Special MDG Edition

Oct 2010 - Jan 2011

whatis AYAD?

Welcome to the Millennium

Development Goals (MDG) special

edition of Exchange. The stories in

this edition highlight the important role

that Australian Youth Ambassadors

can play, as part of the Australian

Government’s overall international

The Australian Youth Ambassadors for Development (AYAD)

Program aims to strengthen mutual understanding between

Australia and countries in Asia, the Pacific and Africa and make a

positive contribution to development. The Program achieves these

aims by placing skilled young Australian (18-30) on short-term

assignments in developing countries in Asia, the Pacific and Africa.

AYAD volunteers work with local counterparts in Host Organisations

to achieve sustainable development outcomes through capacity

building, skills exchange and institutional strengthening.

The AYAD Program provides support to AYADs including living

and accommodation allowances, flights, pre-departure training,

in-country management, insurance, medicals and debrief on

return.

The AYAD Program is an Australian Government, AusAID initiative

and is fully funded by the Australian Government’s overseas aid

agency, AusAID. AYAD is managed by Austraining International, a

South Australian international project management company.

of Exchange has reminded me again of the diversity of

assignments and of the AYADs themselves, from Thomas

working in the Philippines as an Occupational Therapist to

Emma working in land-locked Laos as a Marine Scientist.

In this edition, we also have our first story from Africa -

an engaging insight into how two AYADs, Magda and

Carmen, are helping to combat HIV/AIDs (contributing to

MDG 6) in Ghana.

If you are not familiar with the MDGs, the first article gives

a summary of the goals and targets set in 2000 by the UN.

We have given an overview of what has been achieved

and also, where the gaps remain. Eradicating poverty is a

massive task -but the differences that individual volunteers

make on a local level can and do contribute to the overall

goals being met.

Thank you to everyone who contributed to the magazine

and we hope you enjoy this edition of Exchange.

Anthony RologasAYAD Program Director, Austraining International

development assistance efforts, in contributing to progress

against each of the eight United Nations’ MDGs. We have

also included a great story about the work being done

by Australian volunteers in relation to the ninth MDG,

established in 2003 by the UN and Royal Government of

Cambodia, which is committed to clearing unexploded

ordinance in Cambodia.

Throughout the edition we look at each of the MDGs in turn,

reflecting on how AYADs are making a difference by using

their skills to contribute to local development outcomes in

their host communities. Reading the stories in this edition

The MDG Story So Far

Promoting Paradise

A Dumpsite Education

The Long Journey in th Fight Against Cervical Cancer

AYAD Photo Gallery

Disability... What Disability?

Can Disability Really Be Mainstreamed?

Combating HIV, through Gender Equality

Marine Scientist in a Land Locked Country?

Paddling Fiji onto the World Stage

Mine Action in Cambodia

Where Are They Now?

Australian Partner Organisations

Calendar

Editor: Julia Mann

Sub Editors: Alice McCormack

Lucy Turvet

Design: Danny Connery

Contributors:

Glen Hornby

Elizabeth Mullan

Danielle Prime

Thomas Bevitt

Briana Wilson

Carmen Ghaly

Magdalena Asfaw

Emma Murray

Michael Crowe

Alex Barker

Megan Krolik

Emily Wilson

Exchange October 2010 - January 2011

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contents

Cover: Danielle Prime with local school children in Bharatpur, Nepal Left : Glen Hornby at a Botaki celebration in Kiribati

Photo credits:

Stephen Plummer

Leandro Pereira

Adam Trau

Prue Loney

Michelle Sain

Jessica Crause

Kwankhao Sinhaseni

Irene Dowdy

Nicola Scott

William Holton

Stephanie Denman

Exchange Magazine welcomes submissions from

AYADs and alumni (RAYADs), Host Organisations and

Australian Partner Organisations. Please contact the

AYAD Communications Team for further information,

media.ayad@austraining.com.au

Corrections & Clarifications

In the last edition of exchange we misspelt Maria

Karagiozakis’s name, we apologise to her and for any

confusion caused.

