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Conversations in the midday sun

Cushla Coffey talks with local volunteers Kelebetse, Kgakgamatso and Malebogo. (Australian Red Cross/Debbie Yazbeck)

An informed, active team of volunteers is helping to address the impact of tuberculosis and HIV in Botswana. One of them is South Australian Cushla Coffey.

The sun hammers relentlessly down on the Trans-Kalahari Highway that connects Botswana to Namibia.

Truck drivers seek a few moments' respite from the heat in the small town of Kang. Before long, they are deep in conversation with a group of young people in Botswana Red Cross shirts, and head back to their trucks with a pocketful of condoms and pamphlets on safer sex.

It's not an uncommon sight in Botswana, a country with one of the highest rates of HIV in the world. What is unusual is the tall South Australian woman in the midst of the Red Cross crew.

"If you'd told me before I left Australia that I would have these kinds of opportunities, I wouldn't have been able to fathom it," says Cushla Coffey, the newest volunteer in the Kang branch of Botswana Red Cross Society.

Cushla is in Botswana through the Australian Volunteers for International Development program, an Australian Government, AusAID initiative. She is helping Botswana Red Cross to expand its peer education program, a powerful weapon in the fight against HIV and tuberculosis.

With national networks of highly-engaged volunteers, Red Cross and Red Crescent societies are well placed to deliver public health campaigns. Volunteers act as role models for their peers, offering customised information to help prevent or manage transmissible infections.

Tuberculosis and HIV are significant problems in the region, especially because the population is highly mobile. "Tuberculosis is preventable and treatable, very much so," Cushla explains. "The problem is that it's highly contagious because people live in close quarters here, and you have to go on treatment for six months.

"People start treatment and then they return to their cattle posts without finishing the treatment. Then they become sick again and go on to infect other people."

Botswana Red Cross volunteers have begun to trace people who are receiving treatment for tuberculosis, often travelling long distances to reach remote cattle posts. They help people adhere to their treatment plans and screen family members for TB infection. These interventions complement government efforts to reduce the impact of the disease.

The expansion of the peer education program is a priority for Botswana Red Cross, according to program officer Ms Baboloki. "The peer education program is only in two of our branches, although we have seven branches in our area. But we cannot upscale without having skilled volunteers. Currently we only have 20 volunteers who are skilled in community tuberculosis care."

A paramedic with a Master of Public Health, Cushla is helping to recruit local volunteers for the peer education program. She trains them to disseminate health information among target groups that range from truck drivers to prisoners to school children.

"Cushla has been so, so helpful to the volunteers and to the work of Red Cross here," says Baboloki. "She is one of the best volunteers we have ever had."

For her part, Cushla is revelling in the variety of experiences that volunteering brings - from coordinating a community health fair to handing out condoms to truck drivers. Interestingly, her 'outsider's perspective' can be an asset when it comes to discussing sensitive health information.

"In a village like Kang, it's important that you allow space and time, and develop relationships with individuals and the community before you engage in this kind of work," she says.

"But people are interested in what you are doing here. If you have the knowledge and the facts, you can discuss them as long as you are respectful and take cultural factors into account."