26 May 1994
London, UK
Dear Elizabeth,
I will be in New York for the afternoon of Wednesday, 8th June.
I hope it will be possible to see you even briefly. It will be important to share experiences gained through the mission just completed to the Congo, Zaire, Zambia, Kenya and Uganda.
The linkage of care in the home to change through and by the community is more clearly affirmed. At field level, systematic home visits by a team can be linked through 'confidential sharing' to community mobilisation for support and change.
Every household in the Chikankata catchment area is now listed, by the initiative of the community. Although it is not yet established, the view is emerging that every house can be visited on a systematic basis when there is someone who is sick and every house can be included now in a present and future plan for neighbour support and visitation. These two extra elements of neighbour to neighbour support and inclusion of a future need, expressed now, are two simple but very important elements of a workable approach to management at field level in high prevalence places.
Organisations like the Salvation Army are ready made for this sort of involvement but catalytic funding is needed in low, medium and high prevalence countries to normalise the process of home visits, community involvement and change. It seems to me that this can take anything from six months to several years, and that it can happen in low prevalence areas (e.g. Mizoram, India) as well as high prevalence areas (e.g. Chikankata, Tshelanyemba Hospital).
The team at Chikankata tried to describe both 'community pain' and 'hope'. The pain is reflected by serious disposition in people, lessening or disappearance of wailing when deaths happen, and adjustments to counselling processes that include, for example, recognition that though one person of a couple to be married might be sero-positive, they may still go ahead if they know what the future might hold because otherwise how can love be found and expressed? Also the recognition has dawned that the loss is accumulative and that it is only just beginning. The hope, as we said a year or so ago, is both concrete and mysterious C people can care for each other, but at the same time, the mystery of belonging energises people and motivates them to care, to love, and to be realistic.
Definition of hope is an important theme to spread around the world, because as people find capacity to cope, they can become disabled by the increasing accumulative loss and pain.
I know you know these things but I felt you should be the first to have a reflection letter on my return (today is the first day in the office).
We (Alison and I) look forward to seeing you and/or Mina, if possible.
Yours sincerely,
Ian D. Campbell
Captain
Medical Adviser
The Salvation Army