Newsletter

HAARTHAART for

Children

pourles Enfants

paralos Niños

Edited by:

Msgr. Robert J. VitilloMs Francesca MericoMs Francesca Matera

Contributors:Msgr. Robert J. VitilloMs. Francesca MateraMs. Francesca MericoFr. Mathew PerumpilMS. Kristin Weinhauer

Designer:Ms. Francesca Matera

www.caritas.org

A long and difficult journey, an interview with Catholic ReliefServices’ expert Kristin Weinhauer

A model approach to disclosure and a shelter for children in theloving care of the Camillian Fathers

and the African Union Road Map.....................................13

Growing together with Catholic values

Catholic-inspired organizations discuss lack of involvement

among men in the prevention of mother-to-child HIV transmission

3

Campaign to help reduce the

number of new HIV infections

among children

Dear Colleagues and Friends,

I am very pleased to present thefirst issue of the Caritas Inter-nationalis for 2013.Of course, the ultimate aim ofthe HAART for Children Cam-paign is to eliminate all newHIV infections among childrenby promoting universal accessto early testing and diagnosis ofthe infection among pregnantwomen. We cannot ignore,however, the needs of thosechildren already living with thevirus, the vast majority of whomwere infected through mother-to-child transmission. If suchchildren are not afforded earlyand ongoing anti-retroviraltreatment, they develop AIDS-related illnesses very quicklyand their lives come to an earlyend.Thus our major focus in thisedition of the Newsletter is onchildren living with HIV. Wediscuss the sensitive issue of

when and how to disclose HIVstatus to such children and offersome guidelines, based on livedexperience, on how to preparechildren for facing the reality ofliving with HIV – but doing sowith a positive, hope-filled, andhealth-seeking manner.We also present an excellentmodel of care for children livingwith HIV who are not able toremain with their families oforigin (for the most part, theirparents already have died ofAIDS-related causes. The Fa-thers and Brothers of St. Camil-lus have developed thiscomprehensive model throughthe Sneha Care Home in Kar-nataka State, India, and noware in the process of developinga self-care programme for ado-lescents living with HIV, whowith the help of medication andcare, are now preparing them-selves to become young adultsliving positively and responsiblywith HIV.Among other topics covered inthis issue are: the African UnionRoad Map in response to HIV,TB, and Malaria; networkingamong Catholic Church-relatedorganizations responding toHIV in Asia/Pacific Region; andthe role of men in promotingPrevention of Mother-to-ChildTransmission Programmes.I will conclude by sharing withyou some very good news:

Francesca Merico who has beenthe “heart of soul” of theHAART for Children Campaignsince its beginning is celebrat-ing the arrival of twin daugh-ters, Matilda and Maddalena.Our congratulations go toFrancesca, her husband Ger-mano, and their son, Leonardo,and we send welcome andblessings to Matilda and Madd-alena!We are grateful as well toFrancesca Matera, a profession-al journalist who volunteeredher time and expertise in writ-ing several articles and design-ing this current edition.

For further informationand feedback on the

Msgr. Robert J. VitilloSpecial Advisor on HIV/AIDS

andHead of Caritas Internationalis

delegation in Geneva

rvitillo@caritas-internationalis.combobvitillo@cs.com

4

FOCUS: Disclosure

We asked Kristin to take usthrough the complex processof disclosure in children, out-lining the main objectives ofcounseling and group-thera-py. Parents and care-giversoften fear the consequences ofexposure, but keeping the vi-rus a secret often results indisorientation and lack ofconfidence in the child. Hereis why.

Kristin, how would you de-scribe “disclosure”? Dis-closing one’s status simply

means that a person with HIVtells someone else that theyhave HIV. It could also be aparent or caretaker telling achild that they are HIV posi-tive. Disclosure of HIV statusto children is a process. Theprocess involves caregiverand child, with parent or care-giver initiating and leadingthe process. A counselor orhealth care worker provides asupportive role. Disclosuremay also involve the sharingof caregiver’s and other fami-ly members’ HIV status. Thedisclosure process usually

