The Power of One: Expanding Home-Based Care in Tanzania

Develini, a home-based care provider, is proud of her 125 clients. She knows what a difference treatment and support can make because she, too, is living with HIV.

Develini uses her personal experience and the training she received from Pathfinder to help Mohamedi and Doto. Here, she delivers integrated services—HIV care and family planning—in their home.

The couple’s health has improved since beginning anti-retroviral therapy. They are feeling better and, thanks to testing through the project, they know that their children are “free from HIV.”

Still, poverty weighs on them, and Doto does not want to have any more children. So, in addition to providing HIV and AIDS services, Develini counsels the couple on family planning.

As Develini says, “For all who have lost hope, they should know they can work, and be active as normal people. I am happy and ready to assist anyone like me, to encourage them that an HIV-positive diagnosis is not the end. There is more life.”

Develini might be the most powerful woman in Ukonga. Twelve years ago, she was so ill she could not walk. Now she treks across her community, on the outskirts of Dar es Saalam, Tanzania, bending beneath crumbling doorframes to reach her neighbors.

They call her “the village doctor,” a title that speaks to her importance, though it is not entirely correct. Develini is a volunteer. Pathfinder trained her to visit her neighbors in their homes, educating them about importance of HIV testing and prevention, including how to protect their children from the virus. At the same time, she counsels women on family planning and distributes contraceptives. Develini knows how important it is to receive these services in one location. She understands her clients need privacy and want support because she, too, is a survivor.

For the past 20 years, Pathfinder has been at the forefront of the response to HIV and AIDS because our projects across the globe all stem from a simple idea: that the people you know best are the ones who can encourage you to change your life.

With one hand, Develini removes her glasses. With the other, she wipes her tears quickly before anyone can see them. “In 2000, the clinic told me I was HIV positive,” Develini said. At that time, anti-retroviral therapy (ART) was not subsidized for the public in Tanzania, so there was no treatment available to her. “They told me ‘you could die at any time’ and ‘to sell everything I own.” Develini was shocked. Despite her weight loss and failing health, she thought she was safe. She trusted her husband when he said he did not have HIV.

But the truth is Develini’s husband knew he was HIV positive even before they got married. “He knew his status and was taking medicine every day, but I didn’t know what they were,” she said. “When I asked him about the pills, he lied.” He invented an ailment. Perhaps most painful—“I even took the initiative to remind him to take the medicine,” Develini admits, “without knowing they were ART.”

When Develini finally learned the truth—that she is HIV positive—her husband left. She has not seen him since. She had to rely on her parents and doctors to save her life. And with treatment, her health dramatically improved. It is a debt she repays every day as a home-based care provider.

“For all who have lost hope, they should know they can work, and be active as normal people. I am happy and ready to assist anyone like me, to encourage them that an HIV-positive diagnosis is not the end. There is more life.”

Develini shares this message with her 125 clients, including Mohamedi and Doto.

TO BE FREE: One Family’s Story

In 2009, no longer afraid of the repercussions, Mohamedi decided to disclose his HIV-positive status to his wife. “I had to tell Doto,” he said. “Otherwise, she would have lost her life. It is important.”

Mohamedi had begun anti-retroviral therapy, and his health was improving. So whatever the fallout, however angry she might become, he believed that at least he could make her healthy by getting her treatment. What he did not expect was that, after hearing his news, Doto would not even get tested.

“She kept saying, ‘tomorrow, tomorrow, tomorrow,” Mohamedi said. He glances at his wife, for her assurance to go on. “Doto was afraid of seeing people at the clinic, of their eyes.”

Mohamedi sought help from the one person who had openly discussed their HIV status, who was known to everyone—Develini. Develini arranged for Doto to get tested in her home. When she arrived, she was greeted by 10 other family members, all wanting to find out their status, too. 

That day, Doto privately learned she was infected with HIV, as did four other relatives. Perhaps most critically, Doto and Mohamedi confirmed that their three children “are free from HIV.”

