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"Silence Is Our Culture" ... or Was

By Fia Curley

When the Coral Life Foundation disbanded in 2002, activists in the south Pacific nation of Guam set out to create another organization that could carry out the community-oriented work in HIV prevention that had been Coral Life's mission and purpose.

But there were challenges. Coral Life had disbanded because a staff member had mismanaged funds, and potential supporters were leery of working with anyone who had been involved in the old organization, said Alexis "Al" Silverio, now executive director of the 3-year-old Guam HIV/AIDS Network (GUAHAN) Project.

But Silverio, who had dedicated the last nine years of his life to Coral Life, and two other former Coral Life members persisted. And in March 2003, Silverio, Terry Aguon and Tim de La Cruz founded GUAHAN, which is how Guam is pronounced by speakers of the Chamorro language.

"We didn't know what we were doing, but we knew we wanted to do it," Silverio said. "We knew we needed to ask for help. Silence is our culture, but we needed to break with the culture of silence."

Citizens of and visitors to Guam, as well as Palau and the Northern Mariana Islands, didn't have comparable access to prevention and treatment services for HIV/AIDS, sexually transmitted diseases or tuberculosis that could be found within the continental United States, according to Silverio.

Since 1985, 185 individuals have tested positive for HIV antibodies. Of the 185, 34 people are living with full-blown AIDS, 96 are living with HIV and 55 have passed away, Silverio said. About 85 percent of that population is male and 15 percent is female.

At the start, the fledgling organization needed technical assistance in order to obtain tax-exempt status on the federal level and begin raising money.

So when representatives from the Office of Minority Health Resource Center (OMHRC) visited the island in February 2004 to meet with the health department and local non-profits, a connection was made.

"We approached everyone, but the Office of Minority Health (OMH) and its Resource Center were the first and only government agencies that believed in us then," Silverio said.

The goal of OMH was to increase the involvement of community-based organizations in the area and provide information and services to those in need. GUAHAN looked like a prime candidate for capacity development and technical assistance, said Henry Ocampo, HIV AIDS specialist at the OMH Resource Center, who has worked with the project since the beginning.

By June, the GUAHAN Project had moved into an office and, with help and coaching from OMHRC, they received their tax-exempt status from the federal government in October.

"That was a big deal because before then, we were working out of my home," Silverio said. "It was a very busy place, but it wasn't appropriate. It was a riot. I think some people thought I had a crack house, because people would come and go and there were always cars parked outside my home."

In 2005 the non-profit obtained contracts with public health department and the Life Foundation, and funding for HIV antibody screenings, counseling and referrals.

Silverio, 46, said one of the biggest challenges for the organization was sifting through the confusion to pinpoint what roles CBOs would play in the Pacific Islands Jurisdictions AIDS Action Group (PIJAAG), Silverio said. The purpose of the PIJAAG was to provide a forum for the six jurisdictions to come together in one voice to inform the federal government of what was needed for HIV/AIDS. It is important to be united and say "this is what we want," Silverio said. "This is our culture. This is our people. Let's have one voice to speak and say this is what we want. This is what we need."

Silverio explained that inclusive representation of community-based organizations and health departments from all jurisdictions would provide an accurately portray what is occurring in the Pacific to federal groups.

Involvement with PIJAAG allows "the community to have a seat at the table in dealing with regional HIV efforts," said Ocampo.

Ocampo said he would consider the GUAHAN Project as one of the prominent CBOs in the region based on the goals they have accomplished since becoming an organization. In three years, they have developed unique and successful fundraising ideas, garnered business and community support and have been able to schedule annual events.

"I think they've done amazing work," Ocampo said. "They have a very committed staff and they've built an organization from the ground up."

Despite external issues, Silverio said there are local challenges the GUAHAN Project still needs to battle.

"There's a lot of misinformation going around Guam that there's a cure [for HIV/AIDS] or if you go to church and pray hard enough, you'll get cured, and if you're not cured you didn't pray hard enough or believe enough," Silverio said.

Add to that, HIV/AIDS as taboo, cases of women from neighboring islands breastfeeding children regardless age or blood relation, child prostitution and transient populations, and Silverio said he is bracing for a wave of cases which, in the scheme of federal funding, don't rank as high as other common health problems.

"Although worldwide, the numbers are slowing down, it's like slowing down from 100mph to 95—it's still fast," he said. "I think what it would take to make this a priority in the Pacific is a surge in the number of positive tests because the numbers speak for themselves, but I don't wish that on anyone."

According to the Center for Disease Control and Prevention's HIV/AIDS Surveillance Report, the estimate number of HIV/AIDS cases has increased steadily from 2001 to 2005 for Asian/Pacific Islanders, while all other racial and ethnic groups have seen declines. The same trend remains true for Asian/Pacific Islanders for the number of AIDS cases.

Instead of waiting for official numbers to reinforce perceptions, GUAHAN is utilizing its new Resource Center, which opened Sept. 30, 2006, to offer private testing rooms, hemophilia offices, free internet services and hotspots, informational material such as pamphlets and videos, support groups and house meetings for at-risk groups like women, people who are HIV positive and soon, men who have sex with men. Quilting lessons are also offered weekly in conjunction with the AIDS Memorial Quilt. All of this, Silverio said, will hopefully bring HIV/AIDS to the forefront and allow the community to come together on this topic.

"My favorite quote about community is from Dr. Martin Luther King Jr. -- 'Those who are not vested in the community are doomed to destroy it,'" Silverio said. "It's like the difference between having a rental car and owning a car. You'll drive a rental car into the ground because you don't have to repair it. If you own a car you'll be pickier in it."

Silverio's key to empowering the people: "They have to have ownership of the community and then you have change."

Not only is the GUAHAN Project looking to help people on Guam, it has become "a big brother" to the NAPU Life Foundation, a CBO on Saipan, north of Guam.

Established in July 2005, NAPU Life was created to address the need for a non-governmental organization to respond to HIV issues on the island, according to Board President Joaquin "Jack" Sablan. Currently members are working with GUAHAN to tap dedicated board members and begin solid fundraising efforts for NAPU Life.

Considering everything the organizations are tackling, Jay Blackwell, director of Capacity Building for the OMHRC, said it is not enough to say he is proud of the organizations for not giving up when repeatedly faced with opposition or reluctance, but he commends "them for addressing the issues that directly impact their communities."

"These agencies are partners because they are committed to protecting the health of their communities," Blackwell said. "Health departments can't do it alone."

Due to the contained population and the high risk of contraction of HIV, Blackwell said OMHRC is "looking ahead" to help the organizations enact true prevention methods.

"They're really stepping up and showing these communities they can make a difference and that is true advocacy," Blackwell said. "GUAHAN Project and NAPU Life, to me, represent positive persistence when people truly care about their lives in their community."

--

Fia Curley is a writer for the OMHRC. Comments? E-mail: fcurley@minorityhealth.hhs.gov

Links

Opening of Pacific Resource and Training Center on Guam
http://minorityhealth.hhs.gov/templates/content.aspx?ID=4611

Guam Communications Network - Technical Assistance and Capacity Development FY 2005-2007 Grantee
http://minorityhealth.hhs.gov/templates/content.aspx?ID=4856

Pacific Resource and Training Center Open in Guam
http://minorityhealth.hhs.gov/templates/content.aspx?ID=4569

The Pacific in Action Against HIV/AIDS - Putting the Pieces Together
http://minorityhealth.hhs.gov/templates/content.aspx?ID=4896

HHS Region IX
http://minorityhealth.hhs.gov/images/mappings2.cfm?region=9



Content Last Modified: 3/29/2007 10:06:00 AM
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