101 Tested

We had another big VCT last weekend and magically managed to test 101 people despite the typical chaos (teams arriving hours late or not showing up at all, testing partners insisting they must leave much earlier than planned, and complete obliteration of the detailed schedule, to name a few).

At this event, I finally had the opportunity to test (you can see me being tested in the above picture). I have always wanted to test at one of our events, but I have been unable due to the limited capacity that our testing partners usually have. Even though I have not been engaging in any risky behaviors, it was still a nervewracking process. I underwent precounseling for about five minutes and then proceeded to the test, which was relatively easy and painless. A nurse pricked my finger and squeezed out a few drops of blood. After twenty minutes of waiting, I returned to find one line on the small testing strip. I was nervous because I could not remember if one line meant positive or negative. Fortunately, one line meant negative. However for that moment, I understood the panic that goes through the minds of all of our participants when they receive their results. I strongly advocate for everyone to test at our events and now I'm proud to be an example when questioned by people that are hesitant to test themselves.

Baby Lions!

Two weeks ago, we had friends visiting and finally decided to visit the baby lions just outside of Kimberley. Here are the pictures of the suprisingly tame baby lions. They were allowed to run around near small children and were only enclosed in a one foot high fence that they easily scaled whenever they wanted. The whole situation seemed a little precarious, but we were unharmed except for a few small scratches.

Cute and sweet...

... until he no longer wanted to be held.

"The Battle Against AIDS is Failing"

Check out this recent video about AIDS in Africa featured in the New York Times online.

Vacation

At the end of March, I left Kimberley and traveled to Cape Town to meet my parents for a two week vacation. They arrived on the eve of my birthday and I couldn't have wished for a better present. We spent the first week touring Cape Town - visiting Robben Island (like the Alcatraz of Cape Town) where Nelson Mandela was imprisoned for a majority of his 27 years, hiking Table Mountain and Lion's Head, visiting the wine lands, and more. The following week, we flew to Kruger National Park for some safari time and then concluded with a short stay in Muizenberg, a relaxed beach town outside of Cape Town. I think we all agreed that the vacation was too good to be true and didn't want it to end. I've included a bunch of pictures below to give an idea of where we were. Enjoy!

My Dad on top of table mountain, after we hiked up.


Parents in the Kirstenbosh Botanical Gardens in Cape Town.


Gorgeous view from our apartment. Table Mountain is seen on the left and Lion's Head is seen on the right.


My Dad and I after climbing Lion's Head.


Table Mountain as seen from Lion's Head.


My Dad and I at Cape Point, where the Indian and Atlantic oceans merge.


My mom and I visiting the penguin colony at Boulder's Beach, outside Cape Town.



Celebrating my dad's birthday by doing a little surfing - definitely a vacation highlight.



Below are pictures and video from our five-day trip to Kruger National Park, South Africa's premier safari destination. We were lucky enough to see all of the Big Five (elephant, buffalo, lion, leopard, and rhino) more than once. It was easily the most incredible part of the vacation.

View from one of our overnight huts at Olifant's Rest Camp.
Video of the same view.


Hyena next to our car


The elusive leopard


A little grooming.


Too cute.


A lion walking next to our Safari jeep. Surprisingly, it didn't mind us or even look at us. If you look closely, you can see that it's a pretty skinny lion.






My favorite endangered animal!


Lioness hunting in the night.

Overall, it was an amazing vacation that I will never forget.

Mini VCT

Thuso, our incredible assistant site coordinator and coach extraordinaire, teaching "Risk Field" to eager participants. HIV counseling and testing tents can be seen in the background.

On March 20th, we had a mini VCT. It was the first of its kind in Kimberley and I hope to have more in the future. As discussed in a previous post, I had an idea for small VCTs to increase our testing numbers. Ideally, I wanted to be able to test people without having to invest as many resources or as much money as we do for our bigger events. We setup in the very center of the township, situated next to the grocery store and major roundabout where all major routes connect. At this location, we commanded attention and were guaranteed to interact with a lot of people.


