Tuesday, September 14, 2010

Capacity building for Persons living with HIV project

We just completed a project titled 'Capacity Building for People Living with HIV' which contributed to the global response to HIV by empowering 20 people living with HIV with knowledge and skills that can help them lead positive lives and use social media to take action towards Universal Access to HIV prevention, treatment care and support.

All 20 participants say the project was timely.


Thursday, May 20, 2010

Safe Drinking Water for all Project

 Golden Water


The Millennium Development Goals (MDGs) call for a reduction of the proportion of people without sustainable access to safe drinking water by half between 1990 and 2015. Yet, an estimated 884 million people in the world, 37% of whom live in Sub-Saharan Africa, still use unimproved sources of drinking water1.
Lack of access to safe drinking water contributes to the staggering burden of diarrhoeal diseases worldwide, particularly affecting the young, the immunocompromised and the poor. Nearly one in five child deaths – about 1.5 million each year – is due to diarrhoea. Diarrhoea kills more young children than AIDS, malaria and measles combined2. Drinking contaminated water also leads to reduced personal productive time, with widespread economic effects.
Approximately 43% of the global population, especially the lower-income populace in the remote and rural parts of the developing world, is deprived of household safe piped water. Thus, there is a pressing need for effective and affordable options for obtaining safe drinking water.

Golden Water is the most safe and affordable bottled mineral water in Cameroon. 0.5l is sold at 100FCFA, same quantity its competitors sell at 250FCFA. Each time you drink Golden Water, you safe 150FCF. Everyone deserve safe drinking water!


References
a.  Vestergaard Frandsen: http://www.carbonforwater.com/
b. Clasen, T. et al. 2006. Interventions to improve water quality for preventing diarrhoea (Review). The Cochrane
WHO and UNICEF. 2008. Joint Monitoring Programme for Water Supply and Sanitation
c. UNICEF and WHO. 2009. Diarrhoea: Why children are still dying and what can be done
d. Wright, J. et al. 2003. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health 9: 106 – 117
e. Ghislaine, R and Clasen, T. 2010. Estimating the Scope of Household Water Treatment in Low- and Medium-Income Countries. Am. J. Trop. Med. Hyg., 82(2), pp. 289–300
f. Fewtrell, L. et al. 2005. Water, sanitation, and hygiene interventions to reduce diarrhea in less developed countries: a systematic review and meta-analysis. Lancet Infectious Diseases (5): 42–52

Tuesday, April 27, 2010

Small Grants Management Challenges

The emergence of young leaders in project management has exposed some pertinent challenges in managing small grants projects. The execution of Our Chances with HIV Project' in Cameroon was a great experience on such challenges. We faced challenges like scope changes, adherence to HIV confidentiality policy and working with partners. Let me share an experience on scope changes.

GYCA announce the award of small grants for my project in January. That was quite timely since the project  was planned for January to June 2010 in consideration of the National Youth Week that runs from February 1st  -10th . Somehow, GYCA couldn’t provide the funds until mid February. We were caught between shifting the project timelines to wait for the funds and borrowing funds to respect the timelines. Mindful of the project’s attachment to the National Youth Week, We had to go for a micro-finance loan and partner with an institution that could facilitate the process. The risk with taking a loan to pre-finance a project is paying the interest and/or paying back if the funder changes her mind. This process also brought in a stakeholder that was not in the original plan.

Scope changes in project management have become a common project management challenge in recent years. This happens when there is a need to modify the agreed-upon project scope as defined. Scope changes often require adjustments to cost, time, quality, risk or other project deliverables. ‘These changes must be put back through the planning process, updating plans as needed and notifying stakeholders as deemed appropriate ‘said Sally Stanleigh, BIA associate. Corrective action is needed to bring expected future project performance into line with the project plan.

The term”Scope Change” refers to anything that will now be different to what had originally been agreed-upon in the original Project Scope Statement and subsequently the Project Plan.

Saturday, April 17, 2010

Advocacy Plan: Goals and Objectives

Goals
My advocacy goal is to mainstream openness about HIV and sex as part of the International Youth Day in Cameroon. This will be achieved through community mobilization to stand against cultural norms and religious beliefs that stigmatize YPLWHIV.

Objectives

Mobilize young people to match and sensitize the community to drop the cultural and religious beliefs that stigmatize YPLWHIV in Bamenda Cameroon.

