Already as a teenager, Esther, 21, of Munyonyo, Uganda took upon herself, without any outside prompting, to start the uphill battle against this plague in an area, which has been called "probably Africa's most complex and difficult place to live", the Kalangala district in the islands of Lake Victoria. There is a remarkably high prevalence of HIV/AIDS, generally poor health, lack of government services, frequent family breakdown, widespread belief in witchcraft, alcoholism and very high levels of commercial sex work. In addition, strangers from the mainland come there to escape the stigma of HIV/AIDS and the law.

There are few permanent houses and most people live in shacks with almost no sanitation and hygiene. Family structure is nearly non-existent, putting women and children at risk of neglect, abuse, and increasing problems due to unwanted pregnancies and the spread of HIV and other sexually transmitted diseases. Men tend to spend their money on alcohol and women rather than invest in meaningful projects.

The men fish, but women sort and clean the fish. They are poorly compensated and often expected to provide sex favors for their employers. The only job that pays well is commercial sex, which many women resort to as a last means of providing for their children. Add to that the fact that the islands are a spiritually dark and desolate place where witchcraft is at the center of daily life and constantly impacts human relations.

So it needed an exceptionally courageous heart like that of Esther Nakajjigo to take on the challenge of combatting this quasi-perverse culture ... and that at the age of 14! Her schoolmate Sonia who attended school on the mainland tried to perform an abortion on herself during the night in the school bathroom. After bleeding the whole night school authorities sent her home to the islands. When she arrived there, instead of being rushed to the health center she was taken to a shrine, as the community believed the angel of death would take people's soul there just after midnight, which is when Sonia died.

So Esther mobilized the health workers to begin doing community sensitization and would spend her whole school holidays on the island educating the people in the field of health, encouraging women to go to antenatal checks, immunize their children and young people to seek out adolescent health services. She very soon started a Women's Health Team which would do community outreach work while she was at school, and would then join them during the holidays. They would visit schools and give health talks, especially targeting adolescent girls, as there was a widespread belief that one had to have sex after one's periods so that the next menses would not be as painful. Boys had a strong allergy to condoms, believing they brought bad luck.

Under the leadership of this remarkable teenager, attitudes on the island started to change, with maternal and infant morbidity and mortality falling drastically. But that is just the beginning. In her second year at university, Esther innovated the "Saving Innocence Challenge" an expedition where 3 girls from 10 city schools (i.e. 30 girls) go to the island to educate the most vulnerable of these isolated, rural girls, those living with HIV, and/or victims of violence and teenage pregnancies. The city girls live in the island girl's homes and each team has three days to have an impact on the girl concerned, her family and her community. The city girls use themselves as role models to inspire the locals with a new vision and stop seeing their island lives as hopeless and the mainland as too daunting and unreachable. The most creative of Esther's 10 teams wins a National Humanitarian Award. The island girls under this inspiring new leadership have created 54 small businesses for 114 vulnerable island mothers who are now capable of taking care of their children without having to sell themselves for a few fish to local fishermen constantly looking for human preys with as much eagerness as they seek shoals of fish. The teams have also trained 510 island girls to make their own reusable sanitary pads so as to avoid sleeping with fishermen to get fish to sell and buy sanitary pads in order to be able to go to school when menstruating! These pads can last for a year (12 cycles), are practically cost free, three times more absorbent than commercial pads, dry in only two hours, and are especially designed for heavy flow.

The challenge continues, and Esther plans to reach 5000 vulnerable island girls by the year 2020.
This amazing experience born of the compassion and creativity of a 14-year-old teenager just goes to show the impact one single person can have. Like the proverbial stone thrown into a pool, Esther's courage, vision and perseverance have reached wide and far and go to show once more that "our only limits are our belief in limits". Esther, you are an inspiration to a whole continent. Right on!