TESHO - Turn your not so great marriage into a thrilling one!

Q & A with Dr. FON


Answer; When I started work in 1985 as a young medical doctor, HIV/AIDS was some scary new disease that we had to deal with. The first AIDS patient was a curiosity that drew all the doctors in our Laquintinie Hospital to take turns observing her.
A fierce campaign was mounted in the media to educate the population on this new disease that was transmitted through unprotected sexual contact. All the stake holders were scared of this strange disease and the messages on the billboards and the media reflected this fact. The first messages were quite scary; “Beware AIDS kills!”
Despite these scary messages, the stake holders witnessed an even scarier rise in the HIV numbers.
As a doctor involved in educating the population on HIV prevention, I taught them the A,B,C messages conceived by WHO later on and distributed all over the world. We learnt to pass on the A,B,C of HIV prevention to the population and evaluation tests revealed that the population could parrot all the right answers at the end of our various workshops.
Despite the fact that the population knew all the right answers on HIV prevention, the HIV numbers did not slow down appreciably as a reflection of this increased knowledge.
That was when I started really talking and listening to the patients. Professionally, we were taught not to pry into the patients’ private lives. However, I noticed that when I gave them a listening ear, they had this yearning to tell me the story behind their HIV infections. In most cases they were so scared of stigmatization, discrimination and rejection by family members and colleagues that I was the only one they could confide in. As I listened to their stories of HIV in marriage, there was one common thread that answered the question my husband and I had been asking ourselves. The question was this: “why is it that almost everyone who has attended a workshop on HIV prevention, listened to a radio or TV message on HIV prevention can pass a written or oral examination on the subject but this knowledge is not translated into effective HIV prevention in their marriages or co-habiting relationships”?
After hundreds of hours of brainstorming with friends, patients, married and unmarried people, we conceived the TESHO (Team Spirit Holistic) concept. We then tested the modules on a one to one basis with patients and other individuals. When we got positive feedback from those we had counselled using the TESHO program, we then decided to go public with it. News about TESHO has spread by word of mouth and we are in high demand in our town of Douala. After an introductory TESHO presentation, we ask the participants to indicate by writing down their names, phone numbers and signatures if they think that TESHO will meet their needs on HIV prevention. Over 90% of the participants sign up.


Answer;This is my personal observation of our society. Like little children who believe in Santa Claus or father Christmas, young adults believe in living happily ever after in marriage.
Just as little children have only a vague clue about where Father Christmas comes from, in the same way young adults have only a vague idea of how happy marriages come about.
Come to think of it, many adults, even those in long term marriages are just going through the motions of being married. They do not know what it takes to live happy, exciting and fulfilling marriages. As a consequence, they cannot help their adult children attain that goal.
When people get married, their deepest desire is to live happily ever after in their marriages. In many cases, a short time after the wedding, something horrible happens to their beautiful marriages and they are helpless to do anything about it.
That was our conclusion when we started research on how to develop strategies that will foster faithfulness in marriages in order to avoid HIV.
After interacting with young adults and with couples from all socioeconomic classes and cultures, we realized that there are certain facts that the society has ignored leading to sad consequences for everyone concerned.
Marriage is one of the few professions that offer a license or certificate before the individual has learnt to perform the complicated task. With other professions, one has to go through lessons and a stiff test before that person is offered a license to perform the task. Many adults know that marriage is a complicated task but the society is not doing anything to prepare the young adults for this complicated task.
The society views marriage as the couples’ private life. In the Western world, this inertia of the society to do anything about preparing young adults for marriage leads to an almost 50% divorce rate. In sub-Saharan Africa, we do not divorce like the Westerners but most couples stay in miserable marriages and seek solace outside the home leading to HIV and all the ills that follow in the wake of a marriage or co-habiting relationship gone sour.
In sub-Saharan Africa, HIV in marriage is just the tip of the iceberg that tells the society that all is not well with our marriages. The other fall-outs are delinquent street children, increased crime, psychosomatic illnesses and depression for those who decide to stay in the marriage despite the misery.
The stake holders in HIV control programs have shifted their emphasis from HIV prevention to provision of antiretrovirals to those who are infected. They have made giant strides by providing more and more PLWHA with antiretrovirals which is commendable.
However studies carried out between 1996 – 2005 show that 42% of all new HIV infections in Uganda occurred in the married or cohabiting couples. Dr David Apuuli Kihumuro head of the Ugandan AIDS Commission (UAC) had this to say “There have been great strides in providing antiretrovirals to Ugandans but when we see the number of new infections in married or cohabiting couples, here is a changed face of the epidemic. Here is evidence that we have to emphasize different areas of prevention from what we emphasized in the 1990s. For every 02 people placed on ARV therapy, 05 others will contract HIV”.
TESHO is an answer to the problems that couples have been grappling with for a long time. Problems occur in marriage because young adults have not learnt to build team spirit in their relationships.
They have not learnt because no one has taught them. No one has taught them because no one knows or even if they know, they consider marriage the couple’s private business.
It is time the society wakes up to realise that they have to do something to help married or cohabiting couples find harmony in their marriages in order to avoid HIV and other marital ills.
If the society does not act, many a marriage that started off in “love land” will end up in “coldest Siberia”, the land of no return.


