And in those five years, we have made some incredible strides, taken some risks, and as a result have sustained the lives of more than 20,000 of our beneficiaries, caregivers and siblings.

We began the AIDS Initiative because of an increasing awareness of the impact of HIV and AIDS, specifically in Africa. The virus had already done plenty of damage, and as our programs in Africa grew stronger, we were ready to embark on a new challenge — one that would have an enduring impact, give hope and save countless lives.

As Christians, we felt we had a mandate to do something more to impact the kingdom.

When we first began, the scientific community was still skeptical that Africans with AIDS could take the medicine that would keep them alive. While the sense of urgency was growing, commitments to fund the provision of antiretroviral therapy (ART) were not.

Aware of this tension, and the great need within our own programs, we sought the Lord and felt a confirmation that thrust the AIDS program ahead like never before.

We committed to the provision of the antiretroviral therapy before we really knew the extent of the impact. We just knew that we could not wait any longer, and by providing the highly sought-after ART for those with AIDS, we gave hope to those who prior to this, would not even think about getting tested.

Getting tested was risky, and finding out you were HIV-positive was pretty much suicide, because once that was known to others, a paralyzing stigma and discrimination flourished within communities and ART medicine was unlikely to be acquired.

But with your support we were able to do what few non-government organizations could. As a result, more and more children and their parents have been tested for HIV, as the hope of treatment and support gives them the confidence to do so.

For the first few years, we continued to provide the ART and other essentials, including nutritional support, medical care and testing as well as support for income generation. Our health workers made visiting HIV-positive children and caregivers part of their daily routine.

These were exciting days for the ministry, as we saw the impact of the decision to move this initiative forward. Lives were being sustained. Hope was being given. We went the last mile and that last mile was the difference between life and death.

In just the past few years, a blessing came to the international community. The commitment to providing ART through the Global Fund, PEPFAR (the President’s Emergency Fund for AIDS Relief), President Bush’s lasting legacy, and other multi-lateral organizations has changed the face of this pandemic.

Though the need is still great, and more than 33 million people worldwide are estimated to have HIV, the international commitment to the pandemic has been encouraging.

Following President Bush’s last term, his efforts to contribute to this fight through PEPFAR have been highly lauded. But despite all the commitments, the funds to continue the support are at risk due to the current global economic crisis. As a result, Compassion may once again be in the position of having to provide for ART.

But as Christians with a strong faith in the Lord, we know that if this day comes again, we will do what we did before, and step out in faith to meet the most critical needs of this vulnerable group.

In the meantime, we’ll continue to walk The Last Mile.

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In the global fight against AIDS, the international community has brought access to lifesaving antiretroviral therapy (ART) to many health facilities around the world, but not all. Those lifesaving tablets that travel 10,000 miles sometimes don’t make it far enough.

“Because a jar on a dusty shelf in the clinic must not be the goal of the journey. We cannot congratulate ourselves and call that jar “access”. The jar on the shelf is not “access” – it is merely inventory.

“The entire business is a bitter failure without the last mile. It is the last mile that has proven to be the most difficult. It is a mile beyond the government’s reach. It is the mile into the hurting world and broken heart of the 9-year-old orphan living in the slum.

“The jar of pills traveled ten thousand miles but it needed to travel ten thousand – and one.”

– Scott Todd, Senior Ministry Advisor at Compassion

With our AIDS Initiative, Compassion is bringing the global fight “The Last Mile,” beyond the clinic, down dusty roads, through garbage-infested slums, up hills and into valleys to our church partners and beyond to the homes of our families.

True access to care means going beyond the clinic to the families who are waiting for the hope that only this medicine can bring.

Without ART, lives would be lost and families wrecked.

Our work fills the void, closes the gap and goes the Last Mile … not only in ensuring true access to the ART, but in the holistic approach to HIV and AIDS.

Our health workers know our families well, and visit those who are HIV-positive often, finding out what they need and how they are doing.

Our workers deliver care and support through the church, with the hope of Jesus Christ, to each family.

When a child needs to go to the hospital for care or testing for blood counts, we are there, realizing that without the support to get to the health center or hospital, all of the technology in the world is useless.

The machines used to count white blood cells, the x-ray machines to look for suspicious masses and infections, the medicine to treat opportunistic infections, and the medicine to help keep those with AIDS alive … all would be rendered useless without our church partner’s health workers who work as advocates, educators, comforters and confidants to our families.

When a child needs additional nutritional support to stay strong, our workers are there. When a distraught parent needs someone to talk to about a diagnosis of HIV, our workers are there.

