CABSA was at ... 2010

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Lyn@ Community Implementers Forum at the Birchwood Hotel, Boksburg on 24/11/2010

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The FPD and the Compass Project launched the Community Implementers’ Guide to TB and HIV Research at a series of events.  This guide was developed with funding from the Kingdom of the Netherlands and the AIDS Foundation of South Africa.CABSA is one of the group of partner organisations of COMPASS, which also includes Soul City, The AIDS Consortium, LifeLine and NACOSA. Download resource below.

As usual, my brief notes from the event is limited by my typing speed, and I apologise to the very interesting and competent presenters if I do not give accurate reflection of their thoughts.  I repeat some of the points I heard. The presentations are available here. and a news report on the meeting here.

The day was introduced by Janine Mitchell from Compass. I later asked Janine why this was an important process for their organisation: (This was my first attempt at a mini video interview!  Thanks Janine for being my "guinea pig" Next time I will eliminate some of the mistakes!)


The aim of the community implementers’ knowledge management process is to ensure that the knowledge from conferences and academic events reaches the community level and makes an impact. 

Janine highlighted the relevant dates for the SA AIDS Conference in 2011 and encouraged the involvement of the NGO community.

The first speaker of the day was Prof Geoff Setswe, Head of the School of Health Sciences, Monash University, South Africa.  As always, he managed to convey the complexities of some of the international research in a clear and concise way.

What is Research? Social and Behavioural Interventions to Prevent HIV/AIDS,

Prof Setswe started with a explanation of What is seen as research evidence?

-          Evidence refers to Facts or Testimony in support of a conclusion statement or belief
-          Proof that something works
-          Law uses witness and other evidence
-          Epidemiology uses randomised controlled trials

Strategies for obtaining research evidence:

-          Systematic review or meta-analysis
o   uses a collection of randomised controlled trials
-          Experimental designs
o   Randomised controlled trials (gold standard)
o   Cohort studies
o   Case control studies
-          Quasi-experimental designs
o   Pre and post test intervention designs
-          Survey designs
o   Cross sectional surveys
o   Case studies
-          Qualitative research
o   Key informant interviews and focus group discussions
o   Participant observation

Prof Setswe emphasised that not all research is viewed equally. In order to show that Certain approaches are classified more highly, he provided the following “pyramid” indicating which types of research is regarded as more credible

H e also proposed the following levels to evaluate the value of research evidence:

Proposed levels of research evidence:

  • 80+% - Best evidence
  • 60-79% - Good
  • 30-59% Promising evidence
  • Less than 30% - Poor or No evidence

Biomedical HIV prevention

Best evidence
– male condom - 80-95%
- female condoms - 94-97%
- PMTCT - 92-98%
Good evidence           
- HAART - 60-80%
- Male Circumcision - 65%
Promising Evidence
-HPTN 035 (PRO 2000) - 30%
- STI Treatment – 40% (in one study)
- RV 144 Thai Vaccine trail -31%
Poor or No Evidence
- HIV vaccine trial network
- early generation microbicides
Randomised Control trials which so far has shown no efficacy
- Behaviour change
- Diaphragm

Behavioural HIV Prevention Interventions

  1. Condom use-
    1. Male Condoms -UNAIDS,  90% effective if consistently and correctly                                                             
      1. Safe and relatively effective for family planning
      2.   Condom use self report in SA increasing significantly in all age groups, with young people 15-24 particularly encouraging (85% M, 73% F) report condom use at last sexual intercourse.
      3. However, in younger adults, MCP also increased.
  1. Abstinence only and ABC interventions
    1. Abstinence only programmes
                                                              i.      Cochrane Meta review of 13 RCT of abstinence only programmes show no reductions or exacerbation of HIV in American youth
    1. No randomised studies of ABC programmes.  Anecdotal reports or reports of isolated small programmes show some success
                                                              i.      “ABC infantilizes prevention, oversimplifying what should be an ongoing strategic approach to reducing incidence” Collins et al AIDS 2008
    1. Behavioural interventions that were successful in increasing knowledge did note necessary change behaviour for young people:
                                                              i.      In school education programmes
                                                            ii.      Mass media
                                                          iii.      Community
                                                          iv.      Workplace
                                                            v.      Health Facility
  1. Voluntary counselling and testing
    1. Changes behaviour for those who are positive, but not for those who test negative
  2. MCP
    1. SADEC think-tank: MCP with low consistent condom use in the context of low male circum
    2. As yet not agreement that there is Cross sectional studies, no RCT or observational studies conclusive evidence that MCP are key drivers of the HIV epidemic in Southern Africa
  3. Structural social HIV prevention intervention
    1. Stepping Stones
                                                              i.       failed to lower HIV-1
                                                            ii.      had variable effect on changing risk behaviour
                                                          iii.      less intimate partner violence
                                                          iv.      problem drinking
                                                            v.      men reported less transactional sex
                                                          vi.      Women reported MORE transactional sex!!
    1. IMAGE Study – Microfinance for AIDS and Gender Equity
                                                              i.      Intimate partner violence decreased by 55%
                                                            ii.      No reduction in unprotected sex or HIV

Summary

Good evidence

-          Condoms
-          HCT for HIV Pos individuals

Promising evidence

-          Stepping Stones and IMAGE on drivers of HIV

Poor evidence

-          Abstinence only
-          HCT on negative
-          Stepping Stones and IMAGE on HIV
-          Concurrency

However, this does not mean that we should stop these interventions:“Behavioural HIV Prevention works!” Dr Helene Gayle

There should not be a fight between behavioural and biomedical prevention interventions – behavioural interventions need to be targeted!

Lyn’s Comment: I think as community implementers we should seriously consider the way we operate and the implication this has on the amount of research available.  Many of what is anecdotally described as good or successful programmes are not documented accurately and the necessary pre and post implementation evaluation is not done.

Dr Kerrigan McCarthy, TB Technical Advisor, Reproductive Health and HIV Research Unit (RHRU), spoke about Integration of TB and HIV,

TB is the top killer of young people in South Africa!

If we understand the way in which the HIV and TB epidemics are intertwined and the drivers of the epidemics, we can create appropriate interventions.

The dilemma with TB is that it can for significant periods be latent and asymptomatic. When we have weakening immune systems, such as with HIV, it can lead to activation of the latent disease, and to the disease becoming infectious.

There are high levels of undiagnosed TB in communities with high HIV prevalence. In a study by Robin Wood et al individuals with TB were typically undiagnosed and infected for a period of more than a year.

More than 80% of South Africans in the study had latent asymptomatic TB infection!

Risk of activation of latent TB:
-          HIV+ 5-10% per year
-          HIV- persons – 10% per lifetime
The drivers of the TB epidemic in the community are Smear positive cases + HIV infection. If we want to address this, we need to:
-          Find, diagnose and treat HIV
-          Find, diagnose and treat TB!
By looking only at smear test, we miss more than half of all TB cases!
By not treating HIV in patient with TB and HIV, we fail!
We need integrated services – the right service, at the right time, to all clients, every time – to ensure we break the HIV/TB cycle
The Roadmap of TB/HIV Care is a useful tool to ensure this happens
-          Treatment should include INH prophylaxis if appropriate
It is critical that TB infection control is practiced in all clinical settings by managing suspended bacilli  in the air. These Bacilli (or TB germs) are extremely small and light and stay suspended for long periods (they float in the air).  Preventing infection
o   Administrative control
§  Manage cough (teach people to cough safely/cough hygiene)
§  Treat patients who are coughing quickly
§  Investigate symptomatic patients for TB
o   Environmental Control
§  Fresh air
§  Ventilation
§  Outside waiting areas
§  Air circulation
§  UV lights
§  PPE and Risk reduction – reduce risk of health workers inhaling
§  Filter
§  Know HIV status
o   Create enabling environment

Don’t wait! We need Integrated HIV/TB services now!

To end a very interesting morning, Dr Janet Frohlich of CAPRISA highlighted a few key points on “Combination HIV Prevention –Need for a paradigm shift in Community Involvement.”

Key issues:

-          Know you epidemic
-          Focussed intervention on specific target population
-          Scale up prevention
-          We need synergy between science and activism
-          Treatment scale up is critical
-          We need a more balanced portfolio of prevention interventions
Change paradigm of HIV prevention science
-          Move from individual to structural interventions
-          We need to move from advisory committees to true ethics of partnership

There is a shift to greater and truer participatory methods and acknowledgement of community significance

Key to research success is that it should be shaped and informed by critical community input.

Social mobilisation through community partnerships is critical to their support

-          Household level mobilisation
-          Address fear of stigma and discrimination

The ethics of community consultation should be considered in the planning, implementation and dissemination of research.

