Tuesday, December 13, 2011
I woke up today at 4 am, and the first thing came to my mind was “Come on, KILIYA: WAKE UP AND SMELL THE COFFEE.” I have not stopped thinking about Kiliya teens and members of the community since the World AIDS Awareness Day event, which 5 schools organized in Kiliya, my site. It was not easy for me to understand the two-hour show due to my lack of knowledge of Russian/Ukrainian and the continuous interruption from the students behind my seat. I managed very well to be focused and put some pieces together with my basic Russian. I kept hearing statistics, heard the word Africa several times, saw pictures of famous people (like the Village People singer who was exposed to the virus and died); saw pictures of students exercising, one act showed HIV (a student with the name written on his clothing, black clothing and a sword; a young couple had a baby who died because mother had contracted the virus from the black-clothed HIV), a lot of talking, songs, dances. It was a very colorful, entertaining show, and many students from different grades participated. Although I very much enjoyed the activity, I left the theater very concerned and with many questions.
“Did the student have accurate and updated information regarding HIV- AIDS?” “Did they mention that Ukraine has the highest HIV rate in Europe?” Did they mention that HIV is spreading faster in Ukraine than anywhere else in the world and adolescents and young people account for a large percentage of new infections in the region?” “Did they already know that young Ukrainians from ages 15-29 are at higher risk of infection because they do not know how the virus is transmitted?” “Did they mention that HIV and other sexual transmitted diseases are spreading in Odessa Oblast and Ukraine by unprotected sex or incorrect use of preservatives?” “Did they mention Odessa has one of the highest rates of HIV in the country?” “Did they mention that every day over 60 persons are diagnosed with HIV, and over 6 people die from AIDS in Ukraine?” As I kept walking home that evening, I kept asking myself, “Did they mention that even if you are an athlete, a teacher, a married person, a Peace Corps Volunteer, a sailor, a rich person, an educated member of this community you may also be exposed to HIV?” It is not who you are, but what you do. “Was it mentioned that if you share a razor blade with someone who is HIV positive and both persons have open sores or cuts there is a chance of contracting the virus?” “Did the students know if one kisses someone who is HIV positive and both have open sores or cuts in the mouth one may be exposed to the virus, and how would they know who is infected, if many people do not even know themselves?” “Do the students know that 1 out of 5 people in Ukraine know they are infected with the virus?” “Was the difference between HIV and AIDS explained to the young audience in the theater, and that some people with the virus might not get AIDS for many years, and although they are contagious they would appear to be fit and healthy?”
Wake up, Kiliya. Wake up and smell the coffee. It is time to break the silence. Up until the day of the event (a couple of weeks ago), I had not considered for a moment to educate Ukrainians on this topic. I am not an expert on this subject; I do not do drugs, and I am planning not to be sexually active. So, “that is my attitude. Let it be.” From the beginning of my PC training, I committed myself to abstinence during my service in this nation. I reassured my promise right after my HIV-AIDS training during pre-service. So, I protected myself with a shield of indifference, ignorance, perhaps. My most sincere apology to all non-governmental organization, PCV’s/PCV staff working for the cause, and all Ukrainians. It was that evening after the event that I heard myself thinking, “Wake up and smell the coffee.”
I wanted to go back and ask students and teachers for a script of the show or any translation at all. I hesitated in what to do. I wanted to ask them: “Do students and the community as a whole understand the importance that knowledge alone without life skills such as good communication skills (being assertive and responding to persuasive behavior and peer pressure, self-control); decision-making skills (assessing risk; exploring choices, understanding consequences, critical thinking, learning and managing emotions, negotiation skills, goal setting) are necessary in this new phase of the HIV-AIDS epidemic? Wake up, Kiliya, wake up and smell the coffee. Perhaps, you do not want to hear it, but many young people are becoming more sexually active at younger age, and they need to learn how to act responsibly. Alcohol and hormones together at their age is a really bad combination for judgment, and alcohol is all over the place and they are exposed to it on a regular basis. “A review of 50 sexual health education programs in different parts of the world found that young people were more likely to delay sexual activity when they had the correct information to make informed decisions.”
