Tijuana, a city of 1.2 million people, is located amidst the busiest land border crossing in the world. Commerce, employment, migration and tourism bring a constant flow of millions back and forth across the border each year, and with the multitudes of people come a multitude of issues. One of the most serious issues is a growing HIV infection rate in the Tijuana border region that is estimated to be three times higher than Mexico's national average.
There a many factors contributing to the spread of AIDS in Tijuana, including a booming sex tourism industry – a business being fueled affordable prostitution rates and Americans willing to pay good money for services and will pay more if not required to wear a condom.
A study published last year by researchers at the University of California, San Diego School of Medicine indicated that the rate of HIV/AIDS infections in Tijuana, Mexico are increasing and numbers are much higher than had been previously estimated.
According to the study, the number of men and women aged 15 to 49 years who are infected with HIV may be as high as one in 125 persons – a dramatic increase from 20 years ago. In turn, infection rates on the San Diego County side of the border are spiking as well.
San Diego County currently ranks third highest in the state of California for HIV infections, trailing only behind Los Angeles and San Francisco. As of October 2007, the California Department of Health Services found over 13,000 people infected with HIV/AIDS in San Diego.

Saturday, December 1st is World AIDS Day. In recognition of this annual event, here are a few things YOU can do to help fight this global epidemic:

> Be a part of the solution! Volunteer with PCI on December 1st at the San Ysidro-Mexico border port of entry as we raise HIV/AIDS awareness in our region.
> Educate yourself about the ever-present dangers of HIV/AIDS and understand that no person or region is immune from this disease.
> Talk to your partner, children, younger siblings, or other young people in your life, about the dangers of HIV/AIDS and methods of prevention (using condoms, avoiding illegal drugs).
> Learn more about PCI’s HIV/AIDS programs in Africa and India.
> Urge your government representatives to support HIV/AIDS eradication programs.
> Get tested.

Hernando de Soto is a revolutionary economist who is helping impoverished communities worldwide rise out of financial struggle. Recipient of Project Concern International’s 2007 Humanitarian Award, de Soto is the founder of Institute for Liberty and Democracy (ILD) in Lima, Peru. Time magazine included de Soto as one of the five leading Latin American innovators of the century and among the 100 most influential people in the world. In his award acceptance letter, de Soto shared the following:
"[The people who work for me see]…the economic potential in the shantytowns of Lima and every other city we work in, and thus the opportunity to really change the world – where two thirds of the people, four billion of them, are stuck in poverty. They share with me a love of the challenge of helping poor and struggling countries make the transition to modern, market economies – and convincing their Governments (and the US Government in Washington and non-profit organizations like Project Concern International) that the poor are not the problem, but the solution.
Over the past 25 years, what we at the ILD have discovered is that there is a large constituency for change in developing countries. They’re called the "poor," and what we’ve revealed about these people is that they wouldn’t survive at all if they weren’t hardworking, clever entrepreneurs. They have assets in the form of houses, property, and small businesses. But they need something else to prosper – i.e. the same legal tools that rich nations (and country elites) take for granted: property rights, legal ways to organize their businesses productively, and mechanisms to operate in expanded markets outside the confines of family and friends.
No matter what populist and anti-globalization leaders might say, we know that these entrepreneurs are eager to take their place in their national and then international markets, because, even though costly bureaucracies and just plain bad law keeps them from these legal tools, they replicate them in their underground economies: informal property titles, contracts, wills, credit – all in an effort to do business and protect their assets. But these "extralegal" practices are inadequate.
What the ILD does is to identify the bad laws and the good extralegal practices, and then help Governments make the kind of institutional reforms that will engineer an inclusive market economy under a single rule of law. That’s the only way it can be done, and the good news is that it has been done before – in Europe, the
U.S., and Japan, for example, when these were still developing countries full of migrants, squatters, and peasants trying to make a better life for their families."

Four Ways to Improve the Fight Against AIDS

"Hunger can drive decent people to take terrible risks"