Exchange is printed on recycled paper.

1Eradicate extreme hunger and poverty

Target 1: Halve, between 1990 and 2015, the

proportion of people whose income is less

than $1 a day. Despite the global economic

crisis, the world is still on track to meet this

poverty reduction target.

Target 2: Achieve full and productive

employment and decent work for all,

including women and young people. As

a result of the global economic crisis and

the added pressures it has placed on the

world’s poorest, this target has even greater

importance.

Target 3: Halve, between 1990 and 2015, the

proportion of people who suffer from hunger.

The effort to curb hunger has become even

more vital as a result of the global food and

financial crises.

2Achieve universal primary education

Target 1: Ensure that, by 2015, children

everywhere, boys and girls alike, will be

able to complete a full course of primary

schooling. Many developing countries

have made progress in this area, but

there is still a great deal of work to be

done before 2015. Majority of the world’s

children who are out of school are living

in Sub-Saharan Africa and Southern Asia.

In these regions, like all others, equality

poses the greatest barrier to achieving

universal education.

3Promote gender equality and empower women

Target 1: Eliminate gender disparity in all

levels of education. In some parts of the

world, girls do not receive an education

at all, with poverty being a major barrier.

Dealing with gender disparity in education

is especially important because it directly

links to achieving other goals, especially

those related to maternal health and HIV.

4Reduce child mortality

Target 1: Reduce by two thirds, between

1990 and 2015, the under-five mortality

rate. Globally, child mortality rates are

dropping, but further improvements are

much needed. Millions of children will

benefit by redirecting aid efforts against

pneumonia and diarrhoea.

what are the MDGs?

The Millennium Development Goals (MDGs)

are eight international development goals that

all United Nations Member States agreed to

meet by the target date of 2015.

The Goals stem from earlier international

development targets and were officially

established at the United Nations Millennium

Summit in 2000.

The MDGs identify major issues facing the

world’s poorest countries, and aim to further

international development by improving

social and economic conditions globally.

There are eight Millennium Development

Goals, with 21 specific targets.

The AYAD Program is assisting the

Australian Government in meeting the

Millennium Development Goals. Each year,

400 young Australians travel overseas with

the Program and return with stories of how

they have impacted their host organisation

and communities beyond. In this edition of

Exchange, we look at AYADs playing their

role in achieve the Millennium Development

Goals.

What are Millennium Development Goals?

The MDG Story So Far

8Develop a global partnership for development

Target 1: Address the special needs of least developed countries,

landlocked countries and small island developing states. Despite the

effects of the global financial crisis, aid continues to increase. There are

five countries in the world (Denmark, Luxembourg, Netherlands, Norway

and Sweden) that are giving 0.7% of their gross national product to Official

Development Assistance. It is possible to halve extreme poverty if all the

countries who have committed to the 0.7% target reach it. Five donor

countries have reached the UN target for official aid, but pressure needs to

be applied to countries that have not.

Target 2 : Develop further an open, rule-based, predictable, non-

discriminatory trading and financial system. This goal aims to improve the

governance and economic strength of developing countries by rethinking

the way our global economy functions at both the macro and micro levels.

Target 3 : Deal comprehensively with developing countries’ debt. This

goal is being achieved as developed countries are working with developing

countries to reduce the amount of debt that the developing countries

owe.

Target 4 : In cooperation with pharmaceutical companies, provide

access to affordable essential drugs in developing countries. Many

deaths in developing countries could be prevented with the aid of basic

medicines; this need is being supported by the developed world.

Target 5: In cooperation with the private sector, make available benefits

of new technologies, especially information and communications. Most

people in the world still do not have access to the internet, reinforcing the

gulf between developed and undeveloped countries.

5Improve maternal health

Target 1: Reduce by three quarters

the maternal mortality ratio. Although

most maternal deaths are preventable,

many deaths occur when women

deliver without skilled care. More skilled

maternal care is needed in Southern

Asia and sub-Saharan Africa to reduce

this mortality rate.

