by Mike Rogoff
The 5th Regional Training Workshop on HIV/AIDS Education in the Middle East
carries a long name but a short premise: The world AIDS epidemic knows no
political borders, and neighbors need to fight it together. The medical
search for a cure is critical of course, but awareness of HIV/AIDS and of
how to prevent infection is the other side of the battlefield. Health
professionals from Israel and the Palestinian Authority, from Jordan, Egypt
and Turkey gathered for five days in early October 1998 at Tantur Ecumenical
Institute, between Jerusalem and Bethlehem, to learn how to teach. Youth is
the target. If the new generation can be taught to be aware and take
precautions, then the rate of HIV infection could be slowed down, and the
worst pandemic of modern times might be contained.
The idea of these workshops was the brainchild of Inon Schenker, a graduate
of the Hebrew University - Hadassah Braun School of Public Health and
Community Medicine, Jerusalem, Israel, and founder and director of JAIP, the
Jerusalem AIDS Project. Back in the mid-1980s, Schenker the student was
voluntarily teaching health education to 6th-graders. Questions came up
about a new disease with a bad reputation; but since (at the time) it seemed
only to affect people with "deviant" life-styles, the Establishment was
neither worried nor interested. Schenker worked away at official
indifference, emphasizing the "health education" context of HIV/AIDS
awareness, rather than the "sex" context with which popular opinion had
stigmatized it. With time, he developed an AIDS education program for
Israeli schools, regarded today as one of the most advanced in the world.
El Salvador was the first foreign country to adopt and adapt the JAIP
program for its own schools, sending health professionals to be trained in
Israel, and bringing JAIP people to run workshops in El Salvador itself. The
collaboration was wildly successful, and other countries in Central and
Latin America followed suit. The success of the JAIP program brought it -
and Israeli involvement in the field - to the front-line of the
international campaign against HIV/AIDS. Enter MASHAV. Israel already had an
excellent reputation for reach-out programs in developing countries, but
this was new territory. Through the good offices of MASHAV, Israeli health
professionals became, in essence, partners with countries like the U.S. in
combating the rapidly spreading world-wide epidemic. "Without MASHAV," says
Schenker with no hesitation, "the JAIP program would never have worked
internationally." International funding was provided, JAIP's HIV/AIDS
education materials were translated into several languages, following
cultural adaptations workshops were organized by the Israelis to train local
AIDS educators, and by now over one million youth in 27 countries of Latin
America, Asia, Africa and Eastern Europe have been exposed to the JAIP
program.
Not content with their success beyond the seas, Schenker and his colleagues
turned to their own neighborhood. True, the incidence of HIV/AIDS in the
Middle East was among the lowest in the world, due for the most part to the
conservative social norms of its deeply traditional societies. But even in
that region, the number of cases - much under-reported, experts agree - was
growing; and ironically, it was exactly the greater openness and mobility of
the region at a time of peace initiatives that threatened to increase the
spread of the virus. The region, certainly at official levels, was simply
not addressing the problem, despite the fact that by the early 1990s it was
widely known that AIDS was not just a "taboo" disease associated with
certain "scorned" elements of society, but could be spread through blood
transfusions and heterosexual activity as well as by intravenous drug users
sharing needles and homosexual activity. A new initiative was called for,
one in which Israeli health professionals could collaborate with their
Palestinian counterparts, and ultimately with colleagues further afield,
independent of government involvement.
Thus was born the idea of a regional training workshop on HIV/AIDS
education, above politics, purely a matter of professionals of neighboring
(and not always friendly) nations coming together over a critical matter of
common concern. The only agenda was saving lives, and the workshop's one aim
was to graduate AIDS educators with a commitment to invest time and effort
in their respective communities. The first workshop took place in July 1995
at Tantur, organized by the Jerusalem AIDS Project, but enjoying the
patronage of the governments of Israel, the U.S. and Canada, MASHAV, and
international bodies such as the WHO, UNAIDS, UNDP and UNICEF. A condition
for participation was to actually stay at Tantur for the duration of the
workshop, so that the 62 participants could "connect" with each other and
cultivate relationships outside of the study and training sessions. The
results were encouraging, and the most common response of the graduates was
that another workshop should be organized soon, so that they would "not be
alone out there in the field."
As fortune would have it, Jerusalem was the venue just a few months later
for the 9th International Conference on AIDS Education, a golden opportunity
for the fresh graduates of the 1st Workshop to hear and meet world leaders
in the field. The 2nd Workshop was timed close to the Conference, and a
marvelous snowball effect had begun! The feedback from participants in the
first two workshops helped refine the educational model - "The Immune System
Approach to AIDS Education" (ISYAP) - and the materials. Joint teams of
highly motivated Israeli and Palestinian educators were beginning to conduct
classes in Israeli towns on the one hand, and in the West Bank and the Gaza
Strip on the other, often in religiously very conservative communities. With
time, this effort jelled into the Middle East Regional Network on AIDS,
currently coordinated by Salam El-Issa, a lecturer in nursing at Bethlehem
University, and herself a graduate of the 1st Workshop: "We teach not only
the medical aspect of HIV/AIDS, but how to tackle the subject and how to
talk about it. In our [Arab] community, people avoid talking about the
subject at all. The JAIP workshop changed my attitude to AIDS and AIDS
patients."
Even more remarkable than the local collaboration was the formation of a
joint "Middle East Mission" (MEM) of Israeli and Arab delegates to the
international conferences on HIV/AIDS in Vancouver, Canada in 1996, and in
Geneva, Switzerland in 1998. While MEM delegates came away enriched by the
discussions at the conferences, what they left behind was the indelible
impression of health professionals from sometimes-hostile neighboring
communities dedicated to collaborating in the war against HIV/AIDS.
The 5th Workshop broke new ground, widening the appeal (five Egyptian and
two New Zealand government health professionals were among the
participants), bringing onto the faculty graduates of previous workshops and
enriching the program with the lessons and field experience of those who had
gone before. The formal program was three-pronged: Lectures were at the
highest professional level, and related not only to medical updates on
HIV/AIDS, but to social and ethical questions as well; workshops challenged
the participants to explore ways of using the ISYAP Model effectively; and
small group projects encouraged participants to focus on some aspect of the
subject, and then present their findings to the whole workshop. Some took to
costumed role-playing, while one group hit the streets of Jerusalem to check
how taxi-drivers and hotel staff reacted to the idea of an AIDS-sick guest
(negatively!). The satisfaction and enthusiasm of the graduates was
clear; and, judging by previous workshops, the impact they will have on
their home communities regarding HIV/AIDS awareness will be predictably
powerful. The Jerusalem AIDS Project and Workshop Director Inon Schenker:
"What is happening is a truly major social change. And it's not us, it's the
graduates, it's the fact that we're doing this together!"