Produce strategic messages that can change the communities' perception about being HIV positive and make everyone free and open about HIV.

Encourage the public to recognize the plight young Cameroonians in the face of HIV and show solidarity towards the YPLWHIV.

Promote the sexual and reproductive rights of YPLWHIV as a measure to increase VCT and reduce self stigma for YPLWHIV.

Sunday, April 11, 2010

Universal Access and YPLWHIV - Cameroon study (Know your Epidemic Part B)

For almost three decades now, the Human immunodeficiency Virus (HIV) pandemic has remained one of the most complex health issues among human beings especially the young people allover the world. The joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that 5.4 million youths aged 15-24 were among the likely 33 millions people living with HIV in 2007. Allover the world, young people have never known a world without HIV especially as an estimated 7500 people are still being infected with the virus everyday (UNAIDS 2007).

Sub Saharan Africa is home to two-third of young people living with HIV and most of these youths also belong to marginalized populations that are vulnerable to HIV such as sex workers and men who have sex with men (MSM).

Cameroon is one of the sub-Saharan African countries and home to about 540 000 people living with HIV (15-49 years) – meaning 5.1% of the country’s population is infected (UNAIDS 2008). Youths especially young women (15-24 years) are believed to be two times more infected than any other generation.

To contain the HIV infection, the Cameroon Government has endorsed most of the international treaties that allows universal access to HIV prevention, treatment care and support including the protection of the rights of people living with HIV and AIDS (PLWHIV).Cameroon is signatory to the Millennium Development Goals, UNGASS Declaration of Commitment; the Maputo protocol (not yet ratified to law) and the CEMAC Policy on Mainstreaming HIV/AIDS in Primary and Secondary Education programmes.
It is within this framework that the Cameroon government developed the National AntiRetroviral Treatment (ART) program which has covered about 58% of the estimated eligible HIV infected population by June 2008 (Elsevier Health volume 92, October 2009).

However, young people and male patients, as well as those who only had a primary level education are less likely to access ART at Central and Regional Hospitals, whereas those who are unemployed are less likely to be treated at all. Patients are less likely to be treated in Central and Regional hospitals with higher workload per medical staff member and absence of task shifting policy, and in district hospitals with non-availability of equipment for CD4 counts and larger size (150 beds or more) -.(Elsevier Health volume 92, October 2009)

Young people living with HIV (YPLWHIV) do not only deny access to ART especially in the urban areas but also refrain from joining Support Group and coming out to lead HIV and AIDS activities. According to the report of a project carried out by Cameroon National Association for family Welfare (CAMNAFAW) in 2009/2010, young people constitute less than 5% of the membership of Social support Groups aimed at promoting care and support to PLWHIV; and out of every ten members, 8 are women against 2 men.

Following consultations with Associations of PLWHIV, Treatment Center, SCO working with PLWHIV and Members of the Ministry of Public Health, accountability for the poor access to HIV treatment, care and support by YPLWHIV can be examined at the level of service delivery, societal beliefs and the economic policies in Cameroon. It should be noted that, the AIDS Accountability Card scores Cameroon's Treatment effort as low (2/5).

At the level of service delivery, the treatment centers have limited workforce and infrastructures. Because of the increasing workload on the limited personnel providing services at the treatment centers, stress provoke some of them to say words that creates a feeling of stigma in the clients. At times, this also results into bribery and corruption that works at the detriment of the poor youths.

Still at the treatment centers, the infrastructure does not permit adequate confidentiality especially in structures with multipurpose rooms (one room for reception and/or pre-test and post test counseling) and feebly separated rooms. The beddings infrastructures in the Central and Regional Treatment Centers are usually limited in space.

In many cases, the service providers have limited time to properly counsel the clients. Most of them don’t even have time and opportunity to acquire updates about living positively with HIV. Thus, limited positive living education wreck hope for the YPLWHIV and builds a self stigma which further prevents them from accessing treatment, care and support.

Societal beliefs paint the HIV infected youths as promiscuous and ungodly and thus, YPLWHIV would prefer to hide and die with HIV than to access treatment, care and support where they would be stigmatized.

Economic factors are also accountable for poor access by YPLWHIV. Immediate survival is considered more important than belonging to a Support Group. Since youth unemployment in Cameroon stands at 13%, the rush for limited resources for survival often undermine the need for educational and psycho-social support. Poverty also limits that young people from paying for regular health cheeks.

