Street Skillz at Teen Club

This blog entry is coming on the heels of a wonderfully relaxing long weekend in Lilongwe. Pretty much everyone in Malawi had the day off on Monday to celebrate the end of Ramadan – so I was able to relax a little bit after a fantastic Teen Club session on Saturday. It was only the second Teen Club I’ve ever attended but I already felt a lot more comfortable during the event. I actually felt like I was helping the kids this time, which is a huge turnaround from the last time when everything going on was a little dizzying. For all of you guys who don’t remember what Teen Club is, its basically a once a month event where Baylor Hospital in Malawi hosts about 100 HIV+ kids. The purpose of the event is to check up on each one of these kids on a regular basis to ensure that they are adhering to their ARV medication and that everything else is going well. But ultimately Teen Club is also an opportunity for HIV+ kids to meet other HIV+ kids and make new friends.

The Teen Club session this past Saturday was especially exciting because the GRS Malawi team decided to pilot the first ever “Street Skillz” session in this country. “Street Skillz” is a brand new GRS program that essentially combines playing soccer with HIV/AIDS education during the course of a soccer tournament. So during the day, kids will alternate between playing soccer games and then doing GRS activities like find the ball and my supporters (these are all activities that are designed to start discussions about the massive amounts of stigma surrounding HIV/AIDS). The soccer games themselves are special because GRS decided to inject a whole set of innovative rules that ensure that the game is about more than just soccer. So an example of some of the rules that we used during Saturday’s games include:

· A goal scored by a girl counts as double.

· Everyone on the pitch has to score after every goal, even if it means cheering for your opponent.

· Each team has to come up with a special team name and cheer. The team should perform this cheer before the game, after the game and after every goal.

· Players on the field are responsible for calling their own fouls.

Each one of the rules is designed to encourage the kids to be responsible, communicative, honest, and fair. The rules are also designed to involve girls as much as possible. GRS is actively trying to increase female participation in soccer and other sports. One of the most striking statistics that I’ve heard since I’ve been here is this one: FIFA estimates that less than 1% of the world’s 260 million soccer players are female. And all the Research has shown that female participation in sport improves school performance, reduces rates of unwanted pregnancies & STI and delays sexual debut. So involving girls in soccer and other sports is just one more way to help in the fight against HIV/AIDS.

All in all the day was a huge success. The main reason we decided to pilot “Street Skillz” in Teen Club is because we were having a hard time finding an engaging activity for the older kids in the program. In the past, Teen Club in Malawi has had a lot of problems with problematic/disinterested 17 year olds who end up distracting the younger kids. So we thought that by using “Street Skillz” we would simultaneously engage the older kids and also create a less distracting environment for the younger kids who come. The idea ended up working out really well because the older kids felt special and privileged when they were allowed to play soccer, these feelings made them more willing to engage in the activities and have fun. During the planning process, a lot of people were worried that playing soccer with a group of HIV+ kids would be too risky and dangerous considering the health of each child. I don’t need to tell you how fragile each kid on ARVs is, and obviously one bad fall etc. would be potentially disastrous to them. Fortunately no one got injured and everyone came out of the day happy and healthy.

Between Rachel and I, we ended taking around 200 pictures of the kids during our “Street Skillz” session at Teen Club. I can’t tell you how hard I’ve been working to upload them onto this blog, but my Internet connection in Malawi is about as insecure as it gets so I’ve been having a lot of problems. Each time I try to upload a picture it estimates that it will take about 48 hours to successfully upload. As much as I love you guys I promise you that I don’t love you that much. It’s really a shame that you guys can’t see these pictures though because they are awesome. The first time I saw them I looked through all 200 of them four or five times because they made me so happy.

