Bridget Chisenga. Photo by CRS

President Bush, in a speech this morning before leaving tomorrow for Africa with First Lady Laura Bush, made reference to a woman who made a profound impression on him: Bridget Chisenga, who works for CRS Zambia to promote adherence to antiretroviral therapy, the lifesaving medication for people living with HIV.

Bridget works for AIDSRelief, the CRS-led consortium that is funded by the President’s Emergency Plan for AIDS Relief (PEPFAR). Congress is currently considering legislation to reauthorize and expand PEPFAR for the next five years.

“Auntie Bridget,” as she is known to her co-workers and clients, spent several weeks in the fall here in the U.S. visiting schools and parishes and sharing her experiences of living with HIV and working with others with HIV. She joined President Bush for a World AIDS Day commemoration, and this morning, he recalled what she said that day:

Last November, I met a woman from Zambia named Bridget Chisenga. Bridget’s husband died of AIDS, and she expected to meet the same fate. Then she went to a clinic operated by Catholic Relief Services, funded by the American people. Today, Bridget is healthy. She has a job at the clinic, where she helps provide AIDS medicine to others. I want our fellow citizens to hear what she said: “This face is alive and vibrant because of your initiative. I would like to thank you.”

CRS President Ken Hackett testifies before the Senate Foreign Relations Committee. Photo by Rick Reinhard

Catholic Relief Services (CRS) President Ken Hackett testified today before the Senate Foreign Relations Committee, calling on the influential panel to continue and expand the President’s Emergency Plan for AIDS Relief (PEPFAR). The only witness representing an agency carrying out PEPFAR programs overseas, Hackett focused on critical needs on the ground.

“PEPFAR is above all a program of hope,” he told the committee while highlighting the need to provide adequate resources, to coordinate with other assistance programs – particularly those focused on nutrition, agriculture and education – and to enhance PEPFAR’s basic model.

Read Ken’s written testimony.

CRS Ethiopia holds a vigil with its staff for World AIDS Day. Photo by CRS staff

CRS offices around the world work on HIV projects daily, but employees often don’t have time to stop and reflect together on the impact of the disease on their own lives. Several CRS programs observed World AIDS Day with in-house events that allowed that time for reflection. Following are two entries about those events.

The first entry was sent in by Aynalem Demeke, a deputy administration manager with CRS Ethiopia who also serves as a point person for the HIV in the Workplace program.

CRS Ethiopia held a candlelight vigil to mark World AIDS Day and invited Berhane Kelkay, a woman living with HIV who works to educate other Ethiopians about the virus and lessen the stigma surrounding it. Berhane is a founder and the executive director of the Association of Women Living with HIV, a group known as “Tilla,” which means “umbrella” or “shelter.” The organization works to increase awareness and change attitudes about HIV through education, advocacy and promoting positive living. The association, which has more than 100 members, primarily focuses on women, who are often more vulnerable to the pandemic.

Berhane Kelkay arrives for the World AIDS Day ceremony at CRS Ethiopia. Photo by CRS staff

Berhane is a widow who quietly started serving people affected by the pandemic in her community, and grew to become a national figure on HIV issues. Speaking publicly at international symposiums and workshops, she challenges Ethiopians and those outside her country to confront the stigma often associated with HIV and understand the need to care for those affected.

A mother and a counselor to vulnerable youth, Berhane urged CRS to remember that problems children face today will continue into the next generation. She asked the audience to pledge to take an active role in awareness campaigns, echoing this year’s theme for World AIDS Day — leadership.

“Leadership starts at home, in the family,” she told the CRS employees in Addis Ababa.

Members of the staff said they were touched by Berhane’s presentation.

“She is one of the few HIV-positive women determined to expose her [story] to the public,” one person wrote in comments after the event. “I really acknowledge her effort and the great work she is doing.”

_____________________________________________________

The second entry was sent in by Debbie DeVoe, Catholic Relief Services’ regional information officer for East Africa, after participating in an HIV in the Workplace event at CRS Kenya in honor of World AIDS Day.