Walleligne Beriye

On October 9th, Project Concern went to Washington. Well, to be fair, PCI is always in Washington. We have a fully staffed office in our nation’s capital, working closely with government officials to promote the important work we do around the world. Earlier this month, however, one of our staff had the opportunity to participate in a House Foreign Affairs Subcommittee Hearing on Africa and Global Health.
Entitled "The President’s Emergency Plan for AIDS Relief (PEPFAR): Is It Fulfilling the Nutrition and Food Security Needs of People Living with HIV/AIDS?," the hearing was conducted with a full audience and broadcasted nationally on C-SPAN. Participating in the hearing was Project Concern’s own Walleligne Beriye, Country Director for our program in Ethiopia.
Walleligne delivered powerful testimony, describing his personal experiences working to help families struggling with HIV/AIDS in Ethiopia. Adults that are HIV positive, Walleligne explained, can require up to 30% more food than a healthy individual. Moreover, children suffering from this disease might need twice as much food as a healthy child. HIV positive adults who are malnourished when they begin receiving antiretroviral therapy (ART) are six times more likely to die after received treatment than a person receiving adequate nutrition. Thus, the effectiveness of ART is greatly diminished if the person is malnourished.
Working on the frontlines in Ethiopia, Walleligne has seen firsthand the effects of malnourishment on communities with HIV/AIDS. For example, women who are starving are more likely to engage in prostitution, further spreading the virus. Ensuring people suffering from HIV/AIDS have adequate access to food is of a key tool in preventing desperate and risky behavior.
Walleligne suggested four ways to increase food security and thus improve drug-effectiveness in the fight against HIV/AIDS:
1. Expand food programs in schools and orphanages
2. Provide meals at centers where pregnant women go for counseling and testing; these women will most likely return again.
3. Expanding food programs at treatment centers.
4. Creating economic opportunities by supporting gardens, farms, and collective businesses owned by HIV positive individuals.
The continuous danger presented by the combination of HIV/AIDS and hunger is always present, it never sleeps or takes an extended vacation. Shortly after giving his testimony, Walleligne returned to Ethiopia to once again take his post on the frontlines of this ongoing struggle.

Trial and Hope in Africa

Kamren Charpentier

Africa faces the greatest challenges of our time. A chaotic scene of deathly diseases, poverty, starvation, and war – Africa’s issues collide into a mix of desperation and despair. Each day in Africa is a true duel between hope and anguish – a battle of survival for so many it cannot be ignored, even if tried.

Yet amidst these constant struggles, there remains among Africans the greatest hope, warmth, and inspiration. In the past century we have seen some of the greatest world leaders, visionaries, and Nobel Laureates emerge from this vast continent. Africans are a people who do not beg for charity, but for empowerment; who do not cry for sorrow, but for hope; and who do want our pity, but need our support. It is in the nation’s determination that we find the greatest opportunity, hope, and ability to help restore what was once the world’s greatest civilization.

Diseases such as malaria take the lives of over 3,000 children a day in Africa. Combined with HIV/AIDS, the death toll of children, men and women rises to a staggering 3.5 million people each year. Starvation leads orphaned children to the streets to find work and food; poverty diminishes the means for education or medical services; and disease leaves many bed-ridden and debilitated with no way to make a living. When adding into the equation corrupt government and military officials, natural disasters such as drought in Ethiopia, or the genocidal war of Darfur the outcome is devastating.

The cycle of poverty and disease circulating throughout Africa is vicious. There is not one answer to these complicated problems – they require holistic, integrated solutions that lift people out of poverty and provide the access and means to health care, education and economic empowerment.

Project Concern International is working to address these issues and break the unbalanced cycle of poverty. The organization is providing access to health care for victims of tuberculosis, HIV/AIDS, and malaria; nutritional food, education and support programs of orphans and vulnerable children; economic development opportunities for women; and community mobilization that create strong volunteer efforts.

It is only with great conviction, unfounded dedication and unlimited vision that true change can occur. But, change does not happen overnight, it does not strike like a lighting bolt, it takes perseverance and the will to work untiringly day in and day out. It takes leaders and movement, it takes belief, and most importantly it takes each and every one of us.

Project Concern International : Tijuana
Alex Slattery

When I went to Tijuana to photograph Project Concern International’s work, I knew little about the programs there. On arrival in these poor neighborhoods, I met some of the most compassionate people I have ever come across.
I met local promatoras, or health workers, who volunteer in different communities by providing physical check-ups to children, giving vaccinations, and administering Tuberculosis medicine to patients everyday. These women travel far distances without a car or pay to do make sure people receive health care. I also met a couple who opened their home to administer vaccinations and medicine to patients that otherwise could not afford it.
There can be no other gesture of kindness greater than opening up your own home to improve the health and quality of life for others. I was amazed at how little these people had and how much they gave in return. It is important that we raise the quality of living and health for our neighbors (Tijuana) because ultimately it affects us all.
I’m glad I could assist this organization by visually capturing the amazing work Project Concern International is doing in these areas – it is truly making a difference and it showed on the faces of the children, mothers and community members who were there.

Bolivia does not disappoint
By Uli Heine
Just a few weeks ago, I joined eight other women between the ages of 18 and 84 on an off-the-beaten track trip to Bolivia. Joining a group from Project Concern International, a San Diego-based health and development organization, I had the chance to travel 14,000 feet above sea level to see how the amazing work that is improving the lives of thousands of children and families in South America’s poorest country.
The trip certainly was not for the faint of heart. But hours of delay, lost luggage, challenging terrain and traveling in planes, vans and boats to get to some of the most remote places in the western hemisphere did not seem to phase these female travelers.
We were determined to see what can be done to empower families in desperate need of health care, education, clean water and livelihoods. We were not disappointed. Wherever our travels took us to, we were greeted by smiling faces of children, mothers and farmers who proudly presented their home-made flat breads and grits (made out of the local quinoa) to us.
Everywhere we went, children would line up in their best clothes to begin a presentation of local song and dance. When we visited the schools that benefit from Project Concern International’s school feeding program in Cochabamba or Oruro, children were eager to talk to us and we were delighted to see them looking healthy and strong in an area where malnutrition and child mortality is staggeringly high. They were proud to show off their vegetable gardens and clean water sources and to explain how they are working together to improve their lives.
One of the most memorable and visually intriguing moments was when the group arrived in an area of Oruro, a desolate place in Bolivia’s altiplano, often referred to as a moonscape. As soon as we stepped out of the van after hours of traveling over gravel roads, a group of farmers, in their best Quechua garb, starting playing their flutes and led the visitors in a procession to their proud source of livelihood: their llamas. Project Concern International works with hundreds of farmers and thousands of llamas in this area to increase their revenue from South America’s most famous beast of burden.