Answer;I believe female condoms were developed to give women their own condoms in cases where the men do not want to use condoms. The stake holders were right to develop the female condom in response to the cry of women. Men often use slangs like “man go suck bonbon with wrapping? Yi no di sweet”. This roughly translates into “how can one suck on a candy bar with the plastic wrap still on? You cannot taste the sweetness”.
Studies carried out in various countries reveal that men do not say it as a joke. Condom use by men in sub-Saharan Africa is inconsistent even when the men know the partner with whom they are is not their regular married or cohabiting partner. In short, men in sub-Saharan Africa do not like to use condoms.
Welcome to the female condom. Logically if men do not like to use condoms, the female condoms should solve the problem for the women. In practice, it is a different story all together. Women have to resolve baffling challenges like;
“How do I convince my unfaithful or faithful partner to accept making love with me as I use my female condom?”
“If he refuses the female condom for “X” reason, what is my plan B?”
“For how long are we going to use these female condoms anyway?
“Are we going to use these condoms for the rest of our marriage?”
“If yes, how do I convince him to accept female condom use that long?”
Until women learn TESHO communication and can communicate openly and effectively with their partners on female condom use, the female condoms will forever be a theoretical solution to a problem that has many ramifications.


Answer; The Cameroon National Tuberculosis Control Program came about with the upsurge of Tuberculosis due to the HIV pandemic. In 1985 when I started work, there was only one treatment centre in the Littoral region for those suffering from TB. Today, there are 38 centres.
There are about 25,000 people a year suffering from Tuberculosis in Cameroon. About ¼ of them live in the Littoral region,(6,000patients). Between 30-40% of these 6,000 patients also have HIV.
The 38 centres provide health care for Tuberculosis patients. These free services include:


Answer;The truth is that when I got married, I was a normal dreamy young bride who thought she knew everything about marriage and did not need to learn. This was my reasoning, "I am so madly in love with my prince charming. I have my marriage certificate or license to prove that I know it all. What more can anyone teach me"?
I was so full of myself as if I was the first woman to become a medical doctor (actually being a female doctor was some big deal in the eighties in Cameroon). Of course I immediately ran into problems in my marriage and there were no resources that I could use to resolve my marital woes. Added to that, we had problems starting a family. When you remember that we were living in Africa where having a child is synonymous to being happy in marriage, you can begin to see that we had the perfect brew for conflicts to just naturally occur in our marriage. My husband and I started playing the blame game. Our families got into our relationship to each defend their child (welcome to in-law problems). Hardly a day went by without my husband and I quarreling over some minor or major issue.
I listened to my patients who had stress-related illnesses and as a doctor I realized that I was a prime candidate for stress illnesses if I did not do something fast. I would say that God in His infinite mercy revealed TESHO living to us. We started trying out some of the basic principles that make for a cordial relationship between husband and wife like effective listening and showing sympathy. It was not an overnight sort of thing. It took years with input from many sources for us to reach a stage where we can comfortably talk about TESHO living and effectively live TESHO in our family.
The first TESHO workshop was given to the workers of my husband's company. He had given me the privilege of naming OUR company which proved that TESHO (we did not call it TESHO at that time) was bearing fruits in our life. I promptly named our company TEFON as in Thaddeus/Elizabeth FON our names. It is rare to see a sub-Saharan man involve his wife in his business so I felt like the most valued woman on earth. Since I was intimately involved in his business (he gave me a run-down of his day's activities each evening at dinner time), I was able to see that he had problems at the office. TEFON had grown so fast that the bonding he had had with the first few workers could not be repeated with all the new recruits and team spirit at the TEFON work place was at an all time low.
In addition, really listening to my HIV/TB patients made me realize that many patients lacked team spirit in their relationships at home. The tensions generated by family conflicts drove many of them to go out as a means of escape only to come back home with HIV.
My husband and I started talking and brainstorming on how we could build effective team spirit in our workers at the office. Then it occurred to us that if we really wanted to build team spirit in our workers, we needed to help their spouses build team spirit with them right from home. That way, talking about team spirit to a worker who left home happy would be much easier. I gave my first BTSM (Building Team Spirit in the Marriage) workshop to the spouses of our employees and it was an immediate huge hit. The workers and their spouses could not stop talking about the new skills they had learned, skills that had drastically transformed their relationships from the routine and boring to the thrilling and exciting. They shared so many positive and uplifting testimonies with us that we were encouraged to go on doing research, giving more talks and writing out what we were learning. The more we gave presentations and listened to the worries, questions and feedback from the participants, the more we realized that marriage is not as easy as the society treats it. Marriage is not a matter of living happily ever after like it is portrayed in the romance novels. We were able to gather the challenges facing families into 15 modules that we dispensed according to the needs of the participants. That was when the name holistic replaced marriage. We realized that families, workers and just about everyone needs team spirit skills in order to build meaningful relationships at home, work place and the community.
From having problems in our marriage and learning from the mistakes we made, TESHO was born. My husband and I including our kids are still in the learning process but now that we have learnt to think and act as a winning family team, there are fewer tensions in our home.

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