Target 2: Achieve universal access

to reproductive health. Globally, more

women are receiving antenatal care,

but the inequalities in care during

pregnancy are vast. Improvements

are needed in reducing the number of

teenage pregnancies and to expand

the use of contraceptives by women.

Both of these issues are linked to

poverty and lack of education.

6Combat HIV/AIDS, malaria and other diseases

Target 1: Have halted by 2015 and begun

to reverse the spread of HIV/AIDS. The

spread of HIV appears to have stabilised in

most regions, and more people with HIV are

surviving longer.

Target 2: Achieve, by 2010, universal access

to treatment for HIV/AIDS for all those who

need it. Globally, HIV treatment must be

expanded to help the growing number of

people infected with HIV.

Target 3: Have halted by 2015 and begun to

reverse the incidence of malaria and other

major diseases. Across Africa, expanded use

of insecticide-treated bed nets is protecting

communities from malaria. Production of

insecticide-treated mosquito nets is rising,

but work is needed to promote their use.

7Ensure environmental sustainability

Target 1: Integrate the principles of sustainable

development into country policies and programs and

reverse the loss of environmental resources. Overall,

deforestation is decreasing, but further improvements are

needed to reverse the damage in some areas.

Target 2: Reduce biodiversity loss, achieving, by 2010, a

significant reduction in the rate of loss of environmental

resources. As we move forward to 2015, the effort to

achieve this goal must continue.

Target 3 : Halve, by 2015, the proportion of the population

without sustainable access to safe drinking water and

basic sanitation. The world is on track to meet the drinking

water goal, although there is still a long way to go in some

regions. With half the population of developing regions

without sanitation, further work is needed to meet the

2015 basic sanitation target.

Target 4: By 2020, to have achieved a significant

improvement in the lives of at least 100 million slum

dwellers. Slums are most prevalent in sub-Saharan

Africa and countries affected by conflict. Despite the

growing numbers of urban poor, globally there have been

considerable slum improvements.

The MDG Story So Far

5

Kiribati has long been an island nation of mystery, but perhaps not too much mystery anymore. In 2009 Dr Glen Hornby left the comforts of his academic desk at Griffith University to work with the Kiribati National Tourism Office (KNTO) for nine months, as an AYAD. His assignment was as a digital marketing co-ordinator for the Kiribati National Tourism Office – a role intended to get Kiribati on the tourism map and contribute to economic development of Kiribati; one of the country’s top development priorities as part of MDG #1: eradicating poverty and hunger.

Glen with an eel - the catch of the day!

Q. Why did you get involved in this project?

A. I have always been interested in development work, but my career drifted

into internet marketing and tourism, so when this opportunity came up

I jumped at it. I’ve always had an interest in culture, so this was a great

opportunity to immerse myself. At pre-departure training most people were

working in health, social policy or engineering or something, right at the basic

human needs level, and I wondered how tourism would fit with all this. Now

I’ve done it, I can definitely see the benefits where economic development

provides the end-game, an enabler for a country to stand on its own feet.

Q. So how did the digital marketing go?

A. Before I went I researched Kiribati as much as I could, but couldn’t find

much information at all – a real problem should any travellers want to visit

Kiribati. Guidebooks didn’t have much, and the Kiribati website hadn’t been

updated for a number of years. It turned out that the technology was old and

clunky and it was very difficult for anyone to update. So my main job became

developing a new website for the country, one that would provide plenty of

information for potential visitors, and be easy for anyone to update.

Q. What else did you do apart from work on the new website?

A. There were a few different things, from multi-media slide shows, site

visits and industry workshops. We also developed a weekly newsletter

showcasing events, tours and special packages . There were quite a few

business travellers who had spare time in Kiribati and didn’t know what to

do, so this helped the tourism business connect to them. Everyone who

arrives at the airport gets the newsletter, and it is sent to an ever growing

email list – currently at 345 I believe, three times what we started with.