takes time and occurs afterseveral counseling sessions.Is there a “right age” inwhich to tell a child abouthis or her HIV status? Thereis no “right age,” even in theUnited States and Europethere is no official guidanceon the right age. Each childand each situation is different.Disclosure should occur ac-cording to a child’s develop-ment rather thanchronological age. That stat-ed, children at a younger agemay be less likely able to un-derstand what is sensitive to

by Francesca Matera

5

FOCUS: Disclosure

the caretaker. The caretakerneeds to understand that otherpeople with whom a youngerchild interacts may learn oftheir or their caretakers HIVstatus.Who should be involved inthe disclosure process andwhy? Firstly the parents andcaregivers, because they cansupport information given byhealth care providers. If par-ents are not educated and in-formed, they could contradictor distort information givenby the health care provider,whose role also is to provideemotional support and infor-mation. Parents need to workhand-in-hand with caretakers.Children can be confused bydivergent information fromhealth care providers and par-ents. Children can deny theirtest results if not disclosed tothem in a harmonized manner.What are the advantages ofan early – let’s say duringprimary school – disclo-sure? Again, the timing ofdisclosure is different for eachchild, you don’t disclose justbecause the child is of primaryschool age. But generallythese are the pros: Childrenand caregivers psychological-ly adjust to living with HIV;Children who are disclosed totend to adhere better to theirtreatment; disclosure increas-es a sense of control and thusself-esteem among childrenand adolescents; it helps ado-lescents make informed deci-sions about their behavior;works towards reducing stig-ma, discrimination, and mis-conceptions and myths

regarding HIV; lastly, family-centered disclosure buildstrust in relationships and im-proves healthy communica-tion between parents andchildren.And the disadvantages? Notdisclosing one’s HIV statuscan lead to inappropriate be-havior, such as refusal to takemedication - since they don’tunderstand what the medi-cines are for – discovery ofHIV status from wrong sourc-es; loss of confidence andtrust in parents; poor child-parent relationship and com-munication; confusion result-

ing from unclear messagesand finally self-stigma and/ordepression.

How can healthcare provid-ers and parents preparechildren for “the truth”about their HIV status?Counselors often work withparent(s) to disclose, over anumber of counseling ses-sions, discussing concerns andfinding a way for the parent totalk about HIV in a way thatthey are comfortable with.Similarly, during this time,counselors will work withparents on allowing for the

► Get to know the child (using age-appropriate techniques)

► Allow the child to progress at his/her own pace

► Openly share feelings; provide participants with a safe place tocry and express bottled-up emotions

► Create and maintain a sense of safety for the child

► Involve the parent(s) or caregivers

► Assess current barriers and reasons for delayed disclosure

► Asses knowledge of HIV, then move from the “known to theunknown.”

► Always provide information to the child in an age-appropriatemanner

► Understand child’s perspectives of current problems/child’sillness

► Assess caregiver’s and child’s motivation to engage in treatment

► Assess current family, social, community support system

► Address fears of loss and abandonment

► Directly address silence and secrecy

► Explain the importance of counseling

► Assess emergent psychological and psychosocial symptoms

► Encourage the expression of difficult feelings

► Be ready to deal with denial, distortion, fear, outbursts, painand tears

6

FOCUS: Disclosure

right environment for the childto receive this information.This often includes findingtime to let the child share his orher own feelings openly, pro-viding them with a safe placeto cry and express bottled-upemotions and address fears.Why do parents often feardisclosing their, and theirchildren’s, HIV status? First-ly because they feel guilty andblame themselves for theirchildren’s condition. Thenthere are concerns aboutbreach of confidentiality or inother words, fear that a personlearning of their HIV statuswill tell other people and itmight cause problems at theiremployment, school, commu-nity or family. Others simplydon’t want to “hurt” their chil-dren and fear their reaction aswell as the reaction of otherswhich might lead to isolation,stigma and discrimination.What support is normallygiven to parents? There is aneed for both the child and theparent or caregiver to receivesupport before, during and es-pecially after disclosure. Is itenough? Many parents find ithelpful to seek counselling orto join a caregivers’ supportgroup.Are teachers, tutors andsports coaches also involvedin the disclosure process?Generally only parents or care-givers and healthcare workersare involved in disclosure. Itwould be a personal decisionwhether or not a family wishesto share HIV status with teach-ers and coaches. In many

