Recently in Zebras 4 Life Campaign Category

On Tuesday I attended U.S. Ambassador Katherine Canavan's farewell luncheon at the residency. It was nice to get one last chance to thank her in person for supporting Peace Corps volunteers in Botswana. Ambassador Canavan, an RPCV-Zaire, backed many volunteer-led initiatives. One such example, the Zebras4Life project, would never have started without her highly engaged efforts and financial backing.

I think I can speak for all Peace Corps volunteers in Botswana by thanking Ambassador Canavan. and wishing her well in her next assignment.

I recently presented an abstract, Kicking up Male Interest in VCT via Community-led HIV/AIDS Activities in Rural Botswana, at the HIV Implementers Meeting in Kampala, Uganda. The purpose of the conference was to exchange best practices and research from PEPFAR-supported countries in Africa and other heavily impacted regions. I attended last year’s conference in Kigali, Rwanda, but this was my first opportunity to present at such a forum.

Although the theme of the conference was Scaling-Up Through Partnerships, the main message might as well been “nothing is working in the area of HIV prevention.” Many commentators and researchers noted that HIV testing and abstinence campaigns have not yielded a decrease in HIV incidence in Africa. While these approaches are important and needed in certain respects, however, there is consensus that much more resources and attention needs to be focused on adult male circumcision, breaking up concurrent sexual relationships (e.g., “secret lovers” or “small houses), and to a lesser extent, supporting consistent condom use.

Though I don’t close my service until the end of June, presenting on Zebras4Life—Test4Life was a great way to conclude my unique, non-traditional work as a Peace Corps volunteer in Botswana. While my presentation was well received, there were some expected points of contention, mostly with the need to promote voluntary counseling and testing at all.

I still believe that VCT is important and that our approach helping. For starters, men in Botswana have a higher incidence of TB, commonly an HIV co-infection. Fewer men, proportionally to those infected, are not on treatment. Not to mention that having men test for HIV on their own terms has implications for reducing gender-based violence. Moreover, I think that having on-going, supportive counseling by trained counselors and trained peers, the future the Zebras project, can effectively support behavior change. Perhaps most significantly, however, VCT may become a gateway to male circumcision services. So it’s important for VCT to be male-friendly, which is the purpose of Zebras4Life—Test4Life.

Pic: Me presenting at the conference. I just had to wear the national team colors.

The most recent report to Congress from the President's Emergency Plan for AIDS Relief noted the success of Zebras4Life at linking men to HIV testing. The photo of Zebras defender Khumo "Shoes" Motlhabane, catured at an event in Pandamatanga, along with with caption at left appeared in the Care section of the full report. The numbers, however, are out of date and have been vastly exceeded in the past few months. But hey, it's pretty cool to get mentioned as success story in the global effort against HIV/AIDS. The commitment from Tebelopele staff and counsellors, the American Embassy and CDC in Botswana, the Zebras/BFA, and the Botswana government cannot be understated.
In my personal opinion, the Bush administration deserves a lot of credit for committing $15 billion over five years for global efforts to address HIV/AIDS. Some of the early controversies have been blown way out of proportion by pundits and special interest groups, such as the 'A' provision and "underfunding" during the first few years. That being said, I hope in the near future that PEPFAR places more emphasis on deploying skilled personal to help build capacity, increases its commitment to prevention programming, funds the whole package of family planning when culturally appropriate, and improves the quality and effectiveness of interventions.

Links: Fourth Annual PEPFAR Report | About PEPFAR | The Zebras & BFA

Mascom Premier League leading scorer and national soccer team star Pontsho Moloi spoke about the Zebras' HIV testing campaign in an interview with The Voice on Friday. The article is titled, Captaining the Chiefs.

The best part about the article is that Pontsho was speaking from his own experience and beliefs that relate HIV testing to family planning. In Botswana, many men have the habit of testing through their partners (i.e., assuming their HIV status is the same as their partners). They will wait until after their wife or girlfriend falls pregnant and receives antenatal care, where HIV testing uptake is over 80 percent, to assume their HIV status. This is problematic for a number of a number of reasons (e.g., implications for parinatal transmission as PMTCT is not 100 percent full proof, possibility of discordancy within the couple, potential for gender-based violence, etc.). That is why it is important for men to know their status conclusively and on their own merits.

An excerpt from Pontsho's interview:

THE VOICE: You are also an ambassador in the ‘Zebras4life test4life’ initiative. Can you shed more light on it?

PONTSHO: That is an initiative for every Motswana male; every male supporter of the Zebras is encouraged through this programme to test and know their HIV status. Those who test with Tebelopele, are given a blue wristband, like the one I am wearing (shows off his two blue wrist bands). We were targeted to spearhead the campaign because statistics showed that most men were not coming forward to test for HIV and therefore did not know their status. So we are tasked with going around the country, addressing public gatherings and encouraging men to test.

THE VOICE: How has the reaction been so far?

PONTSHO: I have been to Maun with Tshepho ‘Talk Talk’ Motlhabankwe. I am told the number of men who tested was quite amazing after we addressed them. It is a face to face scenario with us and the fans ask any type of questions. Some take advice and test and of course some only want to know about the Zebras.

THE VOICE: Have you been tested and have you spoken to your younger brother Dirang about it?

PONTSHO: You can’t ask me if I have been tested. How would I have the blue wristband if I had not? I have, of course, talked to Dirang about testing even though he doesn’t take me seriously.

THE VOICE: I'm told you have a baby. Did you test after making her or before?

PONTSHO: I went for HIV tests with my girlfriend and we decided to make a baby knowing our status. It is not a good idea to make indirect tests by impregnating somebody. You can never know unless you test the right way.

