Journey to the other side

Today's blog is dedicated to Katie, my youngest of our first batch of six volunteers accompanying me to Cameroon Jan/Feb 2008. Katie keeps nudging me to write. So here we are. Thank you for your unwavering stand Katie.

I am a public speaker and today I want to share some of the questions/comments I get from my audience and my answer. I am paraphrasing the question/comment.

"I would not want to speak to an HIV positive person, you know," a public official in Westchester NY tells me. "They can spit when they speak and then it hits my eye ball and I get AIDS." The good news is, the AIDS virus is not easily transmitted via saliva. Imagine, kissing would be deadly. The virus really survives in blood, sperm fluid, breast milk, and spinal fluids. It is perfectly fine to speak to HIV positive people.

"Since you work in Africa, does that mean you are HIV positive?" I really did not understand this question. You can't get AIDS through Osmosis or by being in a country with high HIV prevalence. However, it made sense to my friend who explained to me that that person may have been interested in me as a date and did not know how to ask this politely. OK, I can see that. Just ask. When you date someone just ask: do you know your HIV status? When did you take your last test? Remember the test shows anything minus the previous 3 month. Thus if you engaged in unprotected sex and are not sure getting tested will not show if this risky behavior infected you. You have to repeat the test one more time three month later. And, that is especially true for women ask for a copy of the test result - yes, in writing - and still use a condom.

That gets us to the next question: Is AIDS still spread predominantly through gay sex? No, and it never was. In the US male to male gay sex was the initial known spread of AIDS. Woman to woman gay was never a contributing factor and has been overlooked since the beginning. Women on woman sex is the safest sex there is to this day. After that it depends on which continent you are looking at. It is known that Russia and it's former Soviet Union countries are plagued by shared needles of drug users. In Asia, besides the notorious tourism prostitution industry, recreational blood transfusion plays a big part. If that confuses you get hold of a copy of the movie "the 3 needles". In Asia scrupulous money bags go to the country side and have villagers donate blood for a few pennies. They then take it to the cities where it is sold unchecked to wealthy people who get the blood for no good reason other than that they believe it is good for them. Prostitution and hetero sexual intercourse is the main mode of infection in Africa. There are also practises of ritual cutting, unclean needle use or repeated needle use without sterilisation in hospitals, polygamy amongst Christians and Moslem's alike in different parts of Africa, and of course mother-child-transmission at birth.

A concerned Rotarian (a member of the Rotary Club a well known international non-profit organization) asked me if there is any change noticeable in Africa and if it is getting any better? Remember Africa is a continent of 490 million people (the US just hit the 300 million) thus the answer is different depending one the country and location. In Cameroon where I work and spent about 1/3 of the year what is most noticeable is that funeral homes are closing - not enough business. Thus the overall death rate is slowing a little. In some countries like Uganda it seems to slow down because the death rate supersedes the infection rate because too many have died already. To this day Malaria is the number one killer in Sub-Saharan Africa. Lack of clean water and lack of medicine for any sickness are killing people in large numbers in addition to HIV/AIDS.

More soon.
With heaps of love and peace
Rolande

Mission Accomplished

Returning to the US is always like diving in from outer space. It does not seem real.
This years trip to Cameroon was a difficult one. On arrival two children in our school died on Malaria, two easily preventable death. Four year old Benwih (picture) survived because her mother knew how to turn adult malaria pills into pediatric drugs. One funeral after another followed week by week. Nothing worked according to plan. Nothing happened the way it had been anticipated. But the expectations on us as "givers" where sky high. This was in part fueled by our last years capacity of gifts/donations carried by six volunteers. There was no way for me to match this.

Having said that the trip was also utterly successful. We as in AIDSfreeAFRICA strengthened our relationships with Cameroonians and made many more friends. I trained a technician at the Cameroonian Baptist Convention on how to produce a diagnostic reagent that is usually in short supply but urgently needed by AIDS treatment centers and hospitals. We delivered donations in form of vitamins, skin lotions, mosquito nets, tooth brushes, sewing supplies, and crocheting yarn.

On the pharmaceutical side of our work, the trip was in part supported by a grant from Tibotec, a Belgium based Pharmaceutical outfit. With their help I established the a non-profit program selling an antifungal at cost. To accomplish this we were enabled to hire four Cameroonians for the various aspects of the project. They are Eric the sales manager (picture next to me), Tamukum the medical delegate (picture middle), Suh Theresia Bi our secretary and Richard a pharmacist who will be conducting a feasibility study. The jobs are not full time and as of yet limited to a year or less but they create jobs for Cameroonians who educated themselves and would otherwise have to leave the country for employment. Pharmacist Charles Boyo (picture far right) from Bamenda joined us as well. We appreciate his generous gift of his expertise in handling this project.