In conclusion, the government is held accountable for not providing: enough personnel to render services; adequate infrastructures; recycle programmes for personnel and jobs for youths. The community is also held accountable for promoting negative beliefs about HIV and stigmatizing YPLWHIV.


Resources

• World AIDS campaign : http://www.worldaidscampaign.org/en/
• The Joint United Nation programme On HIV and AIDS (UNAIDS): http://www.unaids.org/en/CountryResponses/Countries/cameroon.asp
• Essevier.Journals : http://www.journals.elsevierhealth.com/periodicals/heap/article/S0168-8510%2809%2900075-X/abstract
• CEMAC HIV policy: http://unesdoc.unesco.org/images/0017/001785/178583E.pdf
AiDS accountability score cared: http://aidsaccountability.org/?page_id=1369/

Sunday, March 21, 2010

Universal access and Human Rights - Cameroon study

The Government of Cameroon is a signatory to most of the universal declaration on Human rights affecting most at risk youth group especially young people living with HIV (YPLWHIV).Men who have sex with Men (MSM)and sex workers related deals are still under observation even though their freedom is respected.

Since the United Nations Special Session on HIV/AIDS (UNGASS)2006, the Cameroon government has stepped up universal access to prevention , treatment, care and support to PLWHIV and a good percentage of the positive tested persons are currently placed under free Anti Retroval Treatment (ART).
In 2009, the Cameroon Government signed the Maputo Protocol which allows rights to voluntary abortion and freedom of sexual choices, however, these concepts were never adopted into law following divided opinion within the population.
Prostitution on the other hand has been a subject of discussion for over a decade but there still don't exist any rights for people involved.

In this essay, i will concentrate on YPLWHIV, the group that can be easily identified in Cameroon and is subjected under the current government policy. Unlike other countries whose governments respect, protect and fulfill the rights of this group, the Cameroon Government unfortunately doesn't give enough protection and fulfillment of rights of YPLWHIV.

Respect will mean refraining from interfering with the enjoyment of the rights. YPLWHIV have the freedom of choice of partner; the rights to pursue a satisfying, safe and pleasurable sexual life; and the freedom to access any medical service accessible to Cameroonians.

Protection of rights here would means enacting laws that create mechanisms to prevent violation of the rights of YPLWHIV by anyone. This has been partially done because YPLWHIV are protected by law to access treatment, care and support. However, there exist no laws punishing violation of their rights to employment and acceptance without abuses related to their status by community members. Also, they are no laws to carter for Orphans and Vulnerable children(OVC)basic needs and education.

Fulfillment of rights is another obligation which the Cameroonian government partially executes.Fulfillment means to take active steps to put in place institutions and procedures, including allocation of resources to enable YPLWHIV to enjoy the rights. YPLWHIV have access to treatment centers in all regional headquarters of the country but what about the sub urban and rural populations? An ARV procurement procedure has been put in place but very often, there are shortages in supply and the small quantities are not evenly distributed.

Because of the above lapses in the protection and fulfillment of human rights of YPLWHIV, universal access to prevention,treatment, care and support has not been very effective in Cameroon. How? The failure to put in place a mechanism to cheek stigma prevents youths from openly accessing services. This also create the attitude of 'I'll not dying alone' which further spreads the virus. The fear of stigma also leads to denial of VCT which further renders youth's vulnerability.
Considering that Cameroon is a limited resource country with more than 45% of the population living below poverty line, YLWHIV especially the orphans and those below 18 years deserve the right to free resources for immediate survival.

The few policies that exist were not created with the consent of these youths. youth involvement in decision making is still a national challenge and HIV policies are often not cost effective with much resources allocated to ineffective strategies.

Friday, March 12, 2010

HIV and AIDS Epidemiology in Cameroon

Cameroon is one of the countries in sub-Saharan Africa still struggling with an HIV prevalence above 5%. Over 540 000 out of the estimated 18,900 000 people of Cameroon live with HIV and the youths lead almost two third of these numbers.

The first case of AIDS in Cameroon was diagnosed in 1985. By late 2003, UNAIDS reported that 4.8% of the population was infected by the virus. This number rose to 5.5% in 2004, creating an alarm which deployed the Cameroon Government, Civil Society Organizations and International bodies to step up policies and actions against HIV/AIDS. Four year after, the country witnessed a drop by 0.4%, (UNAIDS 2008).
Over 3900 000 are estimated to have died of AIDS in Cameroon with the greatest number of death recorded amongst the youthful population.

