Co-Director of ACI, a Lutheran World Relief partner organization in Senegal
I came to Senegal in 65 and worked in training related activities over the years gradually moving into health and about 15 years ago with a colleague we started an NGO called ACI, Africa Consultants International, basically training consultants working with community based organizations and government agencies trying to help improve the quality of training, training materials, advocacy activities, and that gradually moved into health in 1990. There was a consultation with UNDP related to AIDS. It was our first contact with AIDS, but from that experience we became very involved in the response to the epidemic.
WAS THERE AIDS IN SENEGAL AT THAT TIME?
Yes. The AIDS epidemic in Senegal was first discovered around 86. The first cases were in 86, but it wasnt a big issue in Senegal. It was talked about but it wasnt one of those countries that made headlines from East Africa at the time like Kenya or Tanzania, which had very high prevalence rates. Senegal was always fairly low.
DO YOU HAVE AN IMAGE OF THE STRATEGY NEEDED TO STOP THE VIRUS
We have a sort of organic view of how the human being has to respond to the epidemic. The virus reproduces very quickly and our feeling is that in any given society you have to produce anti-viral elements in that society more quickly than the virus reproduces&through awareness raising and the training of individuals and the spreading of informationtrying to do that more quickly than the virus itself can spread in any given society.
DOES THAT WORK?
Weve seen changes. Weve seen community groups develop strategies and, for example, we have a group in the south of the country where they told us that teenage pregnancies in the members of their group has dropped dramatically since they began doing HIV and sexually transmitted disease awareness raising. The question is: how can we bring this to scale so that its happening all over at the same time?
HOW DOES ACI WORK?
Well, it all starts with an approach. Its whats called the HIV in development approach. Its an approach that helps people understand the complexity of whats at stake. And after that we try to continue with the groups that weve trained or helped to inform about the epidemic and provide them with whatever they feel they need to be able to go on. In some cases its a question of materialsteaching or learning materials. In other cases its ongoing training in specific areas. It can be a question of networking, understanding whats going on with other groups in the country or whats happening with government or national AIDS control programs. It can also simply be providing them with information areas theyre not familiar with or on the latest developments on the responses to the epidemic.
COULD YOU EXPLAIN THE CASEWORKERS? HOW DO THEY WORK?
We had identified certain people working with local organizations who had really emerged as exceptional in terms of their involvement, their devotion, their interest, their skills, their communication skills. And we decided to use a caseworkers approach&So basically we hired five casworkers, each assigned a region based on where they had come from. We identified four or five key groups in each region that had either been doing good work in an AIDS related project or had the potential to do work in that area.
Our caseworkers would go back and forth between ACI on a monthly visit and each time they came they would bring with them one tool, one additional support, one additional way of strengthening HIV activities. So you see, that over a period of months they would gradually improve in skills and improve in materials and improve in confidence and become resource for other people.
WHAT GROUP ARE YOU MOST PROUD OF OUT THERE?
Oh, thats like having a lot of kids and saying this ones my favorite. DEGGO is a very devoted group of women. Women in the epidemic are very vulnerable. Theyre vulnerable for physiological reasons, but theyre also very vulnerable for cultural reasons and to have a group of dynamic women who are completely devoted to community development in general and to stopping AIDS. Its a group thats coordinated by a health persona midwife whos very dynamic and very devoted. Its very creative. Theyve developed theatre and community strategies. They even developed a strategy of working with the surrounding villages where they would all go out and each one of them would take one sector of society. It was quite a brilliant strategy. And the result was that they created a whole movement to find responses to the epidemic because everybody was made aware of the issues on the same day at the same time and then we could follow up with them.
WHAT ABOUT ANBEP? THE GROUP WORKING IN POOR NEIGHBORHOODS ON THE OUTSKIRTS OF DAKAR.
ANBEP is a different story. ANBEP (National Association For The People's Well-Being) is an urban group. They work in the periphery of Dakar in highly populated communitiespopulated mostly with people of limited income. And they are basically a community group. A community group thats dealing with womens issues and young peoples issues, with theatre and improving economic projects for the community and who gradually became involved in health related work. Theyre run by a wise older man who has a lot of vision and they have done some very, very exciting things, both theatre and community development work in their area.
WHAT DIFFERENCE HAS LUTHERAN WORLD RELIEF MADE TO ACI?
We were working for the AIDSCAP project when we started poles of excellence. Lutheran World Relief has supported us for several years after the end of that project and its thanks to that kind of assistance that we were able to expand and to learn from this experience and to apply that learning to other activities both here and in other countries.
The type of assistance we received from LWR was significantly different from some of the assistance we have received from other donors. It was based on a partnership. It was based on discussion. It was not heavily laced with bureaucratic requirements. Even though there was reporting, it wasnt unnecessary reporting. We didnt have to spend unnecessary time and energy on things that served bureaucratic needs rather than development so that a large percentage of those resources went directly to the beneficiary rather than going back into the process justifying the funds we were receiving.
WHY SHOULD SOMEONE IN AMERICA CARE ABOUT WHATS GOING ON HERE IN SENEGAL TODAY?
I dont see how anybody can separate whats happening in Africa from whats happening anywhere else in the world. AIDS is a humanitarian catastrophe in Africa with huge numbers of people dying and suffering all sorts of misery. And as long as this problem is not resolved in Africa, its not going to be resolved anywhere else.
WHAT PERCENTAGE OF PEOPLE ARE HIV-POSITIVE IN SENEGAL?
I think the most recent quotes are 1.4 percent prevalent, actually. Where in surrounding countries you get up to three, sometimes five, six. In Burkino Faso theyre talking about 6 to 8 percent. In Ivory Coast theyre talking 10 to15 percent of the adult population. Theres really no reason that Senegal should be at the prevalence level it is and its certainly clear that continued vigilance in continuing the activities necessary to keep it at the lower level.
IS AIDS GOING TO BEAT SENEGAL, OR IS SENEGAL GOING TO BEAT AIDS?
Im hoping that Senegal is going to beat AIDS. Im hoping were all going to beat AIDS. I dont think its a question if Senegal is going to beat AIDS. Its a question of whether humanity is going to beat AIDS. And my feeling is that it can be done.
WHAT MAKES SENEGAL RELATIVELY SUCCESSFUL IN STOPPING HIV?
Senegals openness and its response to the epidemic is an example to be followed. At no time has the government tried to hide whats happening in Senegal. Youve got top government leaders including the president himself. Youve got people responsible for education. Youve got the national AIDs control program. Youve got religious leaders, both Christian and Muslim. It hasnt been an easy process. But gradually everybody has been brought into the search for responses to the epidemic. And I think thats really the key. Its getting everybody involved. And if you look at this from a world perspective, its getting everybody in the world involved in this issue, not just everybody in a given country, because the virus doesnt know anything about borders. HIV doesnt know the difference between Senegal and Guinea. It doesnt know the difference between New York and Dakar. It can go anywhere. And it does.
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