Q. Did you engage in much capacity building?

A. I spent time a lot of time training my tourism office colleagues to do the

web development as we went. It made progress a bit slower, but it paid

off. We also developed new work plans to make digital marketing a part

of everyday duties in the office. Today, six months later, the website is still

updated regularly, and the newsletter published weekly. On the website they

have been creating news columns, new pages and new sections depending

on what is happening at the time. A big positive is that the information

available about Kiribati has probably about quadrupled and importantly it is

kept up-to-date and accurate.

Q. How would you gauge the success of your project?

A. We had a lot of good comments about the newsletter and the website,

from everyday people through to other national bodies, which was great. I also

had KNTO begin to monitor website visits, and since the new website went

online, daily visitors about doubled, and visitors stay for about four minutes,

and visit at least four different pages. On the old website they stayed for less

than a minute and often didn’t go past the first page. Together these things

mean people are now finding the information they want, which will result

in more visitors to Kiribati, and the much needed economic growth. KNTO

have now started using the new website in conjunction with public relations

strategies. A few months ago this resulted in over 3,000 website visitors in

one weekend - this is massive considering the country only averages around

4,000 visitors by air each year!

Q. Apart from the project, what else did you get from your time in

Kiribati?

For me the best thing about the AYAD experience was being immersed in

another culture. The geographic isolation of Kiribati has meant the culture

is relatively untouched, and it was a continual learning process, everything

from language, traditional rituals, correct manners, to some different value

sets. It wasn’t just learning for novelties sake either, it all helped with work

outcomes and getting on in everyday life in Kiribati. For example, in Kiribati,

family is put before everything. Once you realise this, you start to understand

why someone might be late for a meeting, and it makes you think about the

priorities we get engulfed in back in Australia. At the personal level it asks

you to question your own behaviours and values, so you start to think about

what is important to you and why.

Q. Does your time in Kiribati impact much on your life now you’ve

returned to Australia?

In a word – yes! I am back at Griffith University now, and as an academic I get

a lot of freedom to work in areas of my own interest. I have started a project

developing a website to document I-Kiribati culture – it is intended to be a

collective effort, reflecting the values of the Kiribati people in structure and in

content. I also have my sustainable tourism class do a case study on Kiribati,

and I take great pride in showing my information systems class the Kiribati

national website. Outside of class I am working on setting up internships

with the KNTO for a few of the students, and together with the Griffith’s

International Office we organised to donate some computers to KNTO. While

I might have left Kiribati, Kiribati has definitely not left me!

More information on Kiribati can be found at www.kiribatitourism.gov.ki –

the new Kiribati Tourism website.

1Eradicate extreme hunger and poverty

Eradicate extreme hunger and povertyHost Organisation : Kiribati National Tourism Office : www.kiribatitourism.gov.ki

Australian Partner Organisation : Pacific Asia Tourism : www.pacificasiatourism.org

7

The Kiribati sunset

!

Left to Right : Crystal Joy,

Diana and Abigail showing

photos of their families at the

Little Blue Day Care Centre

9

I love learning! I was a full-time student

from just after my fifth birthday until my 25th.

Considering my strong belief in the value of

good schooling, it is probably little wonder that

I found myself as an AYAD working in the field

of education.

My Philippine-based assignment was developed in

cooperation with the Australian Partner Organisation,

UnitingWorld and my

Host Organisation,

UCCP Tondo. My

purpose was to

integrate music into

the curriculum of the

Smokey Mountain II

Day Care Centre, in

order to support and

enhance children’s

learning.

The Little Blue Day

Care Centre is situated on the Smokey Mountain II

dumpsite at the north of Manila Bay. It is a hot, dusty,

smoky and materially poor area. But the community

is rich in spirit, and within that community live the

most resourceful people I have ever met – nothing

goes to waste. The dumpsite stands in stark

contrast to the bright, shiny, clean, air-conditioned

monstrosity that is Mall of Asia; one of the world’s

largest shopping malls located at the opposite end

of the Bay.

