Joint Project on Health and Human Rights within the AIDS epidemic 
With Janice Wong - Medical Student

Greetings from Katima Mulilo, the hot and dusty capital city of the Caprivi region in Namibia, right in the very heart of Southern Africa.  Botswana is due south, Zimbabwe just to the East, Angola is only kilometres away to the northwest, and Zambia is actually across the road.  Janice and I arrived here after a weekend of driving - over 1100km of sun, sun and more sun, multiple military checkpoints, leftover landmines, and lawless Eastern Angola just across the field on our right.

Before Katima, however, there was Oshakati, and before Oshakati, there was Windhoek.  So allow me to rewind.

I spent the first month here working with the University of Namibia's Human Rights and Documentation Centre, developing the human rights element of the University's new HIV/AIDS curriculum for students and professionals working in the field, while also making contacts throughout Namibia for our own project.  I also researched the human rights-related legal frameworks and institutions that were relevant to the epidemic, in order to create a foundation for our work on the ground.

After Janice's arrival, we hunkered down and began to figure out our project. In many ways, it has taken on a life of its own, and it has been endlessly fascinating.  We visited multiple clinics and hospitals in the greater Windhoek area. and spoke with doctors, nurses and patients involved in or living with HIV/AIDS.  We watched a school play put on by students about the dangers and realities of AIDS, directed by a U of T undergrad.  And we visited NGOs working within the epidemic, interviewing counsellors and program coordinators, as well as members of support groups. 

After more than 2 weeks working in Windhoek, and getting a pretty good sense of what was happening there, we were both ready to head out of town.  In our rented Toyota Tazz, a little white two-wheel drive that looks like a '92 Corolla hatchback (but runs like a champ), we drove to the north end of the country.

Driving in Namibia is wonderful, and the endlessly changing scenery more than makes up for the seemingly endless rising temperatures during the middle of the day.  The gentle rolling hills that cradle Windhoek give way to flat, scrubby veld, marked by the occassional rise, from the top of which the whole country spreads out in front of you.  Small mountain ranges appear out of the perpetual mist on the horizon, and coming up to Etosha, 4 hours north of Windhoek, the veld becomes much grassier, and the forests actually have trees larger than small shrubs.  

After the crazy adventure of a stop in Etosha National Park (where we came across lions, rhinos, elephants, zebras, warthogs, springboks, ostriches, etc.), we were ready to begin work again.  Oshakati and Ongwediva, two towns at the heart of the northern region, were the next stop. 

We spent the week there, again visiting the hospital, the regional AIDS coordinator, NGOs, and individuals affected by the epidemic.  There are fascinating projects taking place in the north, and the warmth and generosity of the general population was reflected in both the effectiveness of the general approach in the region, and in the quality of the specific initiatives.  The Yelula Project, for example, is an organization doing great work (which we'll talk about in our final report), and we were moved by their simple, but powerful, approach, which involved the process of personalizing HIV/AIDS for each person involved in the project.  The staff actually talks about issues, gets tested together, and understands that there is an emotional element to all of this.  Piet Williams, who runs the local pharmacy, has become a hero for his work in providing confidential and comfortable places for his patients to recieve their drugs.  He is intimately in touch with the day-to-day realities of what AIDS patients deal with, and sees it as part of his job to make their lives as easy as possible.  It sounds obvious to us, but he is far from the norm here.

And we met Anita Isaacs, a former guerilla freedom fighter, and now outspoken AIDS activist, who works to counter violence against women and children - after being ostracized and eventually kicked out of her own family when she was diagnosed with HIV in 2000.  Her courage, the strength of her convictions, and her fierce determination are totally inspiring.  She moved us both, and we left her office understanding that it had been a privilege just to speak with her and share her time. 

That would be an example of one of the positive and inspirational moments of the trip and project, when Janice and I would look at each other and say, "Well, there is hope after all".  In the midst of horrifying conditions and the seemingly endless obstacles to bringing real health back to a beautiful place, we have come across dozens of such people, or programs, or circumstances, that have lifted our spirits, restored our faith in what we both do and want to be a part of in the future, and shine light on the cold darkness that is AIDS, which is creeping through Namibia, relentlessly and without discrimination. 

