The name Kathmandu sounds like Kadamandu, but the similarities between these two cities in Nepal largely ends there. The former is the country's million-person national capital and a centuries-old hub of culture and commerce. Kadamandu is tiny and remote. Situated in the mountains of remote, far-western Nepal, it is home to only 4,000 people.

On sight, you wouldn’t realize it, but the big city Kadamandu has the most in common with is Mumbai.

Eager to find work to support their families, the men of Kadamandu often leave the village to find work. Three-quarters of them go to India. Tragically, money isn't the only thing the men are bringing back from Mumbai. Separated from their families, many of the men visit brothels. As a result, they're also bringing sexually transmitted diseases to Kadamandu. More than 70 people in Kadamandu have died of HIV/AIDS. As the number of men going to India for work has increased, so has the number of infections, bringing added misery to this already very poor town.

With the help of CARE Nepal, director Ramesh Khadka has produced an award-winning a documentary about what’s happening to the village and how CARE Nepal is responding. “Kadamandu” is an unflinching look at the misery HIV/AIDS has wrought on the community, as well as the bleak economic conditions and severe gender inequality that underpin this tragedy. Last month “Kadamandu” won the award for best documentary at the Kathmandu International Mountain Film Festival.

A trailer for "Kadamandu" is on YouTube and embedded below. An especially powerful scene begins at the two-minute mark.

Today at 1pm at the XIX International AIDS Conference in D.C, CARE CEO & President Helene Gayle is co-chairing a session titled "Leadership in the AIDS Response for Women". 

This high-level special session is on leadership in the HIV response, with a focus on the critical role of leadership in improving the HIV response for women, their families, and their communities. The panel will consider an 'AIDS-Free Generation' and how that key shared goal cannot be reached without the empowerment of women at local, community, national,and international levels. Speakers will address topics such as the centrality of democracy and human rights in the HIV response, and the powerful synergies of linking HIV efforts to other important health efforts for women, including breast and cervical cancer.

Leading the panel with Dr. Gayle is Gracia Violeta Ross Quiroga, an expert on sexual and reproductive health rights and the founder of Bolivia's first advocacy organization for people with HIV.

Joining them on the panel are former First Lady Laura Bush (who was in the news yesterday defending U.S. foreign assistance) and Nobel Laureate Aung San Suu Kyi (who's in the news pretty much every day).

"But I'm not in D.C.," you say.

I had a feeling you'd say that.

The discussion will be streamed online. Look for the "Media Widget" on the conference home page.

May 2011

Dear Advocates,

AVAC is pleased to announce the call for applications for the 2012 HIV Prevention Research Advocacy Fellowship Program. This update provides information on the Advocacy Fellowship program and details for an upcoming informational call to be held on Wednesday, June 1.

The submission deadline for the Advocacy Fellowship applications is Monday, July 15, 2011.

Visit the AVAC Fellows page – http://www.avac.org/fellows – to download application materials.

The goal of AVAC’s HIV Prevention Research Advocacy Fellowship is to expand the capacity of civil society advocates and organizations to monitor, support and help shape biomedical HIV prevention research and related implementation worldwide. The Advocacy Fellowship is guided by the belief that effective and sustainable advocacy grows out of work that reflects organizational and individual interests and priorities.

The Advocacy Fellowship provides support to emerging and mid-career advocates in developing countries to design and implement advocacy projects focused on biomedical HIV prevention research activities in their countries and communities. The Advocacy Fellowship is primarily focused on countries where biomedical prevention research is planned or ongoing. Advocacy Fellows carry out their projects while based at host organizations that are active partners in the Fellowship process.

HIV Prevention Research Advocacy Fellows are:

• Emerging or mid-career community leaders and advocates interested in building their skills in understanding and advocating around HIV prevention research
• Individuals with some experience or education in the areas of HIV and AIDS, public health, international development, women's rights, communications and/or advocacy
• Based in developing countries where biomedical HIV prevention clinical research is planned or ongoing or medical male circumcision for HIV prevention is being introduced
• Able to collaborate with English-speaking mentors

Fellows receive training, full-time financial support and technical assistance to plan and implement a targeted one-year project within host organizations working in HIV/AIDS and/or advocacy. The Fellowship builds the capacity of both the Fellow and the respective host organization in HIV prevention research advocacy.

Interested in learning more about the Fellowship Program?

Prospective applicants or host organizations who want to learn more about this program or have questions about the application process are encouraged to read the 2012 Fellowship Information Packet and invited to join an informational conference call:

Informational Call: WEDNESDAY, JUNE 1, 2011
9am EDT USA / 8am Lima / 11am Rio / 3pm South Africa / 4pm East Africa / 8pm India
(Visit www.timeanddate.com to confirm the time in your time zone.)

If you would like to join the call please register here.

Learn about the current Advocacy Fellows and their projects
2012 is the third year of the Advocacy Fellowship. Visit AVAC's Fellows page for more on the 2010 and 2011 Advocacy Fellows and their projects.

All 2012 Advocacy Fellowship applications are due by FRIDAY, JULY 15, 2011.

If you have any questions about the Fellowship program or the application process, please email fellows@avac.org.

We hope you'll share this information with your partners, and we look forward to receiving your application!