All of the pictures are amazing because in each one you can see how incredibly happy the kids are to be outside playing soccer. You can tell in each kid’s face that they feel normal and that they love the feeling. It’s really touching to think about because when you see these kids you know that they probably don’t have the chance to feel/act like normal kids very often. For a wide variety of reasons like stigma and discrimination most of these kids never have the opportunity to go outside and play soccer with the other kids in their village. So it felt really good providing these kids with the right environment to play and have fun. Hopefully I’ll get the pictures up soon, that way you can see first hand how happy the kids look. They’re all hugging after every goal, high fiving each other, dancing and smiling after every goal – it was truly an awesome thing to see. The more I think about it, the more I realize how important Teen Club is to these kids. Obviously Teen Club is important to them because it is where they get there month’s supplies of ARVs and where they get seen by doctors. But beyond that it is also important because it provides kids with a real chance to feel normal and be with kids who are similar to them. After I saw these kids leaving the soccer pitch on Saturday afternoon, I couldn’t help shaking the feeling that as soon as they left the field they were going to be thrown into this world where they were back to being “different” and “social outcasts”. As depressing as this feeling was, it also encouraged me to work extra and do my part to ensure that each session is as fun and fulfilling as possible. If these kids only get one chance and month to be normal, we better make sure that each session is as awesome as possible.

Over the course of the last four weeks, I’ve heard a lot of really unbelievable myths that surround the HIV/AIDS issue in South Africa and Malawi. I thought I would share some of these myths with you so that I can give you an idea of the challenges that we’re facing.

HIV/AIDS was created in a laboratory in the United States:

The belief is that Americans created the virus, and then came over to Africa to infect as many Africans as possible. As a result, many locals are suspicious of any westerners looking to come into their village for HIV testing.

If you become infected with HIV, you can get rid of the infection by having sex with someone else:

This is known as the “hot potato” myth. The idea here is that by having sex with someone else you are passing the virus onto someone else. Some people don’t realize that the virus will stay with you, and potentially infect your new partner if you decide to have sex. This myth seems to be a variation of the “have sex with a virgin” myth that seems to be more prevalent in South Africa. Both myths are obviously dangerous because they are encouraging HIV+ people to engage in as much sexual activity as possible.

If you pray, you will never get HIV/AIDS:

This myth presupposes that if you are a good Christian, or a good Muslim, you will never get HIV/AIDS. This myth is particularly dangerous because it makes people believe that as long as they pray, they are immune to the virus.

HIV/AIDS can be found inside many condoms, so if you use protection you have a higher chance of getting the virus:

This myth is just one more roadblock in the movement to get as many people to use protection as possible. It’s hard enough to encourage condom use in many of these areas because of religious or traditional problems, so this myth is the last thing that we need. This myth also corresponds with the first myth, because some people believe that it was the Americans who put the virus in the condom.

Jacob Zuma’s many HIV/AIDS myths:

In December 2005, Jacob Zuma, the current President of South Africa and the then head of the National AIDS council, was accused of raping an HIV+ woman. According to reports from the trial, Zuma was aware that this woman was HIV+ but he still decided to have unprotected sex with her. When asked why he did this, Zuma responded by saying: 1) He wasn’t worried about contracting HIV because women cannot give the virus to men. Only men can give the virus to men. 2) He wasn’t worried about contracting the virus because he took a shower immediately after sexual intercourse. Can you imagine the impact that these words had on the South African population? Because of this man’s words and actions, millions of people (and especially men) thought it was ok to have unprotected sex with HIV+ women as long as they took a shower afterwards. Keep in mind that this message was coming from the head of the National AIDS Council! This is the type of event that sets the HIV education movement back several years.

As you can see, there are many HIV/AIDS related myths that make our work here more difficult than it should be. These myths really prove to me how important HIV education can be though, because if we can move around and go around to as many communities as possible we can potentially dispel as many of these myths as possible.

In talking with many of our coaches, it seems like they have to deal with many of these myths on a regular basis. Many of them said that they spent more time than they would like to think about telling people that they should not believe these HIV/AIDS myths. Hopefully, by reaching as many different sites as possible we’ll be able to fight these myths and show people how much more effective it can be to learn HIV facts.

You may be surprised to hear this, but there are actually many more myths related to the fight against HIV/AIDS. Many of them are more directly relevant to stigma and discrimination (for instance, if you touch someone with HIV then you will contract the virus etc). If you want to hear any more about these common myths then hit me up at emunir@grassrootsoccer.org and we’ll talk about it.