countries it is likely that fami-lies would not want to sharethe information for fear of stig-ma and discrimination.A number of faith-based or-ganisations, like CatholicRelief Services, directly orindirectly provide health-care services in many partsof Africa and in other low-income countries. How dothese agencies operate? CRSis not a direct implementer.We usually support our part-ners, which include faith-based and non-faith-basedpartners, health networks andhealth facilities and centers,and communities. We work ina number of ways to includetraining, sharing of interna-tional best practices and stand-ards and overall healthsystems strengthening . Ouraudiences can include healthcare workers, support groupsor other avenues for support-ing people living with HIV andtheir families and communitiesWhat happens when a sero-positive child grows up? Canhe or she expect to receivecontinuous support later in

life? That depends on anumber of variables and isgreatly dependent on the avail-ability of antiretroviral treat-ment or other services in thearea where the child lives. Insome countries ART is still notwidely available, particularlyin rural areas. Other countrieshave near-universal coverage.In addition to medical carechildren, especially adoles-cents, often find it helpful tojoin an age-appropriate sup-port group for PLHIV (Per-sons living with HIV).

Kristin Weinhauer, MSN, MPHSenior Technical Advisor, Health &HIV

As CRS’ Senior Technical Advisor forHealth and HIV, Kristin provides glob-al program support; she specializes inpalliative and home-based care, healthsystems strengthening and health inemergency programming.  She previ-ously worked in Vietnam overseeingseveral CRS health programs includ-ing an HIV clinic, a drug rehabilitationclinic and two programs focused onassisting highly vulnerable children. Kristin is a registered nurse with clin-ical experience in obstetrics, pediatricsand home-based care. Prior to joiningCRS, she served as a Peace Corpsvolunteer in Gabon, Central Africa.

► Self-blame and guilt

► Concern about breach of confidentiality

► They may not be ready yet to disclose to everyone.

► Do not want to “hurt” the child

► Concern about children’s reaction

► Fear of isolation

► Belief that child is too sick/weak/young/small to receive the nec-essary information

► Social-cultural: stigma, discrimination, taboos and religion

7

SUCCESS STORY: Sneha Care Home

This program formally startedin Snehadaan Campus on 14thJuly, 2008 with 20 children liv-ing with HIV from the state ofKarnataka. The primary inten-tion behind the initiative was toprovide a caring and protectiveenvironment for the childrenwho are orphaned when theirparents succumbed to the HIVinfection and to lead them to ahealthy future and adult life.Currently there are 100 childrenwithin the age group of 4-13under this programme.Sneha Care Home was startedas a model service to compre-hensively address the multipleissues faced by children infect-ed with HIV.Since pre-adolescent childrenare impressionable, this phaseof the programme focuses onchildren. In a nurturing environ-ment, children are providedwith need-based educational

and recreational opportunities,adequate nutrition and health-care, and psychosocial support.HIV status disclosure is done ina sensitive and responsible

manner along with teaching ourchildren how to deal with socialstigma associated with their sta-tus, building confidence and

Children living with HIV in India

During the past few years and espe-cially in the case of children livingwith HIV (CLHIV) the HIV scenar-io in India gives evidence of twodistinct trends. On the one hand, wesee that the number of children be-ing born with HIV (new infections)is decreasing; on the other hand, thenumber of children already livingwith HIV and reaching adolescenceis increasing. Though both thesetrends appear to be positive; a ques-tion arises about what provisions arebeing made to take care of thesechildren as they enter into their teen-age years? Experience in othercountries has shown that many pro-grammes struggle with appropriate-ly responding to the needs ofadolescents living with HIV and, inparticular to help stay them healthyand engage in responsible behaviour

and relationships. Fr. Mathew Pe-rumpil, Director of Sneha CareHome, puts it in this way: “Therewere no pre-existing policies for de-veloping a programme for CLHIVwho are growing into adolescence.Based on our experience of workingin this sector we have found thatmost of the children living with HIVare ‘lost’ when they reach adult-hood. As they don’t have enoughresources to continue their highereducation, most of the boys becometransport agents of drug peddlers orjoin criminal gangs. Girls are eithersold to ‘flesh trade’ networks ormarried off to someone, thus contin-uing the cycle of transmission.Therefore when we started SnehaCare Home the most urgent need ofthe hour was that there be a pro-gramme model that would take careof the future needs and aspirationsof these children.”

