West African AIDS Foundation (WAAF)

This has been the week of WAAF, the first of many I'm sure.

Monday morning, Ben, Sophie and I woke up bright and early to go on an outreach VCT program - volunteer counseling and testing. We went with three employees of WAAF to Tema, a little outside of Accra, to what seemed to be a truck driving school. They announced that they were doing free HIV testing, and it all began.

We set up in a classroom, with two counselors in two of the corners, and a desk at the other end with the three of us seated with Mark to help record the test results. And we did so for the next five hours. There were about sixty people tested in all, which is actually a low number. WAAF brings 100 test kits to each outreach program, and once they're out, they're out. It's all they can afford to bring with the funding they're provided. That's one thing I want to try to resolve while I'm here. I can only imagine having to turn people away from being tested because we ran out of test kits, and that's unfair.

The process that day was people would come in and speak with one of the two counselors, where they would give a sexual/medical history and get any and all questions about HIV answered. Then they would hand their counseling forms to us, we would record their name. They would get tested, and told to come back in an hour for the result. Mark would then tell us whether the results were reactive (positive) or unreactive (negative), and we would record the result. If they were reactive, we had to fill out a separate form to refer the client to testing at IHCC, which WAAF works out of, and give all the information to the counselor, who told them the result when they returned.

There were three people that day who tested positive. We knew who each was, and saw how they reacted to the news. Speechless, tearing up, walking out fast. And all their colleagues were peeking through the windows, and waiting outside. It was hard to tell how the community was there. There is such a stigma against HIV here in Ghana that it seems it would be the person's first instinct to keep the results private. But everyone was getting tested together, and it was obvious when people tested negative because they were dancing around and all excited. So how do you respond when you're told you're positive? Is it the sort of thing where everyone's waiting outside and wants to know, "what'd you get? what'd you get?" And if you tell them, does that change everything?

Wednesday was our first day of counseling training. We're training intensively for the next two weeks or so. I was going back and forth about it for a while, because being in Ghana has made me very aware of my status as a young white American girl, and I don't know how clients are going to feel about being counselled by someone like me. I'm going to give it a shot, though. We were given lots of reading on HIV/AIDS information and common questions that we're going to have to learn and know all the answers to. We simulated counseling sessions, and it's basically just having a conversation and getting to know your client, making him/her as comfortable as possible and preparing them for the testing process and results.

Today we met once more for another counseling training session. Except, one of the volunteers who has been at WAAF for the past two months is going back to school, so we decided to celebrate and went out to a nearby restaurant - the Pokey House I believe. We ended up talking a lot about pregnant women with HIV. Breastfeeding is one of the modes of transmission for HIV/AIDS, so it is important to know the alternative options. Except, there aren't very many. Statistically, an HIV positive mother has a 15% chance of transmitting the virus to her child through breastfeeding. The ideal solution is to use formula, but because the water here in Ghana is often contaminated, bottled water is the idea mixing solution to make formula. However, most people cannot afford the luxury of bottled water. So, what is suggested is a controlled form of breastfeeding, which basically means ensuring that there are not cuts on your breasts before breastfeeding. Alternating between breastfeeding and formula is the worst - it brings the likelihood of transmitting HIV to your child up to 40%. So unless you have the means to buy formula and bottled water, your baby has a high risk of contracting HIV. And frankly, that's not good enough for me.

The stigma against HIV/AIDS in Ghana prevents a lot of government support from making a difference. There is no WIC program, no health department that can offer free services to HIV positive mothers, as a means of preventing transmitting the disease to her child. There is no way for her to get free formula, free bottled water, or subsidies from the government to lower her expenses. And right now WAAF doesn't have the resources to provide for pregnant HIV positive women. And if I'm being trained as a counselor, I simply cannot tell a pregnant woman that she's HIV positive and there is nothing we can do to help her or her baby.

Now I'm trying to figure out what I can do to help. Sophie said she really wants to put on a concert to support WAAF, and I think this cause would be ideal. A couple kids in the program have made friends with local musicians, so hopefully we can get them to perform. However, fundraising can't be where it ends. Ideally the concert will bring in lots of revenue, but I don't want it to stop there. The people at WAAF said they were trying to talk to people at the U.N., but efforts to receive continuing aid so far have been unsuccessful. It is my goal to try to establish an agreement with the U.N. or an organization like it to provide continuing aid to the cause of pregnant HIV positive women; to set up a program similar to the health departments in the United States, where women can go for treatment and the formula necessary to care for their babies, and to prevent them from contracting the disease.

A girl died at WAAF today. I saw her once when I first took a tour of the WAAF facilities. She was lying in bed, suffering from tuberculosis and full-blown AIDS. She was 21 years old. I don't know her name.