-          Enhanced protection
-          Enhanced benefits
-          Legitimacy
-          Shared responsibility

Acknowledge communities as change agents and advocates in combined prevention strategies!

Gerard Payne from the AIDS Consortium facilitated the Dialogue session. Some of the points raised included:

-          Test and treat as prevention? Affordability, Health system constraints
-          HIV competent communities
-          Is the role of migrant communities accurately reflected
-          Are statistics reliable?
-          We need to ensure that we understand each community’s needs
-          Address household level of understanding through comprehensive programmes starting with social needs and education
-          Can we use street councils to address community needs?
-          How do we use community care workers?
-          Address stigma!! Expand testing

Much to soon the interesting morning was over.  Well done, Compass!

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Lyn @ 1st OVC in Africa Conference, Sandton Convention Centre 31 Oct- 3 Nov 2010.

I attended this inaugural conference from Sunday 31 October tol Wednesday. 3 November.  My daily eports are posted below. Please remember that I am limited by my typing speed and the fact that I am not able to attend al the session at a time!  I also realise that we 'hear' different things, depending on our paradigm and perspective.  So I apologise to the speakers if I did not manage to reflect their thoughts accurately! Some of the presentations are available on the conference website.

Day 4 Wednesday 3 November

Plenary

Ms Moipone Buda-Ramatlo said she was ‘given’ the topic: Food Insecurity – food vouchers or food parcels. Where are we in this debate?

The speaker questioned the value of this debate and the danger of fragmenting the OVC issue, with the risk of diluting service delivery. She reminded us thatOVC issues are not homogenous, but complex. The desired outcomes of any program are well-resourced children in stable environments. It is critical to note that there is no linear way in which to achieve this.

The key focus should be asset based; strengthening the family, ensuring sustainability, ensuring family income security; be reliable and sustainable, should allow for family self determination.

She warned agains the use of grants, which can disrupt community patterns, and problem solving approaches: Problems occur when children become the government’s children, rather than the community’s children.

Ms Anita Sampson spoke on the PEPfAR support on Orphans & vulnerable children programme in South Africa. She again emphasised the importance of strengthening the family and community and prolonging the life of parents. The PEPfAR program is moving from an emergency response to sustainability with strong focus on country ownership and leadership. Funding will increasingly be channelled to and through government.

Ms Mary Crewe’s presentation had the challenging title “It is Wrong.” I whish I could give a more comprehensive report of this challenging session! She highlighted some suggestions for strengthening the response to young people. Ms Crew presented case studies highlighting some of the emotional challenges of young people who face multiple challenges, even when they have the financial and social support required. She speaks of emotional hollowness or emptiness and wonders how much more severe the emotional effects would be on children in more challenging environments.

She warned that a lot of what we say about orphans make us feel good, but does not make any real difference.

We cannot deal with the complex issues of orphanhood using the constructs of our present thinking. We need a new definition of family, community and identity.

New thoughts required:
-          How we think about young people
o   The term vulnerable places youth opposite society, at the mercy of others.
o   This sets the bar to low – at the bottom level of the Maslow scale
o   Rather think of the Valuable Young People or valuable children– assets for the future
-          Think differently about coping
o   Coping is dealing successfully with adversity
o   Coherent
o   To describe as ‘coping’ families stuck in a chronic form of desperation is not coping.
o   Coping accepts things as they are.
o   People do not want to cope – they want to live.
-          We need to address the social arrangements that accepts the experience of alienation and deprivation of children – orphaned or not.
-          We need to accept new patterns of kinship and belonging.
-          What we do, what we advocate and what we support should firstly consider the wellbeing of the child
Ms Crewe ended her challenging presentation with some thought provoking questions:
Is it always
o   Best to be in an overburdened and extended family situation?
o   negative to have children in community or institutionalised settings?
o   good to develop policies based on culture, past practice or history?

Final Plenary and Rapporteur Session

The rapporteur reports will be on the conference website soon. I will identify the highlights from each track.

Track 1: Treatment, Care and Support – Shanaaz Kaperia Randeria

Our main focus should be on the eed to capacitate and build family and community.

Approaches, highlights and suggestions from sessions
-          Referral and/or support desk services based in community
-          Use of narrative therapy
-          Importance of palliative care
-          Potential of small organisation to have large impact
-          Address faulty messages and perception of educators dealing with special needs children
-          Child rights and child participation should be central in programmes for children
-          Care spectrum
o   Who are caregivers – female, older black
o   Integrating children in extended families is one approach but there can be barriers
-          Accurate data collection, management and auditing is essential for programme improvement.
-          ART is a key factor in PMTCT, and although it is part of the SA Govt programme, it is still not implemented everywhere.
-          Kinship systems, family systems but also non family kinship can play a positive role in caring for orphaned children.
-          Early assessment of brain effects of HIV in babies and children is essential.
-          Some form of cognitive delay is often found in HIV+ as well as HIV exposed children.
-          There are strong links between mental health of carer and that of the child being cared for.
-          Food security and nutrition needs more attention and children can and should be included in ensuring food security (food gardens).
-          Disclosure is an ongoing process and the caregiver should play an active role.

Track 2 – Roundtable Report: Sherri Le Mottee

Round table sessions covered:
-          Lessons of management support
-          Educational support in addressing the needs of OVC
-          Psychosocial support
-          The best interest of the child and young adult.
Thematic Issues
-          Research base –
o   exciting that the practice is informed by sound research
o   some of the issues need much deeper questions and analysis
§ eg issues of undisclosed paternity
-          Integrated models of practice
o   Rights based models
o   Challenges if the abnormal becomes normal – eyes wide shut
o   Children ARE Vulnerable
o   Recognise the spiritual needs!
-          Multi-sectorial response and partnerships
o   Early childhood development crucial
-          Beneficiary and community ownership is crucial
o   Asset based
o   Building community base
o   Whose agendas are we serving – donors/
-          Action orientation
o   Capacity building
o   Language or discourse can be a barrier
o   Materials – impact of information sharing
o   Creative tools – games etc
-          Conclusion
o   Support is multifaceted and multi-dimensional and therefore complex and interwoven!
o   Partnership and cooperation essential
o   Find common language – what is the impact of OVC and the message we convey through this term

Track 3 – Disaster and Risk Management - Noki and Scott

Institutional partnerships
-          Problem bigger than traditional resources
-          Para Social work programmes
o   Institutional relationship
o   Appropriate and certified training
o   Connections with government crucial
o   Need to be community specific
-          Overcoming institutional obstacles
o   Increase data accuracy
o   Twinning
o   Curriculum based training
o   Para social workers
o   Creative training, manual based learning for children
-          Building resilient institutions
o   Maximise resources within reach
o   Mobilize community assets
o   Community ownership and support
o   Passion
o   Know your strength
-          Intervention programmes
o   Multilevel programmes
o   Linked to needs of beneficiaries
o   Combine programmes addressing different aspects
-          Data and knowledge management improvements necessary and beneficial
-          Flexibility crucial
-          Building into the future of children – again asset based work is essential
-          Wellbeing and resilience –
o   large burden on children and caregivers
o   Real factors determining well being of care givers: respect, support and supervision of caregivers more important than stipends and financial factors.
o   Address resilience of children and caregivers together
o   Self care of care givers crucial
o   Address children “where they are”, in their language
-          Services should be provided in the context of a fully functional Child Act
-          Gaps between policy and application to be addressed – such as through legal resource centre
-          OVC care by grandmothers
o   Re-parenting is hard
o   Understand what children are going through
o   From adversity can come creativity and resilience
§ Income generation
§ Food security
§ Vital in paediatric ARV roll out
o   Our limited resources can go and need to go even further
§ Grannies Clubs, support groups etc
o   Maximise the wonderful work done by grandmothers, but do not let the rest of the family ‘off the hook’

Closing Plenary Address – Dr Siobhan Crowley

Dr Crowley highlighted a number of crosscutting themes. She also highlighted a certain areas - in line with the conference theme “Don’t Turn a Blind Eye” - where we need to sharpen our vision:
-          The value of children and young children
-          Make sure everyone on all levels realises our lack of progress on the MDG
-          Capitalise on protecting and nurturing our assets
-          Reframe out thoughts about expected outcomes – children coping is not enough!
She closed the conference by thanking organisers, speakers, donors, participants etc
This conference leaves me with much food for thought, and a determination to provide even more resources to help the church to play its role in responding to the needs of children.



Day 3, Tuesday 2 November.

Plenary Session

In this session, chaired by Dr Tammy Myers, we first listened to the sobering presentation of Prof Brian Eley on the challenges of “Reducing Child Mortality (MDG4)”.