8

SUCCESS STORY: Sneha Care Home

The “Camillians” – Religious Congregation of St. Camillus in India

The Camillians in India are pioneers in the care, support and treatment of people living withHIV (PLWHIV). In 1997, they initiated their first such programme in the country under thename of Snehadaan, which has led the way to provide comprehensive care in a holistic andcompassionate manner to thousands of PLHIV’s in the country. In order to coordinate all theseactivities they started Sneha Charitable trust, and today this serves as a lead coordinatingagency to mobilize faith-based organizations that are involved in HIV care and support acrossKarnataka State. In addition to providing care and support, they also have developed outreachprogrammes for HIV affected individuals and families. At present, the Camillians operate four

Care and Support Centres for adults and two centres for children living with HIV. They are also engaged in trainingand technical support for staff of other centres and programs. The Camillians are an international Catholic religiousorder that has been involved in healthcare activities for the past 450 years, following the inspiration of their founder,St. Camillus. VISIT http://www.snehacare.org/

Father Mathew Perumpil

self-esteem while inculcatingmorals and ethics.Is Shining Star School a con-tradiction to the general policyof mainstream schooling ofchildren living with HIV?“The future of many childrenliving with HIV has beenspoiled in the name of tradi-tional schooling. These chil-dren have many individualphysical, social and psycho-logical needs. Besides, thereare also many cognitive anddevelopmental issues.”“Can a mainstream schoolwhere thousands of studentsstudy give enough attention tospecial needs and address theissues of a few of them, likethose living with HIV? Cer-tainly not. Furthermore, in thename of mainstreaming we areonly creating perennially de-pendent individuals with lowself esteem and insufficientskills for any employment.’In this sense, the academicprogramme of Sneha CareHome is unique because itstrives to provide these chil-dren with an exceptional andunique learning opportunityand help them learn things

suitable for their individual ap-titude and intelligence.Therefore their academic pro-gramme is a blend of academicstudies, life skills, and extra-

curricular activities. The mottoof the Academic Programme is

‘educate ad vitam’ or ‘educatefor life’.Children have the right toknow about their illness andthey should not be the last tofind out that they are HIV pos-itive. But unfortunately veryoften the process of disclosureis not carried out in a methodi-cal way. “There is a lack ofscientific procedures for pass-ing the information onto chil-dren. The child’s knowledgeabout HIV and the immediateimpact the discovery may haveis not normally assessed priorto disclosing,” says FatherMathew.. This situationprompted the SCH team to de-

SCH model of disclosureTeachers and staff at Sneha Care Home

9

SUCCESS STORY: Sneha Care Home

9

Counseling

At the Sneha Care Home, inaddition to medical treatment,counseling for HIV positivechildren is truly a life or deathmatter. The counseling roomis organised so that childrencan relate the Care Home tomemories of their own previ-ous village or home life wherethis is appropriate.Sister Mini, together withClera, a professionally trainedclinician, and assisted by Sis-ter Soumya, look after thewelfare of the children in thisrespect. Sister Mini could bestbe described as a ‘pocket-sized dynamo’! Small in stat-ure, alert to what is going on,

always smiling and just as readyto help sweep the veranda ifthat’s what’s needed.Like most other staff at the Cen-tre she must occasionally betough for the common good butthis always ends in a good-hu-moured way. Emotional behav-iour and tears are what she facesdaily from those children stillcoming to terms with their con-dition and the loss or separationfrom their family. Sr. Mini,Clera, Father Mathew and Vincealso deal with the task of settingthese children on the long roadto a stable and fulfilling adult-hood. It is their faith and theirunshakeable belief in the valueof each and every human lifethat guides them.

