April 2005 WCRP-HIVAN Forum: ?“What are FBOs doing about HIV/AIDS??”

Welcoming the Forum guests to the April 2005 session, Paddy Meskin of the World Conference on Religion and Peace summarised the history and purpose of the Forum?’s aims and objectives: to frame the HIV/AIDS pandemic, its effects on and implications for society, within religious and spiritual as well as biomedical and clinical contexts. At this juncture in the programme series, it seemed appropriate to review and reflect on efforts made in recent years by FBOs in responding to HIV and AIDS.

The first presentation was given by Welly den Hollander, senior social worker and trainer at the Sinikithemba Training and Resource Centre, based at McCord Hospital in Durban. This institution has worked for years on HIV/AIDS, and the Centre provides training to churches, which generally had not been accepting of those who were living openly with or seeking counselling and guidance for HIV and AIDS. ?“Places of healing were being turned into places of hurt,?” Welly observed.

In an attempt to redress this, Sinikithemba embarked on developing and disseminating a carefully designed knowledge programme for churches, training church leaders and lay counsellors to establish support teams within and for their congregations. Run in KZN for the last five years, the courses cover issues ranging from Voluntary Counselling and Testing (VCT) and anti-retroviral therapy (ART) to domestic abuse and poverty alleviation.

Initially, there was a perception that church leadership would not take up the offer of this resource due to stigma and denial, but according to Welly, two or three courses are being run per week.

The Programme Outcomes include a monitoring and evaluation project, using focus group sessions held every Friday evening in target communities to determine whether and how the training has helped individuals and groups. ?“Feedback has indicated that church and community leaders are the ones most in need of the training,?” said Welly, ?“although we need to conduct a deeper analysis of this finding to understand all the reasons behind it.?”

The Sinikithemba training course structure involves a Basic Course (which is offered to FBO members and participants from industry), as well as an Advanced Course, and includes an examination on VCT and VCT mentorship as a practical assessment. ?“We run refresher courses, and special courses on child and orphan care, HBC and adherence counselling, for churches only,?” explained Welly. ?“The training model is also adapted for use by Church Leadership and at Bible Institutes, seminaries and colleges in Africa, and these adaptations consist of five-day, basic and advanced Training-of-Trainers courses.?”

In documenting and publicising their work, the Centre issues quarterly reports and case studies, and a newsletter. ?“Essentially, our goal is to build capacity within churches to address the psycho-social needs of their congregants in all HIV/AIDS-related situations,?” said Welly. ?“We are also training counsellors to care holistically for themselves as well as others, and we have established a theological and ethical forum to discuss the attitudes and role of the church in South African culture and within poverty-stricken sectors of our society.?”

Wherever and whenever possible, the Centre has linked up companies whose personnel have completed the training with NGO care teams and church-based initiatives, so that counselling and empowerment interventions are available to people who lose their jobs and need this kind of support. However, Welly noted that so far, they have trained many more churches than companies.

The second speaker was Dr Fiona Scorgie, a HIVAN senior Social Science researcher, who presented her reflections on the work done by the Catholic Mission Station at Centocow. She has conducted much of her anthropological and ethnographic studies for a number of years in this village, which is situated close to the KZN border with Lesotho, about two-and-a-half hours?’ drive from Durban. Her perspective was therefore not one representing the Mission or the Catholic faith, but one developed from close links with the community, both as a researcher and a friend.

Although the Roman Catholic dominates in the area, the Zionist and Shembe churches, as well as traditional healers, are also prominent. The nearby St. Apollinaris Mission Hospital runs a solid HIV/AIDS programme. ?“It was only in mid-1990s that the demographics of the disease started to change,?” noted Fiona, ?“and mortality began to climb, so the Hospital started to dispense basic information in an attempt to counter the denial and disbelief surrounding the epidemic; most people thought it was an urban issue.?”

Youth were seen as most at risk. Printed pamphlets and posters, largely in English, were issued, followed by community theatre interventions. The latter were successful in entertaining youth audiences and proved to be popular and interactive, but as an awareness drive, there was little assessment of its efficacy. There was little follow-up to track responses, and a lack of broader access to the performances so as to include older people. Now that such information is more readily available through mass media, the Mission?’s priority for HIV/AIDS intervention is home-based care, focusing on orphan care and support, all within a framework promoting abstinence and fidelity (with a less explicit acknowledgement of condom use as an option).

In late 1990s, the Mission established a home-based care programme, and trained women volunteers in basic skills to care for the sick and for affected family members, but the extreme stigma enveloping the community with regard to the epidemic resulted in caregivers being chased away from homes.

The local chiefs, who held strong party-political alignments, felt that their power was being threatened by the Mission?’s autonomy and initiative. This was exacerbated by the priests?’ access to overseas funding, which created fear and suspicion among the traditional leaders that an alternative political power-base of this nature might overwhelm their authority. ?“It seems outrageous that these attitudes prevailed when the people were simply trying to cope with the epidemic,?” remarked Fiona. ?“However, it?’s also true that the Mission failed to recognise the impact of their own unilateral actions; they should have consulted with and included the traditional leadership before implementing their plans. Since then, there has been wider participation and there is more support and acceptance from the chiefs, but the volunteer caregivers are still afraid of working too visibly in certain areas where a chief?’s hold is very strong.?”

The full report, alongwith Fiona Scorgie's presentation can be accessed on the righthand side of this page