Digital Domain in DOM

There aren’t many places in the world I more enjoy than Grace and Healing Ministry of Dodoma (GHMD) and Iringa Road Mennonite Church (IRMC), Lahash’s partners in child sponsorship. I am totally overwhelmed by the level of dedication and persistence in caring for vulnerable kids and families, using limited resources in the sort of working conditions that would tax most of our ideas of what’s pleasant. Day after day they are there, reaching out to orphans, many of whom are HIV+, and others living with hunger, AIDS, and all the other signals of deep poverty. 

Why the blank screen?

That’s a good reason Dave Hanson and I decided before we left home to offer our experience and skills with computer repairs while we were there, one small way to help the folks at GHMD do the job they want so much to do. Computers have become valuable tools for their work, providing essential communications and record keeping. We intended to make that aspect of their work as smooth and problem-free as we were able to do.

Both Dave and I volunteer several hours a week at Free Geek, a Portland non-profit that recycles used computers. Many of the hundreds of computers turned in there are usable when rebuilt, and that’s Dave’s and my job, along with dozens of other rebuilders. Some of those rebuilt computers become grants to non-profit organizations, and several are now at GHMD, brought in the carry-on luggage of travelers. Those laptops sometimes run into trouble, as do other computers there. Our Free Geek skills—plus Dave has skills and experience from a career of working with computers and software and teaching computer skills—we thought would help us solve some of those computer problems.

We carried six more laptops with us on our trip, one of which had been returned to the U.S. for repair and three that were recent Free Geek grants. Carrying laptops requires extra effort at security checkpoints, half a dozen or more on our flight path to Dar es Salaam, but we arrived with all in good working order to be added to the collection of computers already in use at GHMD.

Dave contemplating an issue around downloading software.

Within an hour of our arrival at the church on the first day, we had a malfunctioning laptop in hand. This one had suffered several setbacks, including cough syrup spilled on the keyboard and a broken power supply. Right there at the beginning, we ran into a serious problem we’d face in our efforts to get computers running well. This one had a copy of Microsoft Windows 7 on it, although as a Free Geek grant, it lacked the RAM memory, the sizable hard drive, and the fast processor needed to handle a program of that complexity. Then, too, almost certainly the copy of Windows 7 (most of the other Windows products we saw there as well) used on that laptop was not authentic.

Free Geek computers always leave with a clean hard drive and a current version of Ubuntu (a version of Linux) installed. Ubuntu is an open-source operating system, available free, as are thousands of apps usable with Ubuntu, including an excellent Open Office package that’s included with the Ubuntu operating system. To Dave and me, Ubuntu seems ideal for the situation at GHMD, a virus-free system available at no cost. However, Windows is popular worldwide and available at lower prices than in the U.S. on the streets of a city like Dodoma, although of questionable quality and probably with viruses already there among its maze of bits and bytes.

Very soon after that first computer was placed in our hands, we had several others descend on us, with the usual complaint, “My computer is so slow!” On all of the Free Geek grant laptops, the original Ubuntu had disappeared, replaced by Microsoft products. On some computers, it seemed we had no choice but to completely clean the hard drive and start over, doing our best to save files the user would continue to need. With every computer, we also had to cope with network issues, given less than adequate Internet connections. The wireless system in the church, for example, covers less than half of the offices, but we were not equipped to solve that problem. We realized quite soon that our efforts to anticipate what parts and tools we should bring with us had been inadequate. One trip to a quite well-stocked computer store produced no help but confirmation that computers, accessories, and parts are very costly in Dodoma if they’re authentic, thus usually well beyond the ability of a non-profit like GHMD to pay.

To say the least, our visions of being computer saviors soon faded. We were able to do some standard fixes on several machines, and the users were happy for somewhat greater speed and dependability. Others stymied us, and perhaps we left one or two in even more precarious condition than before. Two of the computers came with us to Portland for repair at Free Geek. Our computer work took up the largest part of our time but was hardly the most enjoyable of our activities during 12 days we were in Dodoma. Even so, what motivated us was knowing we were providing a truly needed service.