Hope everyone is doing well. Been hearing a lot from people who are reading up on my adventures, so thanks for the support and hopefully we’ll continue to stay in touch. I’ve been trying to upload pictures for the past week but my Internet connection is too slow/insecure…but I’ll keep trying!

Door-to-Door Testing

So it’s almost the end of week number three in Malawi and I think I’m finally starting to develop some semblance of a routine here. As you can probably imagine, it took me a little while to adjust to everything out here but now that I know a little bit about my surroundings I’m feeling great. Every day I eat at this delicious little tin shack called “Chez Sharif’s” which is run by the eccentric Indian/Malawian man and his wife. I’ve had lunch here every day since I’ve been here, a meal is approximately one dollar and it consists of a full chicken breast, a huge portion of rice, some salad, some cabbage, some green beans and a piece of Chapati (which is like Kenya’s form of Naan bread). Pretty good deal if you ask me. Of course you got the occasional pebble in your plate but this minor inconvenience is more than compensated for by the quality of the food and the price. I’m going to take a picture of Sharif and his wife soon and post it here so that you guys can meet him; he is one of a kind. My name around here is now “two thumbs up” because after my first meal at his restaurant he asked me how it was and I said “two thumbs up”. He had never heard the expression, and now he loves it. He calls me “two thumbs up” at least three or four times each meal.

Enough about Sharif though, onto the work I’ve been doing in my third week in Malawi. On Monday, Rachel and I had the honor of being invited to join some of our coaches in the Kawale district to help them with one of their door-to-door testing events. During these events, an HIV counselor accompanies a coach as they walk around their communities asking everyone if they want to get tested for HIV. Without much access to transport, this is the closest our program can come to service on wheels. Initially Rachel and I were convinced that we wouldn’t be allowed to participate in this activity because of confidentiality rules and other technicalities. But after really pushing for it, and talking it over with several American doctors and of course our local coaches, everyone decided that it would be fine for us to join them. As you can probably imagine, Rachel and I were initially pretty nervous and felt very out of place. But after we were welcomed into our first home all of this anxiety was dispelled by the hospitality of our Malawian hosts. I had fun going through all of the introductions for a couple of minutes, went through all of the embarrassment and humiliation as people slowly realized that I couldn’t speak a lick of Chichewa (local dialect). After all this was done, Rachel and I watched our coach and the counselor go to work. They explained the importance of the test, why it should be performed, and how it was done. They also explained what kind of actions would be taken if one of the tests turned back positive. This is when the reality of what was unfolding in front of my eyes hit me. For a little while, I think I forgot why we were there and I just started having fun meeting these new people. But as soon as the tests started I become terrified – what if it turns out that one of these kids discovers that he/she is positive right in front of my eyes? This wouldn’t be all that unlikely considering the national HIV prevalence in Malawi is around 13% and in some areas it is as high as 25%. What would I do if that happened? What would the child do? All of a sudden I became fixated on knowing the child’s status, all I could think about was how terrible it would have been if it turned out positive. Fortunately, all of the tests we took were negative – something which is fairly rare apparently. The rollecroaster of emotions that I felt through the whole process acted as a jolt to my system and ultimately made everything I'm doing here much more tangible.

I heard a lot about Baylor’s dependence on door-to-door testing before I got here so it was a real honor to be given the opportunity to participate. Apparently many people in the HIV field have hailed Baylor in Malawi for its door-to-door innovation – and now I can see why. It’s amazing because it reaches out to a percentage of the community that may never have tested otherwise. Many people cannot go to local clinics to get tested for a number of reasons: 1) they can’t afford transport. 2) they just aren’t aware that testing is available and free. 3) they are worried about the potential stigma if they are seen going to the HIV clinic to get tested. By going to people’s houses within the community, we are really targeting a group that may never have been tested otherwise – which you have to admit is probably one of the biggest aims that HIV testing has in Africa. All in all the whole experience was incredible for me, and I was happy to hear that being white and being in attendance may have actually helped the testing. At the first house we went to, we were supposed to test one GRS participant, a 12-year-old boy named Victor. After going to visit his house, and being introduced to the whole household and the neighbors and their neighbors we managed to convince 15 people to get tested. The whole thing took a long time but in the end it was worth it, because 15 more people got tested.

