All posts by Akeo Veerman

Fighting HIV/aids by caring?

As a child growing up in the 90’s, when the spread of HIV/aids was causing word-wide panic and sorrow, I was confronted with the knowledge that not all will be well in the end. I was young and unaware of the exact workings and effects of this virus, but I was told that this was a disease that would surely kill you, and no doctor would be able to help. It scared me (I was not sure how exactly you got this disease at this point), and while medication is more effective now, it still scares me. It is not that I am scared to become infected myself. What truly scares me is the fact that so many men, women and children do get ill. Even though there is medication that can keep you relatively safe and alive, many will not be able to get tested or receive treatment because of their specific living situation. In Uganda, there are several ‘high-risk’ groups, such as long-distance truck drivers, prostitutes and barmaids (Ntozi et al. 2003).  

Mama Watoto and RICODE are aware of the need to stay on top of the spread and effects of HIV/Aids infection. The group of street children that they care for is a high-risk group; they belong to a particular kind of group or community that is extra vulnerable for infection and the effects of the disease. These children are more vulnerable to become victims of sexual violence because of their living conditions on the streets. Some will need to prostitute themselves for money, food or shelter, and they have no way of ensuring the use of condoms. They might become sexually active earlier than other peers, increasing their risks. They are also less likely to be tested or receive the needed care and medicines. The young teenage mothers might transmit their infection to their infants at birth. Brahmbhatt et al. (2005) did a study on the transmission of HIV from mother to child and the mortality rates of the infected infants in Rakai District in Uganda. In their study, 16.9% of the mothers was infected with HIV. The infection rate for these women’s infants was 20.9%. The study continues to conclude that more than half of these infected infants died in less than two years time after their birth. Brahmbhatt et al. therefore conclude that treatment, so-called antiretroviral therapy, needs to be started earlier for this group of infants. By starting their therapy in an earlier stage, more infants could be helped and prevented from dying in their early years. But, as Nakiyingi et al. (2003) argue, infants with an infected mother are at greater mortality risk either way, whether they are infected themselves or not. If their mother cannot care for them because of her own illness, the young infant finds itself at risk of becoming an orphan.

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Especially the infants of young teenage mothers, such as those that Mama Watoto and RICODE try to help, are vulnerable. Their mothers might not have any ties left with their families, and therefore the infants have nowhere to go when their mothers turn very ill or die. Of course, the other street children are in need of protection and healthcare too. Because of this reason Mama Watoto and RICODE made sure they were well informed on the health status of all children. A couple of weeks ago all children were tested for HIV. To their great joy, the results showed that none of the street children or young infants were infected with this life threatening disease.

Unfortunately, there is no other way of treating HIV/aids then through rigorous antiretroviral therapy. This is an illness that cannot be cured by singing together, dancing, or witchcraft (some might disagree of course, but as far as I am aware there is no such solution). Therefore it is so very important to do these tests, to be able to interfere as soon as possible before the virus damages the body until a point of no return. But, before treatment comes prevention! As I wrote, street children are at higher risk of becoming infected. Mama Watoto and RICODE are actively trying to change their situation for the better, and this includes trying to keep them healthy. By taking them off the streets, giving them a safe place to sleep, food without asking for favours in return. This means the children are at lower risks to catch this awful infection, and therefore I would argue that the work of Mama Watoto and RICODE is in a way also prevention. Let us hope that their work; including singing, praying, dancing and eating together, prevents these children from the need for antiretroviral therapy against HIV/aids.