The couple wants to keep it that way; they want to get healthy and avoid pregnancy. So, along with anti-retroviral therapy, Doto uses contraception. She receives pills from Develini, who provides family planning in the privacy and convenience of her client’s homes and is never far away. Even now, as her clients bravely tell their story, Develini sits beside them, beaming from behind her glasses, giving them strength.
 
“I am not the type to share a lot of things. Having Develini is so important. I need her,” Doto says, looking at her friend. “After all, she is just like me.”

THINK OF DEVELINI’S IMPACT. NOW MULTIPLY IT BY 1,250

Develini is just one of 1,250 home-based care providers for the Tutunzane project (meaning "Let's take care of one another" in Kiswahili). Led by Pathfinder, the project relies on the talent of local individuals to stop the AIDS epidemic where it starts, one person at a time. And they are succeeding.

In 2011 alone, the project supported 44,000 clients by reaching people in their homes. This means that the person-to-person approach has been so effective that it has grown to support communities across five regions of Tanzania. It is what sets Pathfinder apart.

For the past 20 years, Pathfinder has been at the forefront of the response to HIV and AIDS because our projects across the globe all stem from a simple idea: that the people you know best are the ones who can encourage you to change your life.

Country: Tanzania
Focus Area: HIV & AIDS

Alden Nouga

Alden Nouga is Pathfinder International's Senior Advisor for HIV and AIDS.