In "Find the Ball", the tennis ball is labeled with "HIV". The participants secretly pass the ball back and forth. When the coach says, "stop", they stop passing the ball. The other line of participants tries to guess who is holding the "HIV" ball. Usually, it takes quite a few guesses before they get it right. The person holding the ball is supposed to represent a person with HIV and the point of the activity is that just as you cannot tell by looking at someone whether or not they are holding the ball, you cannot tell by looking at someone whether or not they are HIV positive.

Overall, the event was a success. We tested over 20 people in a few short hours while a bunch of local kids participated in 6 of our Skillz activities. Although the number of people tested was not huge, our testing partner had reached their total testing capacity for the half day and they were really happy with how quickly we had recruited passersby to test. As soon as our testing partners gain more staff, we'll be testing even more people at these relatively simple events. Excited participants! These kids are from a school we have worked with a lot. The girls were part of our pilot Skillz Street League and we frequently play with them on the weekend. My next idea is to start doing similar small VCTs after school at the high schools where we work. I would love to combine an afternoon of HIV testing and counseling with pickup soccer with our Skillz coaches. Hopefully we'll see it in action soon!

"South Africa Redoubles Efforts Against AIDS"

Featured on the homepage of the New York Times today:


Above, President Jacob Zuma publicly testing for HIV.

Check it Out:

http://www.nytimes.com/2010/04/26/health/policy/26safrica.html

Semonkong

This weekend, Hooter and I decided to trek to the Mountain Kingdom of Lesotho to hangout with fellow intern Austin Haynes and his friend, Debz. We made the 3 hour drive to Maseru, the capital and Austin's residence, on Friday night and woke up early on Saturday morning to drive another 4 hours into the breathtaking mountains. Although the actual distance wasn't particularly far, we were traveling mostly on dirt roads, so it took awhile. But we didn't complain, as the slow drive allowed us to enjoy the gorgeous views along the way.

Our destination was Semonkong. It's known for hiking, pony-trekking, and what we ultimately came for: the longest commercial abseil in the world. Abseiling, which I'd never heard of before coming to South Africa, is bascially repelling down the face of a mountain. Despite being afraid of heights, I decided that doing the abseil would be a great idea and a fun way to liven up the weekend since I hadn't been out of Kimberley for 2 months.


This picture shows how vividly green it was there. I loved it since the Kimberley desert is rather lacking in the greenery department. It also shows the gorge where we abseiled.



Here we are walking to the start of the abseil. I'm simultaneously trying not to chicken out or pee my pants with fear.


Once I decided to do it, there was no turning back. What you cannot see is the deep-breathing I'm doing as I try not to look down or panic. I also refused to look at the camera and smile.


Where's Waldo? Can you see me? I'm on there (look for the green shirt to the left of the picture)! Hooter had trouble taking pictures since I accidentaly managed to set or at least near the record for fastest descent. The rope was pretty loose when I went down and I didn't know how to stop or slow down, so I pretty much clung to the rope with a death grip that burned my hands through the gloves. It wasn't until I reached the bottom that one of the guides told me what I should have done. Ha, nice timing. Still, I got some nice views and was less terrified than I thought I would be.


This one is a picture of Austin. I think it more accurately depicts the scale of what we were doing (the length of the entire abseil is 204 meters). He is the white speck to the left of the waterfall.


Hooter and I are happy to be on the ground again.


The crew - Austin, Debz, Hooter, and me - safely reunited.



Our humble abode for the night.


View from our humble abode.


Overall, a great weekend!

A Picture's Worth A Thousand Words?

The reaction I got from a bunch of students walking to recess while I was watching an intervention. They love the camera! And what you can't see are the little ones sneaking up behind me to touch my hair - I don't think they'd ever touched a white person's hair and I'm guessing they thought I wouldn't care. It was pretty cute.




These two depict my "fan club" at one of the primary schools where we work every week. We also held our Skillz Street league there so the kids are pretty comfortable with us. They run and crowd our car when we arrive, making it almost impossible to get out. It's a highlight of the week that I never miss.


