Overview of action communities can take

This guide contains a summary of the four main areas of action the can be taken at a local level. It deals with:

1. Prevention
2. Care for people with HIV and AIDS and
3. Care for children affected by HIV and AIDS
4. Working together

The guides that follow give much more information on each of these topics.

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1. Prevention

A very important area to focus on is preventing the further spread of HIV. The vast majority of people (around 80% of adults) do not have HIV and AIDS and we can still do much to ensure that they stay safe. There are many different things we can do to prevent the spread of HIV and AIDS:

1. Educate every person in our community to understand how HIV and AIDS  is spread and what we can do to protect ourselves.
2. Encourage people to change their sexual behaviour and to practice safe sex at all times.
3. Make condoms freely available and distribute them in places where people can have easy access to them - after hours, and close to where they live. Places like spaza shops, public toilets, taxis and other public transport, hostels, truck stops and garage shops, discos and clubs, bars, education institutions and so on.
4. Make everyone aware of the plight of those of us living with HIV or AIDS and the burden on our families, and work hard to promote openness and compassion to break down the stigma and silence surrounding HIV and AIDS.
5. Encourage testing for all people who have active sex lives so that we can be sure that we are not spreading the disease. Only an estimated 15% -20% of people who are HIV positive have been tested and many people are spreading the disease without knowing it. Testing must be accompanied with counselling and treatment.
6. Ensure that every farm, factory, shop, mine, office and other places of employment has a workplace plan that targets employees.
7. Ensure that all schools are implementing the Department of Education’s Life skills curriculum on HIV and AIDS.
8. Encourage people ill with AIDS to be assessed for antiretroviral treatment (ART).
9. Ensure that rape survivors get access to treatment that can prevent the transmission of HIV through close co-operation between the police service and health facilities.
10. Encourage people, especially men, to seek treatment for sexually transmitted infections (STIs) at clinics and hospitals.
11. Encourage pregnant woman and new mothers to seek help to prevent infecting their child (called mother to child transmission or MTCT).

2. Care for people with HIV and AIDS

The millions of people who already have HIV or AIDS need support, treatment and care. We should do the following kinds of things in every community:

1. Make sure testing is accompanied by counselling to help the person cope, to refer them to support projects and to advise them how to change their sexual behaviour so they do not spread the disease.
2. Set up support groups for people with HIV and AIDS where people meet others with the illness and discuss common problems, feelings and ways of coping.
3. Build and support organisations for people with HIV and AIDS that take up issues and co-ordinate support.
4. Offer treatment for all opportunistic infections
5. Ensure that people living with Aids get antiretroviral treatment (ART) once they need it, and the support to stay on their medication.
6. Support nutrition, vegetable-growing and wellness projects to help people stay healthy for longer.
7. Set up home-based care projects in communities to make sure that people who are ill at home receive proper care. Volunteers should be used to carry out home visits to give support to families and basic care for people with AIDS. Volunteers should work with and under the supervision of local clinic staff.
8. Target people with HIV and AIDS and their families for poverty alleviation projects.
9. Make sure people with HIV and AIDS have easy access to the available grants and government support.
10. Set up step-down facilities linked to hospitals for people who are discharged and cannot be cared for at home.
11. Organise effective support for families and children.
12. Involve the municipality, welfare organisations and the religious sector in providing food, clothing and other forms of relief for families in need.

3. Care for children affected by HIV and AIDS

Every community needs a program that can identify children affected by HIV and AIDS – those who are living with parents who are ill, those whose parents have already died, and children who have HIV and AIDS themselves. These are some of the things that can be done:

1. Set up community childcare committees to identify and help provide emotional and material support to children in need (click here to see Community Child Care Forums)
2. Introduce foster care programs where possible, for children who have lost parents.
3. Make information and assistance to get child support grants available to children and their caregivers.
4. Introduce school programmes to ensure that children who are affected by HIV and AIDS get the necessary support to stay at school.
5. Make sure food and nutritional support programs target children in need.
6. Include special school lessons on HIV and AIDS related to different subjects. For example, biology should include lessons on healthy eating for people with HIV, language teachers should have speak-out lessons and encourage children to write about how the disease is affecting them. Life skills should deal with responsible sexual behaviour, and so on.

4. Working together

It is clear that national, provincial and local government alone cannot tackle or take responsibility for all these projects. Our hospital and welfare services cannot cope with the demand for support. It is essential that local communities get involved and set up projects that draw in and rely on volunteers.

The role of local leaders and opinion-makers, local organisations and local municipalities is crucial. It is only when communities are effectively mobilised by those they respect that HIV and AIDS projects will succeed.

It is also vital that everyone who works on HIV and AIDS cooperate to ensure that those in need are properly identified and catered for. This is especially important for health, welfare and other service organisations or NGOs. Referral systems have to be set up so that families in need can access support. 

For example, if a child drops out of school and teachers find out that parents are ill, the child should be referred to projects for support and the parents should also be referred to the support and treatment programs that exist.

It is essential that all organisations that provide services or can recruit and mobilise volunteers, work together.  Here are some of the things that should be done:

• Coordinating mechanisms like Local AIDS Councils should be used to make sure that there is a coherent and coordinated response from everyone involved.
• People from health, welfare and municipal services should be drawn in to work together with community, religious, business and service organisations. People living with HIV and AIDS should be part of any coordinating structure.
• AIDS Councils should be broken into working groups or task teams that concentrate on one area of work – for example: prevention, care for people with HIV and AIDS and care for children.
• A cross-referral system should be set up between services (more here…)
• The AIDS Council should monitor projects and make sure there is a coherent plan that is implemented.
• AIDS Councils should also develop links to government structures, resources and funds at district, provincial or national level.

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