Ms Lynette Mudekunye spoke about “Children Crossing Borders”. Ms Mudekunye mentioned the different types of children crossing borders: The relatively ‘normal’ situation of children crossing with parents or caregivers, children crossing on their own or with group of other children; ‘oscillatory migrants’ that move back and forth between countries and children being trafficked. Sometimes we consider all these children as ‘victims’. But we should remember that children often make a informed choice based on their circumstances and expectations. It is strange to think that a child could be desperate enough to make a conscious choice to leave behind all that is familiar and travel, in many cases for hundreds of kilometers, to another country where they dream of a better future. “These children have purpose, have agency, have hope and have dreams.”

It is clear that the issue of children crossing borders is complex. Ms Mudekunye shared many touching stories of the realities of these children.

Suggestions for addressing the issue:
-          Regional perspective and solutions,
-          Access to documentation for all children,
-          Strengthening child protection and making information about services available,
-          Recognise the agency of these children and support them. Help children in the countries from which they come or help them to go back.

Mr Zane Dangor (?) conveyed a message from the new Minister of Social Development, Ms Dlamini as well as previous minister Ms Molewa.

He emphasised that the protection of children is a key responsibility of the department of social development. This is closely embedded in the rights of the child according to the constitution.

We have good policies to improve maternal and child health – all the good work was countered by the failure to properly address the HIV epidemic.

Session 2 today focussed on Carers and Caregivers

Kerry Steele reported on “Who are the Carers? Using surveys to identify adults caring for vulnerable children”. She again emphasised that the primary burden of care for OVCs lies in the community.

Their study was based on a question in the SA Behaviour and Communication Survey in 2009: “In the past year have you personally cared for a child whose parents died of AIDS?”

If the results are generalised – 2.8 mil people cared for an orphaned child in past year.

The results were compared with burden of disease and regions, and indicated an unequal distribution of care givers in proportion to children requiring care.

Who are the carers?
-          Large differences in provinces
-          More females than males,
-          Predominantly older women
-          Carers typically have a higher level of knowledge about HIV and TB than the general population;
-          Higher levels of testing
-          Highly exposed to communication channels, especially radio and TV
-          About 9% of carers are not reached by mass media

This method of assessing the situation around carers can be very effective, as can mass media. However, methods of communication with the minority should be kept in mind.

Bev Killian highlighted “Community Caregiver Perspectives on their work and challenges”. Once again she mentioned that the extended family bears the brunt of the epidemic in terms of child care.

In KZN alone there are 10 000 community care givers working with children affected by HIV and AIDS - 2.3 mil in Africa

The ‘edge’ these carers have
-          know community
-          Already accepted and trusted
-          Available 24/7 (also problem!)
-          Eager to help out of good will, cultural values, religious beliefs and a sense of empathy and support.
Concerns
-          Funding agenda drives interventions
-          Timeframe dependency versus sustainability
-          Lack of government support
-          Inadequate protection and care of children
-          Local/indigenous knowledge ignored
Motivators
-          From same background
-          Religious values
-          Income/potential for future
-          Support
o   Organisational
o   Parents, community educators
o   peers
-          Children
-          Personal responsibility
-          Sense of community
-          Very concerned about career path

David Roth reported on a Self Report Measure of Wellbeing (OWT) for orphans and vulnerable children undertaken in Kenia by Catholic Relief Service.

This presentation outlined an OVC Wellbeing Tool developed by Catholic Relief Services to assess self-reported child wellbeing by measuring 10 domains (food/nutrition, education shelter, economic opportunities, protection, mental health, family, health, spirituality, and community cohesion).

They use different tools for appropriate age groups.

In this evaluation spiritual, educational and family wellbeing scored highest, economic domain lowest.

This can be a useful tool to use in communities in order to evaluate services and interventions required

More info about the tool available on CRS website at http://crsprogramquality.org/pubs/hivaids/OWTguide.pdf

Caroline Kuo reported on the unmet physical and mental health needs of adults caring for orphaned children in a HIV endemic community in SA.

It is clear that caring for orphans can have sever adverse effects on the health of carers.

Protective factors of health include
-          Social support
-          Higher economic status
-          Main source of income is salaries
-          Piped water
-          Formal dwelling
Risk factors include
-          Being female!

All carers of orphaned children had less than optimal health and need interventions.

They suggested the following additional support:
-          Group and individual debriefing,
-          Opportunities to celebrate success,
-          Support and recognition in programme design.

Dr Cluver and Dr Casale continued to address the Relationship between Carer and Child Mental Health in a HIV-endemic community in South Africa. This study was linked to the previous presentation

Orphaned children have poor mental health, as carers of orphaned children can have, and people living with HIV can have. This interplay and linked vulnerability can have serious implications for the mental health of a community

There are close links between depression, anxiety and PTSD in carers and the children they care for. This increases dramatically in AIDS affected families.

Suggestions:
-          Family based programmes targeting both carer and child psychological health might have bigger potential impact,
-          Treat both carer and children’s mental health.

After lunch I had to make a difficult decision between attending a session which included presentations on food security, nutrition and disclosure or more about the challenges of carers, social and para-social workers and the best interest of the child and young adult.

The first speaker in the session I attended was Rita Muyambo who spoke about Measuring the Psychosocial wellbeing of community care givers. She emphasised the critical role of NGOs in service delivery at grass root levels

Common stressors
-          Over-involvement and over-identification
-          Boundary problems
-          Stigma and secrecy
-          Lack of socials support
-          Child abuse and neglect
-          Frustration with govt process

In order to measure and evaluate the Thogomelo project, measuring social wellbeing was necessary.

Profile of this group
-          Limited literacy
-          Mostly female

A variety of tools were evaluated – none deemed appropriate

Developed new appropriate scale; was developed and tested (some info available at http://www.aidstar-one.com/task_orders/thogomelo_project and http://www.ovcsupport.net/s/library.php?ld=1096)

Pre and post training evaluation will be compared.

The process and further development of this tool could be very useful.

Daphyne Williams spoke about the tool developed by CRS and highlighted by David Roth earlier in the session “Creating Age Appropriate self-Report tools for children: Using a pictorial scale to rate wellbeing”. This tool highlights the perception of the child of his family health in 10 different domains. It was decided to use a 5 point rather than a 3point scale in order to identify more nuances and assess change more accurately.

In the evaluation of the younger group (6-8yers) the tool was used in a picture format as well in verbal form. It became clear that what adults, even in a specific culture, read into a picture might not be the same as children see. Culture appropriate might not be child appropriate, and especially not young child appropriate!

Conclusion: It is important to pilot any tool or intervention!

Basani Malambe spoke about “Developing resilience in life through psychosocial support: A community based approach for OVCs and guardians in South Africa. Psychosocial support is only sustainable and manageable if handled as cross-cutting issue. It is however essential as it lays the foundation for the wellbeing of the children in their care.

The Red Cross model is family centred and uses many tools already mention – Memory work, journey of life, hero’s book etc. Remember that psychosocial support is an ongoing process and not a one-time intervention. Although the impact evaluation of the programme will only be done in 2011, there are many positive results reported.

Josianne Roma-Reardon highlighted the OneVoice South Africa Schools Programme: HIV and AIDS prevention with and for young people. OneVoice South Africa (http://www.onevoice.org.za) is a vibrant and unique non-governmental organisation (previously known as Dance4Life), which uses innovative and creative ways of actively involving young people in HIV and AIDS prevention. The programme is appealing to young people because it provides them with a platform to discuss and address HIV and AIDS, sexual reproductive health, gender and human rights issues.

The school programme includes a series of nine workshops which focus on Gr. 8 learners and provide a manual and notebook dealing with Life Skills, Sexual and Reproductive health and management of projects.

Russel Linde presented on the topic “The Children’s Act Requires a Legal Resource Unit.

His personal experience in trying to access legal services around the children’s act motivated his approach for this presentation.

Like any legislation, the Children’s Act has no use if it can not be enforced. He highlighted the serious underfunding in the social and legal domain in order to implement the act.

Interventions of social workers:
Problems
-          Far too few
-          Poor resources and infrastructure
-          Insufficient options/alternatives
-          Do not have a good understanding of the Act
Solutions:
-          Legal advice as support and knowledge
-          Assist in court procedures
-          Police more inclined to assist lawyers
-          Training of social workers and others
-          Reduce the technical legal nature of the Act
Relationships between new families and social workers
Problems
-          Not enough accountability by social worker
-          Often rights of child overlooked
-          Delay or failure of background check
-          Personal bias
-          Incompetence
-          Misinterpretation of act
The court, social worker and the child
Problems
-          Backlog
-          Court not child-friendly
-          Inefficient admin staff
-          Narrow interpretation of law
Solutions
-          Lawyer can assist social worker
-          Advocacy etc

Conclusion:The potential benefits of such a unit far outweigh the cost and should be seriously considered.

