A Justice Site
Mirror Sites:
CSUDH - Habermas - UWP - Archives
California State University, Dominguez Hills
University of Wisconsin, Parkside
Soka University Japan - Transcend Art and Peace
Created: January 21, 2003
Latest Update: January 21, 2003
jeannecurran@habermas.org
takata@uwp.edu
Backup of Commercial Farmers Union AIDS ProgramINDEXThe Important Issues
The Problem
Agriculture Funds the Fight Against AIDS
Three Vital Steps
Caring at Home
1 million Orphans by 2002
Condom Promotion
Survival Sex
Helping Young People
Contacts
The Important Issues
"This epidemic is not a medical problem but a behavioural one. However, too many government decisions are not dealing with the fundamental issues -poverty alleviation, unemployment, inflation, declining health facilities and allocation of resources, to mention a few."
- Kerry Kay, CFU project manager, speaking at the CFU Congress, August 1999
The Problem
Zimbabwe is one of the countries with the highest prevalence of HIV per capita in the world. It is estimated that 35 percent of the adult population of 11,4 million is infected, and the Ministry of Health has reported that 3 000 people are infected with HIV every week; informal research backed by epidemiologists suggests that there are at least 700 HIV-related deaths a day.
Zimbabwe is an agro-based economy, and the agricultural sector contributes approximately 18 percent towards the gross domestic product (GDP). At least 70 percent of the population live in the rural areas and depend on agriculture for survival.
The output of maize in communal and resettlement farming has fallen by 61 percent because of the loss of manpower due to AIDS morbidity and mortality; cotton output has been reduced by 47 percent and vegetable production by 49 percent.
Unemployment is approximately 70 percent, inflation is 112 percent and bank lending rates average 60 percent. The current situation of political instability, state sponsored intimidation and violence, farm invasions and the eviction of many farmers, their employees and all their families, the demise of the primary health care system and lack of drugs, is already sending many HIV infected people to a premature grave.
The incidence of HIV/AIDS is similar among men and women (55 percent and 44 percent respectively). The incidence peaks for men at age 25-39 and for women at age 15-25.
Women account for 80 percent of reported AIDS cases among the 15-19 age group.
The AIDS epidemic has been associated with an increase in the incidence of tuberculosis: well over 50 percent of TB patients are HIV-positive. In the early 80s there were only 3 000 reported cases of TB, yet in 1996 there were 33000, and in 1998, 52 5000; 25 000 of the latter were in the 30-50 years age group. World Bank reported in 1996 that life expectancy was expected to fall from 60 to 40 by the year 2000. It is now 2002 and the life expectancy of anyone born in Zimbabwe now is 39 years of age.
Agriculture Funds The Fight Against AIDS
COMMERCIAL farmers, including tobacco growers, are working alongside the Zimbabwe Government and a number of non-governmental organisations (NGOs) to prevent the devastating spread of AIDS. Since 1986 one of the country's most effective agencies has been the Commercial Farmers Union (CFU), which now has more than 10 000 volunteer workers helping to educate and counsel people in rural communities.
Zimbabwe's commercial farming sector is the nation's second largest employer after the government. It also accounts for much of the country's foreign exchange earnings. For example, nearly 30 percent of the Zimbabwe's foreign exchange comes from tobacco leaf sales, worldwide. Only 3% of farming land is used for large scale commercial tobacco. Around two million people (including children) live on commercial farms where the basic infrastructure is provided by the farmer.
The CFU, which has 3,400 members, draws support from 73 Farmers associations in eight regions. It is open to all producers of agricultural products marketed through formal arrangements.
For Zimbabwe the HIV/AIDS pandemic has two major implications: great demands on the health care budget and the cost of replacing skilled workers. This is especially true of farms where the employer and employee enjoy a much closer working relationship than in industry.
Farmers live and work with their staff and are attuned to their protection. This is why the CFU started the AIDS prevention in rural areas project. Farmers could see before their eyes the devastation to farm workers' families and recognised the impact on the nation's economy.
The goal of the CFU project is to reduce the spread of sexually-transmitted diseases on farms through the reduction of high-risk behaviour. Specific objectives include working with farm workers to raise awareness of preventative measures, increasing access to condoms, increasing risk perception among the target population, and controlling the spread of STIs. The CFU implemented a key intervention strategy, behaviour change communication, achieved through peer education.
The CFU expanded the condom distribution system on farms and established or enhanced the STI referral system there.
Effort has gone towards creating a social environment that makes behaviour modification possible, and using existing peer pressures to drive and support behaviour modification. Strong support systems had to be incorporated, such as the recognition and promotion of cultural values, self-help or income-generating projects, improvements in information flows and policy commitment by management and influential people in government.
These approaches yielded positive measurable results. Condoms have been accepted as an effective control tool, reducing all sorts of sexually transmitted infections. Empowerment through education improved independence in decision making and the quality of the decisions made (both by men and women). A recent report noted that the target population is at the advanced steps leading to behaviour change. This is a difficult process, but it has already been recorded within the farming communities.
The CFU project, with its encouraging spirit of voluntarism is self-sustaining only if the burn-out rate of the volunteers is managed and an environment created to facilitate the continuation of the project.