Now back in the US my job is very clear: We need to raise US$ 50,000.00 to buy and ship a blister packaging machine to Cameroon. This machine is the missing link between now and the start of production - with production meaning packaging drugs bought as bulk tablets from India - Acquiring this machine for Diamond Pharmaceutical is a pivotal step that has more impact than what is visible to the bare eye.

I challenge everyone - no I beg everyone of you to send a check or go on-line to our web site www.AIDSfreeAFRICA.org and use paypal for your most generous contribution. Please ask your friends, colleagues and tell your neighbors. The US Ambassador Janet Garvey put it succinctly when she said: "Cameroonians will be so proud when they learn that their country produces drugs." Yes, so am I am and so should you. Thank you everyone at home in the US, Europe and in Cameroon.

Production in Cameroon

I admit, it is not on the scale or level where we in the US think of "production" but it is much when one considers where I am. And thus in the eleventh hour there are the soft beginnings of pharmaceutical production.
Six Chemicals and distilled water is needed. Three Chemicals came from the US via plane, the other three - in equal amount but not equal quantity came from Nigeria.


Distilled water was supposed to be available on site, however, in the middle of production I double checked with the lab technician to make sure he did not use tap water. "Oh, we need to use distilled water? The distillers burners are burned out." And yes, they have to be ordered from the US. No way the distill is up and running before I go home Jan. 27th. I call a friend in Bamenda and ask him to buy me 40 L distilled water from the Government Hospital. Then I take a bus to go and fetch the water to carry it to Mutengene. Each way, the bus trip is 6-8 hours. And I pray that the distiller works in Bamenda.

Before I catch the bus the technician "graduates" a Tuber ware houshold plastic container which we proudly bought for US$ 10.00. He uses a one liter graduated analytical graduated glass flask. To double check we put it on a scale. A liter was missing, but as long as we catch these little hick ups I am fine.

The bucket is filled and since I have a day left before climbing on the bus we try ourselves on issues of quality control. Of course I had brought some already done solution from last year and of course the standard. I also brought some water already with me and a pH meter and our best piece a US$ 200 electrode donated by AIDSfreeAFRICA's Chemist Elliott. But the master piece is already there. There is no water but a brand new ion-selective pH meter. We have all we need. I just have to come back from Bamenda with the 40 L of clean water. Make the solution and leave it up to Clectus to fill these 50 containers. Voila: 1000 L of a diagnostic solution, produced and quality controlled in Cameroon under the Diamond Pharmaceutical name.


We also hired 4 people - creating jobs for the Cameroonians that brave school knowing that there is little employment opportunity to look forward to.
As the US Ambassador said to us when we visited in Yaounde. "Cameroonians will be so proud when they learn that their country is producing pharmaceuticals." Yes, so will I.

Happy New Year! Thank you to our generous donors

Happy New Year and Peace on Earth!
I want to take this opportunity and thank our donors. You are too many to all be listed individually but a few I will introduce to you all and explain the purposes that are attached to the donations.
Thank you to our 200+ donors during the year 2007 who have given big and small to our main cause: supporting people in Africa to produce drugs. We are pushing hard on this and before I come home Diamond Pharmaceutical will be producing a diagnostic reagent that the Hospitals and AIDS testing centers need to make sure patients are on the right combination of AIDS drugs. Most recently my hiking buddy Susan has contributed $500.
Gary Ostrow, Dr. DO PC donated $1800 towards the $6000 we need to give a micro loan so a very successful new school can move onto their own land and continue to grow in peace. He also donated $800 to buy mosquito nets. Pictures on that to follow soon.
Phyllis Pawlovsky and Ann Higgins are our sponsors. That means they contribute continuously on a monthly base.
Jeff Hurst from Herschey Pennsylvania donated an analytical balance
Elliott Bay donated some of the chemicals we need to produce the diagnostic solution. He also donated an electrode to measure the pH of a solution, that is to measure how acidic or basic an aqueous solution is.
Susan from Rockland County was so kind to give us her mothers sewing supplies. See pictures below from Weh.
My dentist Lenore Schwartz, White Plains, NY donated toothbrushes and tooth paste for children living in a poor neighborhood in Bamenda.
My local Ossining Pharmacy "Health Smart" donated chewable vitamins for children.
This trip is sponsored in part by Tibotec, a company based in Belgium. They produce a very efficient and user friendly anti fungal drug and are making the drug available on a non-profit base in countries in Africa. Tibotec gave us a grant to find out what it takes so that this drug can be distributed and sold in Cameroon. We also want to find out if the doctors as well as the patients like the drug - as of today this question can be answered with a resounding YES. Fungus infections are very common in Africa. Children have it in form of ring worms. That is a white flaky, itchy coloring on the head. Women know it as yeast infections and AIDS patients have it in the mouth and esophagus and it is called thrush. It is one of the opportunistic infections of HIV/AIDS. Although thrush does not kill directly, the patient have difficulty eating and swallowing. Thus they stop taking in enough food. Unfortunately AIDS drugs require a patient to eat sufficiently. We are very hopeful that the drug will be allowed to be distributed through the already existing Cameroon Drug Procurement and Distribution Agencies.