He quoted Samantha Waterhouse: “We do not measure success by the number of laws alone, but rather when all South African children have equal access to the protection and services contained within the legislation”

For the Best Interest of the Child and Young Adult

Dr Sissel Olssen reported on her study to Identify Critical and Key factors determining appropriate school support systems.

Case Study School:
-          Peri-urban Poverty stricken area
-          2/3 brown; 1/3 black
-          Study done during time of Structural and cultural change processes in Education System
-          HIV/AIDS Life Skills programme in schools in Western Cape had many components, but focussed on support to teachers and head masters to support children.
-          Teachers in high denial about HIV in their context, although they admit children are sexually active,
o   Many overage learners,
o   foetal alcohol syndrome
o   Child pregnancy
o   High absenteeism
o   Abnormal signs that could indicate HIV infection are explained as caused by other reasons
-          Poor situation of children and stigma and denial causes selective ‘blindness’ in teachers
-          Poverty related problems not only overlap with the problems of HIV exposure and acerbate them, but can even obscure or hide them.

The recommendations of the study were included in a joint partnership that will focus on the support and wellbeing of teachers.

Mokgadi Malahlela spoke on “Improving the Lives of Orphans and Vulnerable Children through Social Access.”

She highlighted the work of Kheth'Impilo, an organisation whose mission is to support the South African Department of Health in achieving the goals outlined in the National Strategic Plan for the scale up of quality services for the management of HIV/ AIDS in the Primary Health Care sector.

Grant Access Strategy – the organisation is involved in most provinces to facilitate access to identity documents and social grants

More about the organisation at http://www.khethimpilo.org/

Evelyne Kamote reported on the Tanzanian approach in “Beyond Handouts! Integrating quality in OVC Services”.

Ms Kamote mentioned many points in the Tanzanian program for ensuring quality in the care of children. An important point for me was that in the focus on MVC – most vulnerable children. They consider the fact that orphans might not necessarily be the most vulnerable, but that a community might have other children, who are not orphans, who could be highly vulnerable for a variety of reasons.

It is important to build consensus on what constitutes quality!

Adele Clark CRS spoke on “Developing Solidarity Among Children Using Therapeutic tools for multiple purposes. She highlighted that 163 mill children have lost one or both parents due to many different causes and that orphans are not the only children who are vulnerable.

Resilience can be strengthened by
-          Supportive family
-          Primary caregiver
-          Social support
-          Connections to competent caring community members outside their own family
-          Basic needs being met

A Toolkit was developed – “Psychosocial care and counselling for HIV- Infected Children and adolescents”. It includes games eg ‘Just like me’ with variety of details and levels and is available online.

Another full and informative day!

Monday, 1 November 2010

Plenary Session 2, chaired by Prof Leickeness Simbayi. Prof Simbayi referred to the cabinet re-shuffle announced yesterday, and mentioned that as Min Molefe is no longer minister of Social Development, her presence at the conference is unsure.

Prof Lorraine Sherr – Bringing up Orphans – Why We Need Support of Families. She highlighted the dilemmas of defining ‘orphan’ and made a plea that we should be clear about what we are speaking about when we talk of orphans.

SSA - 7.5% Paternal Orphan; 5.2% maternal; double orphans 12.1%;

Sub Saharan Africa - 5-10 times higher than other regions.

Family approaches to the challenges of orphanhood and HIV is much more successful than individual models.

88% of orphans are cared for by extended families

Considerations in Orphan care

-          Risk of HIV infection
-          High risk of problems of children who are themselves HIV positive
-          Remember to consider the risk and vulnerability of child before the parent/s die – anxiety, depression, care under adversity
-          A parent is not only a mother – parenting is not just “women’s business” – there is little information on the role of fathers, but much on that of ‘dead fathers’. We need to also consider the positive role of fathers and how important it is to keep them alive for the health of the family.
-          Many risks of institutionalisation
-          Dangers of the focus on orphans
o   Orphan tourism
o   Orphan press appeal
o   Orphan donation appeal
-          Tomorrows problem is HIV exposed children
o   HIV+ and HIV exposed children have many developmental and cognitive delays
o   Interventions can help – many successful reports
§ Treatment of mood disorders
§ Cash transfers

 Prof Sebastian van As: Trauma and Children – A World Perspective

True disasters for children

-          Inequity. 
o   The amount of spending on healthcare does not translate to health
o   In SA population of 50 mil, more or less 20 mil are children
o   Provincial inequity
-          Child injury. Trauma leading cause of child deaths between 1-18 years
o   Many child deaths related to trauma and death
o   Road accidents, drowning, burns
o   Accidental and non accidental trauma
§ Children under 6-8 very vulnerable and depend on adults for safety
§ Supervision in Africa statistically more difficult because
§ Child in SA is 25X more likely to end up in hospital than child in UK
§ 89% of children brought to Red Cross Hospital after motor accidents were not wearing a seatbelt or in a child seat - strap in your child!
-          Alchohol
§ Majority of people dying in homicide or MVA were intoxicated.
§ 80% of all trauma in SA is alcohol related
§ Foetal alcohol exposure is the most common cause of birth abnormalities
-          Child labour
-          War
-          etc

Highligted work of http://www.childsafe.org.za/

Child safety starts with all of us

“A better society will and must be measured by the happiness and health of our children”

Nelson Mandela

Dr Zosa de Sas Kropiwnicki: Child Trafficking and Exploitation of Children across Borders

She started of by warning against the sensationalist and inaccurate data often used in this field. The definition of child trafficking is movement of a child with the intention of abuse. In the case of children, permission is deemed to be irrelevant.

If children move ‘on their own’ it is not trafficking, but that does not mean that children that are not trafficked but still abused need less care

The perceived success of SA leads to increased risks and vulnerabilities to trafficking of children from neighbouring countries.

Many criteria for a effective response were mentioned, including that a response should be rights based, protective and interlocking, regional, systemic, intersectorial, comprehensive, participative, appreciative, asset based, family strengthening, capacity strengthening, evidence based

In the first session 1 there were 2 options – ‘Access/Community Based Coordinated Care’ and ‘Lessons of Management Systems Support’

I attended the session on ‘Access/Community Based Coordinated Care’ chaired by Mrs Lynette Mudekunye

Nancy Kemo spoke on “Improving Access to Health Care for OVCs through Community/Health Facility Linkage”.

A help desk managed by specialised care workers increased the access of children to treatment and improved communication and relationships between community health workers and institute based care workers.

Due to stigma care givers in the community is still reluctant to disclose the HIV status of the children in their care.

David Green explained methods of Developing Caring Communities through narrative practices

The assumptions of narrative practice
-          The life of an individual or community has many stories, but the dominant story overshadows the other
-          Through narrative practices used in time of crisis, other stories of skill competencies and resources are elevated to the dominant story
-          Resources and tools from REPSSI can be used at drop in centres, support groups, community level and individually:
o   Ithemba book
o   Tree of life
o   Hero Book
o   Journey of life

By allowing the community the opportunity to share their stories and experiences sustainable approaches can be developed to enhance the wellbeing of children. The stories and approaches can be documented and used by other communities.

Joan Marston spoke of the Sunflower Effect, and how one programme expanded access to palliative care for children in Free State province.

Palliative care is the care of body, mind, spirit of the child with a life limiting disease and includes care of the family.

Palliative care is sometimes confused with end of life care, but is much wider, and includes
-          Immaculate assessment
-          Pain and symptom control
-          Care and support

A multi-sector approach, partnership and networking is crucial, but can provide a rich resource for the effective expansion of palliative care for life limited children to improve their quality of life.

Jacqueline Khumalo highlighted the magic of networks in supporting organisations that work with orphans and vulnerable children.

The CINDI (Children in Distress) Network does capacity building and provides networking opportunities for the organisations in the area responding to children.

An analysis was given based on a study of 176 member organisations of CINDI

Benefits of the network which were identified in the study include:
  • Networking
  • Capacity Building
  • Advocacy
  • Resource mobilization

Sumaya Mall highlighted the Vulnerability to HIV/AIDS of deaf and hard of hearing adolescents: and the Perceptions of educators in Schools in South Africa.

Literature shows increased risk of abuse as well as low self esteem amongst disabled people, including people who are deaf and hard of hearing. This can be acerbated by the fact that there are limited or culturally inappropriate educational resources for people with hearing disability.

A study on selected schools for the deaf explored condom policies, perceptions of sexual risk behaviour in deaf learners etc

 

After lunch I attended a session on Institutional Partnerships chaired by Dr Sissel Olsen

 

The first speaker was John Capati, who spoke of the use of Social Work Partnerships to Build Sustainable Capacity to address the needs of orphans and vulnerable children. He introduced the work of the Twinning Centre which created 30 North-South and 9 South – South twinning agreements.

Twinning is flexible, collaborative and gets results.

