Change Agent: The Man Behind HIV's Demise

Diminutive at first glance, larger than life after a few moments, ba Komba Cisala is a dedicated man.  Successful in his farming pursuits, an innovative foreteller, and humble father, ba Komba is also dedicated to working in the community, working with the community to reduce the prevalence of HIV/AIDS to zero.


Far from the assigned project, but close to my heart, community health is something I was hopeful to partake in upon applying to serve in the Peace Corps.  It was a blessing to come to work with ba Komba in the antenatal clinic located at Kabongo Rural Health Center sixty kilometers south of the city of Samfya. We teach about pregnancy, its warning signs, labor symptoms, the importance of diet and exclusive breastfeeding; we teach about malaria, and we teach about HIV. The program's main goal: Prevention of Mother to Child Transmission.


For years ba Komba has been a fixture in the antenatal clinic.  He engages in community mobilization, he leads clinic discussions, conducts pre-test and post-test HIV counseling, and performs finger sticks.  Among an infinite amount of other non-visible tasks, ba Komba is a testament to dedication.  What he lacks, not from stupidity, simply for a lack of resources, is how to encourage mothers and fathers who enter the clinic to speak with one another.  He mostly talks at his clients, information pouring out from a squeezed sponge, bouncing off a barrier which is intended to help the recipient.  This is not a deficiency in ba Komba, simply the system he works in.


I was anxious to understand what I could offer this man, this clinic, and the mothers, fathers, and unborn children who are the future of Zambia.  It certainly was not going to be knowledge I would impart.  Promptness is a serious matter in his clinic, contrary to popular practice here in Zambia, intolerable, and not an idea I could bring to the table.  The most constructive tool I had became useful during the first few sessions of observing, chiming in only when requested.  I am not talking about enthusiasm on ba Komba's part, but truly creating an environment of support and dialog between us, the knowledge holders, and our clients.  The people of our community lack not intelligence, but access to information, the courage to converse with people perceived 'higher' or better than them.


Ba Komba understands the importance of this dynamic.  We would ask questions and hear only crickets, rather, mice chasing through the undulations in the tin roof above our heads, in response.  "Ba Komba," I once stated, "We have to encourage our clients to engage us.  Now we ask the question, answer the question, then demand understanding."  His enthusiasm towards this concept was not one of an incredible idea flashing through his brain for the first time, for he said, "Yes, yes, yes," while shaking his head up and down so vigorously the rest of his body followed suit - I nearly had to stop him otherwise I thought he would shake his immaculate white and straight teeth out of his mouth- but relief pouring out because an approach he had been looking for was about to become tangible.


We started slowly.  With often reminders to be the source of conversation, not the conversation, ba Komba started transforming.  Perhaps it was the way he delivered the question, maybe his inflection was off, but we often sat in silence as our clients, or community parents, avoided our eyes, gazed toward the ground, picked vigorously at their fingers.


It is impossible to know when epiphanies happen, especially when trying to be detected from a third party.  Likely, it was not even such an event.  I truly think it was encapsulated within, a seed in a vault not given an opportunity to become something beautiful, a gift to the ecosystem, sacrificing itself for the nutrient of everything it could come in contact with.  But for me, the flowering moment happened when we attended a Peace Corps sponsored event in Lusaka learning about Grass Roots Soccer (GRS), an interactive outreach program to teach youths about HIV/AIDS.  We recently completed the first of eleven practices.  Immediately after the interventions implementation, the very next antenatal clinic, the coaching skills of GRS seeped into our interaction with anticipating mothers and fathers.  We have been having fulfilling interaction between us facilitators and clients, and between clients ever since.


When I think about where I find inspiration, it is often in well authored books, from prominent social figures, in well publicized nature.  I never expected to find it in a rural clinic, set atop well swept and now barren orange Earth, where one monstrous tree growing out the front door provides more shade than all the trees combined in our community.  I never knew I would find a noble, dedicated, intelligent human being interested in serving his community, his family, his God, least himself, on a speck of planet that does not register on maps.  I have been looking in the wrong places all along.