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He pulled the stone out of his pocket and dropped it after its trajectory, calculating fall rates against the wind. He repeated the experiment several times. Then he pulled back on the summit. In minutes, Gambalie would jump out of this place, plunging nearly a third of a mile and speeds up the heart-stopping 120 kilometers per hour before setting up his parachute 1,500 feet above the valley. He BASE jumped from the east face of El Cap more than a dozen times, but the western, or Salathe, face a greater challenge. To avoid spanking side of the wall, I had to clean a large boulder protruding 100 meters below the summit, and then immediately set sail. Gambalie made ??this one jump - prada-outlet-onlines.net the only person to do so. With a friend called Andy West help Gambalie done at the last minute equipment check. He walked to and fro from the edge, surface everywhere. 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He rose to the upper echelon of bungee circuits within a year, but by 1993 was again looking to push the edge. "It was almost by accident that Frank discovered BASE" says Gambalie former roommate, Jim Fritsch. "We just watched michaelkors-outlet-handbags a ski movie one day, and suddenly here's this guy with a parachute on his back skiing off a huge cliff. Frank was completely blown off it. Was like, 'Bing!' A huge light in his head. " As with all other sports, Gambalie threw in BASE jumping, no matter what sport a basic rule: that beginners should be experienced skydivers. "Frank has made ten parachute tops, but he does not believe in going slow," says Gambalie mentor, California BASE jumper Adam Filippino. "He's like a sponge. He absorbed everything he taught and led to her." Gambalie's innovative style sets it apart from other divers, as well as his passion for pioneering touted jumps from places previously considered unjumpable. "Being deceitful is the fun part for Frank. Whether as a mission," says his friend Tom Cooke. By incorporating acrobatics in sport for the first time, Gambalie BASE stunned the world with his triple and quadruple winners, appear to BASE events like Bridge Day, a legal contest is held every year in West Virginia. By 1995, he became the unofficial Gambalie savage BASE. But his brashness come at a price. The Hollywood stunt world closed ranks. "Most professional BASE jumpers work in movies and commercials," says Fritsch. "But it's tight circle, and they froze it." So Gambalie carved a niche in which there is no jumper gone before, into the lucrative world of corporate sponsorship. Armed with a demo reel, Gambalie made ??the rounds of adventure-sports fairs, offering their talents BASE mode wizard-kid cyber-entrepreneur can push his latest start-up. "Frank transport yourself better than anyone I've ever seen," says Filippino, a leading designer BASE equipment. "It was a terrific A sales rep would pop in Frank lane and suddenly, there was Frank doing all this great stuff - .. And he uses the equipment of competitors' Filippino laughs. "Obviously you want to steal some of that for myself." By early 1999 Gambalie they bring in at least a dozen of the most sponsorship in adventure sports, including Oakley, Obermeyer, K2, Nike and Red Bull. But for all his success, he continued to be tested against all major way. However, if Gambalie is compelled to attack deaths, he constructed each jump minimize your risk. Among the hundreds of hours of video footage Gambalie, there is footage from the TV show called "extremists" where Gambalie, dressed in a shirt and shorts, overshadowing the 850-meter-high bridge in northern California. As techno hurt in the background, Gambalie jumps backwards, spinning like a gyroscope and perform multiple flips before popping his parachute. A series of brazen, almost recklessly. But Gambalie calm. "I can handle the jump, jump you can control," he says, on Earth, dark eyes staring unblinking at the camera. "It is the government can not control the catch -. This is what scares me." "Go and run" philosophy has been observed in the BASE of the sport began in the late 70s. The ethos is particularly strong in Yosemite, where the Rangers have a reputation for zealously tracking jumpers. Tales parties sparse, searched vehicles and climbers spied constitute Canon constantly growing anti-Ranger paranoia. The recent death of world-class thebagsstyle.com mountaineers Dan Osman adds especially sad chapter. One extreme sports icon and close friend Gambalie is Osman pioneer dangerous - some would say crazy - jumping rope sport: swinging unbelievable heights by climbing a firm leash on a piece of rock. In November 1998, Osman died in Yosemite after one of his rope snapped during a jump from rock pillars known as the Leaning Tower. Household and BASE jumpers accuse Rangers of "killed" Osman, who spent two weeks before his death in Yosemite prison on various misdemeanor charges. Friends say he got out of confinement badly shaken. They insist Osman was mistreated while in custody, which shook confidence and led him to a critical error in judgment, the most dramatic of his decision to use ropes that are weakened by exposure to a month in the sun and snow. Yosemite authorities deny allegations of abuse, but "the charges" still speaks to the tension between the counterculture and its inhabitants Park Rangers. "Bottom line, there is an aversion us in Yosemite," says Filippino. "It's not a rule, it is a bitter relationship that has been built for so many years." Dan Horner, a special agent in Yosemite, begs to differ. "These guys that get yucks hiding in the forest waiting to be caught," he says. "But we do not have the time, let alone money for overtime, for that." In