Thursday, May 24, 2007

I'm In Rwanda!

I never thought I'd be able to say (or write) this, but I'm in Rwanda! I'm here as an advisor for UNAIDS to work with the Country Coordinating Mechanism of the Global Fund to Fight AIDS, TB and Malaria on its HIV/AIDS proposal, due in July. That's a mouthful! Actually, it's very exciting. Links between sexual and reproductive health and HIV/AIDS seem obvious--both have a lot to do with sex--but very few countries have made a real effort to integrate these services and to make them available nationwide. Rwanda, along with a handful of other countries, is prioritizing this integration for its Global Fund Round 7 proposal. And I get to help them do it!

Sexual and reproductive health (I'm calling it SRH from now on, 'cause that's too much to type every time) includes things like family planning and contraception, pre-natal and post-natal care, HIV counseling, testing and treatment for sexually transmitted infections, and recognition of and response to gender-based violence, especially sexual violence. Sadly, Rwanda has a history of sexual violence stemming from the 1994 genocide, during which as many as 500,000 women were raped and about 75% of them acquired HIV. Unfortunately, the phenomenon of widespread rape has apparently continued, with mostly orphans and other vulnerable children being the target. Thankfully, Rwanda's leaders in responding to the HIV/AIDS epidemic here recognize the importance of incorporating SRH and gender-based violence in all settings that provide HIV/AIDS services. So I'm here to help them figure out how best to do it.

I'll write more later on work stuff. For now I have a few more personal things I want to say. First, Kigali is a beautiful city. There are tree-covered hills everywhere you look. People are so friendly. But there is still a weight here, a memory of horrible atrocities that took place only 13 years ago. The Rwandan people have tried so hard to build a harmonious and compassionate society in the wake of the genocide, and I can tell how important this is to them. They have a quota system, so that at least 30% of elected officials and high-level offices have to be women. I've been told this is because they believe that if more women had been in power in 1994 the genocide might never have happened. There are signs of hope everywhere. Yet driving down the streets I keep picturing the film "Hotel Rwanda," and it almost makes me cry to think of what took place on these quiet streets filled with women carrying plantains in baskets on their heads and men strolling into downtown. Everyone points out the Hotel Mille Collines, the hotel in which "Hotel Rwanda" takes place, as if it's assumed I know its history. It's really intense. And yet my purpose in being here is evidence that things are changing, that the government and the people are determined to set an example for post-conflict development and peace. I know they can succeed!

So, I'm off to eat dinner and prepare comments on the current Round 7 proposal, so that tomorrow we can really begin the work of building SRH and violence services into all HIV/AIDS services here in Rwanda. Till then...

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