From May 22- August 16, 2005, I had the pleasure of spending my summer conducting research under the auspices of CARE Rwanda in Cyangugu and Gitarama provinces.  In Cyangugu, the most remote province in Rwanda, I undertook an assessment of volunteer contributions to COMBAR-AIDS’ HIV/AIDS interventions.  In Gitarama, I focused on the efforts of Nkundabana- “lovers of children” in the local language, who act as mentors to the large population of child-headed households in the province.  They work with both COMBAR-AIDS and a project called NIPS, or Nkundabana Initiative for Psychosocial Support. COMBAR-AIDS stands for “Community Based Response to HIV/AIDS.” 

COMBAR AIDS’ approach is far-reaching, mobilizing and collaborating with numerous community, governmental, and donor partners and focusing on such areas as preventing mother-to-child transmission, increased voluntary counseling and testing utilization, home based care for people living with HIV/AIDS (PLWHA), treatment literacy and support for anti-retroviral  adherence, prevention through abstinence and faithfulness, orphans and vulnerable children (OVCY) and other vulnerable group support and development, reduction of stigma and discrimination, and savings and income generating schemes to increase individual health care purchasing power.  Volunteers are a key component of its community-based activities, contributing through tasks such as linking PLWHA to health centers, participating in social events with PLWHA, or identifying OVCY and other vulnerable individuals in the community.  They also provide important home-based care (HBC) through HBC kit distribution and training of PLWHA, their families and other community members in HBC skills.   Other volunteers under COMBAR-AIDS include traditional birth-attendants (TBAs), or respected women from the community who act as midwives and mentors to pregnant women in the community, educating them on pre-natal and post-natal needs, family planning and HIV/AIDS issues, and referring them to health centers.  Community volunteers, TBAs, and Nkundabanas are not remunerated monetarily for their work.

My research objectives were to assess the contribution of community volunteers through 1) process monitoring of volunteer recruitment, training, workload and incentives, 2) process monitoring of actual services provided and the perceived quality of these services, and 3) understanding the impact of volunteers’ activities on their lives, their motivations, and their perceived accomplishments and challenges.  I accomplished this through a mix of quantitative methods via a survey administered to volunteers only and qualitative methods via 12 focus group discussions with volunteers, their clients and family members in the case of PLWHA.

Challenges abounded, primarily regarding language and logistics.  All activities were carried out in the local language- Kinyarwanda.  Therefore all research instruments had to be translated and I relied completely on local CARE project staff to carry out all research.  Most had no prior experience and learned a great deal during the research period.  I worked entirely in French with the staff.  Logistics are always a challenge in Africa, especially in rural areas.  Less information was obtained then originally planned due to logistics/resource constraints.

My summer practicum provided a true grassroots research experience, allowing me to experience the challenges that HIV/AIDS presents in Rwanda, the ins and outs of working with an NGO in the field, as well as applying all research methods I learned in my first year at Rollins.  Many thanks go to the GFE Student Fund, CARE Cyangugu and Gitarama staff, and Dr. Aliou Ayaba of CDC Rwanda.

Awards made possible by: The Eugene J. Gangarosa Fund,
The Anne E. and William A. Foege Global Health Fund,
and The O.C. Hubert Charitable Trust.