15 May 2008, 11:10
by Lisbeth Fog
A focused, local and innovative programme for preventing HIV/AIDS in young people is proving helpful to teenagers displaced by conflict in Colombia. Funding is coming to an end, but a demonstration project could prove its worth for future donors – and other countries.
Over four years more than 200 000 Colombian young people have been trained in reproductive health issues, stressing the prevention of HIV/AIDS, in a US$8.6 million project of the Global Fund to Fight AIDS, Tuberculosis and Malaria that will come to an end and face its final evaluation in July. Already it has an “A” rating from the Fund.
In an adjacent article in RealHealthNews, the Executive Director of the new Instituto Carso Salud, Julio Frenk, has made an offer to support a demonstration project for any innovative ideas that may have arisen during the project – if they are sufficiently clever, and might be used elsewhere. And no doubt these ideas are here – it will just be up to the participants to identify them and apply.
Indeed, this has been no simple health education project, because it has focused on youngsters displaced by the constant harassment of Colombia’s internal conflicts, in a country where this problem is getting worse each day. For this project obstacles are its daily bread.
Almost three million people in Colombia (7% of a national population of 42 million) have left their lands in recent years, due to the conflict between the government and rebel groups. Most try to reach the cities – where they hope they will find life better. But as in much rampant urbanisation throughout the world, dreams are not always borne out by reality.
Instead, most of the displaced face rootlessness and social exclusion. According to the project documents (see Global Fund READ ON below) they often end up in “…marginal urban areas of extreme poverty, dropping out of school, social uprooting, family pressures to contribute economic resources, despair and uncertainty on a daily basis, and frequent exposure to sexual abuse”.
Lacking alternatives, they often fall into “…irresponsible, fatalistic and reckless sexuality, consumption of psychoactive substances and the sex trade. These circumstances similarly affect youths and adolescents living in extreme poverty in the urban centres that [must absorb] the displaced population”, say the documents.
Their new circumstances and disturbed social relations do not come alone. They carry significant health problems – among them HIV/AIDS.
The Global Fund project aims at reducing vulnerability of 600 000 youngsters living in displaced circumstances, – which means displaced or living in the regions where these people arrive, using an integrated approach in which the defence of human rights is the essential factor.
“The project is the only one that takes the displaced population as its main target, and stresses prevention through offering young people opportunities, dreams, meetings, and friendship”
The Ministry of Social Protection of Colombia estimates that nearly 170 000 of its inhabitants are living with HIV/AIDS, one woman for every two men. Some 18% of them are 15-24 years old, and 65% are 25-44 years old, which means, according to the Ministry, that this latter group – which is the most affected – probably got the infection before they were 20 years old.
As a consequence, authorities think it is imperative to work with people from childhood and adolescence, in the hope of preventing adults becoming infected with HIV/AIDS.
Since 2003 public health policies in Colombia have followed the UN General Assembly Declaration of Commitment on HIV/AIDS, which the country signed in 2001.
Minister of Labour and Health Diego Palacio told RealHealthNews: “This commitment has been reinforced through the Millennium Development Goals – which means that the country in 2015 will have a prevalence of HIV infection below 1.2%, improve the access of antiretroviral drugs, reduce mortality due to AIDS, diminish the number of cases of perinatal transmission and increment the use of protection measures, as the condom, specially in young people”.
The project is the only one that takes the displaced population as its main target, and, most important, stresses prevention through offering young people opportunities, dreams, meetings, friendship, and social networks, in which youngsters play the leading roles.
Even though the project involves international cooperation and the support of national government, it works on the level of municipalities – involving local political leaders, as well as the municipal education and health sectors, to ensure the access and the quality of the services for the young and their sexual education.
With all parties involved, the project has settled alliances, trained health workers and teachers, facilitated access to health services for young people, developing ‘friendly’ services, offering free HIV tests and consequently the treatment in positive cases, with strictly confidentiality. It has also organized workshops and meetings so the issues it addresses become part of the local political agenda.
This training program includes workshops of sexual and reproductive rights, capacity building in designing and developing socially and economically productive projects, called young enterprises.
READ ON: The project: ‘The Construction of a Multisectorial Response in Sexual and Reproductive Health, with an Emphasis on Prevention and Attention to STD/HIV/AIDS among Adolescents and Young Adults Living in a Context of Internal Displacement in Colombia’. Link to the relevant page of the Global Fund to fight AIDS, Tuberculosis and Malaria
But mainly the project aims at multiplication: training young people from different localities so that they become the multipliers of the information and understanding to other young people in their turn.
Almost 145 groups representing the 48 municipalities of Colombia have been organized. Called ‘young enterprises’, their projects are starting to generate income. The include promising industries for the production of snails, stevia (a plant used as a sugar substitute), and ecological paper; and cultural and artistic groups to enhance abilities, such as rock, rap and metal groups, as well as dancing troupes.
Considered as one of the most important results of the project, these new occupations for the youngsters have given them a possibility to create a sense of the future – a life project – and as a result their self-esteem has strengthened. And as this is part of the program, they know now the importance of taking care and respecting their bodies and themselves as people with rights.
However the project is challenging. Many of the 48 Colombian townships are in isolated regions, lacking good means of transportation, equitable health services, modern technology – or even security.
The political and social situation has also inevitably threatened the progress of the activities in some regions. But the enthusiasm of the young people is thrilling. “We are still in the first stage of our enterprise”, said one of them, showing the snails he is cultivating in Bogotá. “But our idea is to export them in the future!”. Dreams that could come true, no matter the difficulties these young adults have experienced in the past.
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