The one thing that really stood out for me as I went home after the event was the lack of male participation in the event. All 15 people that we tested were either females or little boys. We saw three men in the house and all three declined to get tested for whatever reason – which is kind of troubling. In training we learned all about “multiple concurrent partners” which is said to be one of the biggest contributing factors to the spread of HIV in sub-Saharan Africa. This is when young men and women decide to engage in multiple sexual relationships at the same time. As you can probably guess, in a conservative culture like the one in Malawi the vast majority of the time it is the male who decides to have multiple partners at once. While Rachel and I were sitting in Victor’s house, I kept thinking about how important it was for the men to test. Obviously I was happy to see all 15 women and children turn out negative tests, but I was also frustrated because I knew that all this meant nothing if the husband decided to get another girlfriend who was HIV+. If this happens, he would then potentially infect his wife, any newborn children, and maybe even anyone else in the household. After this experience, Rachel and I decided to think of ideas to get men more involved in our program so this is one of our major projects now.

Alright, I’m going to sign off now but I’ll try to write again this weekend. I’m working at my first general testing event on Saturday from 8 am until whatever time in the afternoon. There is going to be soccer, music and fun times all around. We managed to convince a player from the Malawian professional soccer league to attend so the children should be excited. I’ll take pictures.

Welcome to Malawi! My New Home

I just finished my first week in Malawi and I’m really excited about how much I learned in such a short amount of time. I’m based at the Baylor Center for Medical Excellence in Llongwe, Malawi – it is a hospital that specializes in pediatric HIV care and it is affiliated with Baylor School of Medicine in Houston, TX. It is the best HIV caregiver for children in Malawi and ever since 2006 it has been affiliated with GrassRoot Soccer. This is an exciting partnership for GRS because it gives us the opportunity to reach more children and get more testing done by using the established “Baylor” name in Malawi. Everyone around here knows Baylor very well, many because the hospital has saved someone in their community or family, so people are very open to GRS when we say we’re working with Baylor. I’m especially excited to be working with Baylor because it gives me the opportunity to see the medical side of HIV care firsthand. By working and spending time with all of these doctors who are so passionate about pediatric HIV care I think I’ll be able to learn so much more about the whole process.

The Baylor program is also amazing, and exciting for GRS, because it has many innovative ways of thinking of testing and treating HIV patients. For instance, Baylor has initiated this “door to door” testing method that actively goes and seeks out new patients to test for HIV. This has been extremely helpful because many local families do not have the resources to travel to distant locations to test, they also are sometimes scared to be seen at a clinic for stigma reasons or they are just too intimidated by the possible positive result to go out and test. Baylor has found that going door to door around communities has encouraged more and more people to test. The great thing about the door-to-door testing is that Baylor has allocated a certain number of HIV counselors; some are actually GRS coaches as well, to follow up on any patients who have come up with a positive test. This way the patients can be told about the importance of adhering to a regular schedule of ARV’s. I’m really excited to learn about this whole process, and hopefully see how effective it is in person one day.

Last Saturday, I got the opportunity to participate in Baylor’s “Teen Club” program. This is a program that runs every three weeks for children who have already been exposed to the HIV virus. The program gives HIV positive children the opportunity to rally together and spend time in a strong support group. This is important because most of the rest of the community may discriminate against them for being HIV positive. By spending time in this environment the children learn a lot about themselves and actually end up having a lot of fun with their new friends. The program is also supposed to help the children recognize the importance of adherence to their medication (for ARV’s to be successful the adherence rate needs to be over 95%). This is where GRS comes in – our GRS coaches direct many of the activities run during Teen Club. These coaches are recognized role models to the kids in the communities, and therefore when they discuss the importance of taking ARV’s the kids listen up. Watching the coaches work with these children was amazing. The coaches are such an inspiration for the work that they do -- they have absolutely no reason to wake up at 7 am on a Saturday to help with events like Teen Club, yet they come back every week for the sole purpose of helping these children. Because of these coaches, Teen Club runs smoothly and all of the under-appreciated HIV positive children in attendance have the time of their lives doing the GRS activities.