Participants celebrating a goal. Love it.

Skillz Superstars

Two days after our VCT, we had a weeklong holiday program. Rather than describing the logistics and practicalities of the program, which were similar to the holiday programs we held at the end of September, I want to share about a special group of girls that attended.

A few of the girls during one of their Skillz lessons.

Some of the girls celebrating a goal.

To begin, our holiday program was by invitation only. We do this to ensure that participants have not previously gone through the Skillz program and to maintain at least some semblance of order. Despite not being invited, a group of about ten girls from our Skillz Street league walked three miles to get to the camp and arrived promptly at 8am. Lindsay and I were in awe. We didn’t know how they could even know about the camp. Apparently, they had learned about it from their Skillz coach, Tweeny, who had told them that she would be working at it. They insisted that they be allowed to partake in the camp even though they had already been through Skillz. We couldn’t say no to them, after all, they had just trekked all the way there. Who were we to deny them something they were really excited about? Besides, we had a rather lopsided ratio of boys to girls and they would help to maintain more of a balance.

Ipeleng (in hat) - a true rockstar

Like the holiday programs we had at the end of September, each day combined the Skillz curriculum with small-sided soccer games. In the Skillz curriculum and soccer games, these girls were all-stars. For some of them, this was their third time participating in the program and they knew it better than any other kids I’ve seen. When participating in activities, they would wait to see if any new kids wanted to answer first and then they would raise their hands and give perfect responses. They were considerate, but eager and their knowledge made me proud. After having been here for a few months, I’ve seen my fair share of rather poor interventions and sometimes I worry that our program is not effective. But these girls instantly restored my faith. They were like a breath of fresh air. Even if the majority of our kids did not retain the key messages, our program was still worth it simply because of graduates like them. To see them spread their knowledge was absolutely beautiful.


At one point, they shared that they had phone numbers of the male Skillz coaches. I jokingly asked them if the coaches were their boyfriends and warned about sugar daddies (older men who court young girls and provide them with gifts). Sugar daddies are one of the risks we discuss in Skillz that can lead to the spread of HIV. They are actually quite common in South Africa and a huge risk for young girls. The girls immediately started shouting at me about the risks associated with sugar daddies and how they would never even consider them. They explained that the coaches were their friends. Their quick defense made me smile. I had never been so happy to be verbally attacked by a bunch of 12 year old girls.

One of our girls, showing the boys how it's done.

During the last Skillz lesson, participants are given a chance to share their own “coach’s stories”. A girl from one of the groups gathered the confidence to share how she had been raped and contracted HIV from the event. Most of our girls were in her group and they were in tears. From afar, I had no idea what was happening and why everyone was upset. Only soon after did I learn what had occurred when one of her Skillz coaches approached me. The girl immediately entered the post-counseling tent of our testing partner and spoke with a counselor for awhile. Later, her coach sat and comforted her away from the rest of the group. During this time, the girl asked if she could speak to me. I was really surprised, as I had not spoken to her once during the whole week. I felt unprepared for the situation and unsure of what to say, but was happy to provide any sort of assurance she needed. She was timid and said little, but I could tell that my presence as someone who truly cared definitely made a difference. I found that listening and giving a hug is sometimes the best thing you can do. Interacting with this girl was one of the most real confrontations I have faced regarding HIV. Although I’ve read numerous stories of the realities of HIV in Africa, meeting someone who has undergone a horrible experience and become infected with HIV in the process, was more powerful and unnerving than anything I could ever read. There was no way to deny the harsh reality of HIV when suddenly faced with it head-on.