When a mud hut is crumbling because a family affected by HIV and AIDS has lost its livelihood, our church partners are there to help the family regain their dignity.

One mile is not far, but for those living in poverty, with little contact with the outside world, that last mile is the difference between life and death.

“The Last Mile takes counseling, home visits, facilitating transport, payment for clinical services, lab tests and medicines including antiretroviral drugs. It takes a willingness to go the distance. It takes perseverance.

“The Last Mile takes people filled with compassion, whose faith and hope come from a deeper spring than the world has ever known. People of uncommon strength to walk the slums. People strong enough to carry joy in the dark. People with their hands busy at the work of healing today’s hurts even as their eyes remain fixed on eternity.

“Where do we find such people? They are already gathered. They are crowded into little rooms in the slums, in the city centers, and even in the forests. They gather to sing praise to Jesus Christ, to pray for each other and for their hurting world. They are His people, His Church.

“The Last Mile takes followers of Jesus Christ doing ministry the way Jesus did it – holistically. It takes His Church.”

– Scott Todd

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Despite this impressive reduction in the spread of AIDS in Uganda (from 30 percent in the 1980s to 6.5 percent to date), AIDS is still infecting and killing many Ugandans. Uganda’s HIV prevalence rate has stagnated over the past four years, meaning that the country is not managing to reduce the number of new HIV infections.

Damalie Andabati, the health specialist in our Uganda Country Office, says,

“Currently 6.3 percent of Uganda’s population is infected with HIV, and a new issue that has been discovered by the Uganda Virus Research Institute is that 66 percent of the new infections are among married couples.”

The reason for the high percentage in this unexpected group is not yet certain.

It is feared that HIV prevalence in Uganda may be rising again. It has been suggested that antiretroviral drugs have changed the perception of AIDS from a death sentence to a treatable disease. This perception may have reduced the fear surrounding HIV.

As part of our holistic outcomes around health, voluntary counseling and testing (VCT) for HIV is part of the regular health screenings conducted for the parents and children at the child development centers.

Kansanga Child Development Center carried out a VCT session back in March and 233 caregivers and children were tested, which is one of the best success stories of beneficiaries being tested for HIV by Compassion Uganda.

Kansanga, a red-light district of Kampala, is a community in the slum areas, and the child development center is located one kilometer away. Much effort has been put in clearing this district of prostitution and raising awareness about preventing HIV. Many fear being seen going for the test or seeing the results they will receive from the test.

More than 60 percent of Uganda’s population is illiterate and ignorant, and others are even too poor to own radios from which they would hear information on where to go for testing. Our church partner staff, and government officials, are hopeful for the future — that with tireless effort in community training and sensitization this figure will be adjusted.

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• A man who watched his wife of 35 years die of AIDS-related causes.
• A man who has nine children, all born again.
• A man who has known his status for four years but hasn’t been deterred.
• A man who boldly stood in front of my camera when I wanted to respect his privacy but still get a photo of his humble and dilapidated dwelling.

This man with a gaunt face but beautiful eyes shook my hand strongly and with great confidence.

He shared with me his story, one that brought him from finding out his status to living and breathing today as a positive, incredibly inspiring story of someone who has decided to live his life with thanks, not fear.

When I asked John what he wanted others to know about HIV or being HIV positive, he said that everyone should be tested and that AIDS is still a killer disease. He said that if you test positive, you should not fear, for fear will only exacerbate the illness.

John is being helped by Compassion in many ways: by support of his multiple income-generating projects, which include selling used clothing and small foods as well as ironing others’ garments.

He is given other support as needed based on the child development center’s close communication with him. He seems to be a proud man, not ashamed of his circumstances, and very grateful for what the Church and Compassion are doing to help him.

Though we all come from different backgrounds and bring a wide spectrum of abilities to our work, we all comprise a body of Christ helping a man named John. A man that most of us will never meet but who many of us will be impacted by as we gain energy from his story.

John has two children in Compassion’s programs. Two boys who are benefiting both directly through our programs and indirectly because their father is getting much needed support through the AIDS Initiative.

How could these two boys succeed with an ailing father who doesn’t get the help that he needs? We are helping this man to live so that his sons may focus on their education and future pursuits. A win-win if you ask me.

So please be encouraged that the AIDS Initiative you work to support in a multitude of ways is working quite well and being carried out in the most unique ways with some of God’s most cherished children, those living with HIV and AIDS. Your support allows the AIDS Initiative to be integrated into our programs in Africa.