As much fun as the event was, I have to admit that it was also very hard at times. After spending so much time learning about the HIV virus and what happens to HIV positive kids over the course of our training with GRS, it was pretty overwhelming to actually meet an HIV positive kid for the first time. I remember just looking at the first kid I saw and feeling this numbing sense of sadness for him. The chances are the kid did nothing to contract HIV, we learned that 95% of the kids in attendance at Teen Club became HIV positive through their mother at birth or because they were raped as a child – knowing this and then spending time with the kids might have been the hardest part of the whole process. After a while, I realized that there were many reasons to be happy about the whole day. The kids may be suffering and in pain from the ARV’s, but Teen Club gives them the opportunity to spend time with other children with HIV and appreciate the fact that they still have a life to live. One of the worst stigmas with HIV is that your life ends as soon as you contract the virus. Maybe back in the day before the birth of free ARV’s this was true, but nowadays children can live a full life if they adhere to a regular schedule of taking their meds and their bodies stay strong. Ultimately it was impossible to stay sad for too long when you saw how happy the kids were. Pretty much all of them were laughing, talking and joking around – once again proving that they are a million times stronger then I could ever be. Next time I’ll be sure to take some pictures and share them on this blog, it really is a cool day.

This weekend I’m going to Lake Malawi with my two housemates and some other people who I don’t really know yet. Should be a good time, if you have any free time go to Google and type “Lake Malawi” into the images section, pretty impressive.

Cape Town

Hi everybody, I wanted to share this post a couple of days ago but the internet has been pretty poor recently so I'm finally ready to share it now. I'm in Malawi now so be ready to check in soon with my updates from my new home!

Its already been two weeks since I left Boston for Cape Town and in these two weeks I’ve seen a wide range of scenarios that have really left a deep impression on me. For one, the city of Cape Town itself is amazing. I would say that it really isn’t much different from most American or Western cities insofar as it offers a lot of high-end entertainment/food/hotels etc. There were many moments in my Cape Town visit where I really felt like I was in some amazingly beautiful tropical location like Barbados or something. My six months in Senegal last year conditioned me to think of Africa in an entirely different way, and I think the reason for that is the unique nature of Cape Town and South Africa in general. As far as I can see South Africa is split between the extremely rich and the devastatingly poor, and this disparity is particularly relevant to big cities like Cape Town and Johannesburg. On the one hand you have some of the wealthiest people on the planet enjoying 5 star everything and on the other hand you have some of the poorest living conditions in any society anywhere in the world.

I was struck by this disparity more than ever yesterday when GrassRoot Soccer took all of us interns to the largest “township” community in Cape Town. The township is called Kayalitcha and it houses just over a million people from all over South Africa and sub-Saharan Africa – migrants looking for a taste of the inordinate amount of wealth that exists in some parts of Cape Town. Most if not all of the Kayalitcha residents live in a 6 by 6 shack made partly of wood and partly of tin. Each shack is forced to welcome 8 or 9 people each night, with everyone scattered on the floor trying to find whatever warmth or comfort they can. As you can probably imagine, the conditions in these shacks are unspeakably inadequate and against any sort of human rights questions that you may have. Running water is hard to find, with most families being forced to walk across the vast township to simply fill up a bucket for their family. There is no electricity in these shacks and the majority of the toilets are made up of shallow man made holes in the yard – these holes are too shallow to hold too much human waste but unfortunately most families have no alternative so they are forced to deal with whatever diseases and viruses that these outhouses may carry with them. The more I learned about these townships and the more I saw, the more I kept asking myself

How can anyone live in a place like this? How can anyone be happy in a place like this?