On the last day of the holiday program, I organized for one of our testing partners to be present and offer testing to any interested participants. An important part of HIV testing in South Africa is that an individual must be at least 14 years old to be tested at a mobile clinic. However, all ages are able to receive pre-counseling to better understand the testing process. Our girls were among the first participants to receive pre-counseling. They listened to new information and quickly impressed the testing organization with their Skillz knowledge regarding HIV. I was, again, quite proud. The only problem was that the girls, in their excitement and curiosity surround testing, attempted to lie about their ages in order to test. It was only after seeing that some of them were on the list to be tested that I realized what was happening. I immediately gave the testing partner our roster, with the ages of all participants (provided by parents) and then told the girls that they were too young to test. They were diasappointed and a little mad at me, but I explained that they could still be tested for HIV at any local clinic as long as they brought a parent with them. Their disappointment at being unable to test reinforced my admiration for them. Although I would love for all participants to be like them, I am realizing that having these occasional Skillz rockstars are the blessings that I must use to sustain me through the more frustrating times.



Sharp - a happy participant gives the "sharp" signal. I think sharp is the first thing babies learn. It seems to universally mean that everything is okay and when I can't understand someone speaking in Setswana, I just say sharp and give a thumbs-up. It somehow seems to always work. Sharp!

Voluntary Counseling and Testing Tournament

I apologize for my blog absence over the last two months. With a surprise trip home for Christmas and settling back into the daily Kimberley routine, I’ve somehow left my blog behind. Now that I’m finally facing the task of getting you up to speed, it makes sense to start chronologically….bringing us to the VCT we hosted on December 5th, in honor of World AIDS Day (December 1st).

VCT stands for Voluntary Counseling and Testing. Grassroot Soccer has adopted the VCT concept and combined it with soccer and the Skillz curriculum. A Grassroot Soccer VCT occurs during one day, with the goal of making participants comfortable with the idea of testing for HIV and testing as many community members and participants as possible. This event was especially important to me because I was placed in charge of it. From delegating tasks to the other interns to ensuring that our testing partners were committed, everything ultimately fell back on me.

Our VCT occurred in Galeshewe, the local township, on two large dirt pitches (grass fields are hard to come by). We recruited eight girls’ soccer teams and eight boys’ soccer teams from the community to compete in separate tournaments. In addition to these teams’ own coaches, they were paired with one of our Skillz coaches for the day. In their down time, between matches, the teams went through two Skillz games – My Supporters and Find the Ball. These games were chosen because they emphasize the importance of supporting one another, erasing stigma associated with HIV and getting tested to know your status. Prior to the optional testing portion of the tournament, coaches also shared their Coach’s Story. Coach’s Story is an integral part of GRS that allows coaches to share a story of their own resiliency, often related to HIV. By telling these stories, coaches reveal their own vulnerability and triumph, thereby creating a space in which participants feel more comfortable opening up to coaches about their own struggles.

Playing "Find the Ball" with Skillz Coaches


The day started off fairly smoothly, with teams learning the tournament rules and being introduced to their Skillz coach. Our first testing partner arrived and began to setup. According to the schedule, each team would have a break in playing to visit the testing tents and proceed with the optional counseling and testing. Anyone interested in testing must be at least fourteen years old. First, they go through a round of pre-counseling that usually lasts between ten and fifteen minutes. It ensures that they understand the process they are about to undergo and are prepared to handle their results, whether positive or negative. The counselors also discuss the person’s behavior to assess whether or not they are at high risk for HIV. All of this occurs in a confidential, enclosed tent. Following pre-counseling, if the person still wishes to proceed, they enter a new tent to undergo their HIV test. It is done with a simple pin-prick of the finger. The tester then analyzes the blood for the amount of antibodies and gives the results to the post-counselor. In the last test, the post-counselor provides the results to the individual. People who test positive are offered immediate support and referred to a local clinic to begin testing. Overall, HIV testing is incredibly important because people who are positive can begin treatment to live more healthily and they can take the proper steps to prevent spreading the virus to others.


The testing part of the tournament was the part I was most excited about and the part for which I was most responsible. Thus, I was extremely frustrated and disappointed with both myself and our testing partners when it became obvious that the testing component was not adequate to handle the number of people we wanted to test. At the previous year’s VCT, well over 300 people had tested. Granted, their event was the finale of a national Sports Heroes Walk, which featured multiple sports stars, but I still believed that we could reach large numbers with our event. We had placed posters and handed out flyers in the township and even been featured on the radio station to advertize our event. Things were looking good.

