Works of ART
By Angela Savage and Geoffrey Goddard
worst-case scenario sees HIV cases in Asia outnumbering all
those on the rest of the planet. Pooling knowledge and resources
to contain the threat, Red Cross and Red Crescent National
Societies are fighting on a regional front. Young people throughout
Asia are being reached by a border-crossing strategy.
Her nickname is Joy and she promotes safe sex. In conservative
corners of Laos that isn’t always appreciated. Sex
isn’t something you talk about openly, particularly
if you are female. A decent girl can acquire a reputation.
Joy – real name Phuenchit Chantamaly – isn’t
discouraged. At 22, the volunteer Red Cross educator considers
breaking taboos is all part of the job. “Sometimes”,
she says, “people think I’m crazy to talk as
I do but they don’t realise how serious the problem
The problem is HIV infection and AIDS. The virus is spreading
more rapidly in Asia than in any other part of the world
and by mid-1996, the UNAIDS agency estimates, some 5 million
Asian adults had been infected since the onset of the pandemic.
This is 18 per cent of the global total in an area which
is home to 60 per cent of the world’s population.
It is now feared that the people infected in Asia may, in
the end, outnumber those in the rest of the world combined.
Joy’s challenge in Laos is getting the message over.
It isn’t just the taboos. While HIV/AIDS has caused
widespread suffering in neighbouring countries, so far in
Laos it hasn’t hit hard. While Thailand has an estimated
850,000 HIV cases and 40,000 people with AIDS, the problem
in Laos is still largely invisible. People are reluctant
to accept the size of the threat they are facing. So using
Joy, and a growing team of peer group educators, the Lao
Red Cross is raising awareness as fast as it can. Supported
by the Australian Red Cross and funded by the Australian
overseas aid agency AusAID, a nationwide programme is under
The response is the stronger for belonging to a regional
strategy. Since HIV knows no boundaries, and borders cannot
contain or exclude the virus, Asia’s National Societies
are pooling knowledge and resources. Set up by the Federation
in 1994, the Asian Red Cross and Red Crescent AIDS Task
Force (ART) has brought together China, India, Indonesia,
Laos, Malaysia, Myanmar, Nepal, the Philippines, Thailand,
Viet Nam and, since last year, Cambodia and South Korea.
“The ART”, says Patrick Couteau, its former
secretary, and previously health delegate at the Federation’s
regional delegation in Kuala Lumpur, “is for sure
among the best examples of networking the Movement has seen.”
Region-wide it is backing programmes to prevent the spread
of HIV, and to care for those infected, protecting their
rights and combating discrimination. Underlying the ART’s
efforts is a workplan developed with health professionals
and volunteers from all 12 countries. Its focus for now
is on a youth peer education programme, and young people
throughout Asia are being mobilised to meet the challenge
of the frightening worst-case scenario.
By the end of last year most ART countries were busily
training young core trainers. They in turn are training
district facilitators to run grassroots education workshops.
If all goes to plan, within 18 months each country will
have 1,000 youth educators, and some are well on the way.
Myanmar, one of the pioneers of youth-to-youth awareness,
was reporting last autumn that close to 300 young facilitators
from 27 townships had reached over 13,000 young people.
While the strategy – the target groups, the methods,
the educational approach – is common to every country,
cultural and socioeconomic differences are being taken into
account. The training manual that is key to the programme
is fine-tuned to each country’s profile, and to its
sensitivities. But, say the National Societies, it is the
young themselves, involved at every stage of the programme,
who ultimately enhance its relevance. Says Nguyen Thi Y
Duyen, programme officer in Viet Nam, “It is developed
for young people by young people and is using the language
of the young. We understand why we train our friends because
we care about their well-being. We want them to talk to
each other and spread role models widely in our society.”
In Laos, Joy goes along with that. She is typical of the
people the ART is encouraging. Since becoming a volunteer
with the Lao Red Cross in 1994, she has gone through a number
of courses and workshops, among them a course which the
ART conducted in Malaysia on HIV and women, and one in Indonesia
on peer education.
The five-day gathering in Indonesia was crucial, for it
brought together key youngsters from all ART countries to
report on the development and pre-testing of the manual
in their national languages. They pored over vital sections
on the causes of infection and AIDS, on contraception and
birth control, on community-based counselling, on abstinence
and pre-marital sex, and on drug abuse. They examined language,
content and methodology through role play and presentations.
The bottom line was to agree on a programme that tells
young people, clearly and accurately, how to protect themselves
and their friends from the virus and its consequences. For
that they need to understand and avoid risk behaviour, develop
the social skills for good decision-making, learn to support
one another and to provide care and compassion for those
affected. Having had the last say, the youngsters returned
home from Indonesia to finalise manual production and launch
the ART’s training programme.
Just how much it is needed in Laos can be judged by Joy’s
concerns as she educates friends, and friends of friends.
One is a widespread ignorance of condoms. “Some people”,
she says, “don’t know what they are; they have
never even seen one.” Those who have can be embarrassed
by them, and overcoming the shyness is difficult. “Sometimes
I take people to the pharmacy to buy condoms,” Joy
says, “to show them there’s no need to be embarrassed.”
She has mountains to climb but the ART is helping her climb
them faster. With support from the British, Norwegian and
Swedish Red Cross Societies, as well as from the Australians,
the sharing of decisions, concerns, experience, resources
and technical expertise is developing the capacity of National
Societies in the region.
Before the ART there was little collaboration on any front.
Dr Win Win Aye of the Myanmar Red Cross says her National
Society had been working more or less in isolation for a quarter
of a century.
Like Laos, Myanmar did not have a problem on the scale of
some neighbours but knew it could have if no action was taken.
“The official figures”, says Win Win Aye, “were
about 7,000 HIV positive cases and about 200 known AIDS patients.
These we realised could grow at an alarming rate if concerted
efforts were not made in time, as rapid urbanisation and increased
economic development are an inducement to high-risk behaviour
among young people.” With chapters in 308 of the country’s
320 townships, the Red Cross was well placed to respond but
knew it had to break out of isolation. Contacts across borders
Former ART secretary Patrick Couteau says Thai Red Cross
collaboration with Myanmar to some degree inspired the Task
Force. Today cooperation runs to the development of collective
fund-raising strategies, and region-wide partnerships with
UNICEF and UNAIDS to support programme implementation. Those
National Societies with most experience are passing it on
to those with the least. When ART members presented The Benefits
of a Regional Network to the XIth International Conference
on AIDS in Vancouver last summer, enhanced commitment and
productivity were high on the list.
Clearly it is a precedent, and in many ways an exciting one
for Federation-supported programmes glo-bally. But with the
growing threat to Asia of HIV/AIDS, no one is resting on their
laurels. Dr Anis Ahmad, ART chairman and a Malaysian Red Crescent
volunteer, insists, “We have just begun serious work.
We still have a long way to go. We have many other aspects
of the problem to tackle. We need to mobilise our energies,
skills and knowledge to greater heights, produce better results
and become the leading non-governmental organisation in the
battle against HIV and AIDS.”
Writing in Work of ART, the Task Force newsletter,
he called for more National Societies to be involved. There
was, he said, still a need to help sister Societies elsewhere
in the region face the pandemic effectively.
Compiled from reports by Angela Savage and
by Geoffrey Goddard. Angela Savage is the
current ART Secretary and Coordinator of the Australian Red
Cross Sub-regional HIV/AIDS Network, based in Hanoi. Geoffrey
Goddard worked as an Australian Red Cross volunteer.
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