If only there were more athletes like Pontsho...

Image: Pontsho Moloi trading card.

Headquarters in Washington, D.C. sent out a press release in advance of December 1st titled, Peace Corps Turns Hope Into Action On World AIDS Day. The Zebras project was highlighted as key volunteer-led intervention:

In Botswana, Volunteers are working with voluntary testing and counseling centers to help implement the Zebras for Life--Test for Life campaign, which promotes behavior change among football fans, and encourages young people to get tested. Those who complete the full counseling and testing process receive a [blue] bracelet with the campaign's message inscribed. Several players from the Zebra national football team serve as role models and spokespeople for the campaign.

The campaign was also recently praised by local leaders in the Kgalagadi District in a Botswana Daily News article on November 27th titled, Dikereke le borre, matshego a tsholofelo (the article is in Setswana).

This kind of recognition motivates me to keep pushing myself and the campaign, especially considering all of the logistical problems we've suffered through lately. We hoped to end the year with several strong events, but things kind of fizzled out and we had to pull back and regroup for next year. On a more positive note, the data that is coming in shows that the campaign is working: Men are testing in higher numbers, Tebelopele's ration of male-to-female clients is nearly even, and testing centres are posting all time highs in client loads. Scott, Hannah, and all Peace Corps volunteers in Botswana past and present should be proud of their efforts.

Photo: Brian and Libby pose with Botswana national team players and HIV testing spokespersons.

We watched the Young Zebras defeat Morocco in an exciting game at the Botswana National Stadium on Saturday. Both goal keepers were busy throughout, but the Zebras found the back of the net in each half and managed to hang on by playing tough defense. The Botswana Football Association reduced ticket prices for the match. That, along with the alcohol smuggled in by fans, created a wild atmosphere in the packed stands.

This match was part of Botswana's effort to quality for the 2008 Olympics in Beijing. (In men's soccer at the Olympic games countries send their under-23 teams, unlike the soccer world cup) Botswana advanced to pool play for the first time in its history setting up home-and-away games against Morocco, Guinea, and Cameroon. While the Zebras went undefeated at home, they suffered some tough losses on the road. But as of Saturday, they still had a chance to qualify for the Games provided they beat Morocco (which they did) and Guinea beat Cameroon (which didn't happen). I don't think anyone really expected Botswana to quality. So people were dissapointed, but generally pleased with their effort in the qualifying tournament. But four years from now the pressure is on.

The Zebras for Life--Test for Life campaign is continuing to do well. We had some great events while I was away. The response from Zebras fans, men in particular, is very encouraging. We are running out of materials and stretching our resources pretty thin. But hey, that’s a good thing.

The need for the Zebras campaign is that men in Botswana test for HIV in much few numbers than women. Many women elect to test for HIV when they are pregnant. Most men don't accompany their partners to antenatal care visits, nor do they use medical facilities as frequently as women. This accounts for one part of the testing gap. But even at voluntary counseling and testing (VCT) centres the clientele consists of many more women than men.

A lot of past outreach to men on testing has had very feminized messages about supporting your partner at antenatal care visits and such, which is important. However, we are trying to use a more masculine approach by using the Zebras (national football team) as role-models for HIV testing. We hope their celebrity and appearance in advertisements and at events throughout the country can push more men to test for HIV. The players are wearing “Botswana Blue” wrist bands as symbol that they know their status. Those that test are given a similar wrist band.

With a little help from “Lou”, we have a new logo…

and wrist band design.

Ke itse seemo sa me literally means I know my status.

Zebras for Life is the fans' mantra.

A photo diary of Zebres for Life--Test for Life was featured on the PEPFAR website. PEPFAR stands for the President's Emergency Plan for AIDS Relief. Basically, it is the umbrella for all U.S. funding to prevent new HIV infections and care for those infected and affected by the pandemic in target countries. Botswana is one such PEPFAR country.

The Zebras4Life--Test4Life project was offically launched at a press conference at the national stadium on Monday, 22 January. The U.S. Ambassador, several footballers, the Minister of Labor and Home Affairs, Peace Corps Volunteers and other partners were on hand to explain the campaign and offer up continued support. Several papers and BTV picked up on the story. You can access a Mmegi article online that talks about the campaign's launch (Zebras enter anti-AIDS war).

The Botswana Daily News had a little blip at the end of an article on the Zebras4Life, Test4Life campaign that Scott and I are spearheading. Hannah and Scott came up with the idea to get the national team football players to test for HIV and to use them as spokespersons for getting other men to test for HIV. They also had the idea to give out bracelets in the color of Botswana Blue that say Zebras4Life, Test4Life (similar to the yellow Lance Armstrong bracelets) to those that go for testing. The purpose of this campaign is to show unity and eliminate stigma of those that test for HIV. Unfortunately, Hannah had to return to the states (Hi Hannah, hope you are doing well.) so I was pulled into the project by Scott.

It is been a real challenge moving Test4Life from an abstract idea to an actual, viable project. We expect to have a major launch of the campaign next year with the bracelets. In the mean time, Scott and I have been educating the players on HIV/AIDS and having them make appearances around the country at village-level World AIDS Day commemorations. We are hoping that the players will become more confortable and confident in discussing HIV issues. So far, the players have been excited to participate and the audiences have been very receptive to their messages.

On behalf of Scott and Hannah, we are really greatful to the U.S. Embassy in Botswana for funding Test4Life . The ambassador has been very encouraging, engaging and helpful of our efforts. We are also greatful to the National AIDS Coordinating Agency, Tebelopele Voluntary Counseling and Testing Centres and U.S. Peace Corps staff for their efforts in moving the project forward.