It is that darkness that has made up the other half of our project.  Exposure to the realities of Namibian culture that make it impossible for women to make choices about their own lives; geographical and socio-economic realities that make it impossible for AIDS patients to access the food, care and support they would need, even if they could get their hands on ARVs.  The list goes on.  All together, these things combine with everyday life to create the omnipresent aura of a society that is fighting for its life - an aura that permeates everything.

Katima Mulilo, our last stop, perhaps most embodies this contrast between the good and the bad.  The AIDS prevalence rate here is 43%.  That's half the people in the grocery store.  The fact that the Caprivi strip is basically just one long highway (and therefore a higly vulnerable area - truckers, prostitutes, transient populations, etc.); that cross-border population flow is high (between 5 countries); that most of the communities remain bound to deep cultural traditions that are extremely problematic for combating HIV/AIDS (belief in witchcraft, for one, instead of a disease called AIDS), on top of all the other problems that exist in Namibia, make the work here extremely challenging, and the climb back to health that much steeper.  Most people in the rest of the country figure that the AIDS programs must be disastrous too, and that was one of the reasons Janice and I wanted to come up here, despite the potential dangers. 

And it turns out that what we found is a comprehensive, organized and united front, fighting the disease, and making successful inroads into a place where the battle is the most difficult.  Home-based care programs are teaching young volunteers from the traditional nomad communities how to care for the sick in their tribes, voluntary counselling and testing programs are becoming more and more accessible, physically, and acceptable in the mindset of the population. And unlike other places in the country, every organization involved, whether it is the government, international or local NGOs, faith-based groups, or whatever, is closely linked.  The communication is open and there is virtually no overlap. 

We have been lucky to be able to talk to people involved in every aspect of the HIV/AIDS work in Caprivi, but the most amazing and revealing part of our trip has been our participation in an experimental program carried out by the Red Cross, the World Food Programme and a local organization called the Mapilelo Project, which coordinates home-based care and voluntary counselling and testing. Accessing many of the communities in the rural ares is difficult (especially the nomadic ones), and so these groups decided to try and combine their efforts and use the opportunity of having a whole community together for a food drop to also provide school supplies, blankets and mosquito nets, as well as to offer voluntary counselling and testing.  So we drove over 200km out into Western Caprivi, to meet up with a San community (the most marginalized in the country).

It was an incredible experience.  Like much of what we've done, it was both heartbreaking and inspiring, but this experience was the most acute in both ways.  (I've just tried to write why - the joy of the kids, many of whom got their first-ever pen, or notebook, the 13-year-old mothers, proud and strong but with severely limited futures, the pain of anyone having to accept food, because of circumstances beyond their control and a world so far from embodying any type of equality or compassion - but I can't really do it.  Perhaps we'll be able to explain it in person.).  In the end, the drop was a great success, culminating with 19 community members getting tested, including the headman (a major coup)!  Such operations will now continue and develop, and it was, again, a privilege to have been invited to participate in the first.

We have already learned so much, and seen and shared in so many things.  Our next step will be to write our project report, which will hopefully live up, in some way, to the experience that we have had, and contribute even a little to the work that is happening here, and in Canada.  We'll gather all our information and evaluate it within the context of our own health and human rights standards and approaches, and come up with ideas, conclusions and thoughts.  We have also come to understand that it will be an opportunity for people working on the ground in different parts of the country to get a glimpse of what's happening in other areas - which due to time constraints and communication difficulties, doesn't happen that much right now.

We have been overwhelmed by the interest that most people have taken in what we're doing, and in the final product.  That has been wonderful for us, but I think is also just a reflection of the commitment to overcoming AIDS that exists in the community that has dedicated itself to doing so, and the thirst for anything that might help in acheiving that.  There is great strength here, and most importantly, people believe that they can win, that this problem can be solved, and that the future will bring light and hope.  That may be the most important element in all of this.

And so we sign off from Namibia.  Inspired, re-energized (maybe even ready to go back to our respective schools), and profoundly humbled.