The problem arose when I began talking to our first testing partner and realized that they brought fewer than 50 testing kits, which meant that they could not test more than 50 people that day. They also brought numerous counselors, but only one tester. Before the teams even had the option to test, community members had already flooded the testing tents and created a major backlog. Panic set in as I realized that the participants would not be able to test if they desired. I decided to phone the Department of Health, which had made a habit of ignoring me despite my persistent visits to their office and phone calls. A woman answered and after a discussion about testing kits and my explaining that I would drive anywhere in town to pick her up and get the testing kits, she hung up and turned off her phone. Exasperated, I pleaded with our first testing partner about where we could find extra kits. I was willing to buy kits or drive their staff anywhere, such as their office to get more, but they insisted that the Department of Health was the only place they could get them and with the office closed on Saturday and our one contact eliminated, I was helpless.

The testing problem was only compounded by the fact that our second and typically more reliable testing partner had yet to arrive and it was almost noon. I called them numerous times and was finally able to make contact. They had apparently decided to be part of an opening ceremony for tourism in Galeshewe, rather than arrive early in the morning, as we had previously agreed numerous times. However, when they finally arrived, I was just relieved to have another testing partner to begin testing our participants. The relief was short lived, as I quickly learned that they also brought only one tester and could test a maximum of 35 people. Although I knew they had a training for some of their employees in Johannesburg, they did not inform me that they would be able to test so few people. They had numerous kits, but they focus on quality pre and post counseling. I fully support and appreciate this aspect of their work, but I was still desperate to be able to test more participants from the tournament. So, in a last attempt to be able to test more people, I asked if they had extra testing kits that they could share with the other testing partner. Unfortunately, their organization is unable to share them. I quickly changed the game plan to stop testing community members and give priority to tournament participants. After going through the Skillz games, many of them were eager to test. We were able to test a few teams, but ultimately had to turn people away. It completely crushed me to tell people they couldn’t be tested at the moment and must instead visit a local clinic for testing. It’s unusual for people to be so motivated to test and I hated that we were unable to capture the full potential of this precious opportunity.


As the event came to a close and we cleaned up the venue and thanked our coaches, I felt extremely demoralized. I felt as though I had let the GRS team and the Galeshewe community down. We probably tested between 50 and 75 people – a meager number compared to the previous year. But I was much more upset about having to tell people that they couldn’t test because we weren’t adequately prepared. It was hard to realize the obvious missteps I had taken – not telling our testing partners exactly how many testing kits we need, believing that since they had worked with us at the same event last year, that they would understand the scale of it.


Coach Vuyi about to receive his results after testing for the first time!

With time, I have come to recognize that I did not completely fail the people that were depending on me. I did disappoint, but there were still positives. For example, the kids enjoyed the tournament and the Skillz games and became excited and interested by the idea of testing for HIV. They made valuable connections with their Skillz coaches and I hope that their awareness and behavior related to HIV has changed for the better. Also, despite testing many fewer people than anticipated, we still tested over 50 people. Each one of those people took an important step that day to learn their status. They overcame fear and stigma in order to ensure healthier lives for themselves and others. We even had Skillz coaches test for the first time, thereby becoming beautiful examples for the children they taught. Lastly, I learned a lot about planning and interacting with partner organizations. Although I made mistakes, I think that I am stronger for it. A quote by Nelson Mandela that I have happened upon a few times during this internship sums up the situation:

“The greatest glory in living lies not in never falling, but in rising every time we fall.”

I hope that I can heed Mandela’s wisdom and rise from this experience. We no longer have funding to have any more VCTs, but I’ve been talking to Lindsay and I think we can plan some small-scale VCTs where we play pickup soccer, have Skillz coaches teaching games, and offer testing to the community. The soccer would attract both kids and adults and the Skillz games would encourage people to test. It’s all just an idea right now, but I think we can do it.