention, treatment, and care can be integrated more effectively.  EFA’s work promotes understanding about the increased prevalence of TB and other opportunistic infections among seropositive people and advocates for support from bilateral and multilateral donors.
• International: HIV affects economic and societal development.  EFA shares information about these effects and advocates for HIV+ persons in order to reduce stigma and promote continued research about the disease and its prevention, care, and treatment.