I was on a hunt for some prizes for the inter-school HIV/AIDS quizzes I've been tasked to run, and so was contacting various NGO's to see what we might be able to get for free when I came across Kofi, from the SHARPER project (don't ask me what it stands for sorry some acronyms here are just far too long to remember!) who invited me to come and meet his team and see what they do.

Most of the work I've done here and in Malawi on HIV/AIDS has been on the periphery of the issue, working mainly on preventative initiatives, education, and livelihood support, rather than working directly with testing, counselling and treatment. I have worked with a few people living with HIV/AIDS themselves, and have an idea of the way this unforgiving issue affects the lives of people, their families and communities here in rural Ghana, and also in Malawi. One thing I will say is that in my experience so far, HIV/AIDS was seemingly far more prevalent in Malawi, which at the time in 2006 was suffering from a very high HIV/AIDS rate. The impact could be seen and felt in many aspects of my life and work there, with constant funerals for those who died from it, hospitals overrun with people suffering from AIDS related illnesses, and literally hundreds of NGO initiatives to educate and prevent the spread of the virus. Not to say that it's not an issue here in Ghana, with a prevalence rate of 20 percent, it definitely is, but this has given me some perspective and a sense of how far Ghana has come in stemming the spread of this vicious virus.

Going to the SHARPER PROJECT I wasn't really sure what to expect. At first I met the staff team, visited their offices, heard about the different types of work that they do, and listened to their appeal for more funding. It was the second part of the visit that was most eye-opening. Having only ever visited one HIV/AIDS clinic before (in Malawi), I had only a small idea of what it might be like. As we arrived there I could see literally hundreds of people packed inside the clinic, with many more outside waiting to be seen. There was a real mix of people; men, women, farmers, business professionals, petty traders, people who looked fairly well off, and others whose tattered slippers (flip flops / sandals - one subtle way of gauging poverty levels in my experience so far) revealed their poverty and struggle, children and young people, mothers with babies, even one or two pregnant women too, although it was hard to tell.

The difference to what I saw here compared to Malawi, is that these people are healthy, and living positive lives, whereas at the clinic in Malawi, most were already in the later stages of AIDS and were ill with diseases or infections. It was sad to think that many people who have HIV but don't get tested due to stigma or denial will end up suffering more and sooner as a result. I was slightly embarrassed as I was shuffled inside the packed room, where the only free space to stand was right in the middle. This is supposed to be a confidential service, so it was quite uncomfortable knowing that many people would see me as a white person looking in on their lives. The only good thing in these scenarios, is that many people will expect me to be a nurse / doctor or if not then at least someone who has come to help rather than simply nosey in on them.

It was clear that the demand for the service is high; all the people in the clinic were HIV positive and were coming for their regular check-up's and medication that helps them to live for longer. It's a God-send that these drugs are available, but they come at a cost, and it's one that many here cannot afford. The nurse explained to me that "one month's supply costs 5 Cedis (£1.60), but many people who come in here simply can't afford it". When I asked what do they do in that case, she explained that in some instances they will attempt to provide it on credit, hoping they will pay back in the future what they owe, but knowing that in reality this is futile. Many people living with HIV continue to work, run businesses, and live well, but for those in Ghana living in poverty, HIV/AIDS only makes things worse.

Kofi invited me to 'interview' some of the people present, which at first I wasn't comfortable with as I wasn't there on any specific mission, but a couple of people were keen to talk to me, so I saw it as an opportunity to find out more about what it's like living with HIV, what challenges people face, and what kinds of things they think will help to make a difference. One man in particular stood out amongst the people I sat down to speak with, a health worker from a community that is over an hour away. He travels this distance every month, often with no money for a lift, to come for his medication, because although his community provides what he needs, he does not want to access it there due to lack of confidentiality and the stigma attached to HIV. He explained that if anyone from his community did find out, that he would lose his job in the health service (as people would not come to the clinic with a HIV positive person working there), he would lose his only source of income, he would lose his friends, and he would suffer from the discrimination throughout his community. He also said that he wanted to help others and loves his job as a health worker, so by encouraging others he can support more people to be tested and receive the support they need if found to be positive.

He is not sure how he got HIV, but only got tested for it when his wife died from an AIDS related disease, until then hey had not known she was HIV positive. He said he was shocked at how sick she became and how quickly she died, and that for the sake of his three children he wants o live as long as he can. He said that one of his children had been tested, and was negative, but that the other two have not yet been so. When he told me this I could see the pain in his face, the fear of what a positive result would mean for either of his two young boys.

Later, as I left the clinic, I saw a young girl standing outside. She was waif thin, with a loose dress hanging over her tiny shoulders, small white doll dangling in hand, with equally threadbare clothes on. She looked up at me with huge sad eyes and hid behind her mother as she walked past. Even at such a young age she is carrying the burden of knowing she is HIV positive. It sounds like an advert for a charity, but it's true. For me it's knowing that there are good projects here like this one that are working at all levels to bring about change on this issue, that give me hope that in time things will be different, and that HIV will no longer be the ruthless cureless killer that ruins so many lives in developing countries like Ghana.

Xx