the poultry project

Eric Wafana b.2002 – d.2012

June 14th, 2012

This week, Peter Welikhe (Poultry Project’s Uganda Director) shared some devastating news with us. Eric Wafana, age 10, passed away. Eric and his mother, Sophie, joined the Poultry Project  back in 2006. Sophie worked hard to grow her project, purchase a cow with profits and in 2011, she bought a small coffee farm.

When we met Eric, he was just a toddler. Last summer, he was a robust youth, doing well in school and full of smiles. Despite access to ARVs, medical care and education and the unconditional love and support of a powerful, courageous mother, Eric could not fight the odds against him. We don’t have all the details, but it is likely that TB, malaria or another curable, communicable disease weakened his compromised immune system.

One of the main purposes of the Poultry Project is to spread awareness about the HIV/AIDS epidemic. Stigma, controversy and ignorance still hinder national and international prevention efforts. Aid dollars often never reach the folks, like Eric, in need. And then there’s a plethora of historical, structural, economic and political issues that complicate HIV/AIDS prevention, service, and treatment. Add extreme poverty, weak social/medical/academic infrastructure, malaria and TB to the mix and it seems like Eric was up against the world.

It’s days like these that make us recognize the fragility and miracle of life. We are humbled to have walked hand-in-hand with Eric.  And we honor Eric, his family, his mother, his fight, his life. Rest in peace, sweet Eric.

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Meet the Team: Emily Pavlick

June 17th, 2011

Emily Pavlick is a nutritionist, aspiring ayurvedic chef, master granola baker and yoga instructor by trade. But its her immense heart and compassion, her warm presence and careful touch, her understanding eyes and unwavering generosity, her open mind and unwavering determination, and her belief in the connectedness of humanity that make her work with the Poultry Project so important.

Emily helped start the Poultry Project back in 2006, two years before she stepped foot on Ugandan soil. She was moved to act when she learned about AIDS orphans and their caregivers struggling to make ends meet during that first summer when the project was just a dream. She wanted to make sure that James, a 5 year old boy who had lost both parents to AIDS, had access to food and transportation to his clinic appointments at TASO for meds and TB treatment. She wanted to help Hanania get a roof over his head and help Jude care for his younger siblings. As a full-time student and waitress in Boston, she used whatever spare minutes she had to raise money to get the project going. She baked and sold her granola, asked friends and professors for support, and sent hundreds of emails. Fundraising is hard work, but Emily knew that at that time, it was the best way for her to help. When she finally got to Uganda, she worked hard to add 6 families to the project, build a house and restore a roof for some of the participants, provide basic nutrition counseling and education to participants and TASO staff, and work with her husband, Joe, to devise a division and savings match program for the farmers, strengthening their support network and adding incentives for saving money. This year, she planned an amazing fundraiser at the Woods in Brooklyn, baked almost 50 lbs of granola to sell, planned and co-facilitated the new farmer workshops, and took a month of unpaid leave from her job at the New York City Health Department to go to Uganda to build coops, lead workshops, add families to the project and do a little bit of nutrition counseling.

Whether shes in Uganda or stateside, Emily makes herself available to do any task. A jack of all trades, she gets the job done with grace and efficiency. Sometimes the work is hard and it brings her to her knees. At these times, after a child has passed due to an AIDS-related illness or she sees a child with malnourishment and stunted growth, Emily tries to stay strong, but the tears flow and feelings of helplessness and even failure creep in. “Are we doing enough?” she’ll ask. Together, we realize that we are doing the best we can, that we cannot erase suffering or stamp out poverty, and that we can seek change within ourselves. Having these conversations, grieving together, encouraging each other to move forward, celebrating the successes, making life-long friends with the farmers and TASO staff, and knowing that we have changed their lives and they have changed ours–these are some of our personal benefits from this work.

