SACBC AIDS Office Networking for Social Impact, Offering Signs of Hope

Sr Alison Munro OP

SACBC AIDS Office Networking for Social Impact

  Offering Signs of Hope

Sr Alison Munro OP, Former Director, SACBC AIDS Office, Pretoria, South Africa

July 2018

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 The SACBC AIDS Office

The SACBC AIDS Office was established as a direct response by the bishops of Southern Africa to AIDS, a crisis spiralling out of control in the general population. The response at diocesan level was overwhelming as parishes, religious congregations and retired nursing professionals offered care and support to people through education about the modes of transmission of HIV and ways to prevent infection, about home based care to the sick and dying, and about care of orphans and vulnerable children.  It was not until 2004 that the Church, and indeed South Africa, was in a position to offer anti-retroviral treatment as a means of arresting the progress of HIV from full blown AIDS to death. By then it was clear too that Church programmes needed the support of professionals from various disciplines in the provision of high quality clinical services.

South Africa’s AIDS programme

People with financial means had been able to access treatment long before the general public and marginalised groups of people.  The SACBC  joined advocacy networks calling for treatment for all. It took a ruling by the Constitutional Court before the country began providing the life-prolonging drugs. In time South Africa developed the biggest anti-retroviral treatment programme in the world. Despite the gains, the spread of HIV continues today. Screening people for tuberculosis (TB), and HIV counselling and testing through the SACBC AIDS Office programmes, aim to promote early detection and treatment of TB and HIV, and to work with communities towards the prevention of further transmission of both.

The imperative to develop partnerships and foster networks

The attention of the world was recently captured by the rescue of Thai school boys from an underground cave. The rescue against almost all odds was underpinned by collaboration and cooperation between international experts and local officials, highlighting what joint efforts can achieve. An illustration of what is possible among people.

Networking is about creating relationships with partners with a similar mission and goals, or government departments or providers of critical resources and services.  This way maximum value for resources for beneficiaries is leveraged.

Clearly the SACBC AIDS Office, itself not a direct service provider, needed from the onset to work with other people.  These included parishioners and volunteers in dioceses and parishes, themselves  part of local health-care, social and education networks.  There was also collaboration with national, provincial and district organisations  as policies and the implementation of programmes were refined.  The collaboration hasn’t always been easy, but is critical if the Church is to be a competent role-player in the provision of services to marginalised communities.

Donor agencies and their partner organisations also implement their programmes through the SACBC AIDS network.  Often in the past donors, government agencies and the public took issue with the Church’s perceived position on the use of condoms which was challenging for good working relationships. Over time relationships strengthened as the Church programmes do deliver programmes, very effectively, if differently. Sometimes it’s simply about having assumptions challenged and addressed.

Our own experience has shown that some Church projects in their turn do resist collaboration with others, not sufficiently understanding that in fact they cannot manage on their own.

The signs of the times and the challenges they raise

South African society is a fragile democracy, struggling with unemployment; a skills shortage; an educational divide; a health care crisis; major urbanisation; a foreign national population perceived to be taking resources not intended for them. Large scale corruption  enriches those in power, denies the poor access to resources, and impedes development. The gap between the rich and the poor continues to widen. When local communities and trade unions take to the streets to make their demands known, protests often become violent. Over the past year there have been major protests and  labour strikes in the health care sector across several provinces.

While major resources are allocated today to HIV/AIDS in South Africa, not sufficient nonetheless, it is managed as a chronic disease, differently from what was the case when treatment first became available. But life-style causes of HIV infection cannot be managed by governments, or indeed the Church. People need to take responsibility for their lives.  Health workers and Church workers are often fatigued and yet recognise that local circumstances often fuel the poor choices people make even about their own health.  AIDS is not the issue foremost in their minds.

Signs of hope and best practice

The Church, and the AIDS Office as part of the Church, doesn’t go away, even when other agencies sometimes do.  It aims at building bridges, closing gaps as far as possible, between what the various government departments  provide and what is needed in local communities. SACBC AIDS programmes aim to facilitate good communication in families around disclosure issues, educating communities to know their HIV status, and supporting those who need treatment. The numbers of people tested are increased with the engagement of several partner organisations through campaigns to reach entire families, not just people who access clinic services. Buy-in from local people is a key to furthering successful interventions.

We celebrate positive choices people make around life-styles.

Who are the partner organisations?

The majority of the AIDS Office funding is received through recipients of awards made by the United States Government (PEPFAR) and the Global Fund, themselves in bi-lateral agreements with the Department of Health.  There are also Catholic and other Non Governmental Organisation sources of funding for specific programmes.

In the Orphan and Vulnerable Children Programme partner organisations include local Department of Health clinics and various service organisations  commissioned to do screening and testing, or provide assistance with onward referrals.

The Department of Social Development enables beneficiaries to access the grants available to them, and provides social workers as necessary. Most beneficiaries currently are of school going age, most critical considering the particular vulnerability of teenage girls to HIV infection.

 

Challenges

Challenges can sometimes be overwhelming:

  • The attitudes and actions of people either facilitate or impede networking and ultimately the provision of services.
  • Decreasing donor funding is a reality to be faced. Donor support is all too easily withdrawn from projects. Donors choose new focal areas, the quality of services is compromised, people become discouraged. Local community projects are expected, unrealistically, to be self-sustaining at some point.
  • Overcrowding at clinics, delays, poor coordination and collaboration among people meant to work together
  • Inadequate recording and documentation.
  • Onerous government department policies and procedures; contracts finalised late, funds distributed even later, and unrealistic targets to be met.
  • Changes among personnel, within the Church and in partner organisations and the time needed to build new relationships
  • Working with some people who are insufficiently invested in bringing services to the people. Sometimes for the SACBC this means “shaking the dust off one’s feet, and moving to elsewhere.”

Positive experiences

The success of the various interventions is dependent on the people working at local level in their communities with the assistance of others. Some positive experiences include

  • Donors and others visiting community projects observe first-hand the difference being made in the lives of people. Often previous perceptions are changed by first hand experiences.
  • The successful delivery of HIV and TB testing and screening, and education.
  • Issues of stigma and discrimination and HIV disclosure  more openly discussed with both adults and children.
  • Improved communication between guardians and children on issues of sexuality.
  • Programme statistics show improved numbers of people reached. Without the programme many people would remain ignorant of their HIV and TB status, not access treatment, and probably continue to transmit HIV and TB.
  • Church personnel offer various forms of support to the project sites, including on-site staff support, and rooms or office space.
  • A number of community projects are parish-based and run by Catholics, but many in the network involve people of other faiths or no faith.
  • The SACBCAIDS Office has been increasingly recognised and respected as an organisation.
  • When beneficiaries receive the necessary assistance and in a timely manner it is always a highlight. It is a pleasure to work with community sites that excel, having proper governance structures around accountability.

Keeping our own house in order

Among the SACBC AIDS staff themselves collaboration is key so that everyone knows what is expected of themselves and of the local community partners they mentor. We try to model for others with whom we work that no one is in this for his/her own benfit alone. The common good is key.

Consistent monitoring of the programme helps the SACBC staff to establish which interventions are working and what needs changing. Risk assessments, and evaluation of financial procedures and policies of local organisations, help ensure accountability

Conclusion

 

HIV and AIDS has given us a particular insight into the suffering of people, the challenges they face, the choices they have made and continue to make, the results of the circumstances in which they find themselves.  It has also shown us the generosity of spirit of those who have responded through their own actions towards others , individuals and groups.  More people than one may have ever expected have been drawn into networks of service, committed in various ways to the education and support of those affected by AIDS. Solidarity has taken on a new meaning.