fact, he argues, Rangers actually catch only 5% of divers each year. Anyway, enough Gambalie jumped in Yosemite to know that he does not want to be among that 5%. And he stayed under the radar until Uthman's death. In contact with Osman over a mobile phone while his friend a fatal fall, Gambalie raced to the park and stayed with the body until rescuers managed to get there. But he feared his heroism has raised its profile among park officials. "Frank was concerned that the Rangers could try to make an example of him, if he was ever caught," says his mother, Ricci Mescola. "Especially after hearing all the stories about how they mistreated Dano." But although Gambalie achieved celebrity status in Yosemite, not distract him from jumping. "Frank was never caught up in Yosemite and it should never be," says hikers and Gambalie friend Dean Fidelman. "And you know, Frank was confident 'No way are we," he would say,' Let me chase - I'll just laugh in your face and jump in the river. ".." Rising Louis Vuitton Outlet 7,569 meters above sea level, El Capitan Everest jump sites. Towering monolithically at the entrance to Yosemite Valley, the transverse dramatically, allowing divers to navigate away from the rock to 18 seconds - a very long freefall - before pulling his release. And the meadows below offers a comfortable drop zone, El Cap is irresistible to divers. So it was that Gambalie, the Salathe face most of all. The Salathe is one of the highest sheer rock in the continental United States, and of its pioneering first jump in 1998 Gambalie dreamed encore. Morning of the 8th Jun, 1999, he got into his blue Subaru wagon and drove to Yosemite, ready to jump again. It was the first time Gambalie returned to the park because Osman died seven months ago. "He was a little scared right after Dano died," says West, who agreed to meet Gambalie at the top of El Cap in the afternoon. "That was weird.'ve Never seen Frankie says he was afraid of anything." Although he was a friend jump Gambalie for years, the West has not seen him for months. Gambalie spent most of the year working on films for sponsors, and it seemed that the West is that his friend has changed. "I remember thinking it was ripe," says West. "He's like a real man - you can tell from the handshake, even a handshake was strong." Gambalie was eager to show the West point of launch, and two walked together toward the precipice. The group of hikers was hanging near the western edge of the face. one, Scott Burk, was a well-known big wall climber who recently became one of the six people successfully free solo of the nose, the highest point in El Cap's. Burk climbing in Yosemite since 1981 and knew most of the BASE guys. "BASE jumpers are simply not like other people," says Burk. "They are like drug addicts, the way some of them operate. The cat-and-mouse with the Rangers was part of it." West was suspicious of Burk, believing that he was the one who tipped off rangers when I was arrested after jumping West 1997 West El Cap is not even supposed to be close to the BASE jumpers.; He is still on trial. Gambalie spent an hour with Burk and other climbers, and then joined the West in their camp after dark. Besides Gambalie and West, Burk and friend were the only people who Kate Spade kampuju on top that night. The sky was not exactly light on 9 June, when Gambalie woke up just before 5:00 Ten minutes later he jumped, thus projecting rock just below the launch and fly away from the wall. He dropped to eight, nine, 10 seconds, disappeared from the West look at three, and then re-appeared, and continues to fall. Finally, after 16 seconds, West heard the crack opening parachute Gambalie and saw his friend, a blot on the horizon, floating toward the valley. Gambalie slid to the west and to the woodshed times, and then suddenly turned almost 180 degrees and zigzagged east, finally landing across from the turnout at the westernmost edge of the meadow El Cap. It was, says West, a clean jump she had ever seen. And then West saw a set of headlights approach the landing area, blinking several times. He assumed that it belonged to a curious passerby. He waited a few minutes, and then returned to the camp to organize your equipment. He turned on the cell phone; named below to arrange a meeting is standard operating procedure after each jump. But Gambalie never called. Strangely, the West thought, but Frank is on the phone so much, maybe the battery died. Or maybe the phone down. You might as well head down, West said that he finished packing, Frank will call when he can. Then, tape the package, he began the long hike back to the valley. It was mid-October at El Cap meadow, just off Northside Drive, about 50 meters from where Frank Gambalie landed on the morning of June 9. Twenty meters south, deep meadow grass turns into a forest, which in turn leads to a bank in Merced River. In the fall, the river is shallow and less than 100 meters across. But in June, Merced is more than six feet deep, raging with 40 degrees of melting snow. Water at this temperature shock body like lightning, sucking his strength before you have time to react. At top speed - about 8 mph - power and volume of the river can trap body within its rush and sweep it downstream. Gambalie landed at the southwestern end of the meadow, and almost immediately Rangers poured it from two directions. He could have given up. Instead, he lowered his parachute, he turned and, as the Rangers reported, blesnu smile. Then he ran into the woods, according to Merced. Later, Kate Spade Bags he made a lot of decisions Gambalie's. It seemed suicidal, almost absurd, for someone known for his meticulousness. "The river is a seasonal escape," says West. "You use it when it is low, after