 

Brahmbhatt et al. (2005): http://journals.lww.com/jaids/fulltext/2006/04010/mortality_in_hiv_infected_and_uninfected_children.15.aspx?trendmd-shared=0

Nakiyingi et al. (2003): http://journals.lww.com/aidsonline/Abstract/2003/08150/Child_survival_in_relation_to_mother_s_HIV.12.aspx

Ntozi et al. (2003): http://www.ajol.info/index.php/ahs/article/view/6846

The Brick-Moulding Project

Thanks to donations we have been able to start our ‘Brick-moulding project’ in the middle of June. This project is specifically intended for those older boys who cannot (or do not want) to return to school. They are a group of seven to eight young man, aged between 17 and 22 years old. They started in the neighbouring village of Madera, where they collected clay that can be moulded into bricks. By now, at the start of August, they have produced over 10.000 bricks. They start to bake them in ovens when they reach the volume of 25.000 bricks, after which they can start to sell them. The selling price varies, but on average the young man are able to earn about 170 USh per brick. With the money they earn, they can invest in their own piece of land on which they are already planting corn and rice. Local authorities are supportive, and have promised to give the group another piece of land, which will be registered officially in their name. This extra land can be used to increase their harvest, which will then generate more money. RICODE has sponsored the boys for the needed materials, such as shovels, grass to cover the bricks for drying, and wood for fires. They have also sponsored their daily meals of porridge, poshe and beans, as well as pans, cutlery and cups.

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We are very happy to see the boys’ enthusiasm, and the success of this project. This project has the potential to become something bigger, and offers the possibility to support the boys as well as their families and community. This group of young men thinks ahead as well: they hope to switch to concrete bricks in the future, as these will generate an even bigger profit.

Dirk Naaijkens

*translated by Akeo Veerman

Travel journal III: From Groenlo to Soroti

Blogger: Dirk Naaijkens*

Day 63– 28th of July 2016

‘I’m going to miss you, Dirk, really. May God bless you.’ This afternoon was the last time I see Martin. At least for a while. He has been at RICODE for a while, where everyone has warmly welcomed him. He is twelve years old, often smiling his big smile, not afraid to give his opinion, but most of all he has a heart of gold. I keep being surprised by the optimism that many of the children show, especially after what many of them have been through. Domestic violence, neglect, sexual abuse. Sometimes even rape. Luckily Martin has not experienced most of these. He ran off from home two years ago. His uncle, with whom he lived, refused to pay his school fees any longer. This prompted him to search for a place somewhere else. He found this in Soroti, where he ended up after wandering around for a long time on foot.

I met him on my first day at RICODE, where he made an impression on me because of his adult behaviour (this might also have been because I lack that quality sometimes). He was also full of humour and acted in a very casual way. During the last eight weeks he was one of the few that showed up every day at the project site. After his sessions with the psychotherapist he said he wished to return home again, after one and a half year on the streets. Last Thursday was the big day. Before they send him home, RICODE and local child protection had a serious discussion with his uncle, who finally said he was ready to care for Martin again. This means more than just taking him into his house again, there are many obligations and responsibilities. When I called Martin that morning to ask him how he felt, and if he was nervous, he responded with only happiness and excitement. He was ready, he looked forward to it. When he arrived it appeared that he did not have a mattress or bed sheets, so me and Johnson brought those over with the motorbike. Two hours, full speed, on the back on a heavily loaded motor driving on dusty sand roads. Before we left, Johnson promised me to top his personal record. The red sand ended up in all kinds of places where you don’t want any sand…

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‘So, you are the one?,’ his uncle asked me when we arrived. ‘The one?’, I asked? ‘Yes, Martin has been talking about his mzungu-friend for the whole week. That you would finally visit him’. His joy was overwhelming when Martin saw me. It is extraordinary to have such a special bond with a boy that I barely know for two months. Full of pride he showed me where he was from, and he introduced me to his family. He also showed me where he sleeps. I proposed to put the mattress down, he had to check if it was to his satisfaction of course. After his ‘approval’ his family offered me and Johnson some peanuts. ‘you know this African thing?’ ‘Of course,’ I answered. ‘We have those as well in my country’, which led to a lot of laughter. They also thought that the pigs that walked around the house were completely new to me. ‘Mzungu knows pigs!’ Before we left I gave martin a present. ‘Come, open it!’ Johnson said impatiently, who was unaware of my surprise gift. Martin unwrapped it, and saw the group picture which portrayed everyone from RICODE; the staff and the group of children two weeks back. He became very quiet. The photo was immediately passed on between the group of curious family members, who wanted to know who everyone was. It was as if I was home with my grandpa in Eefsele: ‘Denne is daorvan, den werkt daor en daor…’ ‘Dirk, can I speak to you?’, Martin whispered after everything calmed down again. I followed him to his sleeping place, where he put the photo next to his bed. ‘When will you be back, again?’ he asks. I explain to him that I have no clue when I will be back again in Uganda. It’s silent. ‘I am going to miss you, Dirk, really. May God bless you.’