Talking about HIV and AIDS isn’t always easy. There’s often a fear in the back of your mind that someone might think your question is stupid, especially since you’re supposed to be completely informed working for an international aid agency. And there’s the concern of offending someone in the room with the words you choose to use. And then let’s face it: HIV discussions touch on, yes, sex — a topic many don’t want to talk about to anyone but their best friends. And now they’re being asked to discuss it with 40 of their closest colleagues.

CRS Kenya HIV in the Workplace Officer Pauline Kibe makes it easy for staff to discuss HIV issues by keeping everyone laughing. Photo by Debbie DeVoe/CRS

CRS Kenya invited all staff to come together in honor of World AIDS Day. Amazingly, the event facilitator Pauline Kibe, CRS Kenya’s HIV in the Workplace officer, put everyone at ease and led employees to have a frank discussion about the issues they face in Kenya and the support CRS can offer.

CRS Kenya has strict guidelines to protect employee confidentiality — an employee who breaches confidentiality to reveal another employee’s HIV status risks penalties that include possible termination. CRS Kenya will also revise work expectations for an employee if failing health prevents him or her from taking on certain aspects of their job. And, like other CRS programs, CRS Kenya taps one staff member to be available to answer questions about HIV and provide support or counseling.

This event also highlighted the staff’s generosity. Over the course of a week, employees donated enough toys, clothes, food staples and shoes to fill nine boxes. These were distributed to three agencies: a privately funded program that CRS Kenya runs to help children orphaned by AIDS, a group that provides assistance in Nairobi’s slums, and an agency that rescues abandoned infants, cares for young girls and provides HIV services.

I’ve only been working in Kenya for seven months now, but I already feel like I’m part of a supportive family — and even better, one that laughs more than cries.

Most Rev. George Thomas and Constance Proctor, members of the Catholic Relief Services (CRS) board of directors, visited CRS Senegal last week. They visited SIDA Service on Dec. 1, World AIDS Day. SIDA Service is a CRS partner that works with HIV-positive Senegalese (SIDA is the French acronym for AIDS). Lane Hartill, the CRS regional information officer for West Africa, filed this dispatch:

Bishop George Thomas and Connie Proctor talk with Paul Sagna, the executive secretary of SIDA Service. Photo by Lane Hartill/CRS

In a spotless Dakar apartment, decorated with photos of beaming children and plastic flowers, a Senegalese social worker won the heart of an American lawyer.

These two women come from different worlds: one graduated cum laude from Vassar College; the other has never set foot in such lofty institutions.

The lawyer spends her days representing influential clients in the Pacific Northwest. She lectures budding law students with the crisp elocution and precision required of her profession. She sits on boards with some of America’s most accomplished women and men.

The social worker spends her days scuffing through Dakar’s streets, working her way through forgotten neighborhoods that smell of sewage and warm sand. She dodges bleating sheep and dusty kids and hikes up her skirt to step over sludgy canals. She ducks into dank apartments and drinks tea with people who look forward to her visit all day.

(more…)

Elizabeth Jere is CRS Kenya’s coordinator of AIDSRelief, a CRS-led consortium that is providing lifesaving antiretroviral treatment and other care to people with HIV. She oversees AIDSRelief activities at the 20 partner sites in Kenya. She sends this World AIDS Day reflection from Nairobi:

Elizabeth Jere discusses HIV service delivery with a pharmacist at St. Joseph Mission Hospital-Migori, an AIDSRelief partner facility in western Kenya that receives support from the U.S. government’s PEPFAR program. Photo by Dickson Atonga/St Joseph Mission Hospital-Migori

Sister Angela was back at square one. Actually, as she put it, she was back at “square zero,” trying to run a rural mission hospital with no qualified staff and almost none of the drugs needed to treat the 200 HIV patients pouring in the door.

Asumbi Mission Hospital sits in the epicenter of the AIDS epidemic in Kenya. More than 40 percent of the people who come to Asumbi for free HIV testing end up testing positive — the result of considerable poverty and traditional practices that spread infection.