 

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Poultry Project Farmer-Appreciation Day, Mbale

June 3rd, 2011

The Poultry Project expanded its services to TASO centers in Soroti and Tororo this year, but our roots are in Mbale. We planned a party/workshop for our Mbale farmers to create an opportunity for the old and new farming families to meet, have fun and spend a little time talking about poultry farming. Lona, one of the original farmers, sang a song of appreciation to the Poultry Project. She’s a single mother with two children and she has grown her small flock of chickens into a successful business, acquiring several goats and a cow. Her oldest child, Yekosophat, is at the top of his class and their poultry business made regular school attendance possible. Several of the original farmers stood up to share their experiences, challenges and goals. The new families asked questions and relationships were formed. Peter and Joe went over the savings match program with the participants and awarded prizes for Farmers of the Year. Steven and Sophie were the 2011 winners and they each received leather-band watches–something they said they needed and loved but would never buy for themselves.

It was really amazing to be in Mbale five years after the first Poultry Project workshop, to see our friends and learn about their achievements with their poultry businesses, to be able to work with more families and to watch the children grow. But several children were missing from the party. Between 2007 and 2011, five of the original Poultry Project beneficiaries died from AIDS-related illness. Before the party, we were in Peter’s office working on some project reports and I noticed a small note and photograph laying on top of a box of tools. I recognized the photo, so I picked it up. It was a note I wrote to John Natule back in late 2007 along with a photo taken of John and his uncle (also his guardian, both his parents died from AIDS-related illness). It was a short note telling John that we’re thinking about him and we hope that he’s in school and working hard. I asked him questions about his day; what is he in to; how is the family; how’s the poultry – are they laying, is he eating the eggs, selling the eggs, etc; what does he want to be; where does he want to go.

John died in 2008 at the age of 1o or 11. TASO counselors worked hard to ease the tensions in the household, as John was treated differently than his cousins because of his HIV+ status. I felt sad reading that letter. The letter was almost laughable, like how is this silly letter going to make a difference, how is the poultry business going to make a difference. I felt so helpless and inadequate. Francis, a TASO counselor, came into the office and immediately became aware of me and my little moment with the note. He knew I was upset and he took the note from my hand. He remembered John. I told Francis how I was having a hard time understanding and dealing with all the emotions involved in working with sick children. He didn’t have any answers about why John died and other HIV+ children thrive, or why babies are still  being born every hour with HIV in Africa even though it’s totally preventable, or why children suffer abuse from family members, or why some children have access to everything they need and others don’t. He just gave me a hug. He deals with death, sickness and extreme poverty everyday. He’s not immune to its emotional toll, but the work has hardened him. I didn’t feel better, I just felt numb. It’s easy to ignore these realities when I’m home in Ohio in my comfy house, with access to everything I need and the security of knowing that if there was a major tragedy, I have a support network that is unbreakable. I have never starved nor have I ever put a starving baby to bed. I have had my share of suffering, just different kinds. Having the workshop after reading that letter made me feel hopeful and inspired. I met so many women and children determined to work hard and to not let life’s obstacles get in the way. I remembered the reasons why we started the Poultry Project–to give HIV/AIDS-affected children and their caregivers an opportunity to earn income. It’s really simple and it’s been working. Everyday, we are trying to improve our service delivery by strengthening capacity building trainings, improving the assets we give the families (i.e. healthy chickens, chicken coops), conducting in-depth monitoring and evaluation, and diversifying our funding sources. We have all come a long way and we’re going to keep moving forward.

The party ended with a moving performance by the TASO Mbale Drama Group…

[Photos by Kevin Kopanski]

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Mbale Coop-Material Delivery | Willison

June 2nd, 2011

After weeks of artful negotiations with the Mbale lumber and hardware dealers, unloading and carrying hundreds of heavy poles and planks, and hours traveling on bumpy, muddy roads for chicken coop material deliveries, we were finally at the end. We had four deliveries to go in the Manafwa district, southeast of Mbale. We all loaded into the same turquoise painted construction truck used for every pick-up and delivery (including Soroti), with me and Emily in the front and Joe, Peter, Kevin and David in the back, atop the wood, mesh and poles.

