Thursday, January 6, 2011

Pre-departure notes

Introduction:
My name is Shannon Smith and I am a 4th year student at Brescia University College in the Food and Nutritional Sciences program. From January 14th to May 26th, 2011 I will be primarily situated in Tanzania Africa in the cities of Mwanza and Arusha along with Fellow intern, Christopher Taylor. Internet access may be limited/sporadic so responding to e-mails may be difficult at times. I will be using this blog to document my time in East Africa as a “Western Heads East” (WHE) intern. The purpose of this blog is so that my family, friends, project stakeholders, and others interested can receive regular updates. My hope is that this will be a useful place for me to document the progress of my goals, accomplishments and daily challenges, cultural differences, bonds formed with different individuals, and interesting facts/highlights. My goal is to enlighten, inspire and increase the awareness about the HIV/AIDS crisis and the positive benefits of this project.

What is the primary objective of this project?
            To establish a sustainable, grass-roots food based probiotic yogurt project, to improve health, nutrition and alleviate suffering from malnutrition to vulnerable social groups in the context of the HIV/AIDS epidemic.

How did I get involved?
This program first caught my attention at an orientation I attended before I had even started studying at Brescia. Jamie Hemsworth, a past intern in Mwanza Tanzania, was one of the graduate students who presented. She spoke about her journey in Tanzania and all that she accomplished in addition to the positive impact she made in the lives of so many people. I can still remember how inspired I was by her presentation, and at that moment I knew, one day I wanted to follow in her footsteps. Finally, in my fourth year I decided to follow through and applied to me an intern with Western Heads East! 
Background/History about the WHE project
In June 2002, Stephen Lewis (UN Special Envoy for HIV/AIDS in Africa) spoke at a conference of the Ontario Association of College and University Housing Officers hosted by Western’s Housing department. He struck a chord with the group as he explained how 3000 people were killed in the 9/11 tragedy which gained worldwide attention, yet he struggles to get any attention for the 3000 people dying in Africa daily (2.3 million every year) of HIV/AIDS.
            A group of housing staff led by Bob Gough were moved by this speech and developed a Western Heads East Steering Committee to develop a sustainable community development project to help with the HIV/AIDS pandemic in Africa. Amongst those interested parties were Dr. Gregor Reid, Scientist at Lawson Health Research Institute and Professor of Microbiology and Immunology, and Surgery at the Schulich School of Medicine & Dentistry at The University of Western Ontario, and Dr. Sharareh Hekmat (Brescia University College). Dr. Reid developed the bacterial strain (Lactobacillus rhamnosus GR-1) and then collaborated with Dr. Hekmat to develop “Fiti” probiotic yogurt (yogurt sold in Africa) using this strain.  
            In collaboration with local partners including the Tukwamunae Women’s Group (TWG), the Tanzanian National Institute for Medical Research (NIMR), and the University of Western Ontario (UWO), a sustainable probiotic food based development project has been implemented in Mwanza, Tanzania. In Mwanza, the project is being run by a team of people including local mothers, affectionately termed ‘Yogurt Mamas.’ They have been trained in probiotic yogurt production and community organization by WHE interns (Western Students) along with Western faculty and staff members. The Yogurt Mamas from Mwanza have become the official local trainers for other interested women’s groups from surrounding communities and elsewhere.
            The project’s Canadian team works with women’s groups to establish probiotic yogurt operations and to ensure sustainable economic viability, seek subsidies to provide yogurt free of charge to people living with HIV/AIDS, and to collaborate with East African communities with respect to teaching, service and research. Research shows that probiotics can prevent and treat urogenital infections and bacterial vaginosis which are risk factors for HIV acquisition and therefore may slow the progress of HIV/AIDS in women, stop diarrhea which kills many children and immuno-compromised adults, increase immune response, and generally improve population health.  The project has been working since 2004 with the Tukwamunae women’s group who are now licensed as an NGO. They have become an important pillar in the Mwanza community and now aim to become a Regional Headquarters for East Africa to provide training to women in other communities within Tanzania and in neighbouring countries.  

Western Heads East: Our Mission
To engage staff, students, faculty and the broader community in teaching, research and service targeting the African HIV/AIDS crisis. This will raise awareness and funds to support the exchange of learning experiences, while making sustainable difference to communities in Africa

