Namibia, HIV, and Social Work: One Alumna’s Journey

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An Interview with Heather Ross, Wheelock Alumni 2004, Masters of Social Work

A background of Namibia:

“Namibia is located in southwestern Africa and its name actually means ‘the land of no people.’  While being a large country, it is sparsely populated, having only about

Sunsets are never boring in Namibia. Windhoek, the Capital.
Sunsets are never boring in Namibia. Windhoek, the Capital.

2 million people.  It only gained its Independence in 1990 freeing itself from the ruling of South African apartheid.  It is a stable country with great diversity in ethnicity and landscape.  It is appropriately nicknamed ‘The land of contrasting beauty,’ with some areas covered in vast deserts while other areas experience semi-tropical climate, and extremely rural areas existing alongside a thriving city with amazing infrastructure.  A major disparity is the drastic income and resource inequality.  Namibia’s women and children have been disproportionately affected by HIV, and Namibia has been one of the countries hit hardest by the virus. While incredible interventions and advances have been made around HIV since 2004 with the introduction of Antiretroviral medications drastically reducing the mother to child transmission of HIV, its prevalence and impact remain extremely high.

While mother to children transmission is low, there still is a growing generation of orphans from the time before ARVs were introduced.  Families often still struggle with understanding the ability to live well with HIV.  Or they don’t know how to disclose, fear doing so, and/or are not getting adequate support to assist.  Thus, they often avoid it and in many cases tell the children that they are taking their medications for another reason (like tuberculosis).  When kids come of age, they often stop taking their ARVs due to lack of knowledge, resentment, and/or fear.  Namibia estimates that there are 10,000 children under the age of 14 living with HIV and many of them are not yet aware of their status and/or struggle with ARV adherence.  Furthermore, about 45,000 children under 17 have been orphaned due to AIDS.  While there is the ability to live with HIV, too many adults and youth are still dying to advanced disease and/or suicide.

Namibia is home to one of the world's largest cheetah populations.
Namibia is home to one of the world’s largest cheetah populations.

Independent of HIV, the psycho-social aspects of children and families are often intertwined and complex.  The power of stigma is still huge and remains a significant barrier to care and services.  Families affected by HIV are often more susceptible to abuse/neglect and those victims of violence and abuse are more likely to become infected with HIV.  Some supportive services are there, but very few target adolescence living with HIV.  Further service roles are often limited and isolation from one another minimize their collective impact. While social workers are found to play key roles with HIV supportive services in the US, I have found it is far from the case internationally.  The doctors, nurses, and trained community members have been at the heart of training and intervention services with social workers being overlooked and underutilized in the field of HIV internationally.  As the barriers to care are often psycho-socially related, I see the roles of social workers to be the missing link.

What was your journey to Namibia and what is your current work there?

“I first came to Namibia in 1996-1999 serving three years in the Peace Corps (education and youth development sectors).  Here I fell in love with working with an invisible community – the street children (or those at risk of becoming).  Upon returning to the US, Wheelock College’s Masters of Social Work Program stood out to me with their focus on children and families as well as the focus on social injustice.  During my first internship at Wheelock College, I worked with recently resettled refugees and some of them were living with HIV.  Their struggles were real and it inspired me to devote my second year internship at an HIV clinic in Rhode Island.  That one year turned into almost ten years working with the state’s largest HIV provider.  I learned so much from patients, their loved ones, and systems big and small.  Yes, as the medical community often describes it, HIV is a manageable chronic disease similar to diabetes.  Psychologically, emotionally, and socially it remains a felt death sentence – with so many suffering in silence.  Both at home and around the world, people are silently walking around us living with HIV.  It is well researched how those with stronger support systems have better overall health outcomes.  Each loss/hardship offered me inspiration to explore ways to improve services within and between services via collaborative approaches.  Increasingly social work played a stronger role at the individual, family, and systems’ lev

Janet Ananias, Head of Department of Social Work at the University of Namibia and Heather Ross co-facilitating workshops to HIV support group members on basic counseling skills.
Janet Ananias, Head of Department of Social Work at the University of Namibia and Heather Ross co-facilitating workshops to HIV support group members on basic counseling skills.

el. Case after case, we turned the dying into living.  Over the years, we created a model of proactive care for those living with HIV with collaborative, systematic approaches.

I then wanted to return to Namibia where much of the country lives in resource poor areas.  Over the past two years, I have been working with the University of Namibia (Social Work Department) and various NGOs to work at the grassroots level with HIV support groups and local staff to understand their issues, their strengths, their limitations, and the communities’ unmet needs.  There are so many amazing people doing great work with passion, but time and time again, individuals and organizations are working in isolation from one another, which results in significant gaps in care/services.  I develop trainings for volunteers and staff at the community level to enhance their knowledge and skills.  At the regional level I work with social workers to explore their knowledge, their abilities, and their limitations around serving those with HIV. I work to expand their capacity while assisting with strengthening collaborations.  I also am involved in work at the national level to streamline and strengthen the capacity of government social workers with the creation of national processes for case management.  As a shared burden is easier for all, a primary goal is to strengthen collaborative partnerships to promote early identification of issues along with a responsive, more proactive and integrative care/service response.”

What does the mission “to improve the lives of children and families” mean to you?

“In Namibia there is still a vast communal culture, which follows the concept of Ubuntu: ‘means I am because we are.’  There are so many amazing strengths that foster resilience in the traditional culture and ways of caring for one another and safeguarding each other’s families/children.  While the children and families have cultures and practices different from my own, it is an honor to get to know the various communities, learn their strengths, and learn and work towards what might work for them.  It is not for me to come in to know and tell them what might work for them.”

Heather's daughter Kahilu standing on top of the tallest sand dunes in the world, which also touch down to the Atlantic Ocean.
Heather’s daughter Kahilu standing on top of the tallest sand dunes in the world, which also touch down to the Atlantic Ocean.

How did Wheelock help prepare you for the work that you are doing?

“As I lived in Rhode Island throughout my Wheelock internship and the distance to campus was sometimes a trek, it was refreshing to know and have the support of staff to be able to create my own internships (Working with Refugees and HIV) and even an elective in International HIV.   The staff was nothing but supportive in allowing me to explore my ideas, foster strategic planning, and offer support in allowing me to explore my passion.”

 

What advice do you have for current or prospective Wheelock students?

“To see what you cannot see.  There is not always one right and one wrong.  A dice has 6 sides and one can even find 12- and 20-sided die.  Professor Patricia Hogan described herself as a liberal democrat and her husband as a conservative republican.  She tried to maintain an open mind with routinely reading his newspapers and exposing herself to his news/viewpoints.  Her reasoning was that if one ever wants to be able to make headway with others who think differently, one needs to know and respect exactly what they are thinking. These words impacted me then

and even now both in working at home and internationally.  You can see more by expanding your perspective as well as with respectful engagement; one can invite someone else to see that it also can be otherwise.”

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