But I digress. The goal of the Day Care Centre is to

introduce children to a school environment and to

equip them with reading, writing and counting skills

so they can progress to Grade 1.

I worked most closely with teacher Roxanne, a

fellow believer in the importance of education. At

23, Roxanne claims status as the only resident of

Smokey Mountain II (thus far) to have successfully

completed tertiary

studies – a product of the

great value her parents

place on education,

combined with her

own perseverance

and determination.

Roxanne has many

dreams and aspirations,

but for the moment she

has chosen to remain

an agent of change in

her own community,

teaching the day care centre children and also

encouraging local youth to return to adult schools

where they can develop literacy and other skills.

For one year, Roxanne and I taught, learnt, had pika-

pika (snacks) and chika-chika (chats) together. We

shared sad times: students moved away because

their parents could not look after them; siblings of

students died from treatable illnesses.

!

- By Elizabeth Mullan

A DumpsiteEducation

But we also shared a lot of joy. Indeed, my

assignment was great fun. By far my favourite day

of the week was Thursdays – MAPÉ (Music, Arts and

PE) Day. On these days the challenge was to try to

wear the children out before they wore us out.

Favourite moments include the day a box of

fair-trade hand puppets, decorated by German

preschool children, arrived. Our students were so

excited they could hardly keep still, so we had to

send back mostly blurred photos along with our

thank you note.

Another week the children decorated frames to hold

family photos. Roxanne and I had spent countless

afternoons traipsing around the dumpsite taking

these photos and it was worth all our efforts to see

the kids so happy and proud to have something as

special as this photo and frame to take home and

share with their families.

The day we read ‘Who Sank the Boat’ it tickled the

children’s imagination so much that many fell to

the floor, rolling with laughter! They wanted it read

again and again and giggled and chattered excitedly

the whole way through once they knew the punch

line, even without Teacher Roxanne’s Tagalog

translation.

Finally, we taught them the ‘Butterfly Song’ in

Tagalog for their first ever performance, and they

never tired of it. Long after Roxanne and I had

grown somewhat weary of singing and dancing our

way through three long verses and nine animals,

the children continued to request to sing it every

morning – without fail! We always gave in.

The benefits of purposefully integrating music into

the Day Care education were evident. In singing

and performing songs, listening and responding

to music, playing musical instruments and even

creating instruments out of junk materials, we

provided opportunities to enhance the children’s self-

esteem, build community spirit, aid their cognitive,

emotional and physical growth, and reinforce the

value of education.

When the children first performed for their parents,

the mothers and a scattering of fathers stood from

their seats and moved towards the stage. They

watched in awe, eyes shining with pride and entire

attention focussed on their sons and daughters. It

was a special moment. In a country where many do

not progress far in the education system, providing

opportunities for parents to witness the products of

their children’s education is a positive step. These

activities reinforce to parents the value of schooling

and allow them to develop pride and enthusiasm for

their children’s education.

I can proudly say that the Day Care Centre is

achieving its goals. Of the 44 students who

graduated in March this year, ten of the youngest

returned for a second year of Day Care. The other

34 all progressed to Grade 1 in local primary

schools, encouraged and supported by Teacher

Roxanne and others from UCCP Tondo who worked

tirelessly with the families to secure birth certificates

where needed, and to assist the children through

the enrolment process.

The first step in achieving a full course of primary

schooling is enrolment in Grade 1. I’d love to see all

those kids come out at the other end.

As for my own dumpsite education, I learnt many

things. It was certainly tough and confronting at

times. But the support and encouragement of the

passionate and dedicated Philippines In-Country

Management Team was beyond measure. The most

powerful lessons I learned were through relationships,

particularly those formed with individuals at Smokey

Mountain II – with Roxanne, the students, and their

families. For me now ‘the poor’ is no longer an

abstract concept. These people now have faces

and names and as individuals they really mean

something to me. I am not sure that I will ever again

find complete comfort in a comfortable life – but

maybe that’s not such a bad thing.

