A Peer Education Pyramid

Maddie DiLorenzo, undergraduate at Brown University, is here in Mali undertaking quite an impressive and innovative peer education project to spread education about HIV/AIDS in this country where misinformation and misconceptions about the disease persist. I had the privilege of being a guest at one of her three-hour training sessions last week, and I truly believe that her program could and should become a model for HIV peer education across the entire African continent. Check it out and let me know what you think.

Here is her description of the program and an update on its recent implementation.


Projet "Hêré Bolo"

This summer, the GAIA Vaccine Foundation will pilot its first HIV peer education program, "Le Main de l'Espoir," at a clinic in Sikoro, Mali. "Le Main de l'Espoir" (which translates to "Hand of Hope" in English and "Here Bolo" in Bambera) will teach Malians about HIV prevention and treatment by using a mnemonic that is easy to remember and easy to teach.

The program will be five days long, and each day will correspond to one finger of the hand to emphasize a point about HIV - hope (the thumb), identity (index finger), transmission (middle finger), marriage, fidelity and family (ring finger) and the community (both hands together).

At the end of the five day program, all participants will have the necessary knowledge about HIV prevention and treatment to allow them to become peer educators and will receive a tee shirt that identifies them as HIV peer educators in the community. It will then be their responsibility to bring "Le Main de l'Espoir" to other Malians living in Bamako and Sikoro, and teach them the mnemonic so that more people can become peer educators. In this way, GAIA's program will put HIV prevention and treatment directly in the hands of the Malian people, and give them the power to carry out their own public health intervention.


July 17 Hêré Bolo Update

This week, Here Bolo kicked off its first week of peer education training. Due to the overwhelming interest in the program, the program was expanded to include 20 peer educators - 13 men and seven women, rather than ten. Training took place over three days from Tuesday to Thursday, and was conducted by Dr. Malick Kone, Ramatoulaye, and Maddie DiLorenzo.

Maddie administered a pre-assessment survey on Tuesday and a post-assessment evaluation on Thursday in order to assess the peer educators' knowledge of HIV prevention and treatment. While Maddie has yet to fully analyze the data, she has briefly scanned all of the surveys, and found that the majority of the participants have a pretty good basic knowledge of HIV prevention and treatment both before and after training.

However, Maddie did notice that pre-training, participants still held some common misconceptions about HIV - such that one could tell if a person was HIV-positive by looking at them or that one could catch HIV by kissing someone.

The sessions were also characterized by a great deal of debate as men described their reluctance to wear condoms and women described their reluctance to stop breastfeeding despite their knowledge of the benefits of these practices. Therefore, the peer educators' mission will be to not only educate others, but to address the gap between HIV knowledge and preventive practices in Sikoro.

Perhaps the best part of the program has been the peer educators' enthusiasm for their work - each day's session ran at least 45 minutes over time as the peer educators asked questions and began practicing for the upcoming Balonie de l'Espoir, which will take place in Sikoro on Saturday, July 29. The Balonie is a celebration dedicated to educating the Sikoro public about HIV prevention and treatment practices, and will feature all peer educators performing skits that illustrate the five points of the Here Bolo program: hope, identity, transmission, marriage and family, and community.

Dr. Malick Kone, Ramatoulaye and Maddie will dedicate the next two weeks to planning this event. Beginning on August 1, they will begin tracking each peer educator's progress as they begin to educate others in various parts of Sikoro.

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What an inspiring and entrepreneurial approach to public health!