| AYISE |

BUILDING COMMUNITY COMPETENCE IN RESPONSE TO HIV AND AIDS PROJECT - NSANJE AND BANGWE

The project addressed the following core issues:
HIV and AIDS - this was the key focus of the whole project
Education - AYISE assisted vulnerable children with educational materials to help them stay in school
Gender Issues - through raising awareness of how HIV and AIDS disproportionately affect women as a result of gender inequalities
Child Protection - reducing HIV and AIDS deaths reduces the incidences of orphans, and the difficulties in child protection therein. Additionally AYISE directly supported vulnerable children through this project. The project also advocated child rights.

The Issues - click here to read more

HIV and AIDS is a major issue in Sub-Saharan Africa and unfortunately Malawi is no exception. Traditionally is has been common practice for men to have unprotected sex, and to keep more than one sexual relationship existing at the same time. This has led to a rapid spread of the disease, and its crippling effects on the countries it exists in are exacerbated in Malawi by the pre-existing poverty and lack of infrastructure to support any health services.

80% of Malawians live in rural areas, and are mostly too poor to travel far. Thus providing health services to them would be expensive for any government, but the Malawian government has fewer resources at its disposal than most, and so many people live a long way from their nearest health services. Those in rural areas are often provided with health advice by traditional healers who are not medically trained, and have skills only in addressing long-standing illnesses, and not new problems like HIV and AIDS.

A further problem, in all locations - urban and rural - is the misconception that hospitals are dangerous places. This self-fulfilling prophecy discourages people from seeking western medical assistance until the last resort - by which point they are beyond any help and die at hospital. When their family and friends hear they have died at hospital it reinforces their belief that hospitals are dangerous places, and so when they get sick, they too avoid seeking out scientific medical assistance until too late...and the cycle continues.

As in many countries, developed and developing, there is a strong stigma against having HIV or AIDS. Consequently people are reluctant to visit a clinic to be tested for the disease, as others may assume they already have the disease. It is not uncommon for husbands to leave their wives if they find the wife has HIV or AIDS, which leaves the wife with little economic security in the Malawian context. As a result of the reluctance to be tested, there is an ignorance of sero-status, which increases the risk of transmission.

Thus it can be seen that there is a lot of behaviour-change work to be done, and results will not be quick, but we must act now to start the change.

The Project - click here to read more

AYISE had conducted work in Nsanje District before to implement a women and child rights project and understand the practices and behaviours that fuel the spread of HIV and AIDS. The HIV prevalence in the district is the highest in Malawi, and so AYISE wanted to help contribute to the fight against this escalating spread of HIV. To enable this to happen, the National Aids Commission funded AYISE from 2006 to 2008 with US$100,000 to implement a project entitled Building Community Competencies in response to HIV and AIDS in Nsanje district and Blantyre Bangwe.

General objective
The overall objective of the project was to build community competence to effectively respond to HIV/AIDS through improved services in behavioural change interventions, counseling and testing, impact mitigation and advocacy in Nsanje and Bangwe, Blantyre.

Specific Objectives

To raise awareness of current HIV/AIDS issues including: voluntary counseling and testing; gender and HIV/AIDS; stigma and discrimination; and HIV/AIDS in relation to cultural families.
To mobilise, establish and train the community as a response structure to HIV/AIDS in each respective community, to help respond to cultural and traditional practices that are contributing to the continued spread of HIV/AIDS.
To intensify VCT (voluntary counseling and testing) services at the AYISE Bangwe health centre VCT facility so as to increase clientele by 50% through improved service delivery, information, education, communication and recreational activities.
To train women and youth groups in life skills, encouraging healthy sexual relationships and reducing vulnerability.
To undertake income-generating activities for the youth in Bangwe Township so as to reduce their poverty-related vulnerability.
To train communities and the community leadership in Nsanje on the impact of negative traditional and cultural practices as well as gender inequalities in the continued spread of HIV/AIDS
To support school-going orphans with basic school needs such as note books and uniforms
To build the capacity of AYISE in order to effectively deliver services

The Outcomes and Findings - click here to read more

Project Achievements
At the end of three years, the project had achieved the following:

Increased use of the VCT facility by youth and the communities of Bangwe Township
Increased awareness of the impact of gender inequality and negative cultural practices that contribute to the spread of HIV/AIDS in the communities
Reduced stigma and discriminatory attitudes towards persons living with HIV/AIDS