* To read more stories of volunteers and Host

Organisations in the Philippines, log on to the

AYAD-VIDA Portal Philippines http://ayad-vida.

devconceptsph.com/

!!

Achieve universal primary educationHost Organisation : United Church of Christ in Philippines (UCCP) Tondo

Australian Partner Organisation : Uniting World : www.unitingworld.org.au

1

Women waiting for cervical cancer screening at a mobile community camp in a Kathmandu community

It’s 6am and I am standing on the busy and dusty

Arniko Hwy with my oversized backpack. I’m

waiting to be picked up to begin a 15 day research

field trip. To my surprise a lovely golden van slows

to a stop in front of me, and I have a seat all to

myself! From what I have read of other field trips

this one is beginning in absolute luxury! Although,

I was to learn that even the smartest of vehicles

are not impervious to bad luck.

I am working with a small NGO in Banepa, Nepal called

the Nepal Network for Cancer Treatment and Research

(NNCTR) and its sister organisation the Nepal Australian

Cervical Cancer Foundation (NACCF). Our mission: To

increase cancer awareness and prevent as much cancer

as possible. Cancer is still perceived as a disease of the

rich and developed world, and indeed, cancer receives

only a few lines in the Nepal health policy under ‘Non-

communicable disease’. Yet for cancer of the cervix,

nearly 80% of cases occur in developing countries.

Worldwide it is estimated that there are 473,000 cases

of cervical cancer and of these, 245,000 are reported

in Asia.

Cervical cancer doesn’t even appear in the top

10 cancers affecting Australians. This is due to

the enormously successful screening programs in

developed countries. I am sure most women will

empathise with the persistence of doctors for pap

smears? Well, as annoying as they may be, they work –

in developed countries. In Nepal, cervical cancer is the

number one cancer affecting women, and sadly, less

than 2% of Nepali women have ever been screened for

cervical cancer, a clear example of gender inequity in

health services. The effect of this cancer is devastating,

striking women in the prime of their life resulting in

families losing caregivers and breadwinners and leaving

them susceptible to poverty.

Readers may be aware of the ‘I Did It’ public health

campaign for the free cervical cancer vaccine in

Australia. The vaccine protects against the sexually

transmitted Human Papilloma Virus (HPV). Most HPV

infections are temporary, but in some cases they persist

and cause cervical lesions that can develop into cancer.

This is a unique situation where a cancer is caused

by a virus that we can vaccinate against, ultimately

preventing a horrible disease. With the generous help

of the Australian Cervical Cancer Foundation, we have

vaccinated 4,302 Nepali school girls and are working to

deliver a school-based vaccination program, however,

Nepal presents a whole new set of unique challenges.

This brings me to why I am standing on a highway in my

home town of Bhaktapur waiting for a bus. I am part of

a research team that includes six Nepali colleagues. We

are heading off to four districts in the west of Nepal to

conduct a research project entitled ‘The Challenges of

HPV Vaccine Introduction and Management in Nepal’.

Our strategy involves meeting with key stakeholders in

each district and performing interviews. This serves two

purposes; firstly to develop strategies and guidelines for

a national vaccination program in the future, identifying

potential issues. Secondly to increase awareness of

the HPV vaccine and educate about cervical cancer, its

importance as a public health issue for women and the

importance of preventative actions.

Working in Nepal is wonderful, the beauty of the country

is astounding and the people are so welcoming. But if I

could suggest developing one virtue before coming to

a developing country – it would be patience. Everything

takes much longer than it should, including our drive to

the historic hill district of Ghorka where we encountered

our first obstacle of the trip– a landslide. This is an

expected peril when travelling in monsoon season.

After three hours stationary on a cliff edge breathing

in exhaust fumes, we were on our way again, arriving

safely to Ghorka by nightfall.

To ease our way into field trip life, we spent a morning

climbing upwards into the clouds, 1,500 stone steps

up to a palace. Nepal is full of fortuitous moments and

indeed, just as I turn the corner of the palace I am

awestruck by jaw dropping views of the Himalayas, an

absolutely breathtaking sight. Then it was time for work.

