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January 10, 2003

Amy Chesser was in Mozambique with me. This interview was taken about 4 months after she returned to the US.

A Bold Step Forward

by Richard Joseph

"Go to a neighborhood where people are dragging the United States' name in the dirt, and the flag of the United States in the dirt. Save the lives of their children, save the lives of their wives and their loved ones and they will run extremist groups out of town. This is not just hearts and minds. This is lives." – Bono, U2

Life in Sub-Saharan Africa is, for most, a challenge just to survive a third of a century. A majority of the nations in this region are steeped in poverty. The bulk of each nation's population lives in shantytowns flanking fledgling cities. Others reside in isolated tribal villages out in the bush. Food - when available - is not to be squandered. Water, for the most part, is risky, if not deadly. Hepatitis, Typhoid, Cholera, and Malaria are commonplace.

Worst of all, there is the burgeoning AIDS pandemic claiming the lives of millions each year, while leaving dependents behind to support remaining family members - or to fend for themselves. In a recent statement, Secretary of State Colin Powel described the conditions gripping southern Africa as "a greater catastrophe than terrorism." "It's a cold cataclysm," former president Bill Clinton explained in a televised interview on AIDS in the Sub Sahara. "You have health care workers dying, police officers dying, teachers dying, it's just unbelievable."

For years, calls to stem the spread of the worldwide AIDS pandemic were met with tepid support by governments in much of the First World. But now, HIV/AIDS abroad is no longer regarded as some other country's problem. Industrialized nations are quickly realizing that what is festering 'over there' can very feasibly find its way 'over here.' The days of looking in the other direction, while third world nations fall further into states of chaos and disarray, are over. An example of this shift in global policy surfaced in President Bush's January 2003 State of the Union address. During the televised speech, the president pledged to lobby congress to commit 15 billion dollars over the next five years under The Emergency Plan for AIDS Relief. This new relief plan is being proposed "to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean." About mid way through this section of his address, the president paused; panning the audience. "Ladies and gentlemen" he began, "seldom has history offered a greater opportunity to do so much for so many."

As evidence shows, this statement is completely accurate. According to the July 2002 UNAIDS Report on The Global HIV/AIDS Epidemic, an estimated 42 million people are living with HIV/AIDS worldwide. The regional breakdown of these cases equates to 95% residing in the developing world, and 68% - or 29.4 million persons - coming out of the Sub Sahara. The concentration of AIDS in this region is astounding. Africa accounts for only one tenth of the world's population yet it is home for nine out of every ten new cases of HIV infection. Every 25 seconds, another person in Africa is infected with the virus. An estimated 1,700 new infections occur each and every day, and of the 11.5 million that have already died, a quarter of these victims were children.

The president's 15 billion dollar proposed relief plan is an indicator that AIDS in the developing world is finally being regarded by the American government as a matter of great urgency. Unfortunately, it took a little more than 20 years for this to happen. This is not to say, however, that there have not been innumerable benevolent gestures, and noble acts within this time. On their own volition, many individuals have already risen to the challenge "to do so much for so many." Recently we at Wide Angle had the chance to meet one such person who has just returned from The Sub-Sahara in the fight against AIDS.

Amy Spreading Arms with Scenery"Ever since I can remember I wanted to go to Africa," explains Amy Chesser, a fresh-faced 24 year-old. "Africa was like a dream. I don't know why. Then, when I was in college, I was a pre-med major and taking an EMT course. In the process I found this organization that was a free clinic for people who couldn't afford health care. So I started volunteering there as a medical assistant, and loved it. A whole other half of the organization was focused on AIDS counseling, and free treatment for anyone who couldn't afford it. In the first year I worked in the general clinic. As the years progressed, I started working almost exclusively in the HIV division. And I guess that's where my passion for the cause grew."

Shortly after graduating from the University of Richmond, Amy contacted the Institute for International Cooperation and Development. IICD, situated within the picturesque Berkshire Mountains of Western Massachusetts, is a privately funded humanitarian organization. IICD recruits, trains, then places volunteers in community developmental projects all over the world. Project destinations range from Brazil to Angola; from El Salvador to India and many more. After some research, Amy signed up for a 19-month program to live and work as a Developmental Instructor in the Republic of Mozambique. An initial five and a half month training period in Massachusetts was part of the regiment. Soon after, Amy found herself in a struggling rural community in the Nhamatanda district out in the bush.

"The program in which I was placed in Mozambique was a center that had three projects in operation simultaneously. One was a vocational school that worked with kids that had a seventh grade education. The second was a teacher training college. Most of the teachers in training had about a tenth grade education. Basically I was teaching teachers about HIV/AIDS. It was the best way for disseminating information."

"The last was a community health project that went into villages to help their overall health situation with everything from Cholera, to HIV/AIDS, to Malaria, to how to feed a child under 5. I was involved in all three. I did a lot of AIDS seminars in the vocational schools, conducting classes every week about sex education, gender roles, and everything else that plays into AIDS."

Mozambique has a total population of 19,607,519, and a land mass of slightly less than twice the size of California. Yet this small nation has an AIDS population of roughly 1,100,000. UNAIDS findings as of July 2002 have determined that 630,000 of those inflicted with the virus were women, and 80,000 were children. With an HIV/AIDS rate capping off at roughly 12%, the average Mozambican has an estimated life expectancy of only 35.46 years.

