ANSA International Program Blog

According to a 1996 UN report, more than 250,000 women were raped and intentionally infected with HIV as part of the campaign of societal destruction during the Rwandan genocide in 1994.  (Genocide museum's memorial garden pictured.) Today, the Women's Equity in Access to Care and Treatment (www.we-actx.org) provides medical and psychosocial services to thousands of these women survivors and their children at three clinics in and around Kigali.  WE-ACTx was successful at finally getting ARVs for the women - while the men in prison for raping and killing were already receiving ARVs -but they now face a significant challenge in getting nutrition support for the women to be able to take their drugs, stay strong enough to walk to their follow-up clinic appointments, and take care of themselves and their dependents.

I met Dr. Mardge Cohen, a volunteer physician with WE-ACTx, at the ANSA conference in August 2007.  She gave a moving presentation on her work in Rwanda, and mentioned that nutrition was their biggest need now and they were looking for sustainable solutions to this problem, not temporary handouts.

Two months later I met Bob Patterson, a fiesty longtimer with the UN's Food & Agriculture Organization (FAO), at the Partners in Health conference on food insecurity, nutrition and health.  Bob gave a presentation on The Growing Connection, a very cool low-cost, sustainable agriculture and education program currently in schools all around the U.S. and abroad, and showcased at the Google Foundation.  He showed off a little box, talked about its big benefits and said, "This is an ideal way to support health service programs.  Someone have a conversation with us about it."  So I did.  And then together we had a conversation with Mardge Cohen.  And a few weeks later the three of us met in Rwanda.

As it turns out, Bob used to live in Rwanda in the 1980's.  Everyone he knew was murdered in the genocide, so this trip was a bitter-sweet return for him.  Mardge hosted us at the WE-ACTx group house in Kigali, a house like thousands of others with a yard lush and green and tropical banana trees that laze over a wall lined with speared shards of glass. 

Despite its brutal recent history and the ubiquitous verbal and visual reminders of grief and guilt, the country of Rwanda has a shockingly warm and inviting feel.  This is due in part to the people, who range from shy to friendly to comfortably familiar, and in part to laws meant to keep the country clean and environmentally responsible.  Eating outdoors is prohibited, so littered to-go cups and pesky critters are nowhere in sight.  Plastic bags are also verboten, so you won't find these trashing up roadsides.  And, perhaps most interesting of all, the country has national clean-up day the last Saturday of every month.  Everyone, even visitors, are expected to roll up their sleeves and pick up trash, sweep, or do whatever else is needed to beautify the country.  It all works; the country is gorgeous.

To get oriented to area services, the WE-ACTx folks took me to visit several programs, including the Partners in Health site at Rwinkwavu Hospital, two hours outside Kigali.  In this beautifully refurbished hospital, PIH provides everything from surgeries and baby deliveries to malnutrition clinics (young patient pictured) and community gardening programs.  While there we were learned a great deal about the challenges PIH faces in developing a sustainable response to the significant nutrition challenges of their patients.  Like many others, including WE-ACTx, PIH is feeling the painful impact of the World Food Program's recent dramatic cutbacks in the amount of rations they will provide.  Yet another reminder of the urgent need to find community-developed, community-owned responses to nutrition concerns.

Our goal on this trip was to set up a small pilot project using only three Earthboxes, small fabulously simple containers designed by a tomato farmer looking to increase yields and decrease maintenance on his crops.  To tell you all the cool things about this box would take too many words; easier to go here: www.thegrowingconnection.org.  The idea was that these boxes could be set up at WE-ACTx clinics and planted, tended and harvested by the patients. They can grow food to eat or to sell or both.  (Children at a deaf school in Ghana grow nothing but basil, which they sell to restaurants and all the money comes back into the school.)  The women and children also get access to computers to research seeds or which foods would be best for them to eat, and to get connected to others who are doing the same program around the world. 

After meetings with the country's premier organic farmer, the country director for FAO, officials with the Ministry of Health and the Ministry of Mining and Energy, agronomists from Kenya and Australia, and the staff and women of WE-ACTx, the right fertilizer and substrate were identified and the location where the boxes would be maintained was confirmed.  On February 19, the seeds of this pilot project were planted in three little plastic containers.  With great anticipation, the water resevoirs were filled and everyone crossed their fingers in hopes that a simple, sustainable community-based solution would soon be emerging before their eyes. 

Stay tuned!

Peace to all...Mary