wfn.org | LWI 2009-070 FEATURE: HIV and AIDS Training with Convincing Results

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FEATURE: HIV and AIDS Training with Convincing Results
Ukrainian Lutheran Church Initiatives Help Break Taboos and
Perceptions 

ODESSA, Ukraine/GENEVA, 1 December 2009 (LWI)  -  The midday
heat hangs heavily in the seminar room of the Bavarian House
Odessa (BHO) in Ukraine, but Vitali Gorbunow grips the attention
of his audience - 25 men and women. As he strides across the
room, the psychologist trainer gestures with his hands and feet,
looks directly at each participant sitting in the circle, and
wipes the perspiration from his brow. "If your immune system were
a baking ware, how would you feel at the moment?" asks the agile
man in jeans and a sports shirt. The answers are hesitant at
first, then they come faster, more spontaneously and finally the
whole group bursts out laughing. "Like an almond cake," says a
doctor, "a meringue I ate as a child," says another, "a few dry
biscuits," calls an assistant doctor. "I feel like a Kiew
cream-cake," adds a gynecologist.

"This kind of interactive training is little known in Ukraine
but it is a most effective way of cracking open rigid opinions,"
explains Gorbunow, who has many years' experience. "I have had
doctors and gynecologists who recommended that pregnant women
with HIV have an abortion, yet the chances of having a healthy
baby stand at over 90 percent!" This is the kind of fixed
mentality that the former Ukrainian army officer wants to change.

HIV and AIDS are taboo topics in Ukraine's southern city of
Odessa, where the virus is spreading like an epidemic. For years
now, the rate of new infections has been among the highest in
Europe. According to official data from the Ukraine government,
at the end of 2007 over 122,000 people were officially recorded
as having HIV and AIDS. UNAIDS (Joint United Nations Programme on
HIV/AIDS) and the government estimate, however, that the real
figure could be up to 440,000, or around 1.63 percent of the
population aged between 15 and 49 years. In 2006 there was a
nearly 17 percent increase in new infections, while 2007 recorded
an additional ten percent.

Gorbunow will not stand by and do nothing. For eight years he
has been dealing with the HIV and AIDS issue in the Black Sea
city. Since completing a training course run by German
specialists in 2005 he has been working as an instructor at the
BHO, which has taken action to counter the rapid spread of HIV
and the huge increase in the number of AIDS patients. 

The Bavarian state ministry for work, social order, family
affairs, women and health in cooperation with the Evangelical
Lutheran Church in Bavaria (Germany) founded the BHO in mid-1993
as a contact center for German culture. In 2001 the social work
center was established in BHO with support from the German
government's organization for technical cooperation (GTZ), the
German state of Saxony, the Rotary Club "Porta Praetoria" from
Regensburg and the diaconal services of the Evangelical Lutheran
Church in Bavaria. Besides HIV prevention activities, it carries
out numerous social and medical support projects for the needy.

In cooperation with BHO, the German Evangelical Lutheran Church
in Ukraine (GELCU) in Odessa developed an extensive HIV and AIDS
program for prevention and therapy. The aim was to stem the
epidemic by training school students and mentors, along with
multipliers such as doctors or teachers. The Lutheran World
Federation (LWF) has been supporting these successful training
courses for the last four years. 

>Sexuality and Sex Education

"The topics of sexuality and sex education are still taboo in
our society, although far more infections are transmitted in
Odessa by unprotected sexual intercourse than through injecting
drug use," says Irina Swetaschowa. The GELCU training program
coordinator cites four factors for the HIV epidemic in her
country. "People here are terribly afraid of AIDS. While very few
understand the modes of transmission most of them still act
irresponsibly and say: 'That does not concern me.' In addition,
the state does virtually nothing to raise awareness, merely
concentrating on handing out free medication." Those who are HIV
positive in Ukraine soon feel the social consequences - doctors
often refuse to treat such patients, their families turn away,
teachers throw infected students out of school and children are
placed in care homes. 