Early on we were shown an attractive, new room designed to be a computer lab for teaching children and adults. That was exciting, and it appeared we would get involved in actual construction. It turned out that money needed for lumber to construct tables to hold the computers would not be available until later in March, and again the completion of the computer lab had to be postponed. 

Dave teaching a computer skills class.

One successful venture, though, was the class Dave taught on the last day of our stay in which he gave basic guidance about how computers work and how to keep them working well, with the clear recommendation that versions of Microsoft products found on the streets of Dodoma would not ever be likely to work well. He recommended learning to use Ubuntu as a way to promote good computer function. Several who attended the class indicated their wish to make serious effort to use Ubuntu. Perhaps we might even have succeeded in promoting Ubuntu use in the new computer classroom. We’re confident GHMD will be happier in the longer run with Ubuntu, once users are competent in using it.

So, adding it all up, we can say that although frustrating work on computers wasn’t the most exotic facet of our Dodoma experience this time, it was probably a worth-while means of enhancing the hard work our good friends at GHMD.

Christmas in February

Children and family members gather for the party. 

One strong reason Annette and I have been involved with the mission organization, Lahash Intl., since arriving in Portland six years ago, aside from our close connection with the founders, Dan and Erin Holcomb, is its unique child sponsorship design. Lahash works in East Africa, including Dodoma, Tanzania, the destination of our last two Africa trips. Lahash’s partner there is Grace and Healing Ministry of Dodoma (GHMD), based at Iringa Road Mennonite Church. The main method by which Lahash relates to GHMD is child sponsorship. At first glance, that appears little different from sponsorship with larger non-profits: $25.00/month donations, photos of a child, occasional letters from that child, etc. What’s unique is individual, personal relationships encouraged between sponsors and their sponsored child. That’s nowhere more obvious than at the annual Christmas party, which happened this year on Friday, 24 February. Dave Hanson and I were wonderfully blessed to be in Dodoma on that day.

A child gets gifts of clothing (in the bag she holds),
food, and a bed.

A few weeks before Christmas, at one of the regular Friday gatherings of the 100 Lahash-sponsored children, each child is interviewed about what they’d like for Christmas. The usual wishes of these vulnerable kids are pretty basic: clothing, school supplies, shoes, a bed and mattress, food. A list of three items, with costs in US$, is printed with the child’s current photo and sent to the sponsors, who then make a choices of a gift or gifts from the list and contribute the money to Lahash.

Eliya gets a bed and more. 

All of this comes to a grand conclusion a couple of months later in the PARTY! In preparation, several staff persons (primarily Mariam Munga, Tiffanee Wright, and Lauren Hall, this year) are madly busy buying gifts and being sure that not one of those kids is missed. All is ready and waiting as the children arrive. There’s singing and dancing, prayers, and talks, and this year a slide show of events during the year, but the focal point is the mound of gifts waiting to be distributed, beds and mattresses to one side, two bicycles, even a sewing machine! The tingling climax finally arrives, and one by one, called alphabetically by first name, the children walk forward, most shyly, to receive their gifts, often accompanied by Mama or Bibi (grandmother) or maybe Baba (dad) or Babu (grandpa). Child, relative, and gifts are photographed and videoed together before the next child is called.

Sauda (with Mariam and Tiffanee) gets her sewing machine
from her Portland sponsor, Dana Bertermann.
Sauda will now be able to begin tailoring classes. 

Once all of that has happened, the songs and dances and talks finished, there begins a determined effort to get sponsor thank you notes written on charming, hand-made cards the staff has prepared. Swahili words, often revealing deep feelings of thanks, slowly appear on paper, the card is turned in, and then, there’s food, rice and beans and greens happily devoured. But even before the food, new clothes and shoes—every child gets at least a new outfit of clothing and a pair of shoes—appear on many children. Enjoyment and gratitude are keenly obvious and wonderful to watch.

