Since 2003, Teddy Alamayehu, a sociologist and former social worker, has worked with Ethiopia ACT, a multicultural team that helps to reduce the impact of AIDS/HIV on poor families.
Alamayehu is program coordinator for the organization. When he and his colleagues began their work, they quickly realized that Ethiopians affected by HIV and AIDS dealt with more than just medical challenges.
“They were challenged socially, emotionally, and also they were neglected by their neighborhood and family,” Alemayehu explained. “Caring for their children, caring for their family, staying connected with their neighborhood, resuming their responsibilities in society were the biggest challenges.”
Statistics show the primary mode of HIV transmission in Ethiopia is heterosexual contact. Young women are more vulnerable to infection than young men; urban women are three times as likely to be infected as urban men, although in rural areas the difference between genders is negligible.
Alamayehu was interviewed by UM students Lacey Russell and Leah Gibson in his office in Addis Ababa. This is an edited transcript of the interview.
Interviewer: Can you tell us a few ways that you have addressed the problems families were having?
Alemayehu: HIV eroded the economy, the network of the people. This program mainly focused on providing the field need. For example, food, medical supplies, and sending the children to school, creating an environment in which children can socialize in their families. We provide counseling, we teach children, we invite medical teams from the United States, and we provide medical care for the family and neighborhood as well, including people affected by HIV.
Interviewer: Can you give us a specific example of a family that you’ve helped and how they reacted to the foundation’s help?
Alemayehu: When we met one particular family, the mother was highly affected by HIV and her son was infected as well. He was struggling with an opportunistic infection and his face was full of wounds. Their neighborhood figured out that they had contracted HIV, and they were stigmatized. They were disconnected from their network. Their oldest daughter was also HIV positive. Just imagine three family members struggling with medical, social and emotional situations.
By the time we engaged, they were living by the edge of the river. They owed like four years’ worth rent and were on the verge of being kicked out of their house because of economic problems, medical problems, health problems, and social/emotional challenges that they faced. The first thing that this program did was provide them with medical care. Even though anti-retroviral was not available for free in Ethiopia, this program covered the medical costs to provide anti-retroviral for the child, and allocation for the family to sustain their income. We covered food, medication, and sent all their children to school. This program covered their house rent to keep them in their home, in their neighborhood, in their network.
A surprising thing that I experienced with that family was that the second daughter was so determined to continue her education. She completed high school, and she trained in accounting. We wrote her CV and she is hired in one of the organizations in the neighborhood. Now, the family is well. They are living in an even better life situation now.
Interviewer: How do you find the families that you help?
Alemayehu: We are not running this program alone. We are highly connected with the government and existing structure within the community. We work with the local administrative office. We call them woredas. The woreda office has a women and children’s department. Families affected by HIV report to those offices, and those offices refer the family to us. That’s how we work.
Interviewer: How has medical care transformed in Ethiopia over the past couple of decades?
Alemayehu: In relation to HIV, initially HIV was a big challenge. It was well-defined, and it’s not curable. It’s an opportunistic infection, most challenging in eroding the economy of the country. There was no well-trained medical and auxiliary staff to care for these people. From 2002 until 2005, it was a very huge challenge for the people and for the medical system as well. Later, with the introduction of anti-retroviral (therapy), the situation completely changed. People got strength and their medical situation reversed, as well as their economic situations.
Interviewer: Who provides the financial support for the families? Do you have partners that have helped you?
Alemayehu: Yes. Our program is highly connected with people, churches and foundations in the United States, particularly Presbyterian churches, MTW (Mission to the World), foundations like Blood Water. Other good partners support us with financing for our programs. Individuals, through sponsorships, support children and families.
We partner with different charities, and those charities send medical teams. We host eight or nine medical teams from the United States. Each team has on average five providers. That’s a huge, huge help for us. Currently we have about 12 professional program staff, like social workers, sociologists, nurses and other volunteers.
Also, we have “expert patients.” They are victims of HIV. They live with the virus. They are trained by our program. They are kind of workers for us. They go visit families, identify problems and report to the program. We have four regular expert patients working with us now.
Interviewer: Do you have ways to provide HIV testing, maybe for free or through the program?
Alemayehu: We are working in collaboration with other organizations. HPCO (HIV Prevention and Control Office) is one of the big partners of ours for whenever we need a testing group. On top of that, all the health centers and hospitals have that service. Because it is available we don’t need to organize testing units. We test regularly. Two months ago, in five days we tested about 100 individuals. Out of all of them, three were HIV positive. The testing is free.
Interviewer: In your opinion, is the HIV/AIDS problem in Ethiopia improving? Where do you see it 10 years from now?
Alemayehu: Currently, all the data that I come across indicate that the HIV situation is improving. Ten years from now, what I would say from looking at my experience, the infection rate will drop down significantly. Maybe because of the burden, people taking anti-retroviral will be tired of taking that medication and may develop a kind of resistant HIV. That’s what I expect.
Interviewer: You said earlier that you have started to focus on other areas. Can you tell us your ideas on how you will approach those areas?
Alemayehu: The situation of HIV is improving in the community. We are trying to incorporate other community issues. We are currently working on prevention of TB (tuberculosis) and other community problems like cancer.
Churches, organizations collaborate on health care delivery
In 2001, at the height of the AIDS crisis in Africa, Andrew and Bev Warren noticed something missing. There was an important focus on AIDS and HIV prevention, but not much being done to care for people who already had AIDS and were sick and dying, and their families.
Bev Warren, born and raised in Cleveland, Mississippi, and Andrew Warren, a Tennessee native and former journalist, went to work to do something about it.
“We started meeting with families to try to figure out how we could help,” Andrew Warren said. “The neediest people were women who were infected by a partner. The partner died, and there was no support for her or for her children. That became our target audience. How to help with rent, food, school fees for the kids, support groups, short-term medical teams.”
Neither of the Warrens is a medical doctor. “I have a Boy Scout merit badge in first aid,” Andrew said, laughing.
Warren first went to Kenya to teach journalism. In the 1980s, he and Bev went to Ethiopia and Somalia. They returned to the United States and Andrew received a graduate degree in development management at American University.
Bev Warren said she grew up in Mississippi in a family “that taught me to care about the people around me and be aware of needs and respond by sharing the resources that I had been blessed with. …When I met Andy in college, his sense of adventure combined with our mutual desire to serve the needy were big factors in us looking into international service.”
The Warrens returned to Ethiopia in 1996 to lead projects with Mission to the World and SIM (Serving in Mission), international church-centered organizations.
When anti-retroviral medicines and therapy became available, they started working with the World Health Organization and other agencies. Later, they turned the treatment programs over to the Ethiopian government.
This year, Ethiopia ACT is registering as a nonprofit and expanding to new communities. The organization is partnering with a dozen churches in Addis Ababa, leading to short-term teams of doctors to do clinics in churches.
Ethiopia ACT has helped 1,200 families, and more than 1,500 children, Andrew Warren said. He focuses now on fundraising and administrative work, and program coordinator Teddy Alamayehu “makes everything happen” in Ethiopia. The Warrens return to the United States once or twice a year to visit family.
“I think one of the greatest rewards in our 12 years of working in this project, for me, has been the privilege of seeing so many of the extremely ill HIV positive single moms who came into the project before the availability of anti-retroviral drugs be able to regain their health and live full lives,” Bev Warren said. “They’ve been there to raise their children and many of them have even seen their children graduate from high school and get accepted into college. This pretty much guarantees their escape from extreme poverty since their children will have a better opportunity for employment and will have resources to care for their parent.”