When Sister Angela called me, she was desperate. The nearest district hospital, nearly 35 miles away, was full to capacity and so had referred 80 patients taking antiretroviral medications back to Asumbi. The government sent free antiretroviral drugs to Asumbi to support these patients, and the district hospital agreed to send over a clinic officer on Saturdays to prescribe the drugs as needed. This was great, but word had spread quickly that antiretroviral treatment was now available at Asumbi, and the flood of patients began to rise.

Unfortunately, Asumbi hospital didn’t have the staff needed to provide adequate counseling to patients, the necessary lab equipment to diagnose AIDS-related complications, or a pharmacy stocked with the essential drugs required to treat opportunistic infections. Asumbi needed urgent help.

Catholic Relief Services was able to provide such critical assistance as the lead agency of the AIDSRelief consortium, a group of five partners funded by the President’s Emergency Plan for AIDS Relief (PEPFAR). We put Sister Angela in touch with staff at the St. Joseph Mission Hospital-Migori — a hospital that has received AIDSRelief training and financial support since 2004 — and developed a plan for St. Joseph’s to provide weekly support. With financial assistance from AIDSRelief, St. Joseph staff will now visit Asumbi Mission Hospital one day a week to deliver extra clinical, counseling, pharmaceutical, laboratory and management assistance. AIDSRelief will also help cover the cost of equipment Asumbi now needs to provide quality patient care to patients on antiretrovirals, starting with basic scales and stethoscopes.

Based on current testing and infection rates, Asumbi is projected to have over 500 patients in HIV care by March 2008 — and it’s just one of the hundreds of health care facilities in Kenya trying to keep up with demand. Through U.S. government support and PEPFAR-funded programs like AIDSRelief, aid agencies are teaming with governments to help ensure that people living with HIV are receiving the highest quality of care regardless of their economic situations.

Bottom line, you can’t stop patients from coming to Asumbi, and you can’t turn them away. On World AIDS Day, I’m celebrating our ability to meet the need one more time.

Bill O’Keefe, Senior Director of the CRS Advocacy Department, recently returned from Zambia and had this reflection:

Having visited many rural African Catholic health clinics over the last 20 years, I was amazed at how the advent of antiretroviral therapy has brought hope and healing to persons with HIV in Zambia. Where health workers for years were focused on helping people die, they are now in the business of bringing people back to life.

CRS-supported Chreso Ministries Clinic, a Lusaka, Zambia-based program that provides key services to more than 5,700 people living with HIV and AIDS. Photo by Hilary Roxe/CRS.

I am thankful to have just returned from visiting CRS’ PEPFAR-supported projects in Zambia. The experience brought home to me that the work that all of us with the U.S. Conference of Catholic Bishops have done to advocate for HIV funding over the years is truly making a huge difference.

In Washington, D.C., staff from the foreign affairs committees are focusing on the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR). Just last week, CRS had the opportunity to testify in Congress on the critical connection between nutrition and HIV. Having witnessed this connection in Zambia, the hearing could not have been more timely. We are trying to help shape the next five years of PEPFAR so that it is even more effective. We are going to need your help, though, from now until a final bill passes, probably in the spring of 2008.

We face opposition or inertia on a number of fronts. The role of the Church in providing health care in remote parts of Africa is itself underappreciated. While our experience and evidence support the important contribution abstinence and behavior change play in preventing the spread of HIV, others have a very different view. The ease with which CRS and others are able to piece together an integrated program that fights HIV, while addressing nutrition, education, sanitation and other related issues, will be a challenge.

Thanks for supporting our past efforts on HIV and AIDS and other important issues. I invite you to continue with us in our HIV advocacy over the next few months. Here are specific ways you can help:

• Keep an eye out for CRS’ HIV and AIDS related educational resources and action alerts and respond as intensively as you can. If you are not already a part of our legislative network, you can join by visiting our website.
• Also check our speaker tour page for news about events in your area. One of the speakers during our upcoming fall HIV and AIDS tour is Ms. Bridget Chisenga, a Zambian woman who will share her own story and describe her work on HIV and AIDS in Zambia.
• World AIDS Day is observed around the world on December 1. Plan to get involved and spread the word about 2007 World AIDS Day events. Visit CRS’ website in the coming weeks for more information and to download educational and worship resources.
• Visit our website to learn more about CRS’ HIV and AIDS, food security, and peacebuilding programs in Zambia.
• Finally, talk to your parish, your family, and your friends about how they can join this effort as well.