It was momentous for me to be with Annette’s and my sponsor child, Charles John Chatanda (my only sadness: Annette’s absence from the excitement). Charles is six years old now, a stocky little guy, whose grandmother was at his side. When I got to him after the party, he had stripped to his blue briefs and was getting into a new shirt and pants, then struggling to work his way into and tie new shoes. Annette had packed a separate gift for him that I had brought with me, some books and drawing supplies, but the clothes got the focus of his attention. I watched him later laboriously copying Swahili words on a card with Bibi’s help before he got his plate of food. I knew I’d see the card again, translated, when it arrives in a few weeks with his photo taken with his gifts.

Charles, sporting new clothes and shoes,
with his grandmother

Few sponsors have my privilege to be right there, and I was tearfully grateful for it—and to be in the midst of all of that pleasure and gratitude breathed out by the crowd of kids around me. Again, as happens often, I felt great appreciation for Lahash Intl. and its sponsorship program, bringing together across more than 10,000 miles a vulnerable child and sponsors in heart-touching encounters.

Want to sponsor one of those vulnerable kids? It’s all there at Lahash, Intl.. Katie Potter, the U.S. sponsorship coordinator, and Liesha Otieno, working on sponsorship in East Africa, will be delighted to hear from you. Welcome aboard!

Joseph rides away with a 20 kg. bag of corn meal
on the back of his bike.

Village of Hope 2

See the previous post for a story of the morning visit to Village of Hope with Eliya.

Shortly before 4:00 p.m. that same Monday, I was again on the way to Village of Hope, now with Dave Hanson, my friend from Portland, Tiffanee Wright and Mama Jafeti, Eliya’s principal caregivers at Grace and Healing Ministry of Dodoma (GHMD), and Lauren Hall, an American pediatric nurse from Pennsylvania, who is volunteering at GHMD as part of a graduate studies practicum.

Father Vincent Boselli

We had the extraordinary good fortune that our tour guide was Father Vincent Boselli, an Italian priest, who with Sister Rosario and the order of Roman Catholic sisters of which she is a member, founded Village of Hope 10 years ago as a refuge for HIV+ orphans. Father Boselli has lived and worked in Tanzania 40 years, which includes the onset of the AIDS epidemic 30 years ago, and clearly cares intensely for the children he serves and all aspects of the most current AIDS treatment.

Dave Hanson and an infant get close.

He led us first to the infant nursery where babies live after coming to Village of Hope until they are old enough to join a family. We then moved around the orphanage, which shelters 150 children in family groups of about a dozen children with a father/mother team. All are HIV+, and those whose CD-4 count has dropped to 200 or less are in closely-monitored treatment with ARV medications. 

As we walked with Father Vincent and listened to his vivid description of Village of Hope, admiring the beauty of his close, personal contact with the children whom he knew by name, we were constantly surrounded by those children, usually with one or two attached to our hands.

Lauren and Mama Jefeti with a child

Village of Hope also includes a primary and a secondary school, a school of nursing, a small hospital for children who are seriously ill, which we did not see, and the clinic which we had visited earlier, open to the community for AIDS treatment.

A important part of our visit for me was the opportunity to interview Father Vincent about Village of Hope and the treatment protocol used there, with Eliya’s prognosis and treatment in my mind. Father Vincent gave us a mini-course in AIDS treatment from his overflowing knowledge and experience and his urgency to provide the finest treatment possible, beyond limitations of money and access. He has been involved with this tragic disease since the early days when people began to appear with a strange, unnamed disease, always fatal, in the early 1980s. Not until the early 1990s was the disease recognized in children, since death came because of other diseases, later to be called opportunistic diseases that take advantage of a weakened immune system.

Tiffanee with Victoria,  a Lahash sponsored child
 now living at Village of Hope. When Victoria's first CD-4
count was tested, it came up six.

We learned about the importance of CD-4 counts that determine the number of T-cells, an indication of the progress of the disease toward full-blown AIDS. That borderline number in much of Africa is 200 (usually much higher in America). When a child’s T-cell count falls to that number, ARV treatment begins with baseline drugs now available in Tanzania from the government at no charge.