Key elements of twinning
-          Institution to institution pairing
-          Peer to peer prof. Relationships
-          Prof. Exchanges and mentoring
-          Volunteer driven
-          Leverage private sector institutional resources
-          Non prescriptive but rigorous approach to collaborative process, work plan development and outcomes
-          Demand driven
-          Benefit to both partners

He highlighted the work done to strengthen the work of social work auxillaries, or para social workers. This untapped resource links to the community and further capacity building helps to augment the severe shortage of trained social workers in the community.

It was initially important to create a share understanding of the role of this group. Curriculum development is crucial, although there are universal principles, it is also crucial to make it specific to the context and environment. Structured follow up is essential for the success of the process.

Various country representatives reported on the success the programme had in their country

-          Leah Natujwa Omari from Tanzania

-          Justice Chukwudi Ulunta - Nigeria

Marietta Slabbert spoke about a Motivation strategy for rural advancement. She highlighted the work of the Ndlovu Care Group that works through Autonomous Treatment Centre (ATC) and Community Health Awareness Mobilization & Prevention (CHAMP)

Once again the importance of working from an asset based perspective was emphasised.

Ndlovu adapted the Hertzberg Theory of motivation to behaviour change communication

Story from a project: Maria, you get a food parcel and school uniforms, why do you still not go to school? I don’t sleep at night, our door does not lock, and I am afraid people come in at night and rape me and my siblings.

I very interesting session by Susan Wilkenson Maposa focussed on “Understanding Organisational Resilience: How organisations supporting child well being survived Zimbabwe’s socio economic collapse.”

The Firelight Foundation was interested that all grantee partners of the foundation in Zimbabwe survived the socio-economic collapse, even though these organisations are often seen as ‘low resourced organisations’.

An inquiry by the foundation into 22 organisations asked:
-          What were your biggest challenges
-          How did you overcome this
-          What do you view as your most important strength

The results showed:

Challenges
-          Restriction on public gatherings
-          Devaluation of funds
-          Decrease in monetary flow
-          Education system collapse
-          Transport
-          Food insecurity
-          Drought and water shortage
4 main responses
-          Scale back on programme delivery
-          Maximised resources within your reach
-          Mobilise community assets to fill gaps
-          Build and leverage relationships (other organisations, government etc) to spread problems and enhance problem solving

Community based organisations identified 5 resources or strengths they depended to help them survive in challenging conditions

-          Staff commitment, cohesion and confidence
-          Community ownership
-          Supportive community leadership
-          Stakeholder networks
-          Staff and volunteer passion

This is supported by literature where the following 5 behaviours can be identified which are used to construct resiliency in organisations

-          Organisational culture – know who you are, what you do, how you d it
-          Situational awareness
-          Inter-dependence
-          Social capital -
-          Bricolage – use what is at hand

The presentation was one of the highlights of my day. We have all seen so many organisations overcome challenges, where it seems humanly impossible, and do remarkable work. It was good to be reminded that the strengths that help organisations overcome hardship is often internal and local, and does not necessarily depend on tangible factors or external resources.

 Nataly Woolett spoke about “Child Witnesses of Domestic Violence: the Overlooked Victims”. She spoke about Trauma Focussed Cognitive Behaviour Therapy in a art and play based group in a domestic violence shelter. 

USA research shows that a third of US children are exposed to violence in the home. SSA probably higher!

Natalie highlighted the high incidence of Post Traumatic Stress Syndrome or Complex Psychological Trauma in children in South Africa.

Creative art therapies have much strength in dealing with trauma. A process was explained where therapy of this kind was used with children, with very good results.

Many resources are available eg the book “A Terrible Thing Happened: A Story for Children Who Have Witnessed Violence or Trauma”. More info at http://www.apa.org/pubs/magination/4416428.aspx

 

Opening Session, Sunday 31 October

The opening session started with a song “When will the Children Play Again”, starkly sketching the reality and asking ‘how many children must raise more children before we take a stand?’. Suddenly this does not seem ‘just a conference’ but the reality of children who are unable to play or laugh, because they are raising more children. Tina Schouw - South African Singer Songwriter touched the participants’ hearts.

The opening session was billed as follows. 

  • Dr Ashsaf Grimwood CEO Kheth ‘Impilo Conference Chair

  • Hon Minister Bomo Edna Molewa Welcome Address –

  • Dancing with the Darkness on my Back

  • Dr Annette Gerritsen, EPI Result: Estimating the Need for Orphaned and Vulnerable Children Services in the city Tswane Metropolitan Municipality 2010

  • Dr Nono Silemela; CEO SANAC: SANAC’s National Plan of Action for OVC’s

However, as Dr Ashsaf Grimwood CEO Kheth ‘Impilo welcomed participants as the conference chair, he also announced that Min of Social Dev Edna Molewa is unable to attend this evening and Dr Silemela would be unable to attend due to ill health. It is quite a disappointment that these two ‘star’ speakers are not here.

Dr Grimwood highlighted what had been achieved around development and MDGs, but also the challenges that remain for children and the opportunities to address these.

Dr Johanna Kistner and the children Sophiatown Children on the Move Project presented “Dancing with the Darkness on my Back. Children’s Sories of Hope and Courage.” Firstly we were reminded that these children do not think of themselves as OVC’s – they reminded us:

-          I am also a singer
-          I am a person
-          I am a strong young women
-          I have a right to be called by my name
-          I have some dreams – I am tomorrows future

We listened to the children’s stories; stories of death, of loss, of xenophobia, of displacement of overcrowding, of living with multi –cultural life, of displacement, but mostly of “Dancing the darkness away” the incredible resilience of children in the midst of multiple challenges.

Dr Annette Gerritsen’s presentation covered “Estimating the Need for Orphaned and Vulnerable Children Services in the city Tswane Metropolitan Municipality, 2010”.

Key activities in Tswane in 2010 included
-          the launch of the HCT campaign;
-          FIFA HIV awareness campaign
-          Hide and seek; Find and treat
-          HCT in schools

A survey was done on service providers in Tswane between 2005 and 2010:

-          In 2010 72% service providers were NGOs, 18% Public sector; FBO and Private below 10%
-          In time of study public sector services reduced, while NGOs increased. This is positive, as NGOs are close to the community. However, it can be a problem as NGOs are less involved with treatment programmes
-          More than 75% of all support related services in Tswane are offered by NGO/FBOs. Care for OVC is primarily done by FBO/NGOs
-          57% of all treatment related services are provided by public sector
-          In 2010 Tswane had an estimated 82 540 maternal AIDS orphans with 212 service providers – which means an average of 389 orphans per service provider. Although this is still very high, it is improving.

Conclusion – The overall picture of service provision in Tswane is more positive than 2009. The unique information obtained by the survey will assist the metropolitan municipality in their planning in future

The Ndlovu choir entertained participants before we were invited to attend the opening cocktail function.

The function was hosted by SABCOHA and highlighted the “Camp I Am” programme, an exciting public/private/NGO initiative for 15 000 children during the extended 2010 school holiday. Hopefully this successful programme wil be extended in future.

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Lyn @ World Vision SA Launch of the Child Health Now Campaign. 20/10/2010

Child Health Now is World Vision’s first global campaign focused on a single issue: reducing the preventable deaths of children under five.

Lyn attended the launch of this important advocacy campaign by the president of World Vision International at the Birchwood Hotel in Boksburg.

Speakers included Mr Lehlohonolo Chabeli, National Director of WVSA, speakers from the SANAC children Sector and government. and Mr Kevin Jenkins, WVI president.

You can read more about the campiagn and access resources at  https://childhealthnow.com/campaign http://www.wvi.org/wvi/WVIAR2009.nsf/maindocs/FCD0CD1CCF6609B4882576EE00... and http://www.worldvision.org/news.nsf/news/child-health-campaign-advocacy-...

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Nelis @ Micah Network meeting in Capetown, 16 October 2010

Nelis attended the Micah Network Strategy Update meeting Saturday 16th October together with a group of participants of the third Lausanne Congress and other Christian leaders.

The meeting was led by Sheryl Haw who explained the Micah Network strategy.

Rene Padilla spoke about his theological journey and explained his vision of integral mission. Participants had the opportunity to dialogue with him.

CABSA hopes to strengthen relationships with the Micah Network.

 

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Nelis @ Pastors’ ICT Workshop in Worcester, 6/10/2010

Nelis joined a group of pastors in Worcester on 6 October to discuss the use of ICT in ministry. It is becoming increasingly clear that we need to explore all the wonderful opportunities these tools provide. A few key points include:
- Be interactive. Make sure that your website is not just “preaching”, but provides the opportunity for conversations, such as through a blog, comments option, etc.
- Measure your download speed and effectiveness. The free Firefox Yslow add-on was mentioned.
- Questionnaire options are available from Google Documents.
- Make sure users can easily share or pass on your content.
- A FaceBook presence can be valuable.
 