Photojournalist David Snyder is currently traveling throughout southern Africa on behalf of CRS. He writes from Johannesburg, South Africa:

Africa for one more day. Hard to believe it but I left Baltimore three months ago. I’ve been to eight countries in that time, a journey I chronicled in small part through these blogs. But as I sit here now, looking out over a sunset in South Africa, the trip is too much to get your head around in one sitting. You can’t summarize three months in Africa.

Slogans painted on the walls of the Changamwe Primary School in Mombasa, Kenya, warn students of the hazards of HIV and AIDS. For 30 of the school’s students, orphaned or left vulnerable by the AIDS pandemic, they need no reminders. CRS is targeting those children with a range of care and support, including uniforms and books, which many would otherwise have a very hard time finding the money to purchase. Photo by Dave Snyder for CRS

From a work perspective this trip was mostly about HIV and AIDS, and the steps CRS is doing to combat the effects of the virus. Antiretroviral medications (ARV’s) provided through CRS as part of the US President’s Emergency Plan for AIDS Relief are having a tremendous impact. Quite simply, thousands are alive who would be dead, and their children still have parents. I met many on this trip. The struggle now, everywhere, is for those who have regained their strength through the ARVs to find work to support their families. It’s the main theme I hear from nearly everyone I spoke with at the Home-Based Care centers and clinics dispensing ARVs: people are recovering their lives again after starting the drugs, only to face the burdens of finding food and work.

Wrapping up now at the end of this trip – sitting in a leafy suburb of Johannesburg – I’m already feeling that bit of disconnect you feel every time you come back to the US from Africa, every time you leave one world for another. You feel sometimes that you just can’t really ever explain this place – how it feels, how it sounds, how it smells; how it makes you feel. All the work of the last three months seems pretty small – a few thousands photos, maybe 30 or 40 stories about people I’ve met. It’s so small a part of what you see and feel and experience on a trip like this, it feels inconsequential.

But I was talking with a friend over the weekend, getting my head around the trip home and all I have to do catch up on things when I return, and we both hit on the same theme, at the same time. No matter how tiring, no matter the trade offs of a life spent traveling – and there are trade offs, as with anything – I’m still so lucky to do this work, to see what I see, meet who I meet and do what I do. That’s as fitting a summary of three months in Africa as I can come up with.

After living here for two years while working for CRS, it’s good to be back in South Africa. Some of the faces I knew from here have moved on — aid work is a very transitory profession — but some are still here, and it’s been good to catch up this week when we could.

Despite my time here, I never quite get used to the contrast in South Africa. A trip through the fancy shopping districts of Sandton or Rosebank is a glimpse of Europe, or America, as well-dressed urbanites in BMWs or Mercedes chase the gold, in its new iterations, that first brought hopefuls flocking to Johannesburg, the Gold Reef City, in the mid-19th century.

But South Africa has the second-highest wealth disparity in the world — second only, I think, to Brazil — and for most South Africans, such wealth is simply unimaginable. Not far from the million-dollar homes and properties of Johannesburg’s wealthy suburbs, informal settlements sprawl across the dusty winter landscape, their tin roofs rusting from age and neglect. It is here that the face of South Africa’s greatest crisis — the HIV pandemic — is most readily visible.

With more than 5.5 million of South Africa’s 44 million citizens infected with HIV, South Africa had, until last year, the highest generalized HIV infection rate anywhere in the world. Though overtaken now by Swaziland — a small country ravaged by HIV and AIDS within the borders of South Africa — you need not look far to see the impact of HIV and AIDS in places like Orange Farm, an informal settlement of about 1.5 million people southwest of Johannesburg. I spent the day there today with CRS staff, speaking with patients who are receiving antiretroviral medications (ARVs) provided by CRS through the Inkanyezi Clinic.

