Dennis Walto, PSI/Lesotho’s Country Representative, recounts his visit to a Basotho village in Lesotho, where his team conducted an HIV-prevention outreach session.
Cecelia laughed nervously as she dropped the laminated activity cards; it was just past 7 PM and the group had been gathering over an hour for tonight’s Pitso or village meeting. The Chief was clearly disappointed at the turnout, 8 women – each with a child at the hip, and three men, boys really, with another 3 or 4 looking on from a distance – far enough not to be present, but too close not to be noticed. The Chief had sent out the call to all herd boys and men yesterday, and repeated the message several times today, and he was expecting a large crowd. When it was clear that the masses would not be coming, he seemed to take it out on those who actually were there and the folks who had come were to share his displeasure at – and to –those who had not heeded the call.
I don’t blame them for not coming. HIV is not an easy topic to saddle up to, and many people would rather work with those afflicted than talk to those at risk of infection, and here was no different. Maybe it was because when you talk about HIV prevention in sub-Saharan Africa, you are really talking about safe sex, and that means talking about sex, an uneasy topic in almost any culture, but especially so in the 90+% Christian Lesotho. And, well, no matter how many times you watch a lubricated male condom slide over a nine-inch wooden penis or observe someone insert a female condom into a wooden box facsimile of a vagina, I cannot imagine that it gets any easier.
But here we are, two PSI/Lesotho Field Educators, one Program Officer, one Regional Manager, and me, the Country Representative, setting out to do just that – talk about sex.
The Field Education session starts with introductions and some Q&A games that are designed to loosen people up and gently introduce the topic – sex – and break the ice. The laminated cards that Cecelia had fumbled when we first started are actually activity guides and questions. While they seem simple, they are actually based on complicated behavioral data and adult learning theory boiled down to base knowledge points. For example, we know that some people don’t use condoms because they think condoms reduce sexual pleasure. To address this barrier, our field educators use an activity with basic illustrations of the male and female body, which helps men explore and discuss openly the pleasure points of both partners. This activity often leads to lots of discussion about how condoms can be used to enhance sex by using them in conjunction with pleasure points.
At first glance, it seems difficult to see how the concept of HIV & AIDS is even relevant to these people who live life without electricity, without running water, and still very dependent on seasonal rain and a bit of luck to make it through the winters. However, you need only look past the faces that are here to see those who are not – the weathered empty huts, the large fallow fields, the dwindling herds of sheep and cattle. It may be that the lack of men at tonight’s meeting is simply driven by the fact that many of the men are gone – gone to South Africa to work in the mines, gone looking for work to the city or just gone. Even the Chief doesn’t stick around very long, and soon after the meeting starts, he saunters back toward his home.
Back at the session, as the information is shared, the boys, girls, women and men exchange the kind of eye contact and nervous laughter that reminds you of middle school sex education classes. While they are enjoying the discussion, it may be more the resulting laughter that brings the several onlookers who were initially reluctant to actually engage a bit closer. The crowd is growing; it is getting dark, and it seems a new round up has taken shape.
The culmination of these educational talks is the condom demonstrations as it brings the loudest hoots and most wide-eyed laughter. By now the group has hit about 20 people and the men who have drifted in actually make up a majority of participants. Right on target!
When the demonstrations and questions are finished, it is well past dusk and now it is time to distribute free male and female condoms! Hands are moving quickly and repeatedly, and soon we have distributed every last condom in the many boxes we brought. The absolute joy on the faces of the participants, and even the smile of the Chief, who ventured back with the other onlookers, is priceless – a combination of fascination and glee.
At the end of the day, we drive for an hour to cover the 10 kilometers or so that brings us back to our overnight accommodation – the cement block house of another local chief. We spark up the lanterns, eat some snacks that were given to us by the participants and spread our roll-up mattresses on the floor. Even after the lights go out, I am kept awake by the giggling crew recanting the day and pondering the unexpected demand by herd boys for female condoms.
“Comprehensive HIV prevention,” “total market condom social marketing,” “improving the health status of Basotho by reducing the incidence of HIV” – all remote, lofty words and technical phrases. And yet, in the simple act of a group conversation, here they are.
