I apologize--this is a little dull. As part of our site visit week, we were asked to do a community HIV/AIDS assessment. This means that we were each expected to go to schools, churches, health clinics, etc. in our respective communities and ask them basic questions about HIV education, testing, and stigma. The assessment is part of a new Peace Corps/Obama initiative called PEPFAR that includes funding specifically targeted toward educational outreach about safe sex, condom use, etc. Unfortunately for us trainees, it was a bit much to ask of us to arrive at our site, and several days later to be out in the community ‘knocking on doors,’ requesting information. Not only am I not familiar with my community yet, or where things are located, but I’m also not known in the community, and Ghanaians (naturally) are a lot less forthcoming with a foreign face. This sort of assessment is much more appropriate some months down the line, when we have successfully integrated into our communities, know the proper formalities, protocols, and hierarchies, and we (hopefully) have many contacts and friends to help us glean this sensitive HIV data.
On the second day of my arrival in Savelugu, my headmistress took me to the District Health Administration, which was an excellent first step in the assessment process. There, I gave them my Letter of Introduction (given to me by PC), and I was introduced to the Director, and then given an appointment for later in the week to meet with the HIV education coordinator. Perfect! So, that was a positive example of how things work here in Ghana; I had one powerful community member introduce me to another powerful community member, and doors magically opened.
From there, I went on my own to a nearby high school, and spoke to some teachers who basically gave me a bunch of hot air about how they would support and counsel any student who was diagnosed with HIV. I highly doubt that would be the case in reality given the intense stigma against people living with HIV in Ghana. In fact, the student would probably be pressured to leave the school, either from other parents or from the administration. In addition, the student almost certainly would never disclose that they are HIV positive, knowing that it would be like committing suicide within the community.
So, having gained little useful information from the high school, I moved on to a small health clinic across the street. I was told they were very busy and that I should come back the next day. On the following day, I arrived, and spoke to the head nurse who almost had me sit down for our interview, but then she called the District Health Administration, who told her that she should tell me nothing, and that I should come directly to their main office. Well, I thought, great, maybe they are going to give me an early interview. No such luck. After racing across town, I arrived to find a surly woman who reprimanded me, telling me that I could not just go to any clinic and ask questions without getting prior approval from the Director, and that my brazen disregard of hierarchies is not how things are done in Ghana. Thanks Peace Corps (!!) for helping me to burn bridges in my community before I’ve even really arrived. Why on earth did they ask us to do this if it is inappropriate to go to individual clinics? Of course, a layperson can’t go waltzing into hospitals in the U.S. asking for private/sensitive information, but because we are white people in Africa, we should have open access?? No. My one solace is knowing that the surly woman at the District Health Office is known as a nazi among all of the PC volunteers who have dealt with her. And she's being transferred out of the district imminently.
So, 'community assessment' was frustrating; it made an otherwise awesome site visit, somewhat more sour. I did meet with the Public Health Director in Savelugu who essentially told me what she thought I should hear, such as, “Yes, everyone is educated about HIV, and a lot of Ghanaians are using condoms, and stigma is minimal.” Hmm. Right.