Father Vincent went on to describe viral-load testing as an essential next step in determining the effectiveness of treatment. Early on, Village of Hope provided the only viral-load testing in Tanzania. He explained that at first, he was forced to fight for awareness of the value of this test, an expensive procedure requiring costly equipment and skilled technicians Because of the long-standing connection of Village of Hope and the Pope’s hospital in Rome, Village of Hope acquired the needed equipment, but budgets have not been sufficient to provide a full-time technician, which is the reason Eliya must wait until April for his viral-load test. Then, a volunteer technician will arrive from Rome at Village of Hope for a month of constant viral-load testing. Six months later, another technician will arrive for another month. Lauren reminded us all that in American viral-load testing is usually a quarterly procedure.

A child responds to Tiffanee's words and touch.

A viral-load test, Father Vincent explained, provides information about how well the ARV medications are functioning and will show drug resistance. If it were determined, for example, that Eliya was taking his medication regularly but his condition still deteriorated, he has possibly developed drug resistance. Then the task is to determine which part of a three-medicine cocktail is failing and to find a a second-level drug. At that point, problems develop in procurement of advanced drugs from the government. Usually those drugs are more costly, and the government is caught in the bind of restrictive budgets and need to balance the need to expand treatment to more first-level HIV+ persons or to provide more costly drugs to those who have become resistant. Father Vincent described his determined battle to acquire those advanced drugs for the benefit of the children he serves. We listened to a man who is surely an unstoppable advocate for people living with AIDS, determined that they shall go on living.

I then asked, “How is it possible that your patients get free ARV treatment at any level?” His immediate answer: “The Global Fund,” referring to The Global Fund for AIDS, Malaria and Tuberculosis, founded in 2002 and now the main financier of programs to fight AIDS. It was an answer I expected as a result of my work with Bread for the World. Treatment like what Village of Hope was freely providing (although with the untiring efforts of Father Vincent) came from a world-wide fund largely provided by governments, with the USA being the largest donor. Thus, I was hearing, my tax dollars have been directly connected to Eliya’s treatment. Were he an American, his insurance company (or state and federal subsidies) would provide around $1000.00/month for drugs that Eliya receives at no cost. Of course, Eliya and millions like him have no money to pay for medication. His Lahash sponsors pledge $25.00/month for his care, which includes a portion of his food needs, clothing, and school fees; few sponsors could pay the full cost of his medications. Without government subsidies (and government agreements with international drug companies) HIV/AIDS victims would die, as they did, inevitably, in the past.

Children with Mama Jafeti

We talked about the threat that cutbacks in contributions to the Global Fund imply. Such threats are real in Europe and America, related to the economic downturn. Father Vincent sees a direct connection between reduced funding and deaths of AIDS sufferers, and he uses the word “immoral” vehemently. He is a veteran of battles to provide adequate treatment and knows well that he may lose his battles in an era of declining funding.

I was thrilled to be able to assure Father Vincent that he did not battle alone. In America there are battalions of caring people who write letters to their senators and representatives, urging that they work to maintain a circle of protection around programs that make up the U.S. contribution to poverty-focused development assistance, including the Global Fund, PEPFAR, and other programs aimed at reduction of disease, malnutrition, and poverty. I described to him how such programs are at grave risk in the current political climate but guaranteed to him that many in America share his concern and will work very hard to support the efforts of courageous advocates for vulnerable children. He seemed truly grateful for that assurance.

I came from that interview with an enormous sense of gratitude for Father Vincent and Village of Hope and for the resources provided there for the best possible treatment of Eliya and others living with HIV. I felt even more determined that the story must be told at home and more Americans be convinced that the circle of protection is absolutely essential.

I had renewed hope that my prayer beads are still effective.

Village of Hope 1

(See the post above for the story of my second visit to Village of Hope.)

In 2003, during our six-week stint in Philippi, South Africa, eight-year-old Thobela, an AIDS orphan and HIV+, and I became great friends. He appeared healthy; our favorite game was, when he saw me, his running full tilt toward me and at the last moment leaping into my arms (he was a suprisingly light weight!). I recall, though, my sense of forboding: there was no treatment for Thobelah. He would most likely die. I do not know when, or if, that happened, as I had no further contact with him. Still, he keeps a firm hold on my memories. Almost daily since, I have worn a red, beaded AIDS pin, handmade by a South African woman, as “prayer beads” for my little buddy, Thobelah. and millions like him.