Manafwa district borders Mbale, Tororo, Kenya and Bududa District. With tropical rain forest, mountain vegetation and some savannah grassland, it is a lush, agriculturally rich region. Arabica coffee grows in abundance. We drove to the top of a Mt. Elgon foothill for the first drop-off to a home next to a primary school. The school occupied the top of the tiny mountain with panoramic views of the countryside. The children, all dressed in fluorescent pink uniforms, were outside for recess and they gathered around the truck to watch the unloading. We made two more deliveries and ended the day with a home visit and delivery to Willison.

Willison, age 10, and his three sisters lost their father to AIDS-related illness. Their mother abandoned the family several years ago when she learned of the father’s HIV status; her whereabouts are unknown. Willison and his sisters live with an aunt near their paternal grandfather’s banana farm. They are surrounded by family and have lots of support, but additional income is needed to pay for their school fees, miscellaneous medical expenses, clothing and food. We gathered under an old shade tree at the grandfather’s house with Willison’s family to discuss the Poultry Project (coop, poultry management, success stories). Willison was shy at first but started to open up, especially with Emily and Kevin.  As we were leaving, one of Willison’s cousins presented us with a large branch of bananas from the grandfather’s farm–heartwarming generosity!

 

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Mary Helen + Soroti Capacity Building Workshop

May 30th, 2011

Mary Helen is the Soroti chairperson for the Poultry Project. She lives with 4 of her 6 children and 3 grandchildren in a two-room, tattered-roof mud hut in front of Soroti rock. She refers to her home as “temporary housing,” but she’s been there since 2003. The Lords Resistance Army (LRA) invaded her village (and several neighboring villages) and launched a campaign of mass lootings, killings and child abductions. Over 250,000 people fled their homes to escape the violence and pillage. She dreams of resettling soon, but resettlement requires money to rebuild.

Shortly after she left the Internally Displaced Peoples (IDP) camp, she settled in Soroti town.  Her husband is deceased and she’s been on her own for almost ten years. Mary Helen is a certified midwife and has attended to hundreds of births. She fell ill and when she went to the clinic she found out she was HIV+. Then she lost her job because of her HIV positive status. Mary Helen is pushing forward and hopes to reenter the medical workforce someday. She’s already begun doing odd jobs at the TASO Soroti center in the pharmacy and clinic. In the meantime, she has several children to feed, cloth, shelter and educate and she is determined to make her poultry business grow and succeed.


After the Soroti Poultry Project Training Workhshop last week, the team realized that the Soroti might need an extra push to get their project going. The TASO Soroti Project Officer, Paul, and Peter worked together to organize an intimate workshop for five of the participants facilitated by one of the Poultry Project’s most successful farmers, Steven, because he speaks Ateso and is eager to share his knowledge. The Poultry Project build team would construct Mary Helen’s chicken coop while Steven led a participatory workshop with Mary Helen and the five other participants.


Steven and the Soroti farmers gathered under a jambula (Syzygium cuminii) tree and shared their poultry farming experiences, challenges and goals. Steven is an enthusiastic, engaging educator. He put the Soroti farmers at ease and encouraged them to be open and active in the discussion. After they discussed poultry management, Steven gave them another overview of the savings match program and showed them how to maintain and clean the chicken coop. He reminded them that although we want to see the families acquire larger livestock (cows, goats, pigs), it is essential that they always maintain a flock of at least 5 chickens. He answered questions and told them how he grew his 5 chickens to a flock of over 60. He told them that he has been able to pay school fees for eight children with his poultry business profits. He told them that they can do it too.


The build went smoothly (I think Joe, David and John could build a coop blind-folded) and the drive back to Mbale was uneventful. Kevin got some quality one-on-one time with Robert, one of the project beneficiaries, and had a chance to give him a thorough introduction to professional photography (strobe lights, tripods, composition, light meters and all). We left Soroti feeling so proud and energized about having one of our original farmers train new participants. The Poultry Project is truly changing lives.