It was clearly evident that there was an abundance of

men in all of the district health offices that we visited,

a potential challenge when attempting to prioritise

women’s health programs.

Next stop was Chitwan, a flat Terai district which at this

time of year is hot and full of mosquitos. It was here

that we had our second incident, a small collision with

a big bus. Nepal road rules appear to favour whoever

is bigger, has a louder horn and is more stubborn. After

much discussion by all parties involved, each driver

decided to take care of their own damage and we

moved on.

Chitwan is home to the Chitwan National Park providing

an excellent opportunity for team building exercises

which involved canoe trips and riding atop an elephant

on safari with my boss – we were lucky enough to see

a one-horned rhinoceros with baby in tow. Chitwan is

also home to the largest cancer hospital in Nepal, one

of the few tertiary hospitals providing cervical cancer

screening.

Since 2002 my Host Organisation has screened

15,460 women by mobilising teams of specially trained

nurses to Kathmandu Valley communities. We set up in

buildings such as schools and temples and screen up

to 250 women in a day. Screening camps are a highlight

of my work as the women are extremely grateful for

healthcare. I tend to play the role of a ‘bouncer’ – clad

in my Kurta (long tunic), I patiently repeat ‘Parkhanus’

(please wait) and ‘yeta Jane’ (go there) to Nepali women

who are always trying to cut the queue – and who think

my Nepali skills are hilarious!

These free camps are immensely important for women’s

health. Not only are pre-cancerous lesions detected,

but free medication is provided to women with cervical

THE LONG JOURNEY IN THE FIGHT AGAINST CERVICAL CANCER IN NEPAL

Promote gender equality and empower womenHost Organisation : Nepal Network for Cancer Treatment and Research : www.nnctr.org.np

Australian Partner Organisation : Australian Cervical Cancer Foundation : www.accf.org.au

3

infection. An incredible 40% of women who attend are

suffering from an easily treatable infection. The team

have also diagnosed and treated over 1,000 women

suffering from uterine prolapse. One woman had been

suffering for more than 17 years; she gratefully told us

that she could now live a normal life again.

From Chitwan we headed west along the Terai range

through to Dang and then on to Doti. It was on our way

to Doti that we had our next incident. ‘Clunk clunk’ and

the wheel fell off our van. We had a broken axle and

were oozing oil. Locals from a nearby village came,

with their buffalo and ox tow, to inspect the damage.

We had some great fun trying to communicate, as they

only spoke a Nepali-Hindu dialect, and they had a great

time watching a technician try to fix the vehicle. Alas,

it couldn’t be fixed so we headed off by local bus to

our target destination and hoped the van would join us

soon.

Doti is amazing, in the far west hill region of Nepal –

stunning, serene and STEEP! Walking to interviews

was strenuous exercise since our van was missing in

action. This is a place where you follow the sound of

singing and dancing and find yourself at a girls’ home

twirling around receiving dancing lessons and being

offered ‘Khana Khane’ (to eat food). The magical beauty

of a place like this can make you forget how poor

the healthcare can be, especially for women. Some

communities have a staggering 45% of their population

who are HIV positive. The immunosuppressive effect of

HIV makes these women even more susceptible to HPV

infection and cervical cancer progression; these women

would benefit greatly from vaccination.

Vaccination against HPV provides up to 80% protection

from cervical cancer. I remember very little about

vaccine programs when I was at school; a form was

put into my bag, my mother took it out, signed it, put it

back in the bag and my teacher would ask for it. Here,

we do the opposite, we visit the schools and run a

cancer education session, we inform the girls about the

vaccine and ask them to take a consent form home to

their parents. Many parents are illiterate so we rely on

the girls to gain permission by having them convey the

benefits of the vaccine to their parents. This strategy

fails dismally if a girl really doesn’t like needles!

These logistical challenges, combined with geographical

and political hurdles, reinforced why consulting district

stakeholders was so important. We conducted

interviews wherever convenient; an air-conditioned

office, under a tree at a tea stop, or a bedroom floor.