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Jan @ the Sangonet “Fundraising in the Digital World” Conference. 1-2 September 2010

Jan attended the Sangonet “Fundraising in the Digital World” http://www.ngopulse.org/conf2010/ conference held in Johannesburg on 1 and 2 September 2010. Here are a few of the things he heard.

It is not difficult to feel that the internet has always been there and have a perception that everyone has access. Unfortunately this is not so, but access to it is growing fast. The growth in internet access can be seen when considering that in 2005 there were an estimated 3.4 million internet users in South Africa (population 49 million). This number has grown to approximately 5.3 million in 2009 and is projected to further increase to around 11 million by 2015. 

The biggest factor affecting the future growth of internet usage in South Africa will not be capacity of infrastructure but the cost of access to and use of the network. South Africa and Africa can, as result of 3 new under-sea fibre optic cables, only now really start joining the internet world. The 3 new cables will mean that by 2012 Africa will have approximately 220 times the capacity for data transfer that it had in 2008. The effect is already becoming visible in changes taking place in countries throughout Africa as they receive real, and more affordable, broadband connectivity.

Although 15% of businesses in South Africa with access to internet connectivity still used dialup, 46% utilised broadband (ADSL). The number using ADSL is however projected to grow to 86% in the near future, strongly followed by satellite. 

This growth in connectivity has a direct impact on the need for businesses to have some form of web presence and technological footprint. The use of the internet should however not be considered from a limited perspective of providing or accessing websites. The internet should be seen as part of a total revolution that includes electronic banking, social media and even related technologies such as cellular phones.

Despite the internet growth in South Africa, a few practical aspects should be kept in mind. It was indicated that whilst 12% have e-mail addresses but only around 9% of the South African populations have credit cards. This means that the utilisation of e-commerce based businesses – which, other than EFT’s, require credit cards - limits the South African market to a maximum of 9% of the South African population. The banking services available to people still has a limiting influence on web based fundraising.

Regarding other electronic management of money two systems, available in South Africa, introduced at the conference were a cellular phone based system “Mpesa” managed by Vodacom. This system is working well in Kenya where it was developed. The internet linked payment system “Paypal” was also presented but it requires people having an FNB bank account. Pay Pal is also not yet set up to do transactions in South African Rand.

A factor that must be considered with electronic fundraising, is what is called the Digital Participation Curve.  This curve indicates that it takes approximately 5 years of experience with the internet before people start becoming comfortable in utilising e-commerce and making electronic donations. This is also true regarding EFT’s (electronic fund transfers) and online banking.

In contrast to the number of people with internet connectivity, approximately 62% of people in South Africa have cellular phones and thus become potential participants in short code / premium code donation systems and  the new Mpesa programme. There are also numerous international examples of successful cellular phone based fundraising activities.

It must be emphasised that the use of cellular phones for fundraising has many risks attached. Phones are a technology that was designed for conversation and people see unsolicited cell phone contact as a more personal invasion of privacy than they do emails. The indiscriminate use of cellular phone contact could thus result in the creation of resistance against an organisation and cause.

Should a cellular fundraising activity be considered, a few aspects to consider when planning include:
How does the cause/organisation being marketed make a difference?
  • What is the target market of the fundraising?
  • How can mobile numbers be obtained voluntary – with permission for usage?
  • What communication strategy will be followed?
  • How will the money be collected?

In South Africa it should be kept in mind when considering a cellular phone based process that service providers take a very high percentages of all donations made via the phones. Based on the percentages taken by service providers, Sangonet launched a petition entitled the “Mobile Giving Initiative” where service providers are petitioned to waive their percentages for NGO’s. The petition is available for signing and supporting at http://www.ngopulse.org/conf2010/

On a more practical level, the effect of digital age has a number of key aspects that directly influences its use in fundraising. As result of the internet and increased connectivity around the world, the sense of community has changed and is busy changing further. People have a desire to connect and develop “digital friends”. There is however no magic solution, fixed recipe or specific software package that will build a network of friends. The process is slow and requires methods similar to those utilised when cultivating face to face relationships and friendships. The difference is that it is now done electronically.

Organisations must stop thinking in terms of fundraising and start thinking about building digital relationships. The essence of digital fundraising is not asking for funds but cultivating and developing relationships (on or off line) by addressing people’s expectations of transparency and getting to know the real organisation.

People want to share a dream and be part of a story. They want to invest in success and become part of something whilst being kept busy with other aspects of living. To raise money on-line organisations must stop fundraising and start inspiring action. This means the focus should not be on the needs of the organisation but on getting people to become part of, and buy into, the organisational dream by supplying visitors with information. The increased availability of information however means that people have stopped being inspired by the same story presented in the same way on hundreds of websites.

Organisations must ask themselves, and communicate, what the organisation’s big story is and what it is that they are selling. People want to know;
  • Why the organisation really exist and who they really are.
  • That the organisation is vibrant with many facets.
  • The highlights the organisation are most proud of but also that the organisation realises, and can face, their own shortcomings.
  • Answers to the hard questions such as if the organisation is making a substantial difference and ultimately if, and by who, their function be missed if they close their doors.

People that support an organisation must be able to tell “the company story” to their friends. People want to be given a sense of belonging to a cause. When they belong, they will – in the offline - world put things in their own words and start marketing on the company’s behalf. This is the basis of what is called viral marketing.

Contrary to popular belief, people do not donate because of a Facebook page or e-mails.  They are donating because they are hearing a dream and by belonging to this dream they feel that they too are making a difference.

To start building relationships organisations must start by understanding where they are. The process of utilising social networking technologies should be implemented slowly and in a sustainable manner. The key is to listen more than to talk as social networks are not public broadcast channels.

Organisations and CEO’s should join sites such as Facebook and LinkedIn in ways that are related to the organisational cause. They must then respond to every post on their wall, update their status as often as possible, post recommendations on LinkedIn request from others and post pictures and videos. It is important to increase the network by “liking” pages and accepting friend requests but this should be done with thought as it would be done when accepting friend requests in real life.

Where applicable and to keep up to date with what is going on, key members in the organisation must join twitter and follow related twitter hash tags (#). To build authenticity, cover special events before the event to build interest and then reported on and pictures included afterwards.

Organisations should however, be careful as too much technology could frustrate donors. Lastly also remember that an e-mail is not an invitation to solicit funds but merely an invitation to start building a relationship.

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Lyn @ IAC Multi-Faith Pre-Conference. 17/7/2010

Lyn van Rooyen attended the Multi-Faith Pre-Conference at the Technical University in Vienna, Austria

Centered on the theme ‘Rights Here, Right Now: What’s faith got to do with it?’, this one-day multi-faith pre-conference allowed some 250 people of faith to:

-Explore, with a diverse range of plenary speakers, how faith traditions compel us to achieve universal access to HIV treatment, care, support and prevention, and can overcome existing barriers to such access
-Actively participate in breakout sessions to discuss theological and practical responses to HIV and AIDS in more depth
-Network with people of faith involved in the global response to HIV and AIDS
-Prepare and strategize for faith-based participation in the IAC
-Take part in opening and closing prayer and reflection

If you attended the pre-conference, please fill in and return this evaluation form to rfoley@e-alliance.ch by 6th August 2010.

Download presentations and talks given at the pre-conference here. 

 

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Nelis @ CUAHA AIDS Competence Workshop. 3-5/5/2010

Nelis du Toit (CABSA Director) and Patrick Manzini (CABSA trained Churches, Channels of Hope facilitator) were privileged to attend the CUAHA (Churches United Against HIV & AIDS) workshop in Johannesburg from 3-5 May 2010.

Participating in the further development of a participating workshop programme on HIV and AIDS Competent Churches was stimulating and encouraging. The workshop was built around the ecumenical handbook published by CUAHA: Towards and HIV and AIDS Competent Church.

The candidates who attended this workshop came from many countries, e g Rwanda, Kenya, Tanzania and Angola representing various denominations.

According to Mr Manzini the workshop was conducted in a participatory manner. “We were encouraged to share information, ideas, concerns and knowledge. Facilitators ensured that everyone got an equal opportunity to participate. Through active listening and good questioning, they demonstrated that each person’s contribution was valuable. Facilitators helped group members to communication skills by promoting discussion. Activities such as role play and case studies were used to explore different points of view. Facilitators used games to help people to get to know each other, to give participants more energy and enthusiasm, and to help people to work together.”

One of the highlights of the workshop was the sharing of her experiences of living with the virus as well as being stigmatised by her community, by one of the participants. Her story revealed how a community, even a church community, can stigmatise people living with HIV.

