MS training on HIV/Aids mainstreaming

By Claudia Juhl, MS-Zimbabwe

20. June 2004

From the 20 May to 11 June 2004 MS-Zimbabwe and its partners had the pleasure to receive a visit from Kirsten Madsen, an experienced HIV/AIDS adviser from Denmark.

Kirsten Madsen has worked with counselling and training on HIV/AIDS since 1983 both in Denmark and in Africa. She was also part of the team developing an overall MS AIDS Policy and contributing to the MS Guidebook on “Ideas and Tools to Combat HIV/AIDS in MS Country Programmes and Partner Organisations.”

The purpose of Kirsten Madsen’s visit was to train MS Zimbabwe and its partners on how to mainstream HIV/AIDS into their programmes. This was done through a series of workshops combined with research on local health facilities and other areas. Besides Zimbabwe Kirsten visited other MS Country Programmes to do training on HIV/AIDS mainstreaming.

In Zimbabwe Kirsten Madsen conducted training with the following partners:

1. Farmers’ Association of Chief/Headman Investment Groups, Bindura
2. National Associatio n of Societies for the Care of the Handicapped, Harare
3. Insiza Godlwayo AIDS Council, Filabusi
4. Binga Craft Centre, Binga
5. Nkayi Folk Development Foundation, Nkayi
6. Environment Africa, Victoria Falls
7. Gokwe Community Centre, Nembudzia
8. MS Zimbabwe Country Office, Harare

The main objectives of the training were:

- to get to know more about HIV/AIDS prevention, care and treatment
- to encourage partners to communicate freely about HIV/AIDS and sexuality
- to start the process of developing an AIDS-friendly workplace and to mainstream HIV/AIDS
- and to oppose despair and create HOPE.

Mainstreaming implies the introduction of a common policy on HIV/AIDS within your organisation and the adoption of recommended approaches into programmes and activities. HIV/AIDS is often regarded as an issue of concern to people working in the field of health care and HIV/AIDS awareness. In view of the current statistics in Zimbabwe one can only agree that it is important to urge organisations to consider HIV/AIDS and to encourage staff at all levels to participate in training. In other words it is important for all organisations and institutions to mainstream HIV/AIDS regardless the nature of your work.

The first step to begin mainstreaming HIV/AIDS is for each employee to relate to HIV/AIDS in a personal way. Consideration, care and change of behaviour begin at a personal level and should be reflected in the way we act at home and within private settings. Likewise our concern should apply to our professional environments at our working places. At the beginning of the workshops Kirsten Madsen asked the participants to tell their own “AIDS-stories”. Many people told a personal story about a close relative or a friend who had fallen sick with AIDS expressing own close encounters with the disease. The high prevalence rate of HIV infections among sexually active adults in Zimbabwe implies that almost every single family has been affected by the disease in one way or the other. Official statistics show that 24.6% or a quarter of the adult population is HIV-positive. Although people were willing share their experiences the participants did only tell stories revealing the fact that they themselves are HIV-negative. Due to stigma and prejudices associated with the virus it is still hard to come across persons who are open about their status if they are HIV-positive.

Likewise it was also key to the training to encourage the participants to talk openly about HIV/AIDS and discuss freely about issues related to sexuality and transmission of the virus. Questions on why we have sex, why there is sex outside marriage, why one would say no to sex, why people have unsafe sex and why people have safe sex were central to this discussion.

Kirsten noted that some of the young people present at the workshops felt that the issue of sexuality is fairly neglected in the educational system. Furthermore people emphasised the need to talk more openly about sexuality and HIV/AIDS in marriages. One woman said she wished she had attended the training together with her husband, because it would have made a much bigger difference. “It is hard to talk about these things on your own,” she said. The discussion also turned towards cultural aspects with regard to the roles of men and women. For instance did most people agree to, that if a woman in a marriage is tested positive, she would most likely to be chased back to her family whereas if the husband is tested positive the wife will stay and look after him.

Kirsten was impressed by the people’s courage to talk freely about sexuality and issues related to HIV/AIDS. As an example she mentioned one teacher’s openness telling about his personal life and experiences in front of his own students at a youth training workshop in Victoria Falls.

Rights of HIV-positive persons

One of the most difficult questions touched upon was the question of the rights of people who are tested HIV-positive. In particular whether HIV-positive persons have a right to a sexual life or should abstain from sex completely. There were many different views to this question. Some participants did not want infected people to continue their sexual lives, as they feared further spread of the disease. Others were more considerate and stressed that HIV-positive people should be able to live positively and have sex on condition that they protect themselves and their partner. Anyhow knowledge of one’s status was generally viewed as implying the duty to act responsible and under no circumstances put danger to any other people’s lives.
It was also discussed whether it is worth spending resources on people with AIDS if they are dying anyway. Here a woman at Binga Craft Centre said: ”If I got it, I will not eat the food away from my children. I will leave something behind.”

Symptoms and Treatment

Today people have come to realize that HIV is the cause of AIDS due to the great number of dying people. As part of the training the participants were asked to identify signs, symptoms and diseases that are believed to affect a person suffering from AIDS. The participants were able to name a lot of different symptoms and illnesses, which they believed to show signs of the disease. Contrary to this the knowledge about treatment was generally low.

Kirsten Madsen had prepared information and hand outs on various medicines, treatment and care that can be offered to people who have fallen sick with AIDS. This information is now available at the MS-Zimbabwe library including information material from New Start Centre and other local health institutions.

Kirsten Madsen hopes that following her training MS-Zimbabwe and its partners feel better equipped to communicate about HIV/AIDS and encouraged to start mainstreaming HIV/AIDS at the workplace. Her hope is furthermore that inspiration will trickle down to beneficiaries and other stakeholders in order to join forces in the fight against HIV/AIDS.

Generally participants expressed that there is a great need for continuous training on HIV/AIDS. Especially people appointed to monitor mainstreaming processes should if possible go for further training to expand their knowledge.

Today HIV/AIDS poses an all-embracing problem to the society and the challenge to prevent new infections as well as to care for those affected is ever present. Therefore there is a need to address the issue of HIV/AIDS at all levels as much as possible.

Important questions address:

Breaking the silence about HIV/AIDS
How do we start talking about HIV/AIDS?
How do we create an AIDS friendly environment at our workplace?
How do we fight stigma and discrimination?
How do we talk about behaviour change?

Prevention of sexual transmission of HIV
How do we talk about sexual transmission of HIV in a sensitive way?
Why does HIV/AIDS awareness often not lead to sexual behaviour change?
What are the facts of sexual transmission and how can it be prevented?
How do we promote life skills training and behaviour change?

To know your status and to get the right care
What is Voluntary Counselling and Testing and how does it work?
What are the advantages and disadvantages of knowing your HIV-status?
What are the risks of getting infected including mother to child transmission?
How do we get the right care and support?
How do we treat opportunistic infections including antiretroviral treatment?