"Where I was working, AIDS was 1 in 3. When I went, I thought that the villagers would know more about the disease. I didn't think I'd be able to tell them a whole lot; that I would just be repeating what they already knew. But they really knew nothing. I mean nothing."

As every humanitarian organization working toward thwarting the spread of the virus has found, HIV/AIDS in the Sub Sahara is perpetuated and aggravated by numerous factors. In many Sub Saharan communities, AIDS is regarded as a shameful disease. Those afflicted are often shunned by their own communities. This results in a reluctance to seek medical treatment, or to acknowledge the presence of the illness.

Misinformation as to the nature of the virus can also result in its continued spread. "My students believed so many myths about HIV/AIDS," Amy explains. "And there is still such a huge stigma. Nobody who is positive will come out."

Extreme poverty levels have also been serving as a formidable roadblock in eradicating the epidemic. As Amy experienced, "When people can't eat, they can't concentrate on anything else. They are just trying to survive. They don't think about using condoms. They don't think about prolonging their lives."

To exacerbate the situation, AIDS cases among the adult populations in Mozambique all too often translate into the loss of one or more of a family's crucial breadwinners. On a micro-level, these losses are typically catastrophic to individual families. On a macro level, with 70% of the population living below the poverty line and a 12% HIV/AIDS rate, as large numbers of family units slip further and into virus induced economic duress, whole communities within

Mozambique's 10 provinces sink deeper into ruts of impoverishment. This cyclical pattern of falling local and regional economies has been hindering Mozambique's potential for economic progress. In fact, this same pattern has been stunting the growth of much of the Sub Sahara for some time now. In short: more AIDS equals more intense levels of poverty…. and vise versa.

"Health care is another problem." Amy continues in her description of the many daunting factors that she was faced with in her day-to-day work." 'So many people that I talked to had the attitude of 'well, I'm going to die of Malaria tomorrow, so why should I worry about AIDS which won't affect me for years.' Right now there are hardly any HIV/AIDS drugs available to the third world. So even if you are diagnosed with AIDS, which very few are, then there is very little that can be done for you. I had a student who was HIV positive who went on a downward spiral for about 3 months. I took him to a well established hospital in the area. They didn't have enough beds, so he ended up on the floor. They found that he had Tuberculosis, but they didn't have any oxygen in the rooms, so he was just coughing. There were a group of patients with TB all in the same room, just coughing. Then there weren't any screens on the windows, so malarial mosquitoes were flying into the rooms of immune compromised patients. In the end, all the staff could give him was Tylenol, and vitamins. For the doctors, it is really frustrating to have this influx of people every day, and all they can administer is Tylenol and vitamins."

Still other factors contributing to the HIV/AIDS crisis in Africa include issues of promiscuity within many of the tribal cultures, as well as women's overall status in African societies. Literacy rates are also an important factor, in just being able to get information out to the masses. According to the Central Intelligence Agency's World Fact Book 2002, Mozambique has a literacy rate of a mere 42%. Of this group who can actually read and write, 58.4% are adult males, and 27% adult females; an indicator in itself of the low status of women in that region.

At the time of writing this article, Amy had been back in the States for only 4 months. When asked if she had experienced any reverse culture shock upon returning, Amy responded without a moment's hesitation in the affirmative.

"It was a huge culture shock to go from a village of 4000 people in mud huts to New York City. Seeing all the stores again. Seeing the amount of money that some people waste. Seeing how little I could live on and be happy, and coming back and seeing how unhappy so many people are with how much they already have. I had a hard time at first. I had to make an effort in reminding myself where I was. I mean, it's amazing to figure out what you don't need. To never see yourself in a mirror for a year is an amazing thing to go through. To have such a great view of yourself, but not a physical one. To wash dishes every night, but in order to do that you have to go to the well to get water. I mean, do we really need dishwashers? There are so many things that we don't realize aren't really important. Living without electricity was an experience. Yet, despite all those conditions, there was a strong feeling of community. The motto was 'if you have a lot, give a lot. If you have a little, give a little.' Experiencing that was really inspiring.

"In terms of all the great things about this country: I can't tell you the feeling of coming to my first library after a year in Mozambique, and to see all the information that is available to us. I guess I feel really lucky to be an American. Mozambique demonstrated the importance of taking that role as an American, and doing something with it to try to change things. America's potential for greatness is definitely very clear."

In a modification of George Bush's statement made in his State of the Union address: seldom in history has a nation been in a position to do so much for so many. This seems equally accurate. At this point in time, it appears as if the reputation of the United States is slipping further and further out of favor within the eyes of the global community. There has been a lot of speculation over the past year and a half as to how and why this has happened. It's a question most Americans have pondered as of late. Could it be that a superpower of our magnitude could benefit from a shift in priorities? Some may agree. Others might staunchly disagree. Nevertheless, one can only speculate as to how the American culture would grow if more of the country's rank-and-file, flesh-and-blood were to partake in bold, direct steps for the world, and for themselves, as Amy Chesser did. In the words of Mahatma Gandhi: "Man becomes great exactly to the degree in which he works for the welfare of his fellow men." And such could be the case for a nation - this nation - one citizen at a time.