This summer I worked with Raising Voices in Kampala, Uganda. Raising Voices is a organization committed to preventing violence against women and children; the programmatic focus is to provide organizations with the tools and skills necessary to improve capacity and to prevent violence. Co-founded by Lori Michau and Dipak Naker, Raising Voices has been growing as an organization since 1999. The newest project undertaken by the violence against women project of Raising Voices (the other being violence against children) is SASA! SASA! is a multimedia toolkit aimed for community organizations throughout East and Southern Africa working to prevent both violence against women and HIV. The toolkit contains trainings, posters, facts sheets, a DVD, and other related items for both HIV prevention and violence prevention organizations to incorporate into their programs. There is increasing evidence of a linkage between violence and the spread of HIV, but thus far few programs and interventions address the two epidemics simultaneously. SASA! means “now” in Swahili and is first and foremost a tool intended to help community based organizations incorporate issues of violence and HIV into their projects immediately.

I had four main tasks in my work on SASA!:

1.) To develop interview guides that can assist health care providers discuss the links between violence and HIV with their clients. These guides were short and easy to read while incorporating information important for health care providers. The guides aim to provide health care providers with the tools to discuss these two sensitive and stigmatized issues with their clients who may be impacted by either violence or HIV.

2.) To develop training modules that teach health care providers the purpose of the interview guides and how to use them in their day-to-day work. These training modules incorporated participatory modes of learning such as role-play activities and group discussions.

3.) To develop persuasion sheets aimed at convincing professionals and leaders in communities that these issues are connected and that action must be taken to prevent both. These sheets were short and to the point, intended to be stand along pieces that create action at different levels of the community.

4.) To develop advocacy power point presentations intended to educate audiences about the connection between violence against women and HIV and to inform people about what they can do to prevent the dual epidemics.

Working with Raising Voices was an amazing experience. It helped me grow as an individual and as a professional, and helped me to gain practical skills in the public health field while working in an international setting.

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UYDEL was founded in 1993 by Rogers Kasirye. It targets street and slum youth in Uganda with drug and alcohol abuse prevention programs, vocational skills, STI treatment services, behavior change communication (BCC), and educational programs. Its mission is “to empower disadvantaged and vulnerable young people with cognitive life skills and livelihood skills so as to make them useful citizens of Uganda.” UYDEL is based on the core values of non-discrimination, community involvement, gender sensitivity, and full promotion and protection of all rights of marginalized young people.

Young people aged 10-24 make up 34% of the population of Uganda. Uganda’s HIV/AIDS prevalence remains steady at 6.4%, and among youth, prevalence is approximately 3 times higher in females than in males. Despite high levels of contraceptive knowledge, use among youth in Uganda remains low, due in part to negative attitudes toward condom use and perceived difficulty of obtaining condoms. Uganda also has one of the highest teenage pregnancy rates in Sub-Saharan Africa, at 31%. In response to problems such as these, UYDEL implemented an adolescent sexual and reproductive health (ASRH) project, funded by United Nations Population Fund (UNFPA) and coordinated by Ms. Jacqueline Nassaka at UYDEL. The goal of the ASRH project is to provide access to and promote utilization of comprehensive reproductive health information and services for vulnerable adolescents.

The ASRH project currently operates in three districts of the country, Kampala, Mukono, and Busia Districts. The project uses four basic strategies: provision of health services at drop-in and outreach centers, peer-provided services, behavior change communication (BCC), and vocational skills training. A trained health worker provides STI treatment, counseling, and referral services at a UYDEL drop-in-center in each district. Additionally, in order to make services more accessible to hard-to-reach youth, the health worker provides weekly services at an outreach post in a slum area in each district. The ASRH project also trains peer providers in each district and sponsors a weekly BCC session for youth which may include group discussions, music and drama, recreational games, and educational films. Finally, UYDEL provides vocational training in fields such as hairdressing, tailoring, carpentry, and mechanics for a group of youth.

From August through October 2006, my role was to assist in the implementation and evaluation of the ASRH project in these three districts. I worked closely with UYDEL staff to conduct training sessions for peer educators, community leaders, and street and slum youth. I also helped to conduct consultative meetings with stakeholders in the districts. I designed participant evaluation forms for these meetings as well as pre- and post-tests for evaluating the effectiveness of training sessions. I also completed site visits to each of UYDEL’s service sites and evaluated the provision of youth friendly services by the health worker in Kampala, making recommendations for ways to improve service delivery. Finally, I worked with staff to develop a sustainable evaluation plan for the ASRH project, which staff will continue to use upon my departure.