Photos: Counselling sessions with Clera

sign a specific procedure fordisclosure. Incidentally, thismethod was chosen as one ofthe best models in India andstudied by the public HealthDepartment of Boston Uni-versity.SCH model of disclosure isnot a one-time event. It startswith ‘partial’ disclosure andeventually leads to full dis-closure once the children areready. It is done twice a yearfor all the pupils aged aboveeight.Before disclosing to a child,his/her knowledge regardingHIV is assessed using a ques-tionnaire. Based on the re-sults, children are placed intosmall groups. Group sessionsoffer children an opportunityto gradually learn about HIVand their status. Only whenthe group stage is completed,and a post-disclosure evalua-

tion is carried out, do chil-dren move to individualcounselling. During theseone-on-one sessions caregiv-ers address the child’s fearsand apprehension. Childrenare again clustered into dif-ferent groups based on theirage, knowledge and miscon-ceptions. Classes are led byspecialists and often inte-

grate life-skill teachings.‘Initially, when we stareddisclosing I was afraid thatchildren would react nega-tively. Instead, most of themtake it positively. Knowingabout their status encouragestheir active participation intheir own medical care,’ saysClera, the counsellor of Sne-ha Care Home. continues

SUCCESS STORY: Disclosure

10

SUCCESS STORY: Sneha Care Home

11

SUCCESS STORY: Sneha Care Home

“The vibrancy with whichchildren greet guests and theconfidence they show wheninteracting with them is theresult of the positive attitude,freedom of spirit and lovingnature of the staff,” says Mrs.Rani George, one of the vol-unteer teachers. “This workdemands a lot of persistence,commitment and patience butthe changes I have personallyseen in our children from thetime they came here motivateme to continue this work.”“Both my parents died when Iwas very young. But I don’tmiss them anymore becausethe staff here care for me likemy parents did,” says Raju

(name changed), one of thechildren in Sneha Care Home.Children are not subjected toexcessive academic pressureat the school. The staff makesure that no child is de-moti-vated because he/she has apoor academic performance.“We don’t consider that achild is ‘bad’ because he/sheis academically poor; ratherwe trust in the innate potentialof the child. If children are notacademics, they can alwaysexcel in other areas. We havethe duty of helping them torecognize their gifts and de-velop them.” says Mrs. LornaJacob, one of the teachers.Integration of extra-curricularactivities along with educa-tion is an important feature ofthe education programme.Based on individual aptitudeand interest, children are pro-vided with computer training,music, art, dance classes, andsports. “Children are given thefreedom to choose their areaof interest. But we see thatchildren have personal re-

sponsibility for developingtheir inborn talents.” says Mr.Francis, the activity coordina-tor of the school. In the activi-ties department, there arethree clubs entirely managedby the children: the ‘greenclub’ takes care of the greenareas of the campus; the‘flower club’ takes care of theflower garden; the ‘pet club’takes care of the animals.“Through these clubs, chil-dren are made to understandabout the importance of workand it helps us to evaluateeach child’s ability use initia-tive, working in a team andliving responsibly . I have per-sonally experienced the posi-tive impetus this has made onthe personality and behaviourof our children,” says Ms.Clera Lewis the counsellor ofthe school.

Life at Sneha Care Home and Shining Star School

In the activity

Department there are three

clubs entirely managed

by the children

12

SUCCESS STORY: Sneha Care Home

Snehagram (The Villageof love) is the extensionand second phase of theprogramme to be imple-mented in a campus atVeppinapalli in Krishna-giri district of Tamilnadu,which will have the facili-ty of accommodating 200children. Ask Fr. Mathewabout Snehagram and hewould say that it is thepinnacle of his vision forthe future of children liv-ing with HIV. It is fo-cused on planning andpreparing their adolescentyears through vocationaltraining, value formation,and life skill education to leadinto a healthy and responsibleadult life.According to Fr. Mathew’svision Snehagram is to bedeveloped as a Self Sustaina-ble Village. The children willbe trained to manage the pro-gramme themselves by pro-ducing all that they requirewithin thecampus it-self. The veg-etable, cattleand poultryfarms man-aged by thechildren willsupply goodsfor the nutri-tional needsof the entirecampus.Children who

are trained in various voca-tional skills will manage thetechnical aspects of the cam-pus. Children who are trainedin certain vocations will beused to teach other children inthe respective trades as theyears go by.