Thank you for having the patience that I find myself lacking at times; the lack of patience that is embarrassing to admit when standing face to face with those who are HIV positive and have more than I will ever have.

I felt terribly honored to be in that small stuffy room with John, learning about his faith and his life. I felt that I was truly standing on sacred ground.

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And since Monday was World AIDS Day, and Amber and Becky wrote about the AIDS Initiative, I felt compelled to jump in too.

Take a look to see how we’re fighting the AIDS pandemic, one child and one family at a time.

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Sorry I haven’t contributed much lately. I’m still here and still handling crisis communications, in case you were wondering. There is something that has been on my mind that I feel compelled to share with you.

I’m gonna step outside my comfort zone for a minute to share this with you. I have Rheumatoid Arthritis. I was diagnosed with it when I was 15, so I’ve had it for half my life, but you’d probably never know it if you met me. I don’t talk about it much. Most people I interact with on a regular basis don’t even know. In the past 10 years the medical research and pharmaceutical industries have come a long way in treating the disease, and this has allowed me to live to a virtually pain-free, symptom-free life.

But here’s the thing. I have a normal life simply because I happen to have been born in the United States. I have access to powerful drugs. I have insurance to cover the (outrageously high) cost of them. Certainly I am grateful for this, but lately I’ve been thinking about what my life would be like if I were born into poverty in a developing country. What if I was from rural Rwanda? Or a slum in the Philippines? Or a poor community in Nicaragua?

I’d more than likely be totally crippled by now. At 30 years old.

This thought really freaks me out, to be honest with you. I cannot imagine what it would be like to not be able to stand up straight, to walk, or to grip things. To live in constant, life-altering pain. I feel guilty for being happy I was born here. I don’t have to try to live with this disease without the help of drugs. I am not crippled. I assume it’s similar in a way to the guilt a person feels when they survive a car accident where the other passengers died . . . the ugly injustice of it. I understand that God’s ways are higher than our ways, but I struggle to understand why He chooses for some — why He chose ME — to be born into affluence and why He chooses some to be born into poverty. It’s not fair.

Nowhere is this injustice more evident than in the fight against HIV and AIDS. December 1 was World AIDS Day, and Brianne told you about our AIDS Initiative. The amazing thing about this program is that it literally restores justice to an unjust world. Without access to antiretroviral drugs, those battling AIDS in poverty-stricken countries fight an unwinnable war. By providing the antiretroviral therapy, Compassion allows children with death sentences another chance at life. A chance that, had they been born here, they would have had simply by virtue of their nationality.

If anyone is in the position to get this, it’s Godfrey. He understands that he is alive today because Compassion is fighting the injustice of HIV and AIDS in Uganda. His life is his testimony.

Compassion’s AIDS Initiative is more than just drugs. It’s nutritional support. It’s the critical laboratory testing. It’s psychosocial support. It’s treatment of opportunistic infections. It’s transportation assistance. It’s income generation. It’s housing repair. It’s all the opportunities that a person suffering from HIV here in the U.S. would have.

The AIDS Initiative essentially levels the playing field to give every victim of HIV — no matter where they were born — an equal chance to survive this devastating disease.

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When Aline in Burkina Faso (not her real name) was first found to be HIV positive, the other children in the family would inch away when she came near. 

Now that Deede in Ghana has found out she is HIV positive, she’s afraid that if anyone else finds out they’ll stop buying her doughnuts, her only way of making a living. 

When neighbors in Ethiopia found out that 15-year-old Tigist was living with HIV, they told the family to stay away from them and not touch anything of theirs.

Tigist didn’t tell her friends she’s HIV positive; she couldn’t handle their rejection. But they have already started to whisper. She decided to drop out of school. 

One of the huge challenges facing people living with HIV around the world is not only the physical illness, but the overwhelming stigmatization and discrimination that exists in many countries.

People living with HIV are often shunned, disowned, feared, and thrown out. Many people who suspect they might be infected don’t go for an HIV test. They’re too afraid neighbors will see them on the way to the clinic and too afraid of what they might find out. 

Many people who are found to be HIV positive are too afraid to speak out and advocate for others living with HIV. They don’t know what will happen to them.

One mother who is assisted by Compassion says, “I wish I could talk openly to people to try and know their status, but I do not have the courage yet. Maybe I will one day.” 

Beneficiaries of the AIDS Initiative aren’t always comfortable sharing their stories. One mother recently asked that her son’s name not be used for fear that if the sponsor found out her son was HIV positive, he would cancel the sponsorship. Others don’t want their pictures shown for fear that someone in their country might see it. 