In total, CRS is supporting more than 12,000 people in South Africa with these powerful drugs, which inhibit the ability of the HIV to hijack healthy immune-boosting cells within the body. As always, I was astounded by the stories of recovery I heard and saw this week, like that of Michael Baloyi, who I met yesterday at another CRS-supported ARV site. Ravaged by AIDS-related illnesses, Michael, aged 31, weighed just 70 pounds when he was admitted to the Holy Cross Home. His CD4 count, a measure of the immune-boosting cells in one milliliter of blood, was nine. By comparison, that of a healthy person would be around 1,000. For all intents and purposes, Michael was dead.

But ARVs brought him, and thousand of others, back. Sitting tonight in a clean, quiet hotel outside of Johannesburg, I already feel 1,000 miles away from stories like that. Heralded as a success story for making the peaceful transition from white rule under apartheid in the early 1990s, I see South Africa today at a crossroads. The next generation, and the one after that, will determine which South African reality will prevail — the wealth of the few, or the poverty and disease of the many. In the faces of those now receiving ARVs, you see the hope for a future many believed they’d once lost. Maybe that is as good an analogy as any for the country itself.

David Snyder has traveled to more than 30 countries with CRS, working in such crisis zones as Pakistan, Sudan, Angola, the West Bank, Lebanon and the Democratic Republic of Congo.

The book won’t hit the shelves until September, but a website is already up and running. Solidarity Will Transform the World: Stories of Hope from Catholic Relief Services is a collection of testimonies by the people served by CRS. It was written by Jeffry Korgen, the director of social ministries for the National Pastoral Life Center in New York.

The stories in Solidarity Will Transform the World highlight the lives of people in the developing world and the fight against poverty and injustice. Through these accounts, Korgen explores issues like immigration, HIV and AIDS, and peacebuilding.

Solidarity Will Transform the World will take you on a journey to visit the lives of people in Mexico, Zambia, India, Rwanda, and Nicaragua. Read about people in Mexico who are making a better living through Fair Trade coffee and microfinance programs, or about Zambians who through the miracle of antiretroviral drugs have been given a chance at living with HIV and AIDS and who now fight for the lives of their fellow countrymen.

Visit http://storiesofhope.crs.org/, the official website for the book, to read excerpts from all five chapters. The site also contains multimedia about CRS projects around the world — and will soon feature lesson plans and study guides for use of the book in classrooms.

CRS Lesotho is mentioned in a front-page article in today’s edition of The Baltimore Sun. The article is written by Scott Calvert, the Sun’s Africa correspondent, who knows CRS well. He visited CRS World Headquarters in Baltimore in 2004 and was briefed by several members of our staff prior to taking his Africa post.

In Africa, the road to aid is in the sky
Religious mission flies its planes to remote spots carrying medical personnel, HIV drugs, supplies

By Scott Calvert, Sun Foreign Reporter - July 19, 2007

BOBETE, Lesotho – The flight to this remote mountain village went smoothly until the very end, when a flock of sheep decided to run onto the grassy airstrip – straight into the path of a rapidly descending Cessna 206 Turbo.

“Dumb sheep,” growled pilot Tim Vennell. Maneuvering quickly, he kept the single-engine plane aloft 150 feet farther than usual, something he’d rather not do on a strip just 1,800 feet long and nearly a mile and a half above sea level.

Seconds later, the six-seater landed, and out hopped a nurse and two trainers for caregivers of the terminally ill. And so, Vennell’s Idaho-based Mission Aviation Fellowship once again did its part in a growing battle against the HIV/AIDS scourge in this battered southern African nation.

The religious fellowship has become a vital link in a new quest to improve health care for rural villagers cut off by poor or nonexistent roads. Their impoverished isolation is especially acute now, with snow painting the alpine landscape white and temperatures dropping below freezing.

The five red-and-white Cessnas transport doctors, nurses, anti-retroviral drugs for HIV, blankets, coal, food and any other supplies that can fit, including, once, live pigs. And they evacuate patients with emergencies to the capital, Maseru.

In short, the planes make possible the health project recently launched here by Partners in Health, a secular medical charity in Boston that works in rural areas of Haiti and seven other countries. The planes also make possible a support program for 2,000 AIDS orphans being led by Catholic Relief Services, which is based in Baltimore.

To read more of this article, visit The Baltimore Sun’s website (www.baltimoresun.com).