By Simone Galimberti,
Muriel earned her Bachelor degree in Nursing Sciences and Master degree in Applied Sciences from McGill University, Montreal, Canada. Prior to devoting her work to international health development, Muriel worked for few years as a nurse in neurosurgery, cardiac surgery, community health and research on type 2 diabetes in Montreal. For the past 12 years, she has dedicated her work to community and development health in an international cooperation context in Africa (eastern, western and southern) and Asia (South and South-East), in the areas of community health, HIV and AIDS, sexual and reproductive health, gender-based violence and disability.
Currently, Muriel is the HIV and AIDS/Protection Technical Advisor to Handicap International Federation. She is actively involved in various technical working groups on HIV and disability. She co-chaired the HIV and Disability Task Group of the International Disability and Development Consortium (IDDC) from 2010 to 2012.
I met Muriel back in 2007 when she was with CECI here in Nepal. At that time i was busy with the idea of establishment and launching an health working group within the AIN, the Association of International NGO in Nepal. We have been in touch since then and i have been able to follow her amazing career.
How did you develop your interest for international development and in particular on health related issues?
This interest didn't come randomly. It was nurtured from my work as a nurse in Montréal while providing prevention and treatment services to a very multi-ethnic clientele coming from various parts of the globe. Also, this interest was prepared along the years by being intellectually mentored by great nursing professors and team leaders that always challenged me to ask what more can be done to help people help themselves. What fascinated me was the weight of sociocultural and familial factors on people's cognitive processes and behaviour dynamics, coupled with their coping mechanisms. Amidst my clinical work, I was progressively interested to know more about people's environments stemming from their country of origin. It was almost like a "detective" work to decipher what was going on behind a high blood sugar level from the human's perspective or know more about what was the role of family members in health care decision-making and behaviour change. Furthermore, there was this opportunity to work in a Canadian-funded project on health and rehabilitation in Gujarat (India) in the aftermath of the deadly earthquake in 2001. This is how my international health journey began.
What are your current areas of interest in the field of HIV and AIDS?
My current areas of interest evolve around disability inclusion, accessibility, rights to HIV and AIDS prevention and care as well as linkages between disability, AIDS and rehabilitation needs. In the past decade, great improvements occurred in the access of people living with HIV to antiretroviral treatments especially in Sub-Sahara Africa, home to the highest HIV burden worldwide. However still 15% of the world or one billion people with disabilities at risk of HIV and gender-based violence are yet to be effectively targeted by international and national AIDS related policies and programming. Many states have ratified the binding UN Convention on the Rights of Persons with Disabilities, but fail to implement it to allow the full participation of women, men and children with disabilities in all spheres of life, including having access to adapted sexual and reproductive health prevention and services. There is also research on the vulnerability of people with disabilities to HIV infection and sexual violence that interest me enormously. Only with sound evidence and generation of good practices, we as practitioners and field workers can better argue and advocate for the equal access to services and care for marginalised and forgotten populations such as people with disabilities.
How do you create community ownership in the programmes you envision and how do you try to foster community involvement and innovations to fight against HIV and AIDS?
I think we need to believe ourselves first that change is desired and can happen from within the community, within people and within even ourselves. This might sound redundant, but I believe it's key to trying to bring about changes. I think it's a fallacy to think that we can create community ownership without people themselves believing first they can lead the game and contribute to their own success. Of course we should act as catalysts, why not even as cheer leaders, but in all cases, community ownership and participation originate from dynamic and visionary people from within the community. And there are always people like that, we just need to find them, and build the journey to fight against anything, including HIV and AIDS together. There are various approaches, strategies and interventions out there to foster community involvement, but bottom line, I think, is to acknowledge people's and communities' wisdom and desire to have a better life for themselves. And to respect that in order to work and move ahead together.
You recently came back from the International Conference on AIDS and STIs in Africa held in Cape Town at the end of 2013. What are the major ideas/take away messages?
One of the main messages is that there is a renewed promise to set the objective of the three zeros, i.e. attempting to reach zero HIV infection, zero AIDS related death and zero discrimination – and this amidst a period of global financial contraction affecting all donor agencies that are being mainly fueled by tax payers' money from developed countries and of some developing states that are starting to self-contribute to their national AIDS responses. Nonetheless, this will be achieved with great difficulty if the sense of urgency to reverse and halt the AIDS pandemic is diminished because we globally have won a battle against HIV and AIDS; the war is however far from over. For example, it is possible to reach AIDS free generation by having no more pregnant women living with HIV give birth to HIV positive babies. This is possible when policies and laws are enacted and applied, when discrimination and stigma are no longer accepted, when women and girls can freely go to prevention and care clinics without fear of being rejected, beaten or thrown out of their communities just because they are HIV positive, when people with disabilities can have access to adapted services and communication messages, when the LGBTI community can be seen as humans as anyone else and not criminals, when sex workers are respected, when youths are considered as "old" enough to learn about their own sexual health, when indigenous and marginalised populations are heard.
What motivates you the most?
Nice question. What motivates me the most is to see the passion in people to try and make things change in spite of difficulties and challenges that may arise. This realistic drive tells us that nothing is impossible as long as we believe and want it to happen indeed. This in return is fueling further my stubbornness to be part of a change movement, or at least to contribute to create it with others. One of the sentences that I have difficulty with is "but we have to deal with it, it's like that" as everything is immutable, as if violence is tolerable, as if injustice is acceptable, as if inequity is as it is. These are perhaps the saddest thoughts one can have as they can paralyse us to inertia. Ghandi, Mandela, Wangari Mathai changed their world in spite of great counteractive forces. But they persevered and changed things for Humanity. They changed our world. And each and every one of us can also change our own and that of the person next to us, and so on. Hope and idealism that we can have a better and more just world for all women, men and children starting from individual actions for the greater good of the global Community.
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