I am looking forward to 2008 as the year in which we raise 1/2 a million US dollar. We have almost everything in place. What is now holding us back is lack of funding. I urge you to continue to be generous. Our web site www.AIDSfreeAFRICA.org offers the convenient PAYPAL credit card option. Your checks are always welcome.

With heaps of love and peace
Dr. Rolande

Cry Die

Happy New Year to everyone. Peace seems so far away as we see the carnage in Pakistan and the assassination of a strong democratic female leader, Ms. Benazir Bhutto.
And in Africa that dying continues. My host mother goes from one funeral, called Cry Die, to the next. Dying is such a daily occurrence that people developed different coping strategies. First of all when someone dies everyone starts screaming and crying immediately. It sounds like they are screaming their anguish into the heavens and then they breath again. The Cry Die is like a wake. Sometimes it is a year after the person has passed away. It is a social MUST, people have to travel to the place, which cost energy and money and they have to bring gifts. The expectations are rather high, and everyone is obligated. The surviving family also has to provide for the guests drinks and food and the Juju's.
These are people in masks that dance wildly and their job is to appease the elders, the spirits and so on. Cry Dies can last 3 days non-stop singing, dancing, eating and drinking.
It is actually a happy occasion since by then the bereaved have moved on. Often they pick a relative and put this person in charge of the family duties of the deceased. This is an honor and is celebrated. Of course it comes with responsibilities.
In case a husband dies an animal is slaughtered and parts and pieces of the animal is given to the surviving widows (up to 6 wives are allowed by law) in an symbolic act of promising to provide for them after the husband passed on. Of course this is often not the case. Women are lawless and the husbands’ family has the say over her household, children, and so forth. Women often organize in supportive groups once they are abandoned by their in-laws.

My Child's 4th Birthday

I woke up on the 29th of December listening to my host family singing Happy Birthday. I got up and inquired and learned that little 4 year old Benwih in fact turned 4 years old. Here she is in her Birthday dress. The family had to attend a wedding and I was invited to join them after going to the office and getting some important communications out. Benwih's Birthday party with children from the neighborhood was supposed to be in the afternoon. I joint them at 1:00 PM when they were still in church. I learned that the reception was not until 3:00PM and that we would stop by the market. Theresa and Comfort joined me to help me buy a dress for a formal Wedding Anniversary that I had to attend. We found a very lovely Top and Bottom" kind of a blouse with a wrap around skirt, very festively decorated. We went to the reception and sat in front of sodas that made us even more thirsty. COPAAP volunteer Francine and I finally left to walk an hour through town in an attempt to place a small parcel into the hands of the Cameroonian Baptist Conventions driver to transport to Kumbo. We managed but the vehicle had just left. We are promised that it will be delivered. We walk back to the Wedding just in time for the drinks to be served, the gifts are handed to the Bride, food is served, and in no time it is over and we all go home. Cameroonians inhale their food, and lots of it.
We get home late, the child sleeps and everyone watches soccer... Don't know if there is a later date for the Birthday party. I managed to buy a pair of shoes for the child. Her smile when I presented them made it all worth while.

Christmas in Cameroon

The shopping frenzy is just like in Europe or the US. Eating a lot and even drinking a lot is the same. What's different is the 95 degree Fahrenheit or 35 degree Celsius. It feels like summer and it is not easy to think of Christmas. In the markets cheap versions of Jingle Bells blaring loudly.
What's different are the visits. Everyone goes to everyone’s house on Christmas Day. The families who farm bring fruits, vegetables and the all present "Achu". Achu is kind of like mashed potatoes sticky dough of pure starch.... cheap and filling. People who have a salaried job are expected to give things that have to be bought, such as soap, salt, and oil. I gave the children tooth brushes and tooth paste donated by my dentist Lenore Schwartz in White Plains. The adults got Nivea donated by a friend whose daughter works for the company. Nivea products are known and expensive here, so they are a cherished gift.
I was tired of the overload of activities and on Christmas morning I was contemplating to go to Kumbo when Cosmas called I said yes. Because of the busy Christmas season the busses where full and the car parks (bus stations) chaotic. I took a private car - imagine a small car with 7 passengers and the driver flying with great speed over dusty never paved pot hole spiked mountains. I was praying to make it but not really scared. It is kind of fun - in Africa you never know if you wake up the next morning. That's why people are so happy - they did indeed wake up to another day.
Funerals are still plenty. These days it is not always AIDS related.
People here really got the message about AIDS. It is actually amazing how much changed since I first came in Oct 2005.
Let me find some pictures to post for you.
With heaps of love and peace
Rolande