Story by Rick Perera, CARE Media Officer in Haiti

Saturday, February 6, 2010

In earthquake-ravaged Haiti, where broken bones and open wounds far outnumber doctors, people have grown accustomed to long waits for medical attention. But many who turn up at Saurel Saintie's mud-brick home have waited longer than most. These patients have traveled five hours or more along a rutted, dirt road -- aboard battered old buses, in backs of trucks or perched by threes and fours on motorbikes – to escape the ruined capital, Port-au-Prince. Many have gone weeks without having their injuries attended to.

Helene Gayle, president and CEO of CARE, blogs from her trip to Kenya.

August 10, 2008

Well, we arrived last night to Nairobi around 9 p.m. and settled in. Most of the Learning Tours group ended up on the same flight to Nairobi from Amsterdam, which was great as it gave us a bit of time to connect with each other and get focused on the Learning Tour trip.

This morning after a breakfast briefing we loaded up in a van and headed to a drop off point to get to Kibera Tabitha Clinic. Kibera is a densely populated "informal settlement" or slum area of Nairobi. Population estimates for Kibera are as high as 1 million people. It's probably the largest and most studied slum in Africa – nearly the size of Manhattan's Central Park. From our drop off point at the top of a hill, it looks like a corrugated sea of rusted tin roofs and open sewers.

Reaching the clinic involves walking through a maze of muddy walking paths as there are no streets. While there we were briefed by Dr. Rob Breiman of the Centers for Disease Control and Prevention (CDC), who is a former colleague from my days at CDC, and the clinic's director, Salim Mohammed. The clinic took two years to build and was completed this year. The bricks to build it were all carried by hand down the same narrow, windy path to the site and was built by the community.

The clinic partners with the CDC to identify trends in infectious diseases and develop programs to meet the highest priorities for improving health. They also integrate HIV training, reproductive health and antenatal care. About 150-200 people visit this clinic every day.

Staff also do home visits to households every other week, asking questions to identify possible health issues. For example, if someone has a cough or potential complications with a pregnancy, it initiates a specific set of questions to help determine the whether there is a problem that needs attention. I had the chance to go on a home visit to meet with a woman named Cynthia, a mother of five. It was interesting to see how the local health worker, Jaciuta, gathered surveillance information on Cynthia's family that was logged on a handheld PDA – technology put to good use. This allowed the home health worker to go back to the office and upload household health information on a daily basis. Sure beats old fashion paper record keeping!

From there, we walked through another part of Kibera to meet with a group of women. They told us about the daily struggles they face as well as some of the support they receive from a woman named Judy, a retired nurse who started her own organization that CARE supports as a local partner through our Local Links program. Judy helps the women start small businesses, like selling vegetables, to earn their own income.

The story of one woman, Mwinza Mwema, especially impressed me. She has seven children and two orphans in her care. Her vegetable stand was burned to the ground during the post-election violence in Kenya last year but she didn't give up hope. She takes on jobs washing clothes and dishes, making a little over a dollar a day. It never ceases to amaze me the resilience of women like Mwinza, who continues to have a positive attitude despite the hardship she faces. This is a woman who survived home childbirth, cutting the umbilical cords herself because she couldn't afford to go to a hospital. She was lucky to have survived and that her children still have a mother. She mentioned other women she knew who didn't survive home childbirth, a common practice in poor areas. Hopefully as more clinics like Tabitha go up, more people will start accessing health and family planning services.

During lunch we spoke with Peter Anyang Nyong, minister for medical services, who noted health challenges in Kenya, and how improving infrastructure and human resources are critical to the country's development.

(L to R: Admiral Fallon, Minister for Medical Services Peter Anyang Nyongo and me at lunch)

From there we drove to Pumwani Maternity Hospital for our final visit of the day. According to the director, Dr. Charles Wanyoni, it's the busiest maternal health hospital on the continent. This year, he said they've experienced seven maternal deaths for some 11,000 deliveries. He noted that "when it's this busy you can expect complicated cases." The hospital has two operating rooms, one antenatal clinic, family planning services, services to prevent mother-child transmission of HIV and comprehensive care. Because it's located right next to Kibera, many women and girls who deliver there have to work out with a hospital committee how they will pay for services – approximately $40 for a normal delivery and double that if a caesarean-section is needed.

(Here I am visiting the Pumwani Maternal Health Hospital's neonatal unit.)

Because the hospital was built in 1926, it was obvious they've have to expand, which is a constant struggle when facing high demand and low funding. It was good to see that the CDC is supporting the hospital with a laboratory, and it also receives PEPFAR (the U.S. President's Emergency Plan for AIDS Relief) funding. The hospital staff has aspirations for developing their infrastructure during the next five years to include things like a new water system and more skills training workshops for staff.

I really hope for the day when poor women can focus on getting the care they need without putting themselves in precarious financial positions that deepens their poverty. This is what I will continue to push for: more investment in maternal health and family planning. These issues really need to become a priority, not just in Kenya, but  on a global scale.

Tonight, I have to brush off the dust from today's trip to wear another hat: meeting with health leaders and key donors at the residence of U.S. Ambassador Ranneberger. More tomorrow!

For me, meeting with CARE colleagues and leadership here in Mexico City has been crucial.  We need their support, as our work fighting the HIV epidemic in Côte d’Ivoire continues to grow exponentially.

This is my first time at the International AIDS Conference, and I have to admit it's a bit overwhelming!  But I'm learning a lot, especially about how we can improve our work with children affected by the epidemic.

I have the interesting distinction of having been to every International AIDS Conference for the past 18 years.  Every time, I learn more.  It's a rare opportunity to stand back from our daily work and look at the big picture of the worldwide response to the HIV/AIDS epidemic.