Career-Oriented andVocational Skill De-velopmentThe Phase II of thisprogram intends to im-part ‘Vocational train-ing’ to children andyouths who are alreadyin Sneha Care Homeand similar other pro-grams. Apart from this,assistance will be con-tinued for them to ap-pear for 10th classexam under the Nation-al Open School curric-ulum. Thus at large itwill capacitate the stu-dents with skills re-quired for them to

obtain a job and a stable in-come. It is being designed tomake these children able tostand on their own feet and tocontribute to society. Some ofthe areas in which childrenwill be trained are electronics,computer programming, lan-guage and communication,customer care services, medi-cal transcription, arts, sports,etc. ‘We hope that with propertraining they will be able tofind a lot of work opportuni-ties and sustain themselves.’says Fr. Mathew.

Growing up, life after Shining Star School

Extra-curricular activities:sport and dance

“Both my parents diedbut I don’t miss them anymore

Because the staff herecare for me like my parents did”

13

The notion of shared respon-sibility and global solidarityhas been colouring debatesin high-level meetings onHIV/TB and malaria sincethe adoption of the AfricanUnion (AU) Roadmap onShared Responsibility andGlobal Solidarity for AIDS,TB and Malaria in Africa(2012-2015), in July 2012.A major drive to accelerateprogress in the global re-sponse to HIV in Africaseems to have motivated anumber of AU leaders tomobilise international com-mitment by hosting a sideconference on the margins ofthe New York UN GeneralAssembly in September2012. Some say the event,led by H.E. Dr. Boni Yayi,Chairperson of the AU andPresident of Benin, indeedmade history.As a result, the terms ‘AURoadmap’ and ‘countryownership’ now appear indiplomatic and missionstatements more often thannot. But what do they meanexactly? Far from soundinglike ‘we want to take matters

into own own hands’, theadopted agreement proposesa different response to thethree diseases and an ap-proach which is, so to say,more ‘Africa-driven’.Southern countries havecommitted to increasing - insome cases more than dou-bling - the level of domesticfunding intended for nation-al programs. They also havepromised to boost the localpharmaceutical industry inorder to produce good-quali-ty affordable medicines andto adopt a more transparentand data-based approach inthe allocation of resources.These ‘good purposes’ havebeen engraved in the so-called ‘three action pillars’.The initiative has been wel-comed by high- and middle-income donors. The EU,USA, Brazil, the WorldBank, UNAIDS and the in-ternational community as awhole also have nodded theirapproval.During the UNAIDS annualProgramme CoordinatingBoard, held between 11-13December 2012, a number of

African leaders promptlystood up to praise theprogress in their respectivecountries as far as the imple-mentation of the AU Road-map is concerned.However, the stern tone oftheir statements perhaps re-flects greater concerns overthe future of international aidprograms at a time of globalfinancial crisis and containsan unspoken message alongthe lines of ‘Look, we havedone our homework. Nowyou must promise you won’tleave us alone’.NOTE Research carried outby the Catholic HIV andAIDS Network in 2011highlights the challengesthat Catholic Church-in-spired organizations en-gaged in the global HIVresponse are likely to face intheir efforts to maintain orscale-up services as a resultof the global and economiccrises and changes in fund-ing priorities1.

1 Keeping Commitments for HIV and AIDS: Ac-cess for All to Treatment, Prevention, Care andSupport - A Position Paper from the CatholicHIV and AIDS Network (CHAN), June 2011

FACTBOX

The 22nd Session of the Human Rights Council25 February to 22 March 2013

Will include a Day of General Discussion on the Child’s Right to Health

14

CAPCHA 2012

Members of Catholic Asia-Pacific Coalition on HIV andAIDS (CAPCHA) met for thethird time, on 10-13 Septem-ber 2012, at the CamillianPastoral Center in Bangkok,to discuss and report on thedevelopment of the work ofcare and prevention carriedout by Catholic organizationsaround Asia.Fr. Giovanni Contarin, MI,Chairperson of Catholic Com-mittee on HIV/AIDS in Thai-land, introduced this year’stheme ‘Exchanging andGrowing Together WithinCatholic Values,’ with an in-spiring welcome speech. Fr.