This is one reason that sometimes, as with Aline, we change the names of the people whose stories we tell. It’s also why we never reveal the location of beneficiaries of the AIDS Initiative beyond the country they live in. 

Compassion-assisted churches are working to end the stigma and discrimination. Advocacy events and classes to educate about HIV are held at child development centers, and damaging myths about the life-threatening illness are dispelled.

HIV-positive parents are becoming brave and starting support groups and even businesses together. Many governments worldwide are working to raise awareness of HIV and offering free testing and antiretroviral therapy. Attitudes are slowly beginning to change. People are voluntarily being tested. Children and parents are getting the treatment they need, and slowly parents are speaking up to support others who are living with HIV. 

Tigist decided staying at home wasn’t a good option. After receiving counsel and encouragement from her project, Tigist has enrolled in a new school in her area. She dreams of being a pediatrician, to help other children who are sick. 

Photo by Elizabeth Karanja, Compassion Kenya field communication specialist

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And like many other aspects of poverty, HIV and AIDS have the ability to take a frightening toll on children.

Today is World AIDS Day, and I’m taking it as an opportunity to let you know how committed we are to fighting the disease.

It begins with our AIDS Initiative program, which is working on a grassroots level through the local church to take on the AIDS pandemic, one child at a time.

Ok, pause.

AIDS Initiative, pandemic, poverty . . . I don’t like throwing around these words. It is easy to just roll over the keyboard and punch out the words. But can you imagine? I mean really, can you even imagine what it is like to be infected with HIV or affected by AIDS?

To better understand the effect HIV and AIDS have on people, particularly people in the developing world, and to get a better glimpse into what the Lord is doing through Compassion, I think we need to unpack a few details. I hope your mind is engaged and your heart is prepared because I am about to give you just that.

Now, as I was saying, our AIDS Initiative works to aid one child at a time. For example, this child:

One morning, 13-year-old Meskerem, a Compassion-sponsored girl in Ethiopia, woke up complaining of fatigue. The top student with a winning smile and personality said, “I thought I was coming down with a cold and that it would just go away.” But a few days later, Meskerem found herself in the ICU ward of the local hospital.

The doctors suspected that the girl’s persistent cough was the result of tuberculosis, brought on by the kind of compromised immune system that HIV infection causes. A subsequent test, given at the permission of her mother, Aberash, revealed the truth: Meskerem had HIV.

After the shocking diagnosis, the doctors scrambled to save Meskerem’s life, which was quickly slipping away. “It was hard to believe this brilliant, healthy girl could come so close to death in such a short period of time,” says Ato Cherent, her Compassion center’s health worker.

Ato stayed by Meskerem’s bedside day and night, praying for God’s help while the critically ill girl underwent transfusions and other procedures to bring her back from the brink.

When she was finally well enough to go home, her mother broke the news to Meskerem. Meskerem later explained, “I felt so sad when I heard about my condition,” she says. “But at the same time, I was glad I was still alive, and I believe Jesus was holding me by the hand when I came face to face with death.”

For the past two years, Meskerem has been taking antiretroviral therapy (ART) twice a day, every day. Her mother is also HIV-positive and on ART. But through all the hardship, the faith of mother and daughter is steadfast.

“God didn’t abandon us, and He will never do so,” says Aberash. “Compassion provides us with nutritional support, medical treatment and education for my daughter. God in His infinite mercy also gave my little girl a second chance. What more could I want?”

And there are hundreds more stories just like this. But if you want more concrete information to help understand the affect the AIDS Initiative is having in the developing world, I have that too.

• Over 2,700 HIV positive children in Africa are receiving support through the AIDS Initiative.
• 1,261 of these children are receiving antiretroviral treatment as well as many life-saving benefits through Compassion.
• Over 16,000 HIV positive caregivers and siblings of Compassion sponsored children are being supported through the Initiative.
• 43 percent of caregivers and siblings in Africa are also receiving antiretroviral treatment.

Ok, wait. What is antiretroviral treatment and how is Compassion’s provision of this treatment different from the approach other organizations take?

I asked Amy Metzger, our senior international health program specialist.

“Compassion’s support for HIV positive children and those living with AIDS is special because we meet the needs that are often unmet. While most governments are now providing ART, we realize that this alone is not enough.

We offer nutritional support, CD4 count testing, psychosocial support, treatment of opportunistic infections and transportation assistance, along with income generation support and housing repair when needed.