External assistance is greatly valued, as complementing the CFU 's internally-committed resources (bridging finance as and when needed, plus aid on an "in kind" basis and services such as book-keeping). After five years, USAID withdrew its funding of the programme in December 1998; the programme has for the past three and a half years being funded by the Royal Netherlands Government.
It is confidently stated that the CFU AIDS project will undoubtedly yield a greater impact on the population than that of any other employer in Zimbabwe.
CURRENT SITUATION - August, 2002.
To say that the lives of the large scale white commercial farmers, their employees and families, have been thrown into total disarray due to the prevailing anarchy in the country, would be an understatement. The ripple effect of these invasions, with all the accompanying violence, lawlessness and the displacement of over half a million men, women and children, has set Zimbabwe back at least fifteen years in the many gains that have been made since 1980 in health care and HIV/AIDS and STI prevention. This, riding on the back of a man made famine, is a national disaster, and one that could have been avoided with responsible government and planning !
Three Vital Steps
THREE well-trained levels of advice and support make up the Commercial Farmers' Union AIDS prevention programme. In three years to July 1998, the CFU trained 52 co-ordinators, 132 trainers and about 8, 000 peer educators, with funding from Family Health International. Previously, a total of 2, 000 peer educators had been trained. They are led by a four-person project team.
Co-ordinators are farmers' wives who have volunteered to become involved in HIV/AIDS activities. They come from a variety of backgrounds - nursing, the police force, occupational therapists, counselors, and so on - and they meet the sole selection criterion of having volunteered to give of their time and expert knowledge. They organise training and distribute literature about HIV/AIDS and condoms. They use their own vehicles, and at times their own telephones and fax machines.
Over 50 co-ordinators in the project have received training during their annual conferences from other experts in the field. This training includes project management, monitoring and supervision and reporting techniques, among others. Their major responsibility is to organise appropriate and culturally sensitive training sessions for peer trainers and peer educators in their respective areas. They also extend the training to farmers in neighbouring communal and resettlement areas. Co-ordinators ensure that peer educators have the knowledge and skills to address the changing needs of their peers.
At quarterly meetings, they share information about what is happening in their area, the strategies that prove to work best, research issues, and coping with bum-out. They assign themselves to additional areas of specialisation: women's issues, youth issues, counseling etc. They also share experiences and lessons learned about HIV/AIDS from the conferences and other gatherings some of them might have attended since the last quarterly meeting.
Education on HJV/AIDS has been extended to schools, so as to reach tomorrow's leaders, playing a complementary role to those of the Ministry of Education and UNICEF's school health project. Young people engage in sex, and, often, unprotected sex, and they rely on informal sources for gathering information on STIs. There is no open child-to-parent communication on sexual issues, which are regarded as taboo topics for discussion.
Peer trainers are selected from the farm workers and, at times, from surrounding communal and resettlement areas. They are respected members of the community who have a certain educational level so that they can understand information and pass it on clearly to their peers. They hold a variety of positions, such as middle managers on farms, storekeepers, teachers from farm and rural schools, policemen and women, and telephone operators. All trainers must be able to read and write English well.
hey were trained by CFU co-ordinators, Family Health International staff and the Family AIDS Counselling Trust (FACT). (Training manuals used are those of FACT.) The course includes basic information on HIV/AIDS and other STls, how they are transmitted and prevented, counselling skills, communication skills, condom negotiation skills, reporting techniques, home-based care, spiritual and cultural issues.
Peer trainers conduct follow-up visits for peer educators and report back to co-ordinators on peer education activities, as well as making recommendations when necessary. All peer trainers are volunteers and use bicycles to get from place to place in their monitoring and supervisory role. The bicycles were donated by U SAID and the Dutch government.
eer educators are also respected men and women, selected by their colleagues or volunteers. They are respected for their knowledge and approachability so far as HI V/AIDS is concerned, so it is essential that they have self-confidence in their work. They must be able to tell when to enlarge messages, when to listen, when to empathise and when to bring in skills like counselling.
electing, training and following-up with peer educators is crucial to the success of the project. A training programme was drawn up which included the basic facts about STls/HIV/AIDS, basic information about sexuality and condom use, communication skills and basic counselling techniques. Training was conducted by the CFU co-ordinators and peer trainers, assisted sometimes by FACT staff, and took place in the different farming areas. Food and facilities are contributed by the farmers.
The number of people who have benefitted from each educator is not easy to determine. (A peer educator spends considerable time in several meetings with either a single peer, or a small group.) The peer educators themselves are convinced that their work meets the goals, and the needs of the target audience.
Refresher training is carried out from time to time based on needs discovered during implementation of the project.
Peer educators distribute condoms, give condom demonstrations, distribute educational materials, perform and/or present drama, conduct informal group discussions about HIV/AIDS, video shows and individual counselling. They teach home care, refer people to care facilities and, most important, support people living with HIV/AIDS.
Men and women are trained together, in groups of 15, which has itself gone a long way to overcome the inherent cultural reluctance to discuss intimate sexual matters in mixed company.
