Hope Training - Ngaramtoni

Izabela Tolowinska November 2007 - Fenruary 2008

I arrived in Arusha on 13th November 2007 and can’t believe I have been here 3 months and it is now time to leave. My volunteer project involved providing HIV/AIDS training for the 6 community volunteers of Hope Trust (there are normally 7 but one has been on maternity leave). Hope Trust is a small local HIV/AIDS community organization based in the village Ngaramtoni, 16 km outside Arusha.

Ngaramtoni village is on the slopes of Mount Meru and is about 30 minutes ride in a daladala (shared minibus taxi of questionable safety) from Arusha. It was originally a Maasai village, but is more and more becoming a dormitory village for Arusha. Consequently there has been an influx of other tribes, notably Chagga. Unlike most of Arusha and other parts of Kenya the soil is black not red and when it rains the village turns into a bit of a negotiation hazard with all the black mud!

Hope Trust provides small business grants to selected recipients so that they can start a small business thereby providing income from which they can feed, cloth and educate their children. It also provides HIV/AIDS and health training to schools and community groups in the nearby sub-villages thereby aiming to raise HIV/AIDS awareness, and hopefully dispel many of the cultural beliefs and myths of HIV/AIDS. All this is done by the 6/7 community volunteers.

The community volunteers had previously received some HIV/AIDS training back in 2005/2006 and had expressed interest to get more – so that was were I came in. All sounds very easy but when my Swahili is not very good, there is no ready access to a printer, the flip chart board is made up of a plywood board that leans against a concrete step, with two pointed sticks behind on which to hang the paper, unpredictable power cuts so you are unable to print/photocopy your training material, people do not arrive on time, it becomes quite a challenge! My first training session started on 7th December with an “Introduction to HIV/AIDS” and ended on Monday 4th February with a knowledge quiz. For two of the sessions I arranged for a local counselor and TB/HIV physician to come and do the sessions on Stigma and TB and HIV respectively, as they could be given in Swahili. The training information had to be tailored towards the “resource limited” situation as general healthcare, HIV/AIDS treatment, healthcare infrastructure is so completely different to what is available in the developed world which meant a lot of internet searches, a great deal of preparation and meetings with local HIV physicians which I found extremely interesting as I learnt so much. Unlike in Europe and US, there are very few antiretrovirals (drugs) available, two types of regimens when treatment is first started and only one regimen when that one fails. All so very sad and not surprising that HIV/AIDS care is such a difficult task. Even giving the training sessions was a learning experience and an insight into the people’s beliefs, and understanding e.g. the CVs were not aware of how the HIV/AIDS epidemic has spread and how huge a problem it is compared to the rest of the world, the belief that antiretroviral (drug) treatment is bad because people start looking healthy and so start having sex and consequently pass on the HIV virus or that HIV transmitted can by sharing sweets from mouth to mouth!

The classroom was in the open air, sitting on tree stumps. Fortunately it was under a galvanised iron roof otherwise when it rained we would have got soaked! I worked very closely with the CV coordinator called Daniphord who helped with translations during the training sessions and also when I visited some of the community training sessions with a women’s group and school. He was an invaluable help and I would have been lost without him.

Two other aspects I worked on included putting together a "training syllabus/module" of the topics to be covered for the CVs to use when they go out to the community (schools, women's and church groups) to do the HIV/AIDS training which seems a relatively easy task and one that could be done in a week. However when there is no overall overview of what training sessions where done, the topics and no coordinated planning (topics and which CVs will do the session seem to be decided 2 days beforehand), but we finally have one. I went to one of the school training sessions where class sizes are typically around 100 to see the CVs in “operation”. Even though there is a chalk board only one CV used it, instead the typical format for doing training is standing in front of the class and talking, which is very similar to how general teaching is done.

The third area I looked at was trying to establish collaborations with existing HIV/AIDS groups and/or local clinics. I had a stroke of luck when I was introduced to the District Medical Officer for the Arusha area who is also a HIV physician who was very happy to meet with me and ended up giving 2 hours of his time discussing a number of HIV/AIDS treatment issues with me. He is also in the early stages of starting an HIV clinic in the village where Hope Trust is based and very keen to work with them and help with their community training sessions. My meeting with Dr. Shungu has therefore been the highlight of my work and I feel that this collaboration with Hope Trust will be mutually beneficial.

My volunteer experience with Hope Trust and MondoChallenge has been wonderful and even though there is still so much that can be done in terms with HIV/AIDS education awareness I feel that some small steps have been done in the right direction. My last meeting with the Hope Trust group produced an unexpected surprise when all the CVs handed in their completed HIV/AIDS knowledge quiz forms, all of them got more than 20 out of 33 questions right!!! I shall miss all the kindness I have been shown and willingness to help but hope to return in the not too distant future.