In 2006, during a 13-week stay in Old Mutare, Zimbabwe, I walked in the funeral procession of Shingirai, also an eight-year-old boy, an orphan and HIV+. By that time, anti-retroviral (ARV) medication had become available in Zimbabwe, and he’d begun to receive an ARV regime. However, it was too late to prevent meningitis that took advantage of his severely weakened immune system and killed him.

In 2009, during a 10-day visit in Dodoma, Tanzania, I met Eliya at Iringa Road Mennonite Church (IRMC). He was, too, an AIDS orphan and HIV+, but to an untrained onlooker, he appeared completely healthy: active, bright, responsive, his sly smile captivating. For me, Eliya became a poster child for the effectiveness of ARV treatment of children with HIV and a delightful indicator of changes in AIDS treatment in Africa since my encounter with Thobeleh six years before. Hey, perhaps my prayer beads were working!

Returning to Dodoma this time, seeing Eliya was a priority. I had heard through Dan Holcomb of Lahash that he was not doing well; doctors said his heart was enlarged. Even so, I was not prepared for the change I would see when a friend brought him to me the first day Dave and I were at IRMC. Now 12 years old, it seemed he had not grown since I last saw him in 2009 and was thinner than I remembered. He had a severe rash on his arms and legs and skin eruptions on his face. The brightness I’d remembered just wasn’t there. I was dismayed. I wondered if the story of Eliya might not after all be much different from the stories of Thobeleh and Shingirai. I felt sad for Eliya, and I felt sad that the optimism I’d been feeling was seriously threatened.

Eliya (white, printed tee shirt) dancing with his choir.

My first impressions, however, altered much when a day or two later I watched Eliya practicing with a church youth choir. The contrast between that slight, little boy and the much bigger kids around him was obvious, but still, when he sang and danced—African dancing is intense and very physical—he was amazingly transformed. I was thrilled and a little puzzled by what I saw. Although sweaty, he seemed perfectly able to keep up with the dancers around him.

Even so, Eliya’s issues could not be easily dismissed. His caregivers at IRMC were obviously much concerned, which led us to Village of Hope on the outskirts of Dodoma, one of the most remarkable places I’ve visited anywhere in Africa, It’s a Roman Catholic “institution,” but a better word might be “miracle,” certainly for hundreds of people living with AIDS. Eliya, Mama Jafeti, Edwin Angote, and I traveled there by taxi and went to the outpatient clinic. I was surprised to enter a large waiting room that compared favorably with any American medical setting. We waited a few minutes, then were led into a doctor’s office. 

Edwin and Eliya in the doctor's office.

He studied Eliya’s records, saw his current weight (the same as at his last visit, despite a therapeutic diet including Plumpynut that provided 2,500 calories daily), examined his rash, and then commented about his treatment, all in Swahili with occasional attempts at English for the benefit of the Mzungu (Swahili name for a white person). The expected viral-load blood test, the primary reason for this visit, could not be given until early April. Meanwhile, his assumption was that Eliya was not in “adherence”—not taking his medications regularly. In a previous living situation, Eliya had been one of two dozen or more people in a chaotic home situation and on his own in taking his medicine. He had recently moved to a sister’s house, and his caregivers had hoped for better adherence. Eliya readily admitted he sometimes forgot to take his medicine. The final agreement of that session was that Mama Jafeti and others would attempt to find a foster care situation where his adherence would be closely monitored, then hope for his condition to improve.

Swinging on the clinic porch

(Before we left that office, the doctor urged Edwin and me to allow an HIV test. Well, why not? As he had surely done hundreds of times before, the doctor drew blood from a finger and placed a few drops on a small test strip, then a drop of reagent—and we waited. Sure enough, after five minutes or so, only one line appeared. We were both HIV free.)

Leaving the clinic, Mama Jafeti led me to another surprising room, a large, bright, immaculate laboratory. It was quiet, one technician only writing at a table, but seemed, again to an untrained eye, to be superbly equipped. The four of us then returned to the city, stopping at a pharmacy so that Mama Jafeti could fill a prescription for Eliya,  

Village of Hope laboratory