Then we ran a consensus building workshop. We even

had a projector – how is that for professionalism! But

it gave out on a number of occasions due to the heat,

and you can’t run a projector without electricity –load

shedding power cuts were at eight hours per day. So

the prepared team would pull out the butcher paper and

it was back to basics.

Meanwhile, our van arrived, just in time for departure.

They had brought in a new part from India – but it didn’t

fit. So the driver had opted to weld the pieces together

and hope for the best. Arriving back at the van we found

that it had been broken into. A small person had made

their way through a small window and our noodles,

lollies and bread were missing. Somehow I felt the crime

was forgivable.

It was time to head home, but first we had to make

our way through eight checkpoints on the way out of

Doti. Not police or army, though they are everywhere,

but rather groups of children holding a rope across the

road covered with hanging branches. If you chose not

to pay the asking fee of a few rupees you risked being

slapped with a tree branch that apparently caused an

itchy rash!

It took two days and 30hrs of driving to get home. The

roads are often in poor condition, and the trucks have

priority, but at least you can see the trucks coming at

night with their blinding, flashing lights. Even with a flat

tyre three hours from home we arrived safely.

My boss had expressed concern about my health when

joining such a field trip; he warned me that it was very

hot, there would be many mosquitos and I would be

eating local food. Yes, it was indeed very hot, but I had

my DEET and antimalarials and very proudly I didn’t

have any stomach problems! I am also so glad to have

had such an amazing opportunity to see areas of Nepal

that are off the beaten path. But it has left me with a

daunting realisation of the long road that lies ahead to

try to provide women the health care they need and

deserve.

THE LONG JOURNEY IN THE FIGHT AGAINST CERVICAL CANCER IN NEPAL

Far Left : Danielle enjoying the mountain view in Doti with research colleagues Hira Manandhar and Soni SresthaLeft : A Kathmandu Valley community receiving cancer educationAbove : Elaborate discussions in the Chitwan community after our mini-van collided with a local busRight : Innocent eyes watch on as a technician tries to repair our vehicle after the wheel fell off in Doti.

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Welcome to the AYAD Photo Gallery, a chance for AYADs and alumni (RAYADs) to share photos of their experiences in-country. Want to share your photo? Simply email the photo with a caption to info@ayad.com.au

By submitting your photos to the AYAD Program you are giving consent for these images to be used for promotional purposes by the AYAD Program (including website, promotional materials and Exchange) so don’t forget to get consent from the people in the photos.

From top to bottom, left to right:

Stephen Plummer starts the morning with a tropical sunrise and Tavurvur volcano spewing ash over Rabaul Harbour© AYAD Photographer: Stephen Plummer

Sally Bolton on assignment working with her colleagues Bosco, Marco and Myrtille © AYAD Photographer: Leandro Pereira

Adam Trau experiencing a beautiful Vanuatu sunset © AYAD Photographer: Adam Trau

Prue Loney one of the few Socceroos supporters in Ghana during the World Cup celebrate with a Ghanaian local © AYAD Photographer: Prue Loney

A paddy field in Bangladesh © AYAD Photographer: Michelle Sain

Returned AYADs at a recent Sydney Alumni event © AYAD Photographer: Jessica Crause

Robyn Sakkara celebrates The Loy Krathong festival in Chiang Mai, northern Thailand © AYAD Photographer: Kwankhao Sinhaseni

AYADs about to mobilise to Ghana at the Intake 28 Pre Departure Farewell reception meet the Hon. Stephen Smith MP and the Ghanaian Foreign Minister © AYAD Photographer: Irene Dowdy

Staff at the World Heath Organisation in China practice what they preach during the morning exercises © AYAD Photographer: Nicola Scott

Antonia Clarke on a field visit to help rebuild a school affected by a monsoon © AYAD Photographer: William Holton

The Brisbane Alumni event served as a catch up for five Intake 18 Vanuatu AYADs © AYAD Photographer: Stephanie Denman

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