Volunteers: prone to diatribes and beards

Last week marked the international “Day of Remembrance” for those that have passed away due to AIDS, recognized every third Sunday in May. Many organizations around the world gather to hold awareness or candle vigil events, and Public Foundation Challenge of Pavlodar, Kazakhstan (my primary workplace) was no different.

With the assistance of Challenge’s dedicated youth volunteers (Annya, Arina, Timorhan, Nastya, Julia, et al) and my trusty counterpart Dina, people gathered along the sandy beach of the Irytish River to hold a candlelight memorial. To be true, the event was hastily planned. I knew the date was coming, and that it would be a perfect time to hold an awareness event that directly correlated with the Challenge mission. My colleagues, however, were drawn dispassionate to work in general due a recent spate of unsuccessful requests for financial support from local and international donors.

I cannot say that I am any less prone to being discouraged by the state of non-government financing affairs either – the following represents a certain admitted cynicism – but the number of donors willing to support HIV/AIDS organizations that are either not a) in Africa, or b) handing out syringes in CIS countries, are scarce. And though many HIV/AIDS donation programs include aims to decrease discrimination and increase awareness of the pandemic, their selection of organizations and programs to target such goals is becoming narrower and shorter-sighted than ever.

Let us cite some recent public health history. In America during the 1980’s, AIDS was coined as the “gay disease”. People became squeamish of gays and that sort of lifestyle, and took on the ‘it’s a problem but not for me’ attitude until more people practicing unsafe heterosexual relations started becoming infected in higher numbers. It was only then that measures were taken to teach about safe sex in a broader manner, to trust in partners and testing procedures for people of all sexual choices. Add drug issues into the fold and you can see why America’s difficulty with AIDS could be pointed to a noted lack of foresight in prevention methods and appropriate target grouping.

The same could be said for Kazakhstan and other republics in the CIS. When you talk about HIV/AIDS here, you get a sorrowful headshake, a gesture of a syringe into the arm and a tsssk-tssk’ing “it’s those drug users” remark. For sure, statistics show that nearly 60 percent of registered HIV-positive people in Kazakhstan were infected through intra-venous drug usage, but that most likely reflects the statistical gathering process. Every drug user arrested must be tested for HIV, while sex workers and people caught patronizing their special services are not required to do as such. These statistics are then used as the main source for nationwide research and fact. These statistics are further sighted by many international donors, and people come to believe that the main reason (read stigmatized) for HIV/AIDS is from drug usage, and not much else. When asked about the potential for HIV infection, the most typical response I get from people is, “I don’t do heroine.” Promoting regular HIV analysis is seen as something barely short of walking around town with a giant red A emblazed on your chest.

Along the Irytish river, a ribbon of candles in remembrance of those passed away from AIDS.

Try looking for funding that supports youth education on safe sex, anti-drug awareness campaigns and healthy lifestyles in Central Asia, and you find a short list. Your program best be about teaching sex workers about condom usage and providing drug users with needle exchange. That approach is incomplete, and sometimes ineffective. Not to rattle too many cages here, but there are roughly 3,000 sterile syringes, courtesy of The Global Fund, sitting in a closet in my office which are the responsibility of another HIV/AIDS ‘organization’, and they aren’t going anywhere or to anyone. What does this mean?

Convincing donors of high drug use + closet space to keep syringes safe, unused and useless = Salaries!

Taking a walk in the spring time is one of those simple pleasures that, despite its annual occurrences, always jolt a surprise. Walking around Pavlodar, I humbly and securely admit to noticing the gorgeous feminine beauty around me. There is not a lack of sex appeal going on here, or at least in MTV overdrive, short skirt, see-through blouse aspect of it. Perhaps it is an effect of the region’s historically suppressive past (see: “There is no sex in the USSR”), but public images of sex are now quite prominent and find their way into the most seemingly innocuous places. Billboards selling washing machines show an older man, no less than forty years old and cardigan-sporting, cradling his younger wife, no more than twenty-five years old and showing the perfect amount of cleavage and just the right hint of red lace lingerie underneath to pique certain thoughts. It breathes of creepiness; the creepy kind relating material purchasing power and sexual attraction, vitality. The young woman’s age and appearance, particularly the observable lingerie, had to be calculated by the advertising company or photographer. Now perhaps it is my self-imposed restraint coming into the fray, but this is still an advertisement for a washing machine. (Personal side note: I opt to wash my clothes by hand.) Playboys and other ‘newspapers’ with bare-assed chicks are displayed at children’s eye level in supermarkets and street kiosks. Condom wrappers with naked women are sold in shops everywhere (maybe not a bad thing actually), and I have to take off my shoes to count how many times I’ve been invited to go for a banya steam and get some prostitutes to really round out the cleansing process afterwards.

