VAST Project

Friday I completed my VAST project, a workshop I organized using PEPFAR funds. VAST stands for Volunteer Activities, Support and Training and all funds must go toward HIV-related activities. I decided to apply for funding to run a training on HIV test counseling for community health workers, brigadistas. HIV testing is really picking up in Yalaguina, but it isn't carried out the right way. Each person, according to Law 238, must receive counseling before being tested for HIV and when they receive their results; however, that is rarely the case. Usually, they just test the person and then tell them the result, without explaining how HIV is transmitted, how it can be prevented, what resources HIV-positive people have, etc. Because of this complete lack in HIV counseling, I decided to organize a training for the brigadistas since I figured they are already trusted leaders in their community, with confianza or trust among the population, and already work with MINSA(the Ministerio de Salud or National Health Department) in health promotion in their communities.

To be able to finance the project, I applied for VAST funds. The application wasn't difficult- I wrote out a Spanish and English project proposal, collected proformas or cost estimates, and calculated my budget. I submitted it to the committee who approves the projects, and then waited a month to receive my funds.

Explaining the materials they received

For the training, I invited 25 community health workers, one from each community of Yalaguina. Ten showed up. And, the nurse who was supposed to help me bailed. But, if I've learned that you have to take what you're given and go with it. I started the training with a brief charla about HIV. I explained the general info- how HIV affects the body(including a fun dinamica), transmission, prevention, and how HIV is different from AIDS. Since the brigadistas are sources of health information in their communities, I wanted to make sure they were completely clear on all the facts; part of the counseling includes clarifying facts for people getting tested for HIV. Next, I broke them into two groups so they could brainstorm why getting HIV-tested was important and why counseling for HIV testing was important. This led into the main portion of the training, discussing pre- and post-test counseling. One of the doctors from the health center gave this charla, although I had done the whole powerpoint(*Side note: The training included 2 powerpoints and a folder with several sheets I typed up further explaining the steps to conduct proper counseling. Problem was, I forgot that some of the community health workers are illiterate).

Dr. Lopez talking about consejeria or counseling

After the powerpoint presentation, the brigadistas broke into partners where one was the patient and the other the counselor. When they had completed the pre-counseling, the patients came to me and I "tested" them for HIV. I gave the "result" to the counselor, who then had to do the post-counseling according to what the result was. Then, they switched roles.

My friend Amanda and another brigadista participating in the role-play

I think it went pretty well, considering our low number. After the role-playing exercise, a group of men from the mayor's office showed up to get tested(In addition to the workshop, I had asked the health center to bring materials to conduct HIV testing so that when we finished with the training, the brigadistas could put practice what they had learned by counseling people who came to get tested for HIV. However, very few people showed up to get tested). Since they had no interest in being talking to someone about HIV, I had to force them to talk with a community health worker before being tested.

Not perfect, but all-in-all it went pretty well. This was pretty much my last hurrah, work-wise. I am still working with a women's group in the campo, but I only have 5 weeks left in site, one of those is Holy Week, and I have to go to Managua every week this month for PC activites. Home-stretch!