AIDS education is urgently needed but is left to non-state
institutions such as BHO or open-minded churches like GELCU.
Bishop Uland Spahlinger, whose 250-strong Lutheran congregation
in Odessa is one of the biggest in the country, speaks of a "cold
shoulder mentality" toward those in need. "The church is
challenged to be the advocate of human dignity and reliability
precisely in this context of state disregard for social distress.
The church must get involved," the bishop asserts. He adds, "Its
mission is, first, to focus on compassion for the needy. Second,
it must arouse understanding for the ethical and practical
responsibility of individual members in daily life. This means
raising awareness in the broadest sense." 

>Convincing Results 

The church’s diaconal center offers a mobile psychosocial
service for people affected by HIV and AIDS. The BHO has also
launched a hotline and mobile medical assistance. In order to
break the taboo on the issue as fast as possible, Odessa’s
Lutheran church first organized training for trainers such as
Gorbunow and Swetaschowa, who have in turn trained over 4,000
teachers to offer classes on AIDS prevention. From November 2005
to September 2007, with the financial support from the LWF, these
specialist teachers held classes for all students between the age
of 13 and 17 in the city of Odessa, totaling 22,000. 

"The results were impressive," reports Swetaschowa. "At first
only 30 percent knew anything about the dangers, transmission
methods and protective measures, but at the end it was 98
percent!" The figures also persuaded public officials and
politicians: AIDS prevention is now included in health education
in the whole Odessa region. The teachers involved receive a bonus
from the school authorities. In a press statement in February
2009, the chairperson of the territorial education administration
in the region, Dmitri Demtschenko, especially thanked GELCU and
the LWF for their commitment. "Together we have created a basis
for successful instruction," he stated. 

>In-Service Training for Doctors and Nurses

Members of the next group have taken their seats in the BHO
seminar room. Since April 2009 Gorbunow and his colleagues have
been training doctors and nurses, with 500 of them expected to
complete the program each year. The participants stand up, each
displaying a sign. "Talking together," one says, "living
together" or "gynecological examination without protective
gloves." Gorbunow asks them to stand in line "according to the
degree of infection risk." The medical personnel discuss the
matter, move back and forth and finally form a semi-circle. 

The first, easy situations are put in the correct order and
remain without comments. However the "repeated use of medical
instruments" is placed in the middle, something the trainer
cannot comprehend. "That is impossible!" Gorbunow protests,
running his fingers through his hair. "I've given you so much
information over the last two days and you still think that is an
acceptable risk! Move to the back!" The doctor obediently takes
her sign and lines up next to "unprotected anal intercourse" and
"a syringe picked up in the park".

"The seminar is timely and extremely interesting," remarks Elena
Yatmanowa during coffee break. The 37-year-old heads the general
medicine ward at the public hospital in the Primorski district.
"We often have HIV patients," she says, and is surprised that
some colleagues at the seminar know little about the virus. "The
problem is everywhere and there is enough information around if
you are interested," she remarks. Yatmanowa definitely wants to
recommend the course. "I will send all the staff on my ward here
by December," she says. Next door, two of her nurses are already
participating in the seminar for nursing staff. (1,308 words)

(A feature by LWI correspondent Constanze Bandowski.)

LWI correspondent Constanze Bandowski also interviewed Dr Vitali
Nowoswitnij, director of the Odessa City Center for HIV and AIDS
prevention and control, on the spread of the HIV and AIDS
pandemic in Odessa and ways of tackling it. Read the whole
interview at:
http://www.lutheranworld.org/News/LWI/EN/2446.EN.html

A summary of the situation in Odessa and GELCU projects in
Odessa is available at this link:
http://www.lutheranworld.org/News/LWI/EN/2445.EN.html

For more information about World AIDS day reflections and
resources, please visit the LWF Web site
at:http://www.lutheranworld.org/What_We_Do/HIV-AIDS/LWF-HIV_AIDS-WAD09.html

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