Days later, as I sit in my New
Orleans home, it is hard to imagine that I ever was in Mumias. What were
chapatti, ugali, and boiled greens has now been replaced with fried oysters,
poboys, and crawfish etouffee. What used to be mulish cows and goats roaming
our front yard is now the domesticated cats and dogs I call my pets. In short,
much has changed about my surroundings. Kenya, and probably all of Africa, is a
vastly different setting than my hometown in the United States. Different
environments, different socioeconomic factors at play, different cultural
norms, and different health care struggles. According to the CDC, the leading cause of death in Kenya is
actually HIV/AIDS, attributing to 38% of deaths nationwide. In the United
States, the leading cause of death is heart disease, often credited to the voracious
appetite of Americans and the high stress of civilized life. Kenyans are
plagued by infectious disease like malaria and tuberculosis that thrive in the
climate and poverty of Africa. Americans, on the other hand, are plagued by
diseases caused by lifestyle choices like obesity, diabetes, and lung cancer.
There is a phrase that both GlobeMed and WOPLAH love to tout: ‘health is a
human right.’ Are we, as Americans, taking this right for granted?
Tuberculosis for example, now the
disease of developing nations, used to be an urban plague. Due to sanitation advancements,
educational reforms, and the growth of medicine, infectious diseases like TB
are no longer able to prey on urban dwellers. In essence, thanks to the
affluence of an industrialized nation, we were able to beat theses diseases
down to the shadows. And in their place we have cultivated a slew of lifestyle
diseases. Many people are all too willing to point fingers at developing
nations and blame cultural practices for the proliferation of disease. For
instance, when HIV first hit Haiti, multiple medical publications in the United
States blamed romanticized notions of voodoo for its rampant spread. This exaggeration of personal agency
leads the assignment of blame without any movement to address the phenomena
that propagate powerlessness. It is easy to say that voodoo rituals play an
important role in the spread of HIV/AIDS in Haiti. It is less easy to say that
lack of education and proper medical care play an important role in the spread
of HIV because these factors have connotations of global, not personal
responsibility.
Days before I left for the GROW
internship, I had already gotten used to hearing how dangerous this trip would
be and how brave I was for going to Africa. But I found one interaction to be
particularly startling. A physician practicing in the U.S. told me to be extra
careful not to contract HIV. I went home that night and did research on the
transmission of HIV through nonsexual interactions. All the sources I had found
said that, outside of sharing needles, HIV is not easily spread via nonsexual
contact. So did he know this, or did he just have questions surrounding my
moral turpitude? To me this represents an example of the “the geography of
blame.” We have all heard about the HIV/AIDS crisis throughout Africa (Africa
usually being used as a blanket term, referring to no particular country in
general). But the HIV rate in Kenya is comparable to the rates found amongst poor
urban Americans. This challenges the notion of HIV as a virus unique to
‘third-world’ nations. Would people have been as worried about my health if I
had traveled to the projects of Boston or New York? The tendency to assign
cultural blame, exaggerate personal agency, and propagate stereotypes is
counter productive at least. The fact is that HIV is a global pandemic and
there is a great need for global solutions.
Working with WOPLAH this summer has
provided me with a unique opportunity to study the treatment and management of
HIV both in Kenya, and now in my own backyard. One of my biggest goals this
year is for GlobeMed at CC to become active within the HIV positive community
of Colorado Springs. I also hope to find a local partner that will educate us on
the ongoing programs that address the needs of those living with HIV/AIDS in
Colorado. I wasn’t in Mumias when HIV first made its impact and so it would be
impossible for me to identify any social factors that lent to proliferation of
HIV in the community. However after six weeks, I do feel confident in pointing
to distinct cultural elements that make the fight against HIV/AIDS in Mumias so
influential for me. The one that stands out the most for me is the amazing
sense of community. On one of our last days of the internship, we sat down with
Edwin to discuss some of the strengths and weaknesses of the GROW team, of
WOPLAH and of Edwin. As one of his strengths, Edwin listed the support of his
families and friends. As Edwin had just demonstrated for us, the importance of
family in Mumias cannot be stated enough. One of the support groups we visited
in that last week, The Sky is the Limit, has a similar devotion to the idea of
community. The support group was named after the potential a community can
reach when HIV positive and HIV negative community members band together. Many
of WOPLAH’s programs are aimed at supporting the ‘infected and affected.’ To me
this shows a strong sense of solidarity. At first I was confused to see HIV
negative people in a HIV support group, but now I see how important that
incorporation is. HIV can have powerful emotional and economic impacts on a
family, and those family members were also in need.
While we were there, I also noted
on the burgeoning role of women in the Mumias society. When I was assigned the
task of creating an informational pamphlet on clean water, Edwin instructed me
to include a section of gender equity. At the time, I had no idea how the two
were related. As I researched for the pamphlet, I learned that gender equity in
the gathering and treatment of water was a global movement. Women in the
developing world are often forced to travel miles for a source of water. This
task alone can take up hours of he day. If men were to help with this
acquisition of water, women would have more time for self-improvement. Edwin’s
insistence that this information go into the pamphlet represented to me the
ongoing movement of female empowerment in Mumias. The clinic Edwin works out of, Maternal and Child Health
(MCH), also offers birth control and viricidal methods to women, putting the responsibility
and power in their hands. I was surprised at first to learn that MCH provided
IUDs to women and found it to be very progressive. These types of measures help
empower women in the community with visible effects. The vast majority of
support group members and community health workers that we met were truly
inspired and determined women.
This internship with WOPLAH served
for me as a powerful lesson about the types of social movements that occur when
a population bands together for the shared purpose of achieving health.
Throughout support groups we heard again and again about the importance of
shedding self-stigma and the empowering effects of education. We also saw a
dynamic willingness to adapt in Mumias. For example, WOPLAH now advocates
against traditional polygamous marriage as a way to impede the spread of HIV.
While we were there we also saw a large movement away from traditional male
circumcision, which involves the same knife being used on up to fifty boys. In
fact, MCH hosted a voluntary medical male circumcision day and around 80
teenagers and men from the community came to be safely circumcised. Large
strides like these against the spread of HIV/AIDS are what make WOPLAH so
inspiringly farsighted. One day I will return to Mumias, maybe as a physician or as a doctorate of public health always carrying with me the lessons I learned from the Ambassadors, and I will find little to no HIV, less poverty, a liberated community, and the next generation of Ambassadors with even bigger dreams. I will find the achievements of WOPLAH in every successful support group, every empowered community health worker, and every child that grew up learning the importance of reproductive health.
-Alexis
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