Facts on HIV/AIDS
1.    HIV (human immunodeficiency virus) infects cells of the immune system and destroys or impairs their function. Infection results in the progressive deterioration of the immune system, breaking down the body's ability to fend off infections and diseases. AIDS (Acquired immune deficiency syndrome) refers to the most advanced stages of HIV infection, defined by the occurrence of any of more than 20 opportunistic infections or related cancers.
2.    HIV can be transmitted through unprotected sexual intercourse (vaginal or anal) or oral sex with an infected person; transfusions of contaminated blood; and the sharing of contaminated needles, syringes or other sharp instruments. It can also be transmitted between a mother and her baby during pregnancy, childbirth and breastfeeding.
3.    According to estimates by WHO and UNAIDS, 33.4 million people were living with HIV at the end of 2008. That same year, some 2.7 million people became newly infected, and 2.0 million died of AIDS, including 280 000 children. Two thirds of HIV infections are in sub-Saharan Africa.
4.    HIV/AIDS is the world’s leading infectious killer claiming—to date—more than 27 million lives. An estimated 2 million people die every year from HIV/AIDS.
5.    Combination antiretroviral therapy (ART) prevents the HIV virus from multiplying in the body. If the reproduction of the HIV virus stops, then the body's immune cells are able to live longer and provide the body with protection from infections.
6.    More than 2 million children are living with HIV/AIDS, according to 2008 figures. Most of the children live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Almost 1200 children become newly infected with HIV each day. The number of children receiving ART increased from about 75 000 in 2005 to 355 000 in 2009.
7.    Mother-to-child-transmission is almost entirely avoidable, but access to preventive interventions remains low in most developing low- and middle-income countries. However, progress has been made. In 2008, 45% of pregnant women living with HIV received antiretrovirals to prevent mother-to-child transmission of the virus, up from 10% in 2004
FAQ
What are Antiretroviral drugs (ARVs)?
Antiretroviral drugs are primarily medications for the treatment of infection by retroviruses. They are the the main type of treatment for HIV or AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of a person’s life. The aim of antiretroviral treatment is to keep the amount of HIV in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV might have caused already. These drugs can have many adverse side effects and this is where the probiotic yogurt can have substantial benefits. It has been shown that side effects from taking the ARVs can be reversed or reduced by consuming yogurt with probiotic cultures.
It is important to understand that the yogurt is NOT a substitute to antiretroviral treatment or a cure for HIV/AIDS, but it provides nutrition that is required for the drugs to work to their greatest potential and helps alleviate some of the side effects of HIV/AIDS.

What are probiotics?
Pobiotics are defined as “live micro-organisms which when administered in adequate amounts confer a health benefit on the host (consumer)."These products primarily influence the intestine, which is home to an estimated 100 trillion bacteria important for immunity and digestion.

What are the health benefits of probiotics?
Probiotics can be used to benefit EVERYONE including individuals who consider themselves to be healthy since they assist in retaining health and well being and prevent health complications in the future. Probiotics represent a relatively simple and inexpensive method of alleviating diarrhea, urogenital infections, and other gastrointestinal side effects as a result of malnutrition, HIV/AIDS, and the uptake of highly active antiretroviral therapy. Certain strains of probiotics have also been shown to reduce bacterial vaginosis, a condition that predisposes women to HIV/AIDS and other sexually transmitted diseases. The FAO/WHO have indicated that “efforts must be made to make probiotic products more widely available, especially for relief work and populations at high risk of morbidity and mortality.”

Why is yoghurt used?
Note: In Tanzania and the U.K this is the way they spell “yoghurt” so for consistency I will likely be using this spelling from now on.

            Yoghurt is the perfect delivery medium for probiotics. Travelling through the digestive tract can be a challenge for bacteria. High acid levels in the stomach and exposure to pancreatic secretions can lead to the death of many orally administered probiotics. Consumption of probiotics with dairy products, buffers stomach acid and can increase the chance the bacteria will survive into the intestine. Yoghurt containing probiotics makes a healthy “functional food package.” Probiotic yoghurt contains high quality protein and an appropriate amount of carbohydrates, and fats which will help with increasing the weight of women, children, people living with AIDS (PLWA) and those who consume yoghurt (preventing wasting disease).

Additional benefits of the project: This project recognizes the interaction between income and health. The yoghurt production will empower women through income generation and skills development, and will increase consumption of nutritious protein sources locally, and thereby help people living with HIV/AIDS including children. The yoghurt mamas have grown to contribute to the health of their communities, draw an income for their families, stimulate significant economic development and to become a hub of social support within their communities.


I am extremely excited about this wonderful opportunity! I have heard so many great things from past interns and the amazing things they have accomplished in Africa. I have always been interested in how people live in other parts of the world, but I have been informed that nothing prepares you for your first visit to a developing country like Africa. I am a little nervous as I have never been away from home for this long or been anywhere that has required any major cultural adjustments. However, having spoken with many people who have who have made this trip before me, I have a difficult time thinking I won’t come back in some way changed. As a personal goal I want to try and fully immerse myself into the Tanzanian culture as much as possible by learning/speaking Kiswahili, eating/cooking the way they do, and wearing some of the local African clothing.
Now, a flight to Amsterdam, followed by Nairobi, and finally to Mwanza is all the stands between me and this exciting journey!

Stay tuned for my first update from Mwanza!



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