The Foreign Service Journal, December 2004

Djibouti, for example, the centers operate in trucker rest stops, in residential and recruitment sites for dock workers and in the city center of Djiboutiville, where community counselors and several volunteers provide services. Further, HIV/AIDS education pro- grams conducted and implement- ed by peers there are critical to prevention initiatives. The HRCI program has this year trained more than 90 dock workers, 60 truckers and 40 highly vulnerable women. Each of the trained peer educators reaches up to 15 or more of their peers each week, providing them with information on HIV/AIDS prevention and access to care and support. Currently, there are 19 sites offering voluntary counseling and testing that have already tested approximately 10,000 people for HIV/AIDS and treated nearly 2,000 cases of sexually transmitted infections. Future plans are to consolidate programs, especially in Ethiopia, and to focus on expansion of services in 2005. Last but certainly not least, HRCI’s network of home-based care providers have provided support to 500 people living with HIV/AIDS and education sup- port to over 600 orphans and vulnerable children. Deep Into the Corridor As in other countries in Africa, HIV too often is transmitted to vulnerable young girls and women whose low social status and poverty render them par- ticularly susceptible to sexual exploitation. The truckers, transport workers and dock workers along the corridor who encounter them then run a higher risk of contracting the virus and transmitting it to their wives and sexual partners. It was this facet of the HIV/AIDS epidemic that we focused on during our trip. My colleagues and I visited many diverse compo- nents of the HRCI program along the corridor. At the information centers in both Ethiopia and Djibouti, we spoke with numerous energetic, com- mitted counselors and volunteers who are providing practical awareness and risk reduction information to their clients — both those who actually go to the Information Centers and those in the wider community. I was repeatedly impressed by the staff’s diligence and dedication to assist- ing people affected by or living with HIV/AIDS. One young woman counselor told me that her zeal was motivated in part by the fact that several members of her immediate family and friends had died of AIDS. She says working in the field is her way of healing her sense of grief and loss, and “giving back” to those who are afflicted, to ameliorate their bleak prospects. The HRCI program also provides counseling opportunities that create demand for prevention ser- vices; referral to voluntary counseling and testing centers; and outreach and peer support to people liv- ing with HIV/AIDS. Particularly noteworthy, the members of our delegation visited Dire Dawa, Ethiopia, where we met a group of about 25 home- based care providers who briefed us on their com- munity activities. Armed with a basic care kit con- taining antiseptic solutions, gloves, gauze, plastic sheeting and other materials, these indefatigable individuals regularly visit private homes to provide care to hundreds of sick AIDS patients in the area. The assistance these home-based care providers give is, in a word, extraordinary! Where outreach, treatment and care services are negligible or absent, these unfaltering caregivers fill a glaring void in the lives of sick or dying patients. Their skill and dedica- tion are matched only by their compassion. Those I spoke to all shared a common vision and similar rea- sons for wanting to provide care for HIV/AIDS patients. Empathy for fellow Ethiopians and a deep desire to improve the quality of their lives provided the foundation for these providers’ call to service. What was for me the most profoundly moving experience of all during the trip was a visit to the HRCI community-based child-care center. In Dire Dawa, I visited a classroom of vibrant, joyful chil- dren, 4 to 6 years old, all of whom were either orphaned or essentially abandoned as a result of HIV. Prior to their enrollment in the center, the teachers working there told us, these children had been chronically malnourished, riddled with suppurating F O C U S D E C E M B E R 2 0 0 4 / F O R E I G N S E R V I C E J O U R N A L 39 The potential for cross-border HIV transmission in Africa and elsewhere is substantial.