What this represents is generally a good thing for society in Central Asia – an opening and outing of sexual mores – but what about the health consequences of such public displays and casual suggestions? That whole 1960’s sexual revolution thing in the USA produced plenty of people that had kids and instilled a generation probably more comfortable with themselves than any before, and talking about sex wasn’t a big deal. Despite the lack of social friction in its content, safe sex didn’t always occur (and probably never will) and more people were okay with having it (maybe, I have no factual knowledge of this, just anecdotal). People had more casual sex, didn’t think of diseases so much, associated HIV with gay stuff and flim-flam! you have a high number of HIV cases infected through heterosexual relations. Only then did you see an increase in awareness events and prevention programs…prevention programs for something that should have been prevented years before.

It’s just a different take on it now in Kazakhstan and Central Asia in general: HIV/AIDS is assumed to be a sex worker and drug user problem. People are given more freedoms due to the fall of the Soviet Union (in most areas), and an entire generation is raised and comes of age under a society free from a communist form of suppression. Kazakhstan declared independence in 1991, and there is now a group of 16 and 17 year olds hitting that stride of life prone to trial and error that has not known the rigors of Soviet life and behavioral expectation.

And this is my working hypothesis: Due to the growth of the first adult generation to live under independent societies and an eventual improvement in statistical gathering procedures, regions in the CIS will experience a counterfeit success on the decrease of intravenous drug HIV infections at the expense of increased infection through unsafe sexual relations.

Basically, preventive behavior awareness will be focused upon – and funded – only when it becomes a problem that could have been prevented.

But back to the actual awareness event…

There we were, gathered at the beach and scenic city park along the Irytish River. Passersby were asked to participate in the lighting and subsequent remembrance ceremony, and many joined in to see what all the hubbub and burning was about. Even with all the flashing lights and attention sucking cell phones out there, fire still draws a crowd.

168 candles were lit to represent the number of people that have died of AIDS in the Pavlodar oblast thus far in 2008 (statistics provided by the Pavlodar Oblast AIDS Center). It seems like a low number when compared to the compelling and unfortunate millions in Africa. But why does a number have to be grand to garner acknowledgement and attention to the way a person dies if it could have been prevented? I am not calling for a full swing of resources from Africa. Absolutely not. But there is a chance to help prevent a greater spread of a terrible global virus in Kazakhstan and Central Asia. Just take a look in Central Asia from time to time, okay Bono?

Pavlodar is known for its high winds that come whistling off the flatland steppe surrounding it, and the lack of breeze was noticeable and welcome. The amount of mosquitoes was unwelcome and noticeable. Lesson learned: when writing any grant for candlelight vigils near bodies of water in the Spring/Summer time, request funding for insect repellant. Some people simply could not bare the attacks long enough to stay for the whole vigil, and we lost some good people out there, their bodies swollen and scratchy.

Despite the previous mention of acute professional melancholy and the onslaught of winged vampires, the event proved a visual sign of solidarity, respect and remembrance to those passed on in a way that was nothing less than uplifting. Kudos to those people that don’t care about financing and monitoring and sustainability and expected results and partnership programs in order to simply do the good.

C-e-l-e-b-r-a-t-i-o-n

May 16th marked the second best day in the month of May: my birthday. The best day, obviously, goes to May 28th, the day of the National Spelling Bee Finals. My colleagues at Public Foundation Challenge organized me a day in the forest marked with roasted chickens, vegetables, beer, guitars, potatoes, chocolates, fires, footballs and friends. It was nice that my colleagues and local volunteer friends could come out, and was delighted that fellow friends and Americans Nicholas the Jersey Greek Pappas and Adam the Mad Henricksen could attend. Free food and beer is always a good persuasion. With no oil in tow, Henricksen cleanses my feet with his saliva.

Astounded at the glory.

It was calm, relaxed and outdoors. Appropriate. For my 23rd birthday last year, the entire day took place during a train ride in a cramped coupee with a two vodka-bottles-deep, pissed pants professor and a pair of withholding prostitutes that were relocating from Pavlodar to Almaty for better business prospects. The 24th year rang in markedly better in the forest, thank you.

Celebration.