Giovanni expressed apprecia-tion for the work carried outby CAPCHA members andoutlined the challenges thatlay ahead. He mentioned, forexample, the need to imple-ment the United Nations Planto address Non-Communica-ble diseases and to join theglobal effort in the fightagainst HIV/AIDS by advanc-ing the so-called ‘triple-zero’target of no discrimination, nonew HIV infections, and nodeaths due to AIDS-related ill-nesses.Msgr. Robert Vitillo, CaritasInternationalis (CI) SpecialAdvisor for HIV/AIDS andHead of CI delegation to the

UN in Geneva, reported onprogress with implementationof the Global Plan to Elimi-nate all New HIV InfectionsAmong Children by 2015 andto Keep their MothersHealthy. He also discussedways for Catholic-inspiredOrganizations to maintain fi-delity to Catholic Churchteaching while they engage inadvocacy activities at theUnited Nations and in otherinter-governmental organiza-tions. Mr. Eleazar Gomes, Re-gional Coordinator for CaritasAsia, also attended the meet-ing.

by Francesca Matera, Volunteer at CI Delegation to the UN in Geneva

15

CAPCHA 2012

Upon his return in Geneva,Fr. Vitillo commented on theoutcome of the event:“This gathering is an excel-lent example of South-Southexperience exchange.Participants face many chal-lenges each day – many ofthem work in environmentswhere the Catholic Church isa small minority; “the poor-est of the poor” are amongthose served by these organi-zations that are forced tostruggle with lack of ade-quate and long-term funding.Yet they remain determinedto accompany those livingwith or affected by HIV tofully develop their God-giv-en human dignity.”The delegates began themeeting with an exposure

visit to HIV programs in theBangkok area. One such sitewas the Human FoundationDevelopment and Mercy Cen-tre of Bangkok. This agencywas founded in 1972 to givethe children of Klong Thoey, aslum suburb of Bangkok, achance to exit poverty by im-proving education and fightingdiscrimination. The visitorswere inspired by the humanapproach and the enthusiasmof staff and volunteers, Oneparticipant commented as fol-lows, “Looking at the faces ofthe children, I could see theywere very happy… Fr. Joe’skindness and love penetratesthrough the hearts of workers.”CAPCHA was founded inMay 2010 when the CatholicCommittee on HIV/AIDS,

supported by the CatholicBishops’ Conference ofThailand (CBCT), and Cath-olic Relief Services (CRS)organized a workshop at theCamillian Center to discussthe challenges of HIV andAIDS to the Catholic Churchin Asia and Pacific. Some100 people from 38 organisa-tions of 15 Asian countriesparticipated in that event. Atthe end of that first meeting,organisers and delegatesagreed on the need for a morecooperative approach in thefuture.A second meeting was heldbetween 28 June and 1 July2011.

Summary reports of the 2010and 2011 events are availa-

The exposure visits during CAPCHA 2012 included: Mercy Center, HIV Netherlands Australia Thailand ResearchCollaboration, PATH, Access Foundation in Bangkok, Glory Hut Foundation, Baanjingjai Foundation, Fountain of LifeWomen Center in Pattaya, Camillian Social Center, Eastern Network of PLHIVs, independent Living Center, Garden ofEden in Rayong, Lorenzo Home, Fountain of Life Women Center in Chonburi

Some pictures from the exposure visits

16

Male involvement in PMTCT

Contents

In many countries, pregnantwomen must seek permissionfrom their husbands beforeaccessing a simple HIV testthat could be the determiningfactor for future health, illnessor even death, both for them-selves and their babies. Otherwomen do not return for theirtest results because they fearthe negative, or even violent,reactions of their husbandsshould the test result be nega-tive. And a final group ofHIV-positive women refuseto avail themselves of pro-grammes designed to preventthe transmission of HIV frommother-to-child (PMTCT) –again out of fear of male reac-

tions and rejection from theextended family.PMTCT treatment programs,which include HIV testing, fol-low up appointments, adminis-tration and adherence toantiretroviral (ARV) medica-tions, are at the core of strate-gies being promoted bynational governments and in-ternational agencies in order toto reduce vertical (mother-to-child transmission of HIVwhich still accounts for approx-imately 90% of new infectionsin children. The medicationsare provided to the pregnantwoman as soon as HIV infec-tion is diagnosed and to thebaby soon after birth and,whenever possible, until thechild has finished with breast-feeding. Such regimens are

