USAID: From the American People

There is a group of counselors in Nakuru that does incredible work. As a team of eight, they maintain regular contact with some five hundred clients, all of whom are HIV positive. Additionally, many of these clients have families which are not counted in this list. That means this small band is ultimately providing services to well over a thousand people. These services include grief and bereavement counseling, treatment adherence monitoring, nutrition and exercise training, and even home visits for clients who are no longer strong enough to venture out. They also form support groups for clients with similar situations, and run a small farm from which they sell vegetables to clients for token fees. Needless to say, their work is very, very important.

Of course, it also carries great risks. As one volunteer said, “AIDS is dying slowly. It is terrible to watch.” Even with the best treatments, the survival rate isn’t good. Wealthy American AIDS patients are not guaranteed anything. And these people are not often receiving the very best treatments. “You reach stage 4 (of the disease), and that’s it.” Emotional trauma is a part of the counselors’ daily routine.

There are medical risks, too. Although HIV itself is actually fairly difficult to catch, most advanced AIDS patients also carry opportunistic infections. These can include Tuberculosis, Viral Pneumonia, Thresh, and any number of virulent skin infections. Home visits always carry a risk of contagion, but the counselors are too invested abandon their clients. Even so, they worry. “We don’t even have gloves. Maybe they need to hug you, what do you do?”

Complicating matters is the lack of medical services for the counselors themselves. Despite encouraging counselors to expose themselves to these risks, the overseeing organizations provide NO annual medical treatment, NO risk allowance, and NO sick leave or paid vacation. This last part is especially damning, as the counselors (often as in need of money as the people they visit) cannot afford to take time off, meaning they are interacting with clients even when they themselves are ill. This only serves to spread the opportunistic infections farther around the immuno-compromised HIV+ community.

Even assuming the counselors come to work every day, the payment is insufficient and inefficiently distributed. One counselor who has a long history of such work, having served under the UNHCR (United Nations High Commission on Refugees), MSF (Medecenes Sans Fronteres), the International Red Cross, AAH (Action Against Hunger), and UNICEF (United Nations’ Children’s Fund) said the situation here is the worst he’s ever seen. Payment comes every 45 days instead of the regular 30, making bill paying impossible. For people who are often living paycheck-to-paycheck, this extra delay can be devastating. Children cannot go to school without school fees, electricity will not come if the bill isn’t paid. And this NGO pays less than the others he has worked with. Talking about his former employers, he asserted that “others are without problems. He shook his head as he trailed off, “Here…”

These problems were recently compounded by an unexpected turn of events. A letter from somewhere up the chain of command, October 17th, 2007:

“To all counselors and Volunteers:

RE: OCTOBER 2007, SALARY

This is to inform you that (the program) funding from (old sponsoring program) ended on 30^th September, 2007. Meanwhile we are in the process of transitioning most of the activities under (your program) into (another program.)

I wish to inform you that, during this transition period we will not be able to pay your October salary. However, as soon as the structures to run the program have been put in place, the program will continue and we will inform you accordingly of any future developments.

We apologize most sincerely for this inconvenience and regret that this information was not communicated to you earlier in the Month. It was our hope that the process will be completed by this month but due to unforeseen circumstances this was not possible.

Lastly, I take this opportunity to thank all of you, for your commitment and the tireless service you are giving to the community; and hope that this temporary situation will not deter your spirit of serving the less fortunate in our community.

Sincerely yours,

Xxxxxxxxx”

This letter was printed on USAID stationary alongside the slogan “From the American People.”

The counselors are understandably upset. The lack of pay is devastating. Finding out after two and a half weeks of work that they won’t be receiving their due compensation makes it even worse. And the cavalier attitude of the author (They apologize for the ‘inconvenience’) added insult to injury. Of course, there is no legal recourse here. They cannot complain to a union or take the case to court. All they can do is wait it out. And so they do. But amazingly, they don’t allow their clients to suffer. The morning after the letter arrived, all 8 counselors were in their office at the usual 8am time. There have been no irregular absences in the two weeks since. They are afraid to abandon their clients for fear that they will begin to regress. They are dedicated to their cause.

This isn’t to say that the counselors aren’t feeling the pain. “Our (adminstration) isn’t going to help us, but we will continue helping our community. The money (when it does come) isn’t enough to help us, but not having it hurts us.” Others were more resentful. “Those up there, you just give (them) reports. Nobody cries on their shoulders. They don’t know what we do.” She sounded close to giving up. “Even with the call, with the willingness, you tire because you are a human being.”

“If they will not change, it will be difficult for us.”