August. Never in peak season. Frank did not know that. Was so good at evading, I doubt I ever thought I would need. If you ask me, he was in a hurry to get to the top before dark, and he slipped on the prep work. " Approaching the right bank, in the area known as the Ribbon Creek, Gambalie threw the rest of your rig, and with an evil smile, he took the Rangers, diving headfirst into the river. The surface was smooth and glassy where he entered, but a little further down the large boulders blocking the rest of the Merced views. To see Gambalie next to Boulder he would have realized that immediately after, fed directly into the river rapids language. As he started to swim across, towards achieving the Rangers, Gambalie paddles grew more urgent. He tried to swim upstream, struggling against the current that pulled him further downstream. Nearing Boulder, Gambalie body went across to the rapids. Rangers watched from the shore as he disappeared behind a rock. It is possible that Gambalie is pushed under as he walked around the rock. It is also possible that, with the heat and strain the jump Chase, hypothermia set in well before he was caught by a rock unconscious. What is known is that the force of the river, made ??of aerated swirl of white water, keep it tucked under within a few seconds of his hitting rapids churned around him like a washing machine. Obstruction in the river, such as rock, increases the pressure even more. If there is a gap under a rock, a person can easily be tucked under and pinned there. Divers call it "strainer." It is, apparently, is what happened Gambalie. For the next month, his body lay submerged in the icy waters Merced to Yosemite divers finally found on July 7, three soccer fields, from where he went in. Until then, Gambalie had dark hair and eyes have lost their color, and his skin, well-preserved in the cold, began to separate from his body. "It was his fatal mistake, not knowing about the rapids," says Jeff Follett, rescue diver who discovered the body. "If he'd gone to a quarter mile upstream, he would have New Balance Women's made it. But people drown in Merced even in flat water. Jumps in the river's stupid to do at any moment, any time of year." Initially Gambalie disappearance was treated as a criminal incident. Frightened, West left the park. "I just assumed Frank was not called because his phone was wet or something," he says. "I knew I did not want to be part of this, whatever it was. Did not want to be in jail." From his home near Los Angeles, West waited for word. Several hours passed, and then one day. So far, he is convinced something went wrong, West called Filippino, crying. Filippino never heard West so upset. However, he thought of his desire to invite friends Gambalie mom was premature. But when Gambalie voice mail is full, Filippino knew. "Somewhere in there, I knew it was not there." Rumors circulated around the BASE community: Frank jumped out of the country; injured, perhaps, in the woods; had amnesia. "Nobody believes that to die in the river," says Lottie Aston, Gambalie girl. "If someone would not have survived that is said to Frank. Everyone who knew him knew that. Frank got away with everything." When his body was found, rumors have been replaced by questions. What really happened that morning of 9 June? Yes overzealous Rangers pressure Gambalie in bad decisions? And who warned the Rangers? Is that Burk? (He says no.) One of his friends? Is it fear of being caught that drove Gambalie to the river? Or is this belief in its indestructibility, believing that showed something so many times before? "Frank had an unbeatable view of life," says Filippino. "" I will die for this - but this time it will not happen to me .. "" The official accident report states the cause of death of the park as a result of accidental drowning fleeing illegal parachute jump. Shortly after Gambalie disappearance, his father met with the Rangers. "I told them, look, my son has broken the law, he made a bad decision. But there is something wrong with all this. Law is designed to protect people, not to them where they feel they have no choice." But, of course, Gambalie had no choice. "Frank was not worried about losing their platform," says West. "He has not paid one in years." And although Osman alleged abuse may have been forced to the edge, at least one who knew his case Gambalie kate spade outlet different thoughts. "Frank had a record of maintenance," says Kevin Thaw December hikers and Gambalie friend. Thaw believes that the Rangers had even stopped looking, Gambalie be kept running. "It was a game to him, all of this," says Thaw. "And Frank loved the game." Last October 22, the event was held in honor of Frank at Yosemite in protest against the ban BASE jumping. Five jumpers were supposed to take off from El Cap, with rangers on hand to cite them and seize equipment. More than 100 spectators watched as the first jumper stepped to the edge and jump. The other two followed. Then stepped up fourth, committed and fell. I constantly fall. The crowd grew silent as a jumper, an expert skydiver and stunt woman named Jan Davis, struggled to find release on her borrowed rig. But it was too late. Her body hit the cliff base, sending a booming echo off the rocks that roars across the valley, soul-crunching noise. Human error, not equipment malfunction, caused the accident. "It would have jumped Jan without 100% safety with her equipment is unheard of," says BASE equipment manufacturer Martin Tilley. "Know your equipment. This is given in BASE jumping." It was a terrible shame for the park, another disaster in the already disastrous PR year. All talk of legalization BASE jumping in Yosemite is stopped. Ironically, Davis dies while jumping in