And the answer, unsurprisingly for most of you, is that more and more people are deciding not to live in these conditions. Crime rates and suicide rates have skyrocketed in the past couple of years, ultimately making Kayalitcha one of the most dangerous communities in the world. One of the men I met in this community told me the most amazing story which I’ll share with you all – this man was an ex convict and a major criminal in Cape Town. From the age of 5 he carried a gun and was involved in armed robberies. He had been arrested three times, all for armed robbery counts and after the third arrest he made the decision to change his way of life (something that most criminals around here do not realize until its too late). Today, this man, is a respected member of the community. He just started a tour guide business that enables him and his friends to show tourists around Kayalitcha, which in turn allows tourists like myself to get a glimmer into the township way of life. It also allows him and his friends to make a living outside of crime and do something productive for the community. He was a truly amazing man and thinking about his life after he told me his story while watching him play around with smiling township children was a really jarring experience.

Shortly after this eye opening experience, GrassRoot Soccer decided to take whoever was interested for a brief shopping mall on the waterfront in Cape Town. Many of us, myself included, were leaving the following day for our various placements so the mall trip group was big. Most of us just needed adaptor plugs, an extra sweater, some books or other simple things that might be more expensive in Malawi or Kimbereley, South Africa. Ultimately it was hard to find these things in this particular mall because everything inside was too high class for the simple things that we were looking for. This mall had LaCoste, J. Crew, Polo Ralph Lauren and Woolworths but they had nowhere to find cheap books or simple sweaters. This mall would put any mall you’ve ever seen in the states to complete shame. In addition to all of the high-end stores, the mall was full of incredibly gourmet and expensive restaurants. Even the bathrooms were gorgeous, which is not something you say everyday.

As I was walking through this mall with my new GRS friends, I couldn’t help thinking back on the conditions I saw in Kayalitcha. I spent the rest of the night trying to reconcile the two Cape Town communities and to be quite honest I haven’t found a reasonable explanation in my head, maybe I never will. The American equivalent to this situation in Cape Town would be if David Beckham’s mansion were next door to the homeless shelter in South Central LA – total poverty living next to disgustingly gluttonous wealth. To close, I’ll mention a brief conversation I had with one of the US embassy members, an American who had been living in Cape Town since the end of Apartheid. I brought up all these issues with him during our conversation and ultimately he ended by saying that he could not believe that these township inhabitents had not started a total rebellion against the wealthy Cape Town residents. He was saying that if he lived in Kaylitcha, he would have a hard time believing that he wouldn’t resort to crime, protest or rebellion in some way – what other option does he have?

I also wanted to take advantage of this internet session to post "Lusaka Sunrise" -- this was a video made by a former Grassroot Soccer intern and it's supposed to encapsulate the GRS mission pretty succinctly and effectively. It takes place in the capitol of Zambia, Lusaka, and it stars a lot of Grassroot Soccer staff members.

Enjoy!

http://www.youtube.com/watch?v=kyplef2Hi6Y

Landed Safely!

My seemingly never-ending journey from Boston to Cape Town finally came to a close this morning. The past two days have been incredibly intense -- 7 hour flight from Boston to London, followed by a 12 hour layover in London, followed by a 12 hour flight to Cape Town -- but as soon as I got in the taxi destined for our temporary hotels I knew that all the travelling was worth it. The 15 minute drive from the airport to the hotel reminded me of all of the different aspects of South Africa that made it such an appealing destination for me. On the one hand you had these beautiful mountains (Table Top mountain, Lion's Head mountain and Devil's Peak mountain -- all three are one day hikes, something I will definitely be doing at some point over the next 12 months), then you had this incredibly gorgeous ocean and then in the middle of it all was Cape Town. A beautiful city. But at the same time, it was hard to ignore the masses upon masses of shacks alongside the road that made up a part of Cape Town's township area. These houses are inhabited almost exclusively by black South Africans and other immigrants who live in absolute poverty. The shacks seem to be made out of a mixture of tin, metal and whatever they can find to patch up all of the windows/ceilings. The whole thing was a pretty immediate reminder of the type of poverty that exists in this otherwise amazing city.

Obviously I don't know much about the city now, but I'm really looking forward to hearing as many details as possible and maybe visiting some time soon.

Not sure when I'll have the internet next but make sure to write me emails and check out this blog!