Kiliya, please read the following excerpt from an article from a concerned Ukrainian professional: “The topics of sexuality and sex education are still taboo in our society, although far more infections are transmitted in Odessa by unprotected sexual intercourse than through injecting drug use,” says Irina Swetaschowa. The GELCU training program coordinator cites four factors for the HIV epidemic in Ukraine. “People here are terribly afraid of AIDS. While very few understand the modes of transmission most of them still act irresponsibly and say: ‘That does not concern me.’ In addition, the state does virtually nothing to raise awareness, merely concentrating on handing out free medication.” Those who are HIV positive in Ukraine soon feel the social consequences—doctors often refuse to treat such patients, their families turn away, teachers throw infected students out of school and children are placed in care homes. The German Evangelical Lutheran Church in Ukraine (GELCU) in Odessa developed an extensive HIV and AIDS program for prevention and therapy. The aim was to stem the epidemic by training school students and mentors, along with multipliers such as doctors or teachers. The Lutheran World Federation (LWF) has been supporting these successful training courses for the last four years. AIDS Education is urgently needed.
Days after this event, I was invited to facilitate a lesson (the lesson was on a different topic, not HIV) to students in one school. I took the last ten minutes, with permission from the teacher, to ask questions relevant to HIV-AIDS. Keep in mind that these students had already presented material and information on HIV-AIDS days back. After listening to a couple of male students during a role play buying/ choosing a condom without checking for expiration date and succumbing to the power of persuasion (student wanted a red condom, but took the flavored one at first request from the “seller”). I decided to prepare my first HIV-AIDS lesson. My initial audience was a group of professional sailors, ages 25-45, from a different community. It was very interesting, helpful information to these men. They were unaware or had incorrect information of approximately 90-95% of the needed information I presented. One man said he bought his preservatives following “advice” from television advertisement. However, he could not name one brand or what to look for in a well-made quality preservative. Another gentleman asked if we (Americans in the US) read boxes (he meant instructions/information on the back of the preservative box). Later at home when checking the photos my counterpart had taken during the lecture, I noticed the same guy was actually reading the content on a condom package I used as a visual aid and had given it to him. The group was very cooperative, honest, and appreciated the lecture. They asked for another lesson. My second presentation on HIV was to the same group of students mentioned above (30 students from 11th grade). Students and teacher were also in need of this information, and they recognized the importance of it. I covered all my questions of concern when I left the theater. The majority of the group had no or very little knowledge about the topic. The students were “thirsty” for more, and they requested the second part of the lecture.
The second part of my lecture is “Condom Sense.” I decided to go on “condom research” with the help of a young lady who I consider my moral support and who has shown interest in the issue. We both went “condom hunting,” and she helped with translations from the boxes. I was looking for date of expiration, good-quality construction (the frequency of condom break is also attributed to poor quality condoms on the market and the lack of quality control in certain developing countries), ingredients, instructions on how to use it correctly (when used CORRECTLY, condoms play a special role in combating the spread of HIV/AIDS; what type of lubricant NOT to use because it may break the condom); place where the preservatives were placed in the stores (exposed to heat/heater? Condoms can deteriorate if not stored properly as they are affected by both heat and light. Also, it’s best not to use a condom that has been stored in your back pocket, your wallet , or the glove compartment of your car); information on HIV-STD’s protection, electronically tested, latex, polyurethane, or lamb skin? (In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through; however, outside of the laboratory condoms are less effective because people do not always use condoms properly. Lamb skin condoms may protect against pregnancy but not against sexual transmitted diseases, including HIV); nonoxynol-9, a spermicidal chemical (there has been a debate over this product: Nonoxynol-9 was once believed to offer additional protection against STDs-HIV, but some studies have shown that, with frequent use, nonoxynol-9 may increase the risk of HIV). If you would like more information, please attend one of my lectures.
Although this was a very small research project and I visited very few places, I learned that of the several brands and different prices in my town, only two brands offer the necessary information and basic requirement for allegedly preventing HIV and STDs. I did not see any female preservatives on the shelves. Yes, ladies, there is also protection for women. Wake up and smell the coffee. Ladies, remember, it is your life and it takes only one time. Take control; be in control, empower yourselves with knowledge and action. Do not leave the knowledge at home…use it! Do not leave the responsibility only to men. If you cannot talk to your man or a man cannot talk to his woman about a healthy sexually relationship and discuss this important health issue, then you do not trust him/her, and remember no protective method is 100% effective. According to the Centers for Disease Control and Prevention, the surest way to avoid transmission is to abstain from vaginal, anal, and oral sex, or to be in a long-term, mutually monogamous relationship with a partner who has been tested and you know is uninfected.
I want to thank my friend, who helped me in this small project. I want to thank one of the stores where employees were patient and allowed us to do our work (I welcomed the giggling and staring). I want to take the opportunity to thank the pharmacist and employee-assistant who were professional, understanding, and answered all my questions. This is the type of customer service that should be given to anybody, especially young ladies and young men coming to any store or pharmacy asking for preservatives. There is a need for HIV education and HIV prevention and everyone needs to be equipped. Wake up, Kiliya; wake up and smell the coffee.