Health workers follow up with home visits to monitor a child’s home environment, the treatment progress and work to address any needs a child may have.

These are the critical components that keep the children alive. Our program is holistic and considers the full range of needs of those that are HIV positive and those affected by this pandemic.”

Wow! That sounds pretty comprehensive to me.

More importantly, even though many children in our care are not infected, their lives and well-being are jeopardized by HIV infections within their families and communities.

Therefore, our response to HIV and AIDS extends beyond prevention of new infections and treatment of the infected, to include care for those whose lives are indirectly affected by the pandemic.

Ok, I know that was a lot to take in. But can you believe, in the midst of such horrifying circumstances the kindness and provision of the Lord that is going forth? And He is using you to make the difference!

Help us spread awareness about our AIDS Initiative — please add this widget to your blog and social networking profiles.

While you’re at it, please make a donation to our AIDS Initiative program to help more children like Meskerem.

Special thanks to Tigist Gizachew, Compassion Ethiopia’s field communications specialist for the story and photos about Meskerem.

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While most people I spoke with have noticed an increase in food prices in their local markets, no one seemed too adversely affected by the trend. That was until I met four women, all beneficiaries of our AIDS Initiative.

I met these women at the child development center their children attend. When I first walked in and greeted the women, all of them looked away. They found it more comfortable to stare at the floor as we shook hands. This type of nonverbal communication is common for people living in abject poverty as they have been so marginalized by society that any sense of self-worth has long since left them.

After our introductions, the women sat quietly, softly responding to our questions and continuing to avoid eye contact. Slowly their body language changed, and they eventually started to make eye contact.

As they began to open up one woman asked that we turn on a TV to drown out our conversation for anyone within hearing distance beyond our small group. Each of the women then proceeded to share that they were infected with HIV/AIDS and feared being stigmatized if their friends found out. When asked about the increase in food prices, one woman told of being hospitalized and that her family was unable to afford food for her.

In many developing countries hospitals do not provide food. The only food patients receive is what their families bring them. For people living with HIV/AIDS, lack of food weakens their already-compromised health and often makes sticking to their antiretroviral drug therapy even more difficult.

So, is the Global Food Crisis truly global, and is it really a crisis?

Based on media reports, information provided by a number of Compassion’s field offices and my experience in Tanzania, the increase in food prices is global. Every country is affected in some way.

Yet the crisis is not global. The crisis is country and region specific for the most part — affecting only certain areas. Even in countries currently able to manage the increase in food prices, the slightest rise in cost is devastating to some families.

For the woman I met in Tanzania, the increased cost of food meant her children could feed themselves or they could feed their mother in her illness. That’s a burden no child should have to carry. Sadly, I fear this story is not unique.

The growing cost of food is forcing people living in poverty to decide who eats and who does not, assuming they are fortunate enough to be able to buy food at all.

What would you have done?

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Wednesday marks the second year that the Fox reality show takes a break from their regular programming to do something virtually unheard of on television these days — focus on something other than making money.

Idol Gives Back is an effort to raise awareness and funds for children in need around the world. Last year the event raised $76 million. This year they’re shooting for $100 million.

Whether or not Fox brings in the millions this week that they normally make on the show, the event probably does enough for their public image to make the monetary sacrifice well worth it.

Whatever their motivation, though, it’s refreshing to see the spotlight shining on those who truly need it but rarely get it — children in poverty.

Among the recipients are organizations like the Global Fund, Malaria No More, Children’s Health Fund, Children’s Defense Fund and Make It Right, Brad Pitt’s campaign to help New Orleans recover from Hurricane Katrina.

There will be celebrities. There will be music. There will be tears. Millions of viewers will undoubtedly be moved to donate. Some will likely be profoundly impacted by the stories they hear and the images they see. Hopefully many hearts will be softened towards the plight of children in poverty and people will do more than just give once … they will begin to get involved.

I’m just excited that for a couple hours this week, children in poverty will have a real voice. That’s really what Compassion is all about.

What do you think? Do you agree? Will you be watching?

While Compassion might not be featured on the show, we are working just as hard to fight for children in poverty. Here are a couple specific things you might like to know about:

Malaria: A Plague of the Poor
In recognition of World Malaria Day on April 25, Compassion has produced a new radio special.

AIDS
Compassion’s AIDS Initiative is focused on Africa. Yet HIV and AIDS are also significant threats to children outside of Africa and for that reason Compassion is also conducting HIV/AIDS work in non-African countries.

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