The World Health Organization (WHO) considers Cameroonian sex workers, truck drivers, mobile populations and military personnel to be the professional groups most likely to contract HIV. Sex wise, women, especially those between the ages 15 to 24, are three times infected than their male counterparts. Cameroon is divided into 10 regions and the HIV prevalence varies per region with the North West Region topping the charts with a prevalence of 8.7% (Demographic and Health survey 2004).

Women (15-49years) account for 300 000 of the 540 000 living with HIV giving an outnumbered ratio of 3:2 when compared to men. This ratio is much similar to other countries in sub-Saharan Africa, meaning women’s vulnerability to HIV here is a regional issue. However, pertinent socio-ecomomic factors such as polygamy, prostitution and gender violence greatly account for the faster spread of the virus among women in Cameroon.

Even though women are generally more infected, young women(15-24) are at a critical position. The DHS 2004 states that, girls aged 15 -19 and 20-24 are the most infected by HIV and are 3 times more than boys of the same age groups (2.2% and 7.9% for girls as against 0.6% and 2.5% for boys respectively). Because the primary means of HIV transmission in Cameroon is heterosexual intercourse, women are particularly at risk along with youths who engage in risky sexual practices. This vulnerability within the youthful population can also be attributed to inadequate sex education at many levels. For instance, Many youths misunderstand the nature of HIV transmission. UNICEF reports that, among youths (15-24 years) only 63% of males and 57% of females know that a healthy looking person can have HIV. Only 16% of females youths (15-24 years) reject local misconception about HIV transmission, identify condoms and monogamy as methods to prevent HIV transmission, and know that a healthy looking person can have HIV.

The fact that girls between 15 and 24 years are more infected that their peers of the opposite sex is a clear indication that they don’t only contract this virus from their peers. A study carried out by GTZ/ACMS in 2005 proves that 45% of female students in Cameroon have sexual relationships. Out of the 45%, 35% have sexual relationships with sugar Daddies (older men). The entire sexual risk with sugar daddies is to meet up with economic needs. It should be noted that, more than 42% of Cameroonians live below poverty line and youth unemployment stands at 13%.

The Cameroon Government and her international partners have developed a National plan to help improve the HIV/AIDS response in Cameroon especially among youths. The National AIDS Control Committee was created in 2001 and since then, has been decentralized to the grassroots to increase access to information on HIV/AIDS. Every region in the country has at least an AIDS Treatment Center which offers counseling,testing and treatment services as well as community relay. District hospitals also render HIV services at the sub-urban and rural area but not to the extend of conducting CD4 counts. Prevention information is gradually being integrated into primary and secondary school programmes following a commitment signed by countries of Economic Community of Central African States (CEMAC). Civil Society Organizations (SCO) such as ACMS, IRESCO, CAMNAFAW and Chantal Biya Foundation also put young people (15-24) at the center of primary prevention by organizing annual campaigns such as ‘Holidays free of HIV’ and publishing monthly magazines such a the ‘100% Jeune’ and ‘Among Youths’ which promotes prevention education. The male condom has been available for decades and in 2009, ACMS in partnership with the Cameroon Government lunched the Universal Access to Female Condom (UAFC) project. Peer educators of all age groups above 18 years are allover the national territory to promote the female condom as a measure to curb the spread of HIV especially among young women.

Generally, youths can access HIV/AIDS services without restrictions or discrimination. However, stigma on people living with HIV (PLWHIV), sex workers and men who have sex with men (MSM) discourages some youths from benefiting from the available HIV resources. Most SCOs have expressed concern about these and believes that, if the rights of MSM and sex workers are liberated, they will access HIV prevention, care and support freely and the national prevalence will drastically drop.

Monday, March 8, 2010

About me


On May 5th 1984, a son was born to the Munteh’s family called Numfor (Kings man) Alenwi (God's blood). This prophetic name predestined me to the path  of kings as i grew up. I've never know a world without HIV, hurrible climate, gender inbalance and hunger. For many years, a balance diet was seen as luxury and the anxiety of a future misery was my closest feeling.

As i king to be,  I had to fight through all these to reach the crown.  My 28 years on earth are defined by the effort to change something about these challenges: HIV, Gender, poverty  and climate.