I will certainly forever keep the faces of the children, mothers, farmers and llamas in my memory.

The Empowering Women of WORTH
Donna Fay Harati

For the past two months, I have had the fortunate opportunity to intern with Project Concern International’s WORTH program in Zambia. I could never adequately express my gratitude and appreciation for having been a small part of such an amazing initiative.

As soon as I learned about the WORTH model, I knew it was something special. The WORTH motto "Dependency is Not Empowerment" signaled to me that this is a program that truly values women. Coming from the United States, I was only familiar with women's development programs that provided some kind of start up money or micro-enterprise loan to begin with. After working with WORTH, I can't imagine such models since WORTH women are taught that they must help themselves to improve their own lives. Every WORTH woman I have met has fully taken this advice to heart. I had no idea women could even be as strong and empowered as the remarkable women I met.

On my very first field visit, I visited a WORTH group composed primarily of elderly women. These women were engaging in building a chicken pen. I remember watching in amazement as they stacked their freshly made bricks row upon row. What impressed me even further was how genuinely selfless these women were. They repeatedly explained that their ultimate goal was to raise money by selling chickens so that they could more adequately care for the orphans and vulnerable children in their communities.

This noble spirit proved to be a common thread among all the WORTH groups I visited: WORTH groups building schools for orphans and vulnerable children, WORTH groups visiting the elderly and sick of their community, WORTH groups rescuing the troubled youth of their area who were dabbling in prostitution and drinking. These women are not satisfied with merely being empowered- rather, they are so thrilled with their newfound voice and strength that they want to touch as many people as possible with good.

I was touched and inspired a million times over by the women I met. I always found myself thinking that American women could learn a great deal about hope, gratitude, and perseverance from these dignified Zambian women. I always felt apprehensive about intruding on their meetings, but each time, they greeted me with lovely songs and passionate dancing, immediately making me feel welcome. I feel unbelievably thankful and privileged to have caught a glimpse of the impact WORTH is having on Zambian women. I'll never forget standing in a circle with other WORTH women and listening to each woman share how WORTH has change her life – that's empowerment in action.

Breaking the Cycle of Poverty
by Janine Schooley

Everything is interconnected. Everything is vital. The interwoven issues of health and poverty form a cycle that must be addressed as a whole, rather than in separate parts. If we neglect any aspect of development, our program’s success is in jeopardy and there is no chance of long-term sustainability. Isolated interventions can seem helpful, but only as band-aids, with limited shelf life.

There are limitless examples of the connected problems we face. After years in development, I found the concept of "holistic" well-explained by one of our most visionary of funding partners:

• A farmer, even when he has access to irrigation, improved seeds, credit and markets, will make little progress if his soil is being washed away or blown away. So, environmental conservation is vital.
• A man with a potentially thriving farm business will not do well if he is cowering in the darkness of his hut with untreated malaria or AIDS. So, healthcare is vital.
• A good healthcare system will not have the desired impact if the person recovering from an illness is starving, as the drugs will have little effect on an empty stomach. So, economic empowerment is vital.
• A person is less likely to be able to take advantage of new economic opportunities if he or she cannot read. So, education is vital.
• Even if there is a school, a child cannot take advantage of it they keep contracting deadly water-borne diseases. So, clean water is vital.
• Even if there is clean water, a malnutrition child is still at risk of starvation. So, food security is vital.
  

The cycle continues…
Unless this cycle of poverty, ill health, malnutrition, and lack of education and opportunity is broken, the negative impacts will gain momentum and carry well into future generations. Project Concern International understands these critical dynamics and aims to work holistically at the community-level, addressing the complex dynamics of health and poverty in a broad and empowering way.

Unfortunately much of the funding and programming for health and development work around the world is compartmentalized or provided in "silos" and true holistic programming is not as common as it should be. This means that organizations such as PCI must use alternative strategies such as integration, layering or wrapping-around program interventions, piecing together funding from different sources to cobble together a more integrated whole.

Thankfully, the communities we serve inherently understand how the issues they face compound upon each other in their daily lives. It is these local perspectives, issues and priorities, combined with the technical expertise and experience of an organization such as PCI that ultimately leads to practical, appropriate, impactful and sustainable outcomes. This is what we call "community-led social mobilization for real and lasting change" and that is what PCI is all about.