Sex Workers, Injecting Drug Users, and District Hospitals…

(My DQA counterparts from USAID and PAC)

My life continues to be intoxicating. This past month has been exceptionally exciting, with flash floods, typhoons, and coastal ‘hot spots’; followed by Hillary Clinton’s historic visit to Hanoi.

(Scene captured around Hanoi during the floods of July 13, 2010 – Photo: Craig Mackintosh)

As part of my job, I’m now conducting monthly Data Quality Assessment/Quality Improvement site visits. As such, I went to Nghe An Province in the North Central coast of Vietnam to look at several of our FHI-funded projects, including their prevention programs focusing on Female Sex Workers (FSW) , Injecting Drug Users (IDU) and Voluntary Counseling and Testing (VCT); and their Care and Treatment facilities providing Antiretroviral Therapy (ARV) and Community Home Based Care/Orphans and Vulnerable Children services.

Secretary Clinton Prepares To Sign the U.S.-Vietnam PEPFAR Partnership Framework
(Hillary Clinton signing PEPFAR’s Partnership Framework)

I must say that I am truly happiest when I’m in the field seeing first hand how our HIV program is operationalized. This particular province was more rural, and definitely poorer than what I’ve experienced up to now. Ironically, I felt more at home here than anywhere else in Vietnam (hmm…not sure what that says about me).

Amy & Nemat @ Press Club
(Amy & Nemat @ Press Club)

Regardless, everyone I met was incredibly down-to-earth and friendly – from the managers of the Provincial AIDS Committee (PAC), to the peer/health educators, to the doctors and nurses at Dien Chau District Hospital. In fact, they insisted that we be their guests at every meal! Yet, when dining in a rural province, one never knows what to expect – oh wait, except for large quantities of alcohol!

(Cultivating shells on the beach)

I’m simply blown away by the sheer volume of alcohol that is consumed. Lunch includes a steady stream of free-flowing beer; and they ante up for dinner, with endless shots of locally brewed rice wine (similar to grain alcohol). I became somewhat concerned when the heaviest drinker in the group turned out to be our driver!

(District Hospital)

And despite Vietnamese food, in general, being delicious, for some reason it borders the grotesque when in the field. A steady stream of snails, tripe, frogs, clams, eels, small fish (eaten head, tail and all), and other unrecognizable animals were placed before me. I was thrilled when I saw a huge platter of chicken, yet my excitement immediately turned to dismay when I discovered that it was boiled chicken – tough, rubbery, and flavorless! Needless to say, I ended up drinking more than eating…

(Staff at Vinh’s Women’s Health Center)

Despite my culinary disasters, the highlight of my trip was hanging out at the local ‘hot spots’, or in this particular instance, brothels, to observe peer educators teach female sex workers how to use a condom. Prostitution is illegal in Vietnam – as such, I didn’t take any photos of the girls…, which is exactly what they were! Bright-eyed, innocent teenagers! So young! It saddened me to no end to think that these beautiful kids have to resort to prostitution for survival.

(Vendor on the beach)

Interestingly, sex workers consistently complained about the quality and quantity of the condoms that we were distributing. First, peer educators only distribute six condoms per sex worker per month! That’s how many clients they see in a day! Second, they expressed their dissatisfaction with the quality of the condoms, stating that they were too thin and that they break too easily! Even if there is no validity to their claim, this perception can greatly impact their behavior. Ultimately, there’s a fine balance between offering free condoms vs. social marketing, in which we empower women to purchase condoms to protect themselves.

(Glass-blowing factory in Hanoi)

By in large, it was a fabulous trip to the field. Each outing reveals both data quality concerns as well as systemic issues that need to be addressed!

(Not the most impressive beach, but the coastline nonetheless)

On another note, I’m heading back to Africa next week! I’m presenting at a conference in Cape Town, South Africa, followed by a brief return trip to Malawi. I’m looking forward to getting back to my African roots, running the HASH, dining at Blue Ginger, and seeing all my old friends in Lilongwe.

Much love,

1 comment to Sex Workers, Injecting Drug Users, and District Hospitals…

  • Enjoy your trip to Cape Town and the return trip to Malawi! We will be arriving in Malawi on Thursday to begin our 3 year posting. I watched the new post video we got from the overseas briefing center (we are state department) yesterday and saw number of your pictures in the presentation, some of them I recognized from your blog. I found your blog ages ago, when we first talked about going to Malawi and now we are going there ourselves. Maybe I will see you around Lilongwe on your brief reunion tour. Safe travels!

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