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Hunger

May 26th, 2011

Proper nutrition is a critical component of care in people living with HIV/AIDS.  In partnership with USAID, TASO implemented a therapeutic feeding program to support malnourished child clients.  Each Tuesday and Thursday the clients gather in the children’s clinic and patiently wait to be seen by their counselors and physicians.  While waiting, a nutrition technician gathers anthropometric measures suchs height, weight and mid arm circumference.  These measures determine which children receive the high energy, fortified feeding packs called “Plumpy-Nut”.    The supplement is basically 3/4 cup of peanut butter with added milk powder, sugar, soybean oil, and vitamins & minerals.  Some children are prescribed up to five per day depending on their status.

In the past, all children who presented with moderate to severe malnutrition were given the supplements.  However, a recent cut-back in funding has made the cut-off more stringent and TASO can only provide supplements to those who are categorized as “severly malnourished.”

One of our newly added participants receives the nutrition services at TASO.  His name is Akoth – we met him at the Tororo workshop, he sat in the front row with his older sister.  At first glance, I thought he was around 8 or 9 years old.  His eyes are large, glassy and black, with a focused stare that seemed to look right through me.  His shoulders were narrow and the sleeves of his tee shirt fell past the elbow, hiding his bony forearms.  His chest would slowly rise with each inhale; labored breathing was apparent.  He would place his hands on his somewhat misshapen head to either stay awake or fight back the pain of a headache.  He seemed uncomfortable, so I quickly asked the counselor if there was anything we could do for the little boy.  She shared with me that this small child was hungry, he didn’t feel well and he in fact, was not a child, but 17 years old.  This was the first time that I’d seen such marked effects of undernutrition.  Akoth is HIV positive, has stunted growth and is severely anemic.

Childhood stunting is a reduced growth rate caused by malnutrition in early childhood or malnutrition during fetal development due to a malnourished mother.  Stunting and its effects are permanent.  Children who experience this nutrition-related disorder, in most cases, do not regain the height and weight lost as a result.  Overtime, the child will be faced with physical conditions that result in premature death because vital organs never fully develop.  Children born with HIV are at a higher risk for stunted growth because of their increased nutrient needs and compromised immune systems.

While TASO provides the therapeutic feeding program, it’s never enough for some children.  Due to extreme poverty, chronic illness and inadequate healthcare, some children will never get a chance at a normal childhood.

This post, and blog in general, is not a call for action from our readers.  Rather, an opportunity for the reader to imagine the reality as it exists here in Uganda and much of the developing world.

Akoth, 17

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Shamim

May 25th, 2011

It’s hard to forget a girl like Shamim. Full of charisma, spirit, soul and cheer, her presence cannot be ignored. She is the star of TASO Mbale and, as we learned today, her village. It was the first time Emily and I had the chance to spend a whole day with our friend Shamim. While Joe, Kevin, David and Eric built the coop, we went exploring the village with Shamim. She took us up a steep, red-dirt road to her school, to her teacher’s house, to meet her friends and elders, to the clothing market and to meet her friend the tailor (she repurposed an abandoned truck cabin into a sewing studio). Everyone seemed to know Shamim and she greeted each acquaintance, relative and classmate with a handshake and smile. Every old man was introduced as her grandfather, adult women-auntie, and the old women were grandmothers. We walked back to her house to avoid the rain and spent the rest of the afternoon lounging under the trees on papyrus mats. Shamim speaks perfect English now, making it easy for us to communicate with her (ideally, we would speak her language, Lugisu). Back at the house, she shows us her recent school reports and they don’t match up with her obvious intellect. She’s been struggling at school lately because of sickness and the subsequent absences. And when she is at school, hunger, fatigue and ARV side effects affect her concentration. She kept telling us she was hungry, so we went back to the market and got her lunch and some bananas. When we returned to the house, she gave all the elders her food and left only a small portion for herself. This really bothered us, as we know that she needs every bite of protein, fat, and carbs she can get.