Upcoming Monday Martin starts school again. He has a lot of catching up to do, but the biggest step is already in the past. RICODE will stay in touch with him and his family; from time to time they will call or visit. This is one of the many stories of the children that RICODE is helping. One glance in the very diverse lives and backgrounds of this group of street children. One story, one child, whose live we have been able to drastically chance for the good thanks to the many donations.

Would you like to make a donation? Great!

You can send your donation to  NL92 INGB 0003 4247 92, in the name of  ‘Stichting Mama Watoto’, noting ‘Street children Soroti’. For more information, check the website www.ricode.org, or www.mamawatoto.org, the organisation funding this project.  

*Dirk is a student from Utrecht University currently doing his internship in Soroti / Uganda.

Translation: Akeo Veerman

Singing your sorrow away

When I was sixteen, I was going through a rough time. Fights at home with my parents, low self-esteem, worries about what my peers thought of me, moving between the houses of my divorced parents… quite usual for a Dutch girl that age I believe. One thing always kept me sane, and helped me to overcome or deal with negative emotions: music. I am not talking about ‘boy-band happy romance’ songs here, those that are meant to uplift your spirit and make you feel good. No, my music was dark, angry, and sometimes just plain lamenting. My friends at the time were confused by this choice of music and tried to convince me that listening to this sort of lyrics only made me feel worse. I disagreed, because this music gave me something crucial: a feeling of being understood, recognised, a feeling of being part of a group that felt just like me. Now, my sorrows were quite manageable and I grew up to be a very happy, confident young women. Nevertheless, I still want to feel understood and I still need to be part of a community when I deal with my troubles.

There are countless forms of pain, sorrow and illness, but there are also countless ways of dealing with these. One of these is music. Singing together, listening to music that relates to your feelings, making music as a group or by yourself; all can be ways to deal with anger, fear, loneliness or other difficult emotions. This might sounds a bit ‘kum ba yah style’ to you, or maybe you imagine a group of middle –aged ladies in new age dresses holding hands while chanting. Or maybe you know exactly what I mean by own experience? Have you ever been to a concert where you felt truly exhilarated? As if you became part of something bigger than yourself, and it gave you such a burst of energy? Try, and remember when music made you part of something bigger than yourself. Try, and remember the impact it had on your wellbeing.

Music is a well recognised way of therapy in many places all over the world. Andoline Dos Santos (2005) writes about a music therapy project at an HIV/AIDS hospice and orphanage in Johannesburg, South Africa. She argues that this form of therapy had four positive effects: building community, creating safe spaces, the opportunity to give, and finally vitality (as opposed to death). I would like to look a bit closer at building community and the ability to give.

Many of the people participating had been isolated from their communities because of their illness. Dos Santos explains how music-making could help these people feel “part of this world” again. Although the hospice and orphanage  are institutions, the coordinator explained that “this is a village that is not a village”. The staff working here explained that music offered them the possibility of bringing the people together and being a tool through which they could show the patients they truly cared for them. Music also had the potential to create a sense of togetherness between both the staff and patients, as well as between the patients themselves. Furthermore, the staff at the orphanage highlighted that music-making provided the children with the opportunity to give. These children were used to always receive help but were not able to give something in return. Performing and making music together made them feel they had contributed to each other’s lives in a meaningful way, thereby building on their self-confidence. Music and performance are “capable of developing community, not merely reflecting it” (Dos Santos 2005).