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My field studies took place at the Uganda Youth Development Link (UYDEL) in Kampala, Uganda, under the supervision of UYDEL’s executive director, Rogers Kasirye. UYDEL is an indigenous NGO, founded in 1993, that targets hard to reach vulnerable youth between the ages of 10 to 24, including adolescent commercial sex workers, drug users, abused children, and teenage parents. UYDEL’s mission is to empower disadvantaged vulnerable and marginalized street and slum youth with sustainable life skills that will enable them to become happy and productive citizens of Uganda. UYDEL provides services for youth in reproductive health, drug abuse prevention and rehabilitation, HIV/AIDS, behavioral change, child protection, counseling and rehabilitation of sexually exploited children, and vocational skills training.

I worked specifically on the program called the Youth Friendly Services/Adolescent Reproductive Health (YFS/ARH) Project, which aims to bring reproductive health information, family planning services, STI counseling and treatment, and HIV/AIDS counseling and referrals to the many street and slum children between the ages of 10 to 24 at drop in centers and the more remotely located outreach posts. Housing is also provided at these centers for a few young people who have no other alternative or who need an escape from an unhealthy home environment. In addition, the YFS/ARH program provides activities such as music, dance and drama, which is practiced and performed by the vulnerable youth for the community and contains messages about HIV/AIDS and reproductive health. Weekly behavioral change counseling sessions are held at each drop in center, among other group activities. These activities are provided to lure the children off the streets by offering fun and healthy activities, while providing valuable information about health for both the young people participating and the community members who attend the performances. UYDEL also provides and encourages these young people to come to the drop in centers for free vocational skills training. The vocational skills training that is provided is chosen with the input of the young people so they can have a choice about which skills they want to learn at UYDEL. This component exists so that the young people, most of whom are not in school, can learn income generating skills, giving them the option to get off the streets and make money in a way that does not put them at risk (many of them are currently engaged in prostitution or drug sales to enable them to survive).

Together with UYDEL’s executive director and the project coordinator, I managed the the YFS/ARH program which involves one drop in center, one outreach post per district, and one paid health worker/nurse who provides STI counseling and treatment and makes referrals for other needed services (such as voluntary HIV counseling and testing (VCT), which UYDEL does not provide). In addition, it includes social workers who manage the drop in centers, and 20 volunteer peer educators who recruit and educate the young people in the community about UYDEL and about reproductive health issues. They also distribute condoms and IEC materials.

This program tries to involve the community at every level, including youth, business owners, local community leaders, and other community members. They are all invited to an informational meeting and asked for support and advice on an ongoing basis during program implementation.

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I spent an incredibly high-energy summer doing a combination of office work and field work toward the prevention of gender based violence (GBV) in a high-density urban area of Kampala, Uganda. I worked with two, linked organisations: Raising Voices and the Centre for Domestic Violence Prevention (CEDOVIP). After having spent several years doing crisis work in response to violence against women, it was refreshing to see comprehensive, effective programs working to prevent violence.

I worked on five main projects within my internship. First, I worked on capacity building and training for staff, community volunteers, and community counsellors of CEDOVIP through workshops in the office and in different community settings. Second, I assisted in the development of a media campaign (radio and print) on the links between HIV and domestic violence. The third objective of my field experience was to work on a newsletter that will appear on a website aimed at linking GBV prevention organisations in East and Southern Africa. Fourth, I worked to support the development of two community theatre troupes in making their dramas more participatory. The troupes were already functioning within Kampala, but noticed a need for more community participation. We worked on improvisation and facilitation skills, developing their dramas to a point where they could freeze between scenes and hold a community discussion about what the characters should do next. They were then able to change the dramas based on community ideas. Finally, I conducted a field review and sat on a committee to develop a needs assessment tool for the creation of a program to increase male involvement in GBV prevention. Male involvement in prevention work is relatively new throughout the world, but increasingly seen as the key to making real headway in ending violence against women. This program was perhaps the most inspiring of them all, given the potential for significant change in GBV prevalence if the project is successful.

Throughout all of these projects, I had the benefit of being a part of an incredibly healthy, inspiring group of staff. They constantly pushed each other forward at an inspiring pace, truly intent on creating a change in the world around them. The internship was exactly what I needed to see-true sisterhood across cultures, deeply committed to making peoples' lives better. In addition to the internship, I managed to have some good adventures in Uganda as well. Between tree-climbing lions and baboons stealing my camping food, I definitely feel like I had the benefit of a good educational experience during the week mixed with a great vacation on the weekends.

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