That 'Community Assessment' Thing

During our first two and a half months at site Peace Corps Volunteers have one big assignment, known as the Community Assessment. As I’ve spent the last two months interviewing community leaders, observing trends, analyzing clinical data, and writing this report, I thought I would share a bit of what I am working with. Besides, I should probably describe what I am actually doing here beyond stalking hippos and learning how to cook elaborate meals.  

For some background, the reason that all PCVs are in Botswana is to work in one way or another with HIV/AIDS. Peace Corps actually left Botswana in the 1990s, but was asked back because of the pandemic in 2003. Botswana has the second highest prevalence of HIV in the world but is also considered a middle income country, hence the leaving and returning.  But about that- the area that I am living in is often overlooked, especially in comparison to other parts of Botswana. Etsha 13 and 6 have the worst (main) roads that I have seen in the country; numerous buses come through daily and, when packed so full that you’re standing on top of each other, choose to drive on the sand because the paved portion is so bad. The closest equivalent to a high school is 5 hours away by bus. There is only one hospital on this western side of the delta, and many of the clinics in between share ambulances.

We were told that most people have been inundated with HIV education so we’ll need to find other ways to reach people than plain and simple health education; this has not seemed to apply to many people in Etsha 13 and the surrounding areas. This sub-district has repeatedly scored among the lowest for HIV knowledge of prevention and transmission, Etsha 13 has one of the highest rates of teenage pregnancy in the region, and I have had some very interesting conversations with a couple of community leader who insisted that sperm is the only thing responsible for pregnancy and that women are just the carriers of the baby. Other PVCs in my region have told stories of ‘women giving birth to black mambas’ (and they mean the snakes, not the Duck's RB DeAnthony Thomas) or that HIV is one of the easiest diseases to have, because you don’t have to watch your diet like with diabetes. One of my neighbors is a traditional healer who regularly handles blood and other biohazardous waste without any sort of protection.

Thus, an area that I will be continuing to focus on is HIV education. Aside from these alarming anecdotes, nutrition, teenage pregnancy, lack of support for orphans & vulnerable children, and alcohol abuse are the other large issues in my village, and there just aren’t as many resources up here. Etsha 13 also has many challenges in terms of general education level and a huge language barrier between the elderly and the clinic staff. Transport is constantly a problem here as well, as there just aren’t enough ambulance to go around for the clinics and there are many rural communities (even more rural than Etsha 13) that maybe see some minimal sort of health care once a month, if they’re lucky.

In spite of the many challenges facing Etsha 13, there are also some wonderful things already happening. Backyard gardens are popular considering the very sandy terrain, three community mobilizers are working in the village to encourage a better understanding of HIV, and there are a few motivated individuals working on getting a support group for those infected and affected by HIV. My main projects for the next few months should revolve around a clinic-based garden, the support group, PACT/GLOW Clubs at the schools (clubs that promote healthy lifestyle, self confidence, leadership etc), and working with some basket weavers, for fun J I’ve gotten a few things off the ground for each of these and I’m looking forward to returning from In-Service Training in a couple of weeks to really dive into my projects!