According to Mr Manzini he learned the following during the workshop:
§ “That Pastors must mobilize their churches to respond to the needs in the community particularly to the epidemic of HIV.
§ “That Pastors and church leaders are encouraged to carry out integral mission, and also to envision their congregations.
§ “That a church is supposed to be a place of safety, known by its love and support to people living with HIV and AIDS.
§ “The church must accompany people and communities living with HIV and AIDS on their journeys of faith, giving them hope.
§ “Stigma and discrimination was mostly originated in the church where people living with HIV and AIDS were condemned.
§ “The church should be continuously exposed to the realities of HIV and AIDS by informing them about what is happening in their area with regard to HIV and AIDS.
§ “Information sessions should be continuous in the church to keep the members enthusiastic and updated on HIV and AIDS, and how they can respond better.
§ “The church must have a deepened understanding of the disease; growing commitment to prevention, care and support, accompanied by members’ understanding of how and why they should get involved.
§ “The church must identify team leaders to implement HIV and AIDS elements.
§ “The church must identify infected and affected orphans and vulnerable children who might need support and developing strategy to help and support them.
§ “For prevention, the church must teach value-based education to the youth and must have pre-marital counselling support.”

CABSA thanks CUAHA for the opportunity to participate in their programme.

 

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Lyn @ PACANet Consultation on Multiple and Concurrent Sexual Partnerships. 26-30/4/2010

"It was very good to discuss this topic so openly in a faith setting. I have to admit that I was quite shurprised by the some of ways in which participants feel faith communities increase the opportunity or possibility for multiple partners" Lyn said after she participated in this consultation held at Ezulwini Sun International Hotel in Swaziland from From 26th-30th April 2010.

The consultation was organised by PACANet in conjunction with the Church Forum on HIV and AIDS, Swaziland. The aim of the consultation was to is to provide a forum for key stakeholders from churches, Christian organizations and theological institutions to discuss the issue of multiple and concurrent sexual partners as a risk behaviour for HIV infection.

Prior to the consultation the outcomes were identified as:

  • Gain a clear understanding of the role of MCP in HIV transmission and of social and cultural factors which must be addressed in changing MCP behaviours and strengthening protective behaviours such as mutual fidelity and marriage;
  • Discuss the strengths and weaknesses of the present Christian response and how the church can effectively address MCP;
  • Determine realistic steps and commitments that can be taken by consultation participants and begin to plan country and regional action.
You can read the PACANet MCP Consultation Communique here.
 
The PACANet Chronicles, Volume 4, Issue 2 published in July 2010 reports as follows:
 

Multiple Concurrent Sexual Partnerships: A risk behavior in HIV transmission

 

From 26th to 30th April, PACANet in collaboration with the Church Forum on HIV and AIDS in Swaziland organized a consultation meeting on Multiple Concurrent partnerships (MCP). The meeting that ran for 5 days saw 90 senior church leaders from Eastern and Southern Africa representing various denominations. There was representation from 18 countries; Botswana, Burkina Faso, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mozambique, Sierra Leone, South Africa, Sudan, Swaziland, Tanzania, Uganda, United States of America, Zambia, and Zimbabwe. The goal of the consultation was to provide a forum for key stakeholders from churches and Christian organizations to discuss the issue of multiple and concurrent sexual partners as a risk behavior for HIV infection.

While speaking at the opening session, Derrick Von Wissel Director of NERCHA, explained HIV transmission dynamics using a case study on Swaziland.

Mr. David Cunningham of Family Impact and former chairperson of PACANet led the devotions and spoke about Marriage and relationships and the experience of the church with MCP. He described marriage as a significant unit in society and the church contributing to the strength of the nation. He however remarked that marriage and family are under attack, that there are forces both physical and spiritual working against its well being. He said that the church is in the world but not of the world and should be the salt and light in order to have impact.

“Today God’s church is divided, we ignore one another; we fail to communicate; we do not share; we duplicate what each is doing. We fear competition for funds if we tell another group what we are doing. We do our own thing. God is not glorified and the world is not saved” he noted.

Derrick Von Wissel said that only 21% of children in Swaziland have both parents. Derrick remarked that this leave us with many questions for instance; is the marriage strong? How does a mother teach a boy to be a man? What role modelling is there for these children? Has the church been too silent or is it losing its moral ability?

There were three plenary sessions during which presentation were made by various speakers including Rt. Rev. Bishop Mabuza of Council of Swaziland Churches, Rev. Dr. Nyambura, Rev. Njiru Pauline of EHAIA, Mrs. Allison Ruark of CCIH, Dr. Taruvinga of The  Leadership Agenda, Dr. Okaalet of MAP International, Mr. and Mrs. Lubega of Maternal  Life Uganda, Rev. Fr. Maulano of SECAM Rev. Lubaale of OAIC, Rt. Rev. Banda of  Expanded Church Response to HIV/AIDS Trust and Dr. Chitando of WCC-EHAIA.

Some of  the topics discussed include epidemiological perspectives on the family, The joy of marriage, The blessing of faithfulness and the pains of betrayal, The challenges of maintaining a good marriage even in the church, The experience of the Roman Catholic Church, African Instituted Churches, the evangelical movement and the mainline established  churches.

Being a consultation, plenty of time was allowed for group discussions. Participants explored the causes of MCP, the relationship between MCP and the rapid transmission of HIV and some specific actions for the church take to respond to the issue.

At the end of the consultation a communiqué was produced and presented during the closing ceremony which was attended by the Swaziland minister of Health, his deputy and other dignitaries. The minister thanked PACANet for organizing such an important event. He said that the church has comparative advantage in addressing the challenge of AIDS, as it has a presence and reach to every community, making coverage achievable. He said that the church is the right partner for government to work with to respond to HIV and AIDS.

Participants made commitments on specific actions they intended to carry out back in their countries as a result of their engagement in the consultation.

You can download a selection of presentations from the consultation below:

- The Challenges Of Maintaining A Good Marriage, Even Within The Church! Gonzaga & Paskazia Lubega, Directors Maternal Life Uganda.

- The Joy of Marriage: Marriage As It Was Intended To Be. Grace Taruvinga; Leadership Agenda

- The Experience of the Church With MCPs - An Evangelical Perspective; Bishop Joshua H K Banda

- Epidemiological Perspectives on Marriage & Family; Allison Ruark, MSPH; Christian Connections For International Health

- Why Is HIV Prevalence So Severe In Southern Africa? And “What Works” (And Doesn’t) For Aids Prevention?  Daniel Halperin, Phd, Ms Senior Advisor For Behavior Change/Primary Prevention, USAID

- Marriage and Family: The Blessings of Faithfulness and the Pains of Betrayal. Dr Peter Okaalet, Map

- The Experience of the Catholic Church with Regard to the Situation of Multiple Concurrent Sexual Partnership in HIV Transmission: The Historical Evolution, the Present Practice and Theology, and Future Intervention. Fr. Martinho Maulano

- The Socio-Cultural Perspectives. Bishop Mabuzo

- Multiple Concurrent Partnerships – Defining the Problem: Causes and Effects the Gender Perspective; Dr Nyambura Njoroge and Revd Pauline Wanjiru

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Lyn @ "Rolling On and Rolling Out: Circumcision and Sexual Health, 2010 and Beyond". 8/4/2010

The Centre for the Study of AIDS at the University of Pretoria hosted the second colloquium on circumcision and sexual health. This was hosted by Professor Gary Dowsett (La Trobe University Melbourne) and Professor Peter Aggleton (University of Sussex).

Powerpoint presentation of two of the talks are available below:

- Opening Address. Professor Gary Dowsett, PhD, FASSA

- Sex, Sexuality and Sexual Health by Peter Aggleton 

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Lyn @SABCOHA Breakfast - Business/Faith-based Cooperation on HIV. 25/03/2010

 Together with about 50 representatives of business and faith based organisations Lyn answered the invitation from SABCOHA, which read

In light of Governments’ renewed commitment to combating the spread of HIV and treating those already infected, Business and Faith-based Organizations both have a role to play in extending and complementing the services offered by Government.

How do Business and Faith-based Organizations ensure collaboration in order to capitalize on each other’s strengths and areas of specialization to strengthen Government’s HIV programs? How can Business and Faith-based Organizations raise the response to another level in order to prevent further infections, improve access to treatment and help meet the targets of the National Strategic Plan?”

On the panel was Abdia Naidoo (Baha’i Health Agency), Pastor John Thomas (Living Hope), Gen Sec Eddie Makue (SACC), Paul Germond (ARHAP), Chief Rabbi Hendler. Brad Mears from SABCOHA chaired the session.