As we were loading up the car to leave, she pulled me and Emily aside for a confidential chat.  She gazed toward the ground and her smile faded as she told us her caregivers don’t love her and treat her poorly.  We didn’t have much time to gather more information before one of the elders came over and Shamim quickly changed the subject.  We have requested that a counselor speak with Shamim and her grandmother to figure out the whole situation and hopefully prevent any abuse, should that be the case.  It could also be that the caregivers are favoring the other children over Shamin, because of her HIV status.  It’s very common, for  the positive child to be treated differently, whether it be with access to school, food rations or the amount of housework given.  It’s really frustrating to not be able to solve all of Shamim’s problems right now. To make sure that she has the childhood she deserves. The Poultry Project is not going to bring Shamim’s parents back or take away her illness, but it will help her and her family make some money and it has the potential to flourish into a thriving business. Shamim’s family purchased a cow with profits from their poultry business and her enrollment at school, from P1 through P4 has been a direct result of the project. We are hopeful that the TASO counseling team will be able to identify and resolve the current issues the family is facing. Before we left, we hugged Shamim and told her that we love her and that everything will be okay-I hope we can keep our promise.

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Soroti Workshop + Build + Material Drop-off

May 24th, 2011

Last week, we held a training workshop for 10 new Poultry Project families in Soroti, a town west of Mbale. The 100 kilometer drive down Kumi Road was dotted with potholes and a speed bump every 25 meters.  Along the way we were able to take in the lush scenery including Lake Aoja, wide expanses of greenery where livestock grazed and rice paddies flourishing in the moist soils.  The Soroti TASO branch opened in 2005 and has already taken on a client load of 6,000.

Our team included Nova, Dr. Sakwa, Kevin, and me; Joe and Kelly were busy dropping off materials to the homes and building a coop. TASO Mbale counselor Nova works with the Therapuetic Feeding program for malnourished child clients.  Dr. Sakwa has been working with the Poultry Project since 2008 as our program Veterinarian.  He is 29 years old and graduated from Makere University, Uganda’s largest and most prestigious school.  He is always eager to join the team at workshops and never fails to deliver informative and detailed information to our participants on how to best keep their chickens.  When we arrived in Soroti we were given a warm welcome from Patrick, the TASO Soroti manager and long-time friend of Kelly.  He delivered a welcoming speech to new participants including stories of success from Mbale participants to increase interest in the project the children would soon be a part of.  While we snacked on warm chapati’s and freshly brewed black tea, we listened to the 3 hour lesson on proper chicken rearing.  Dr. Sakwa explained proper nutrition for the birds, how to mix feeds, the vaccination process, hygeine, housing and breeding. He said to the participants, “It’s not just me giving you my knowledge. You have knowledge about poultry too and I want to know about your experiences. We share knowledge.”

Just like the workshop in Tororo, the participants selected a chairperson. Mary Hellen Akol spoke throughout the workshop and when the time came to express interest in the chairperson role, her hand shot up and she enthusiastically volunteered for the position. Mary Hellen lives near the prominent, granite Soroti rock formation on the outskirts of town with her daughter, Cecilia Amunyir (Poultry Project beneficiary) and 5 younger children. The drop-off team told me that despite the heavy rain and messy mud, Mary Hellen and her children helped unload every piece of wood, mesh and papyrus for the coop. Her home is a small mud hut with a makeshift roof made of plastic tarps, tires, rice bags, grass and whatever else she can put there to keep the rains from coming in. Mary Hellen has kept chickens before, but disease and mismanagement affected her ability to ever make a significant profit from selling eggs. She told Dr. Sakwa that she learned a lot at the training and she is feeling confident about her ability to grow her 5 birds into a successful poultry business. The workshop ended with an overview from TASO counselors, discussing the next workshop time/date, distribution of bicycles and portraits by Kevin. The Soroti workshop didn’t run as smoothly as Tororo, but we are working with Peter to provide a little extra capacity building to ensure that the Soroti Poultry Project farmers have the support and resources they need to be successful.