While discussions about HIV/AIDS take place during working sessions, peer educators tend to meet people during lunch breaks and after work, in the farm village, in halls, the street, beer drinking places and churches. Discussion tends to centre on prevention methods, such as abstinence, faithfulness and condom use - the latter because many men do not subscribe easily to the first two methods.
Peer educators distribute thousands of free condoms to their peers. The condoms are obtained from the Zimbabwe National Family Planning Council (see page 3), and funded by the British government.
Peer educators are not paid for their activities. Small incentives such as T-shirts, bags and certificates of appreciation are often given, which helps keep the peer educators motivated.
Caring At Home
AS the epidemic takes its toll the health system is failing to cope with the demands being made on it many people who require palliative care are being nursed in their homes, and commercial farm workers are no exception. Home-based care is even more difficult when there are scarce resources and limited knowledge. The CFU project therefore found it difficult to separate prevention from care, as doing so might have reduced the efficacy of the programme.
Peer educators have been equipped with the skills for the care and management of people with HIV/AIDS; they can also supply counselling. Their training has incorporated the use to be made of available local resources, the methodology of care and how to feed the sick.
However, since farm workers are minimum wage earners, it has been difficult for them to get even the basic resources required for adequate care of the sick, so in most cases the commercial farmers themselves took over the responsibility of providing resources and food for the sick farm worker.
The CFU has appealed for donations in cash and kind for home-based care, as there are many sick people on the farms.
1 million Orphans By 2002
THE impact of AIDS on children is immense. For those children whose mother and father have both died and whose extended family is already overextended and cannot, or will not, help, the only chance of survival usually is on the streets of towns and cities. There are increasing numbers of children, some of them as young as four, who have no-one to care for them but the private organisations who rescue and rehabilitate as many as they can.
The Farm Orphans Trust was initiated by Dr Sue Parry, and registered as a pro-active regional welfare organisation in March 1996. It was tasked with addressing the issue of HIV/AIDS orphans on commercial farms.
The CFU has called for the intensification of the Schools Health Programme and itself helped with training teachers in farm schools on the subject of HIV/AIDS. It has also called for a review of the legislation regarding rape, child abuse and incest; for tax concessions for families caring for orphans and farmers providing health care/education/care facilities for orphans; and for orphans to be exempted from paying school fees.
Condom Promotion
THE MALE condoms are collected from the Zimbabwe National Family Planning Council warehouses by trucks belonging to commercial farmers. The farmers then distribute the condoms to other farmers for passing on to their farm workers. It is the responsibility of each farmer to ensure the availability of condoms on their own farms.
Condoms can be accessed from a variety of different outlets on the farms, including farm stores, garages, post offices, butcheries and halls, and the farm health worker, so the worker does not have to request them from the farm owner. Peer educators also distribute condoms. The CFU distributes more than 1,5 million condoms a quarter.
The female condom is too expensive for the rural women, but as it is the only preventive device which women can control, the CFU continues to lobby government for the female condom to be subsidised. Its role in preventing sexually-transmitted diseases and HIV cannot be over-emphasised.
Survival Sex
"Although sexual abstinence must be preached as the first option, in developing countries it is often not an option at all. I do not need to dwell on our current economic climate, save to say that survival for most of our population today is more difficult than ever before".
"If a woman is single, divorced or widowed and unable to find employment, especially in a rural area, and has children to feed and educate, she has often only one - life-threatening - alternative, and that is to turn to 'survival sex'. This is why the use of condoms must be offered as an alternative to abstinence. Realism as opposed to righteousness!
"We have seen a very positive acceptance of the use of condoms and an ever-increasing uptake on farms."
- Kerry Kay, CFU project manager, speaking at the CFU Congress in August 1999
Helping Young People
IT IS easier to prevent the onset of sexual activity than to stop already-entrenched behaviour. Enquiries at urban secondary schools in Zimbabwe show that the number of girls in the fifth and sixth forms thought or known to be taking the contraceptive pill is seldom below 50 percent. However, as project manager, Kerry Kay, points out, pregnancy is not fatal, but the combination of STDs and HIV is.
This is an era when sex, drugs, alcohol and violence are continuously glamourised in the media but young people are very receptive and if informed, guided and supported wisely will come through as the next generation relatively unscathed by this epidemic.
FUNDING
The programme would welcome any donations at this crucial time in our history as we attempt to concentrate on counselling all those displaced farmers, their employees and their families. If we are prevented from living and working on our farms and in the rural areas then we will turn our efforts to helping all those who have been subjected to human rights abuses through violence, intimidation, displacement etc. especially the children.
We have not lost hope, adversity has strengthened us !
" A man with a grain of faith in God never loses hope, because he ever believes in the ultimate triumph of Truth " Mahatma Gandhi.
26th August, 2002.
CONTACTS
KERRY KAY, JENNIFER SWIFT,
COMMERCIAL FARMERS UNION
Agriculture House,
Marlborough Drive, Marlborough,
Box WGT390
Westgate,
Harare,
Zimbabwe
Tel: 263-4-309800
Fax: 263-4-309874
kerrykay@cfu.co.zw OR chipesa@zol.co.zw
JUDY RICHARDS.