The highlights Tweets from the conference (remember these are limited to 140 characters!):

· Eddie Makue, SACC: The denial we have accused the Mbeki era of is also our problem in faith communities.  
· Eddie; What we do in South Africa if we have a problem is to create a commission!
· Eddie: We are part of an African population with a profound spirituality - we need to tap into this and strengthen this to respond to
· Abdia Naidoo, Bahia' Health Agency: We need to focus more on equality between sexes in responding to HIV.
· Paul Germond, ARHAP: what is the contribution of health in Africa - also in policy development?
· Paul: Focus on assets and then position religion as one part of the search for health and policy formation.
· Paul: As faith communities we have a limited, western and mechanical view of health. We don't understand the impact of our values on health.
· Paul: Role of religion in shaping youth sexual behaviour and healthy choices crucial. Youth view religious affiliation +- how to use this?
· John Thomas, Living Hope: Challenges of the cycle of sexual abuse makes preschool and primary school prevention programmes essential.
· John: In SA we have a dual burden of disease - HIV and substance abuse. At the moment we have a marriage of HIV and substance abuse.
· John: Faith communities are often the 'delivery sector'. We need to expand the public/private discussion to a public/private/nonprofit talk.
· John: Believe shapes values, values drive behaviour. Religious entities are crucial in shaping values and behaviour.
· Rabbi Hendler: Ever life saved is like thousands of lives saved.
· Brad Mears: Isn't there a way in which we can do business in a ethical way, in which we can overcome the dichotomy bet. faith and business?
· Rabbi Hendler: Move away from blame and accept our own moral responsibility
· The relationship between business and faith sector is difficult to manage on national and regional level, but much easier on local level.
· Brad Mears: :Large percentage of infection in context of marriage - how does faith com. handle this?
· Paul: we live in a highly sexualised world, and this sexualisation is driven by profit. Business need to examine their ethical motivation.
· Paul: Much of the commercial world mitigates against marriage and healthy family relationships.
· Brad: How is the faith based sector redressing the inequalities between men and women.
· Question to Religious Sector: Is there a prospect for a coherent religious sector strategy in support of the NSP?
· Participant: Workplace programmes that focus only on psychosocial aspects are less successful: Business should also consider spiritual needs.
· How does faith based organisations market themselves to business? Spirituality key part of wellness!
· There is a massive testing drive - what is faith communities doing to ensure that they can deal with needs of newly diagnosed?
· How do we deal with treatment adherence and faith healing? How prevalent is this in your experience?
· Paul: There are cultural worlds of health and multiple health seeking behaviours that may be in conflict and need to be negotiated.
· Exciting session - hope that the conversation will continue!

You can read the SABCOHA press release here.

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Lyn and Jan @ Microsoft's "ICTs for NGOs" Day. 15/03/2010

From the invitation:

"As part of its aims to strengthen its role and contribution to the NGO sector, Microsoft, together with SANGONeT will be hosting a one-day seminar on 15 March 2010 at the Microsoft offices in Bryanston, Johannesburg, to discuss ways in which NGOs can use ICTs more strategically.

In the State of ICTs in the South African NGO Sector 2009 survey, conducted by World Wide Worx on behalf of SANGONeT, and sponsored by Microsoft and the NDA, it was found that technology is increasingly impacting on all aspects of the NGO sector. The study showed that for the first time NGO decision-makers are becoming adept at cutting edge tools like mobile applications and social networking services. However, these are mostly being used in their personal capacity, with half of all respondents using local social networking services, but only 6% of them using it in pursuit of the goals of their organisations. The benefit of the pervasiveness of the personal use of advanced tools will be a faster adoption of these tools and methodologies, going forward. It is anticipated that many new platforms and applications, primarily focused on mobility, will become the mainstay of technology adoption in the NGO sector."

Lyn tweeted from the session:

 

·    Mahad Ibrahim: Stop thinking about technologies, think about information as driver of success. 9:33 AM Mar 15th via mobile web
·    ICT is an enabler of development, not a product 9:40 AM Mar 15th via mobile web
·    In many cases familiarity and not expertise is needed 9:41 AM Mar 15th via mobile web
·    ICT is nothing without users, but effective use requires trust. 9:54 AM Mar 15th via mobile web
·    Participant highlights challenge of resource allocations - ICT - especially hardware - is expensive! 9:58 AM Mar 15th via mobile web
·    Matthew de Gale: Findings from research; State of ICTs in SA NGO sector. 10:11 AM Mar 15th via mobile web
·   Is the uce of ICT making a difference in their ability to serve their constituencies? 10:14 AM Mar 15th via mobile web
·    800 NGOs - lack in-depth IT function or capacity. NGOs are 'surprisingly mainstream'. Very similar to comparative SME 10:19 AM Mar 15th via mobile web
·    ADSL use of organisations in the study in SA is 77percent. Websites are not mobile friendly, yet mobile internet is key method of access 10:32 AM Mar 15th via mobile web
·    Do you know about the SANGOTeCH program providing heavily subsidised software and it, including Microsoft products 11:44 AM Mar 15th via mobile web

 

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Lyn @ Community Building Workshop. 2-3/03/2010

I attended the Community Building workshop with Peter Block and Symphonia for South Africa.  These workshops are "about the nature of real transformation and what kind of leadership is required to achieve it."

The workshops focus strongly on possibilities, rather than problems, an approach we have spoken about after the African Religious Health Assets Conference and our visit in Kenia where we learnt about the SALT methodology

Tweets from the workshop included:

·    At Community Building Workshop' 7:42 AM Mar 2nd via mobile web
·    Our relatedness is a prerequisite for the change we want. Peter Block 9:42 AM Mar 2nd via mobile web
·    Change the world one room at the time - connection is more important than content 9:45 AM Mar 2nd via mobile web
·    The small group is the unit of transformation, especially if observed by other small groups. 9:47 AM Mar 2nd via mobile web
·    The enemy of nation-building is like-mindedness. 9:48 AM Mar 2nd via mobile web
·    Message to leaders; I need you to hold your certainty a little more lightly, to create space for my voice to be heard. 11:52 AM Mar 2nd via mobile web
·    We don't create a future that is different from the past by continuing the old 'problem solving' conversation. 11:55 AM Mar 2nd via mobile web
·    Participant: Sometimes we view a crossroad as a cul de sac or a destination rather than a crossroad! 12:36 PM Mar 2nd via mobile web
·    Community is a place where parents become partners, where leaders do not own 'their people', where communities are accountable. 2:39 PM Mar 2nd via mobile web
·    Will continue from the Community Building workshop tomorrow. Hopefully Peter Block will be there - after his passport and travel challenges! 6:38 PM Mar 2nd via web
·    The task of leadership is a convening capacity - creating space to confront citizens with their freedom to create the future 8:49 AM Mar 3rd via mobile web
·    Participant's comment; we are not friends or enemies, we just are 12:07 PM Mar 3rd via mobile web
·    Participant: I am not going to outsource any part of my life to anyone else. 12:08 PM Mar 3rd via mobile web
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Minie @ AIDS Consortium BUA. 02/03/2010

Minenhle Moyo (Churces, Channels of Hope facilitator and Regional Representative for Zimbabwe) attended the session and shared her report with us:

Community Champions - Rhulani Lehloka

 Launched Heroes Campaign in 2009 where they encourage prominent people in communities to talk about stigma . Each month a hero is launched and they share their journey with HIV (profile). People are looking for those who will be open and testify in their own communities and not those from other places. Hence this year the focus on communities. There is therefore need to engage communities in 2 parts or levels:

1. Using the AIDS Charter

2. Sharing of personal stories and community dialogues to inform the AIDS Charter.

 Currently, The AIDS Consortium is working with the following number of Support Groups in its 3 provinces:  

North West: 3
Limpopo: 3
Gauteng: 3

 

 Between March and November 2010 it will work with 9 Support Groups in its campaign as it profiles the journeys of HIV positive prominent members of communities. It will also conduct trainings for these groups.

 Questions: What about youths living with HIV in these areas, how are they being engaged in fighting stigma and how will the work be monitored.

In response to the questions, participants were made aware of and referred to the components of the AIDS Charter.

 Challenges: Of the 3 provinces taking part in this campaign (Gauteng, Limpopo and North West) Limpopo was not represented in the profiles. It was also difficult to find a black, heterosex prominent man. Their view on such issues is that one spoils their business if they share their HIV status, they will no longer get customers or clients.  

When a gay person shared their status, a pastor could not understand it, showing how people still do not understand issues to do with their health and rights.

Group Work on Child and Maternal Health followed. This involved Managing HIV and AIDS symptoms in children, universal precautions, disclosing status to children, issues of infection and breastfeeding, progression of HIV in children and Post Exposure Prophylaxis PEP. (notes provided in previous meeting)

 Highlights: New guidelines announced by the President of SA; That pregnant women are to start ART when their CD4 count is 350. Children under 12 years will from APRIL 2010 receive ARV's.

 Next meeting: Child-Headed Households and OVC

 

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