While Kelly and Joe dropped off materials to 10 homes and Kevin and I facilitated the workshop, Emily A. worked with the build team (David, Eric and John) to build a coop for Poultry Project beneficiary, Vincent. Usually, the first coop build takes place at the chairperson’s home, but since Soroti is so far away and a chairperson hadn’t been selected it made sense to build a coop at a randomly selected home. Vincent is 14.  He lost his father to AIDS and now lives with his mother who is HIV+ and 6 siblings.  After his father passed, the family began to struggle paying for basic needs.  Borrowing and stealing in order to obtain enough food became a regular means of survival.  Stable housing is a luxury of the past.  Being a resourceful teen, Vincent began doing manual labor for a neighbor to earn extra money.  The neighbor later arranged for Vincent’s family to move into their home.  Although the home is safe, Vincent’s family worries about the future, should  the well-wisher decide the family of 8 should leave. It is our hope, that participation in the Poultry Project will help Vincent and his family earn enough income to become self-sufficient and not have to struggle to eat, go to school and pay medical fees. And maybe, they’ll make enough money to build their own home.

Kelly, Joe and TASO Soroti Project Manager Paul delivered coop materials to 10 homes. With one home nearly 60km from town and a late start, the drop-off took nearly 12 hours. Joe unloaded materials for 5 families in the rain (Kelly helped with a few, but she focused on meeting with the families and staying dry). Meanwhile, Emily A. and the build team waited at Vincent’s house for the truck. They finished building the coop around 6pm, but didn’t get picked up until 9pm. The family kept insisting that they spend the night and declining their generous hospitality proved uncomfortable for the build team, especially Emily A. She maintained her usual optimism and assured the family that the truck would be their soon to get them.  Emily and Kevin, back in Mbale  by 7pm, waited patiently for the team, unsure of their whereabouts or if they’d make it back that night.

It was a long day, but we all know why we are here. We look at the families we’re working with and we are inspired and motivated by their courage, strength, endurance, and hope.

Cecilia in front of her home near Soroti rock.

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Tracy, Sharon and Winnie

May 22nd, 2011

Sisters since birth, best friends forever – kind of cheesy, but so true. My aunt Mary bought us a print with that saying and I can’t get it out of my head. Last Wednesday, we met some sisters with an impenetrable bond. Tracy lives in a peri-urban neighborhood in Tororo. Her father died several years ago from AIDS-related illness and her HIV+ mother has been living in the village with the grandparents, too ill to care for herself or her children. Tracy (age 19) took on the role of mother and father to her sisters Winnie (17) and Sharon (11) a few years ago. Although Tracy is the oldest and the primary caretaker, it’s evident that they take care of each other.

I have two sisters and I consider them my best friends. But we are not orphans. I still have a hard time trying to truly understand the challenges these children face when they lose one or both parents. The simple thought of losing a parent paralyzes me, and I’m thirty years old. As a mother, I think about my daughter and I’m so grateful that I have the health and resources to care for her. Tracy is one of the top students in her Senior IV class. She aspires to be a doctor but, aware of her responsibility to care for her sisters, she is considering becoming a teacher because it will be less expensive and allow her to enter the workforce sooner. Tracy’s counselor and the rest of the Tororo Poultry Project participants recognize her sharp intellect, reliability and strong work ethic–the group of farmers unanimously selected her as the Tororo chairperson.

We spent the day with Tracy and really got to know her. As the chairperson, her coop would be built first. While the build team cut poles with pangas and constructed a chicken coop, my sister Emily and I shared stories, challenges and dreams with Tracy. She showed us her school books and report cards. She told us about her friends at school and in the neighborhood. We walked to the market together and helped her gather food for supper. It’s spring holiday, so most Ugandan children are off school until the end of May. Tracy confided in us about the rocky relationship between her mother and her sisters. Her youngest sister is HIV+ and she struggles with seeing her mother ill and bed-ridden. She fears the progression of the disease and tries so hard to adhere to her treatment regimen.

Tracy ensures that her sister has food to eat, transportation to TASO appointments, and a durable mosquito net. It’s not easy for Tracy to keep up the house, her sisters’ health and wellbeing, and her schoolwork. Tracy tells us about the challenges and is hopeful that the poultry business will help make ends meet. She smiles often, but you can see the pain and struggle in her eyes. She rarely gets the chance to enjoy her teen years. I don’t know how she does it. She is one of the strongest women I have ever encountered.