The shelter that Mama Watoto and RICODE have created together supports street children from Uganda by offering education, food and a bed. I believe, that equally important, they offer these children community, ‘a village that is not a village’. At the shelter, singing together and making music together is an integral part of daily life. In the morning and evening the children sing as a group, often as part of daily prayers. According to Dirk Naaijkens, a volunteer at the shelter, the children become happy when they participate in this group activity, and he believes that this activity strengthens the “we-feeling” within the group. He also explains how singing together is a way of starting and ending the day together as a group. I personally hope that these children also experience a feeling of being able to ‘give’ to each other, as Dos Santos writes. The children participating in this project have very little material to give to each other, and are now also dependent on the shelter for their basic needs. Being able to share something with the others, and in this way being able to contribute to the ‘shelter village’, can be healing and supporting in itself.

Making music and singing together is a powerful way of therapy and healing I believe. It is creative, it builds community, it connects people in something bigger than themselves, and has the ability to make you feel understood. People all over the world use music and singing as a way of building on health and wellbeing. So, next time you feel blue, grab your favourite song (if you dare, even grab a friend, sister or brother to help you out), and don’t hold back singing your sorrows away.

Clip: The street children in the centre while singing togehter. Credits: Dirk Naaijkens. 

If you want to read the article Dos Santos wrote as a whole, check out https://voices.no/index.php/voices/article/view/219/163 

Bye bye Freud: another take on therapy

For many Dutch people a visit to a psychologist has become a normal way of dealing with stress, depression, fear or sadness. These one-on-one talks can help you discover the source and reason of your emotions, help you find new ways of dealing with them, or changes thoughts or behaviour for the better. The private character of this form of therapy is taken (by some) as a positive feature, it makes the client feel safe, protected and the centre of attention. Freud, the well-know psychiatrist from Austria, has been at the root of this form of individual, soul-searching therapy. And while his search into the depths of the individual human mind has been very fruitful in some cases, his approach is definitely not suitable for everyone, or everywhere!

When I ask Christine Among, founder of Mama Watoto, if they also have individual therapy sessions for the children in the new rehabilitation centre in Soroti, Uganda, she smiles and shakes her head. “No no no, of course not! We don’t do that kind of thing. We don’t pay someone to listen to our troubles. My neighbour or friend can do this for free!”. But what about the basic therapeutic counselling they offer at the centre? Christine explains to me how they offer “therapy”, and help the children heal, in ways that are more connected to Ugandan culture. Healing is not something you do by yourself, alone. Healing happens when you become part of a group, when you become part of a new family. This can be realised in many different ways, and these different forms of healing will be my focus for the upcoming months.

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photo: Dirk Naaijkens

My field of study is medical anthropology and sociology, and this background will be my starting point when I address the different forms of healing and therapy that take place at the rehabilitation centre in Soroti. Many people will now raise an eyebrow and wonder: what is anthropology? And more so, what is medical about that? Medical anthropology and sociology is the study of how illness and health are shaped, experienced, and understood in light of cultural, historical, political and global forces. It is not about saying one kind of therapy is better than another, but about understanding why and how these differences exist and affect people. 

This sounds complicated, but all of us know about cases in which time, culture or politics influenced the way we look at diseases. Think for instance how the legalisation of homosexuality in 1973 made sure that homosexuals would not be locked away in psychiatric hospitals in the Netherlands anymore. Or what about Lisa Cooper who, in her Ted Talk, explains the relation between racism, ethnicity and health disparities in the USA? Maybe you can think of an example from your own life, in which your cultural background, the year you live in, or the geographical region you reside in influences the way you see your body, health and illness? If you would get a seizure today, how would the people around you interpret this? As a problem of the brain? Or maybe as a sign of being possessed by the devil or an evil spirit? Or possibly as a way of communicating with God? In all these cases a medical anthropologist would be fascinated! As am I, while I start my discovery of different forms of healing and therapy in the centre in Soroti.

I would like to invite the reader to take a new look at health, wellbeing and therapy. We can learn that healing can be done as a family, as a community, together. By looking at the work of Mama Watoto we can learn more about others and ourselves.

For a closer look at the interaction of ethnicity and health, check out Lisa Coopers Ted Talk: https://www.youtube.com/watch?v=CBNWaQM2JrE