widely used in high-incomecountries and thus have led toa virtual “elimination” of ver-tical transmission of HIV inthose countries. In many low-and middle-income countries,uptake of PMTCT is still se-verely limited. This may beresponsible for the vast ma-jority of some 370,000 newHIV infections among chil-dren during 2011.During a meeting in Geneva,on 17-19 October 2012, themembers of the CatholicHIV/AIDS Network, forwhich Caritas Internationalisserves as Secretariat, dis-cussed these urgent issues.The participants examinedsome interesting programmesdesigned to increase male in-volvement in PMTCT efforts

by Francesca Matera and Rev. Msgr. Robert Vitillo

17

Male involvement in PMTCT

and thus to facilitate greateruptake of these programmesby HIV-infected, pregnantwomen. In the course of thediscussions, it was recog-nized that, whether directlyor indirectly, men have asubstantial impact on thesuccess of PMTCT programsin developing countries, par-ticularly in the Sub-Saharanregion of Africa. Since faith-based organizations (FBOs)play a major part in the cul-tural and spiritual welfare ofsociety, CHAN membersconsidered it a duty to reflectupon the role of their organi-zations to promote strongerengagement men as familyand community leaders.Presenters focused on differ-ent approaches aimed atachieving the same goal: toensure that men are betterengaged in the antenatal careof their wives by creatingpositive role models of mas-culinity for the community.Dr. Dorothy Brewster-Lee,of Catholic Relief Services,said that promotion of ‘maleinvolvement’ represents acomponent of her agency’sreliance on the principles ofIntegral Human Develop-ment and Catholic SocialTeaching. These principlesput people at the center ofdevelopment and insist thatwomen and men, boys andgirls should have equal op-portunities, resources, rights,access to goods and servicesand should be able to interactin mutual partnership..

An initiative which mirrors thenature of the Church’s missionto the community was present-ed by Rev. Richard Bauer aMaryknoll Father working inNamibia, and was entitled

‘Men of the Bible as modelsfor Male Involvement’. Fr..Bauer maintains that the bestrole models, those to whommen-of-faith could easily re-late, can and must be thefound in Sacred Scripture .His educational project alsoexamines negative stereotypesof masculinity with a view ofeliminating them.Fr. Bauer based his pro-gramme on the hope that menand boys in rural villageswould find inspiration in someof the best-known Bible pas-sages - a book that, to use Rev.Bauer’s own words, “peopleare rather familiar with” - andwould look to the Bible forpositive models of masculini-ty. In the New Testament, Je-sus Himself showed respect

for women as mothers andsisters, care for the poor,compassion for the womancaught in adultery and even astrong emotional reaction tothe death of his friend La-

zarus. “What kind of manwas Jesus? Was he really dif-ferent from our concept ofmasculinity?” Fr. Bauer alsopoints out to the male partic-ipants in his discussions thatAbraham was a listener and,as for honour, Joseph did notact when given the chancefor revenge. Another approach discussedduring the CHAN meetingwas that of encouraging mento support one another byjoining discussion groups.Such groups represent an ex-cellent opportunity to ad-dress common fears,confront prejudice and standtogether create a new socialnorm where love is predomi-nant. In a similar way, Sr.Tarcisia Hunhoff, Director of

Care centers in PNG are creating awareness on HIV

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Male involvement in PMTCT

the Catholic HIV/AIDS of-fice in Papua New Guineareported good success in at-tracting men to seek HIVtesting by establishing “maleclinics” in several Catholichospitals and Care Centers.She claimed that, too often,HIV testing is based in ma-ternal and child health pro-grammes, which can causemen to feel “out of place”.

Catholic Relief Services alsointroduced its “Faithful HouseProgramme”, a three-day HIVprevention initiative designedto strengthen the relationshipwithin the couple. Participantsin the course reported in-creased involvement by menin accompanying their wivespre-natal care. Furthermore,some 79% of husbands fromthe intervention group felt the

need to show more concernand responsibility for theirwives and children withsome of the men deciding towrite a will to ensure the fu-ture security for the house-hold.