People with HIV/AIDS being empowered to manage their lives positively.
In 1997 I was parish priest in Villa Maria, one of the poorest suburbs of Lima, when I received a phone call to go to the local barrio clinic run by Sr Mildred McNamara, a Sister of Mercy from Ireland who first arrived in Peru in 1969. Two brothers had died of AIDS in the same week and a third brother was in the throes of an emotional fit as he believed that he would be next to die.
At that stage I knew nothing about HIV/AIDS so I began to ask around and found out that many people were living with HIV and dying from AIDS. It was a “taboo” subject in the shanty town where the people only spoke about it in whispers and my Columban friends and the local clergy alike did not see it as a major pastoral issue.
Even the families of the people living with HIV/AIDS would refer to their relatives’ illness as tuberculosis or leukaemia. It was as if we Columbans were colluding in the generalised denial in the population. It was not that my fellow priests were uncaring towards the plight of these vulnerable people. They would sympathise with the families of the deceased, do whatever religious ceremony was appropriate and leave it at that as they simply did not know what else to do.
I called together a group that I thought might help find a way to respond to a steadily worsening situation. I met with a psychologist, a teacher and a lawyer but we did not know enough to go beyond the basic recommendations of prevention. In 2002, for personal reasons, I left Peru and went to London where I spoke with a friend who was working with people living with HIV/AIDS. He urged me to take time to learn more about HIV and as the position of Coordinator of the Multidisciplinary HIV/AIDS Team in a hospital in north east London was advertised just at that time, he encouraged me to apply for the position. I did and got the job.
There I learned a lot about living with HIV and was introduced to the Stanford University programme for self-management of chronic conditions, which was implemented by the National Health Service under the title of ‘The Expert Patient.’ I eventually got trained to the top level for running the programme.
At the time, there were only three people in the UK trained to that level for work with people living with HIV/AIDS. After three years I decided to bring the programme to Latin America and so returned to Lima in 2005.
The programme’s purpose is to educate people living with HIV/AIDS in the self-management of their chronic condition. Through the programme we set out to empower people so that they might discover within themselves the tools and ability to manage their lifestyle while living with HIV/AIDS.
We constantly talk about response-ability, i.e. the ability to respond to new situations in their lives. We further train suitable participants as future trainers in the programme and as promoters of prevention in high risk populations in the metropolitan area of Lima and Callao.
The basic programme consists of seven consecutive weekly two and a half hour sessions, to which we have added two more sessions, an introductory information session and a follow-up meeting one month after completing the seven sessions. This is to get feedback about how participants are implementing the programme in their lives. 
Over 1,600 people have been through this programme over the past seven years, 120 of whom have been trained as instructors of the programme, and 20 of whom are soon to be accredited by Stanford University as Master Trainers of the programme.
Fifty two of these instructors continuously run programmes in more than 20 locations, scattered for the most part around the poverty belts of the cities of Lima, the capital and Callao, the major port city of the country.
From my experience to date I can see that major issues around HIV infection are lack of information and myths about sexuality, gender inequalities, the lack of good father figures and the stigma and discrimination attached to a HIV diagnosis which cause many to avoid being tested. Correcting these issues will require major changes in Peruvian society, especially as regards the authoritarian, patriarchal mindset of many men.
We have developed a good working relationship with a number of state and local authorities, allowing us to provide awareness raising and prevention workshops with members of the Armed Forces, the National Police Force, the Metropolitan Police and in some of the National jails.
In our centre we coordinate our work of training and prevention campaigns. We also offer ongoing education for the trainers on topics such as human dignity, human rights, self-esteem and leadership.
We also run a programme called “Yo Soy” or “I am,” which is open to all who have been through the basic programme. This project includes a Support Group, a 12-step programme and re-socialization activities like Karaoke, BINGO and a Cine-forum.
This allows us to help many combat depression, shame, social stigma and discrimination. This programme was awarded second place in “The Competition in Best Practices in HIV 2011–2013” run by The National Institute for Health and The Ministry for Health.
I see men and women who live with HIV/AIDS as the present day lepers. Our job is to help them move from exclusion to inclusion, as did Jesus of Nazareth when he acted to help the lepers of his day belong once again to society.
I see HIV/AIDS as largely an illness caused by poverty, poor education and inadequate health facilities.
I would like all to feel welcome at the table of the banquet of the Kingdom of God.
Columban Fr Cathal Gallagher lives and works with people with HIV/AIDS in some of the poorest areas of Lima, Peru.
Read more from The Far East, March 2014