Gambalie name has not escaped your friends. "Frank is probably rolling in his grave," says West. "He was a total pro, and someone who does not live up to his standard, well, it's not appreciated. And do not forget that he made ??his leap, and it's a nice jump as I have ever seen. The Revolutionary War was a rebellion against the British, but first needed a battle between Tories and Patriots. Ted Cruz fights for the honor of leading the conservative movement. The main goal is to be the voice of the American people, the victory of the Democratic Party, and take Congress and the White House, so that we can reduce our federal government back to constitutional limits. At the moment the battle is ObamaCare. But first opponent who must be defeated Republican establishment. Is it any wonder that the Republican leadership in order to make sure the defunding effort not? Ted Cruz prika?uju his ambitions for large real Tea Party Presents: Conservatives really fed up with both parties in Washington, DC Republican Coach Factory Outlet base allowed Obama to be re-elected, when an estimated five million were left at home in the elections 2012th It may not be wise, but it happened for a very good reason: they did not see the Republican Party to represent them. DC establishment, and that includes the party, doing very well, thank you. In the suburbs around Washington were the richest in the nation. They and their families are untouchable for the economic collapse of Obama. A huge government spending a quarter of the wealth of our nation, with nearly half of the population depends on their generosity, good for them. It's not good for us. Republican leaders want to defeat ObamaCare, but mainly want to use it as a talking point of the campaign to return to power. They are not ready to fight with all their hearts and minds to protect the American people from this disaster. It might be risky. It may not play well in the polls this week. It might not be good for them letting it go through, and then complain in 2014 and in 2016. Republicans have ignored the will of the voters for a long time. They ignore their base and ratcheted up the national debt by President Bush. Instead of slinking further into shame to lose the base, Karl Rove is as powerful as ever, struggling Cruz pages of the Wall Street Journal and every TV station can be used to push the status quo. Republican elites fought desire base to stop illegal immigration. They were happy when the Tea Party Revolution surrendered control of the House in 2010, then turned around and bad mouth us as fanatics and incompetent who did not also win the Senate. Interestingly, Republican Party Chairman Priebus reincite establishment is one leader who does get it, perhaps because he is the guy who has to get out the vote in the next election. Priebus published a brief piece today entitled "In a battle between Ted Cruz and Harry Reid, we must stand with Senator Cruz." The Senate leadership is not listening. Ted Cruz knows something the establishment does not. The Tea Party is a genuine populist uprising. This government is not an elite tyranny yet. People do have power when they pick up the phone or e-mail their senators and congressmen. Commentators keep talking about Cruz not working with McConnell and Cornyn, as if he is a lone wolf. Cruz is not Michael Kors 2014 a lone wolf. He is a man of the people. Cruz is appealing over McConnell's and Boehner's heads, listening and talking directly to the voters.Everyone said he could not get the House to attach defunding to the continuing resolution.So Cruz did not try to convince the speaker and his complacent, pusillanimous followers.He went on TV, he took out ads, he ran an internet petition, and he called for people to fight.They responded.They're hungry to fight.People are fighting for their health care, their jobs, for control over their own lives.A million and a half people signed Cruz's petition.Thousands of phone calls from angry constituents followed, and all the talk of how it couldn't be done disappeared overnight. The same thing could happen in the Senate. It will be decided not by Cruz, not by the establishment pundits, and certainly not by the Senate leadership. It will be decided by the conservative Republican base plus Democrat voters frightened enough of ObamaCare to call their senators. October 1 is not just the potential start of a government shutdown; it is the roll-out of ObamaCare. We keep being told about polls showing that people don't want a government shutdown. What will voters be more upset with: losing their insurance, paying more for their insurance, losing access to their doctors, losing their full-time hours or worse, losing their jobs -- or a partial government shutdown? Is it impossible to unite Republican senators to vote against cloture and then turn five Democrat senators to vote against funding ObamaCare? It all depends on how many voters pick up the phone. (Scroll down here to get a list of senators' phone numbers.) It is not out of the reach of ordinary people to overturn the ObamaCare disaster. Same question here. I would like to assign Knowledge BAse rights besed on Organizations! The reason is, that I want the users of those organizations watch into the KB first instead of calling me. By inserting articles into the KB based on the customers infrastructure I don't want customers to see infrastructure details from each other. I am thinking of buying Kayako because of the knowledge base. And creating user groups for every Organization and then add every employee to the user group is not applicable because the employees can sign in by themselves and I don't want to assign user group all the time by hand.
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