|From The Field: Twinning as a Catalyst for
Reaching Immigrant Communities
The NASTAD Global Program has supported a twinning partnership between the Minnesota Department of Health (MDH) and the Oromia Regional Health Bureau in Ethiopia since 2009. In their joint work plan, Minnesota sought technical assistance from Ethiopia to address the high incidence of HIV, lack of knowledge and awareness of HIV and high levels of HIV stigma in the Minnesota Ethiopian diaspora community.
Minnesota recognized that the most effective way to address HIV stigma is for HIV positive people to speak out to their own communities about the disease. However, as one service provider explained, "The community does not have anyone who is living with HIV/AIDS that speaks out openly and it's still hard for people to associate HIV/AIDS with a real life."
To address this need, Minnesota worked with their twinning partner to identify an HIV positive activist from Ethiopia who would be willing to reach out to the Minnesota diaspora community. Mr. Mesfin Feyisa was one of the first HIV positive individuals to travel to the United States after the U.S. lifted its ban on admitting HIV positive individuals. With NASTAD's support, MDH worked with a local CBO, Sub-Saharan Youth and Family Services in Minnesota (SAYFSM), to schedule meetings and presentations for Mr. Feyisa at community churches, on community radio programs, and with support groups and individual clients. The following are excerpts from a report made by Mr. Ephraim Olani, Executive Director of SAYFSM. They remind us again of the devastating effect that HIV stigma continues to have on people living with HIV, as well as of the great impact that courageous and committed individuals can have on entire communities.
"Mr. Feyisa made three different radio broadcasts to talk to Ethiopians /Oromo in the Twin Cities. Mr. Feyisa emphasized that all people living with HIV/AIDS should get in to care services and seek professional mental health services if necessary. He also stressed that stigma is more of a burden than the HIV itself and stigma is what keeps people isolated and depressed. Mr. Feyisa received several phone calls immediately after he was off the show both from people living with, as well as those affected by, the disease.
Mr. Feyisa's visits to the Oromo and Ethiopian Churches were overwhelmingly successful. Everyone was amazed with his boldness to openly tell his life story and engage people with this highly stigmatized topic. One person who came forward to talk with Mr. Feyisa after the church service was crying and told Mr. Feyisa he wished that his sister could have heard his testimony. The man lost his sister due to ignorance. Her husband and the pastor of her church commanded her to stop taking her medication since they said God had healed her. Unfortunately his sister passed away within six months of stopping her medication. The man was devastated that his sister could have lived a healthy life by following Mr. Feyisa's kind of advice and urged him to stress his message when speaking at churches.
Mr. Feyisa met face to face with at least 2 to 5 SAYFSM clients every single day for the entire time he was in Minnesota. He counseled, empowered and encouraged everyone he met. Some of them said they didn't know they could realize their full potential after [being diagnosed with] HIV, or that they could [still] be useful. Many said their worries of dying left them after talking to Mr. Feyisa. Some of them testified that they no longer fear what people might think or say if they find out that they are HIV positive.
Mr. Feyisa openly spoke about himself and, in so doing, empowered people to openly talk about HIV and its impact on their communities. It was obvious to see that the stigma around HIV/AIDS is starting to loosen and since Mr. Feyisa's departure, people have been talking freely about HIV/AIDS."
This example of the benefits of twinning for the local U.S. response to the epidemic is instructive in many ways. Ultimately, helping individuals and families access the kind of information, support and reassurance that Mr. Feyisa provided is what public health is all about. As communities become more diverse worldwide and resources continue to become more constrained, these types of innovative bi-directional exchanges become ever more important. This may be particularly true when U.S. health departments simply do not have the culturally and linguistically appropriate resources to reach specific communities impacted by the epidemic. Through twinning, NASTAD is able to facilitate access to this expertise to further our mission of a world free of HIV/AIDS and viral hepatitis.
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NASTAD Leadership Development
One of NASTAD's strategic priorities is to bolster the public health workforce by strengthening health department leadership and effectiveness. NASTAD also supports health equity in our programs and services, including ways to help health departments develop and support a strong and diverse public health workforce. NASTAD's leadership development opportunities are grounded by our foundational peer-based approach to technical assistance that connects health department staff with colleagues in other health departments with experience and expertise specific to their needs in public health HIV/AIDS and viral hepatitis programs. The NASTAD staff has developed several opportunities as part of our leadership development portfolio:
NASTAD continues to track developments to support public health leadership development, including programs funded through various agencies of the Department of Health and Human Services. NASTAD is an affiliate member of the National Public Health Leadership Development Network, and routinely communicates with the National Network of STD/HIV Prevention Training Centers and the National Alliance for HIV Education and Workforce Development.
For more information on NASTAD's leadership development opportunities, visit the NASTAD website or contact Lynne Greabell.
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National Public Health Accreditation Update
A national public health department accreditation program was launched in September 2011 by the Public Health Accreditation Board, with support from the Robert Wood Johnson Foundation and the CDC, to advance the quality and performance of public health programs. The program was developed through extensive collaboration with the Association of State and Territorial Health Officials (ASTHO), of which NASTAD is an affiliate, and the National Association of County and City Health Officials (NACCHO) and is based on a specified set of standards and measures. State, local and tribal health departments that desire to seek accreditation must apply for, and pay fees, to participate. The program was launched after extensive piloting and beta testing in several states (AL, FL, IA, OH, OK, MI, WA and WY) and local and tribal health departments and entails compilation of materials to document adherence to the standards and a site visit by a PHAB team. Although no health department has yet completed the official accreditation process, the PHAB website has online accreditation materials available.
Please share any experiences or questions about this accreditation process with Lynne Greabell.
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CDC Public Health Gateway Resource
On a related note, CDC recently launched a new website for state, tribal, local and territorial public health partners. CDC's Office of State Tribal, Local and Territorial Support (OSTLTS) recently developed the State, Tribal, Local and Territorial (STLT) Public Health Gateway, to provide information specifically relevant to the state, tribal, local and territorial public health. The intent of this site is to help matrix CDC content related to state, local, tribal and territorial health departments.
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Member and Staff Updates
In member updates, Carmine Grasso is retiring from his position as director of the New Jersey HIV/AIDS Care and Services Division. Connie Myers, Assistant Commissioner of the New Jersey Division of HIV, STD and TB Services is now the NASTAD representative from New Jersey. In Pennsylvania, Janice Kopelman retired from her position as Deputy Secretary of Health Promotion and Disease Prevention. Joe Pease remains the NASTAD member. And in Ohio, Bill Tiedemann announced that on December 2, he will leave his position as the Program Administrator for the HIV/STD/AVH and TB Prevention and Control Program to become the Executive Director of the Minnesota AIDS Project.
In staff updates, Natalie Cramer has been promoted to Director of Prevention and Chris Taylor has been promoted to Associate Director of Viral Hepatitis. In November, Joy Mbajah left NASTAD to become a manager with ETR Associates and Tyler TerMeer left NASTAD to become director of the Ohio AIDS Coalition. NASTAD brought on two new staff members in November as well; Lorraine Denis-Cooper and Jillian Casey will be joining the Prevention team as Associates.
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