Being with my sister Emily while spending the day with Tracy and her sisters made me feel so lucky and grateful. When I came to Uganda for the first time back in 2006, Emily took a sincere interest in HIV/AIDS work and started helping right away. She helped me start the Poultry Project and began working in HIV/AIDS in the US. Theresa, our other sister, is equally committed to the Poultry Project and has mobilized her high school friends to get involved with fundraising and HIV/AIDS awareness.

I watch how Tracy interacts with her sisters and, although my heart aches for her because her parents aren’t around, I am reminded that they have each other.

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World AIDS Day

December 1st, 2010

World AIDS Day – a day to remember our friends, parents, siblings, children, lovers, leaders, family, and fellows that have died from AIDS related illness; a day to honor the changemakers that have made ARVs and other life saving treatment available to millions; a day to thank the AIDS activists that continue to fight for access to evidence-based HIV/AIDS prevention (i.e. syringe exchange, comprehensive sex-ed, condoms, female condoms, harm reduction); a day to recognize that everyday is AIDS day because we are all affected.  There’s a t-shirt that TASO staff wear and it says, “Stopping AIDS starts with me.”  I just read an article in the NYTimes about the new wave of AIDS activists on US college campuses.  These kids are putting pressure on Obama and White House staffers to keep the 2008 campaign promise of $50 billion to fund AIDS programs.  A funeral for the 1.8 million people that have died from AIDS related illness will be staged today by ACT UP Philadelphia on the White House lawn.  There are some simple things you can do today to advocate for more resources for AIDS prevention and treatment and to join the movement to end AIDS.  At Change AIDS Obama, you can sign and send a letter to Obama urging him to address the dwindling resources available to US AIDS service organizations and health departments to provide prevention and treatment to people living with HIV/AIDS in the US; click here to send your letter.  Get tested.  HIV testing is one of the most important HIV prevention tools.  Click here to find a testing site by zip code.

We honor the Poultry Project participants that have died from AIDS related illness:

James

Jacqueline

Rashid

John

Hanania

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HIV/AIDS in Uganda – WSJ article

February 5th, 2010

Aid Watch, a blog I love and read often, posted “How the war on AIDS was lost” in response to a recent Wallstreet Journal article about AIDS treatment shortages and increased HIV incidence in Uganda.  Both articles describe a shortage of AIDS treatment for the increasing HIV infections in sub-Saharan Africa, but then point to spending on treatment rather than prevention as the cause of increasing HIV infections.

I have worked in HIV/AIDS services for almost 5 years and what I know to be true, in the US and Uganda, is that treatment and prevention are interdependent.  I also know that HIV/AIDS is a complex problem with social, economic, political and public health factors – a complex response is essential.  There is not a silver bullet solution to HIV/AIDS.  And prevention is difficult.  The WSJ article praises the Bush administration for PEPFAR, but fails to acknowledge the misguided PEPFAR prevention policies that ignored evidence-based prevention practices in favor of ideology and may have contributed to increased HIV incidence in Uganda and other PEPFAR-funded countries. Finally, the WSJ article failed to mention the innovative and effective work of The AIDS Support Organisation (TASO), an indigenous AIDS service NGO in Uganda.  TASO uses a community-based approach to provide care and services to Ugandans infected and/or affected by HIV/AIDS.

Paul Farmer has spoken out against the treatment vs. prevention debate.  Here he describes the connection between structural violence and HIV, shedding light on the complexities of the HIV/AIDS epidemic and the need for a multi-faceted response (from Pathologies of Power):

HIV attacks the immune system in only one way, but its course and outcome are shaped
by social forces having little to do with actual virus
… From the outset of acute HIV infection to
the end game of recurrent opportunistic infections, disease course is determined by, to cite but a
few obvious factors: (1) whether or not post exposure prophylaxis is available; (2) whether or not
the steady decline in immune function is hastened by concurrent illness or malnutrition;
(3) whether or not multiple HIV infections occur; (4) whether or not TB is prevalent in the
surrounding environment; (5) whether or not prophylaxis for opportunistic infections is reliably
available; and (6) whether or not antiretroviral therapy (ART) is offered to all those needing it.

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