Taking Shape and Getting Started

So you have an idea of how WeAct was started and the mission of the organization, this last week has provided for additional assessing of needs and has provided a scope of work for me to begin. But first I will give you a little background info.....

WeAct's HIV+ youth population is struggling with adherence to their medication. For those of you unfamiliar with HIV treatment (which I am learning as I go). There are levels of medication (ART) 1-3. Level one is one pill daily and which most people are able to stay on for roughly four years before having to move to the second level, however if you do not take your medication on a daily basis than your body can not fight the virus and you are moved to the second line to get the virus under control. The second line is 9 pills daily ( 4 in the morning and 5 at night). For a large group of WeAct (a global problem not specific to WeAct youth) is having multiple barriers in taking this on a daily bases, thus many are putting themselves at risk of shortening their life span and risking death within the next few years if not adhering. In addition level 3 ART is not available in Rwanda. So if level 2 is not working for you any longer, you are essentially out of options.

Focus groups and psychosocial assessments have established that barriers to ART adherence are too many pills, pills are to big, and bitter tasting; depression, hopelessness, and self deprivation; gender based violence; and social stigma. For many youth they live in fear of disclosure of status, many have not told anyone, they fear someone seeing them take meeds, hearing the pill bottle rattle in their school bags. HIV is still shrouded in myths and misconceptions of transmission. Many live with caregivers (1 out 4 are orphans) that isolate them by making them have separate dish ware or treat them differently then non HIV youth in household by not sending them to school for example.

The US consultants (a medical physician and a psychologist) have been working on a substantial grant that would implement an intervention using Trauma- Informed Cognitive Behavioral Therapy to train Youth Leaders to run peer groups to work on changing the negative thinking surrounding HIV, social stigma, depression, and trauma. For resource limited communities this has been a way to intervene and provide psychosocial education and support.

So, essentially my role will be multifaceted. In part, (a) I will be working with the youth counselor to consult on using TI-CBT with the youth she sees in individual counseling. There are a few youth who speak English, so I will be sitting in on the sessions (I was able to sit in one a session yesterday to get a feel for the process and have to say I am very much looking forward to client contact). For other cases, we will be doing case consolations weekly. (b) I will be working with the child psychologist to develop a psychosocial assessment for children 6-11 to help build preventative care for younger children with depression or other mental health indicators. (c) I will be developing a curriculum for the TI-CBT intervention psycho educational section (cross your fingers that the grant is approved) for both the Youth Leaders and corresponding parent workshops. and (d) provide follow up CBT training for the WeAct psychosocial counselors. Did you get all that? cause I'm not sure I do!!!

In the meantime, I ventured out of the city about 5 hours southwest to Nyungwe Forest National Park this last weekend and hiked through the rainforest, no wildlife, but the foliage was incredible. Here are some pictures to share...so beautiful, refreshing to be in nature!