The community conversation facilitators
June 28, 2010 – During May and early June of this year, a series of Nelson Mandela Foundation community conversations were held in towns in six provinces across South Africa.
Conversations took place in Giyani, Lerome, Thaba Nchu, Galeshewe, KwaMakhutha, Lusikisiki, Mthatha and KwaLanga.
Common concerns emerging from some of these communities included drug and alcohol abuse, unprofessional treatment by clinic nurses and a shortage of clinic and medical staff.
At the two May meetings of KwaZulu-Natal’s KwaMakhutha community, held on May 20 and May 27, a combined total of 312 people attended.
Concerns spilling over from 2009 – poverty, substance abuse, crime and rape – were revisited and reflected upon as a start to the 2010 conversations. Issues identified during the first conversation hinged on medical support, treatment, HIV counselling and testing, substance abuse and the fear of death.
The second meeting focused on creating a vision for the future, which could be used as a baseline to direct community conversations during the year ahead. The community acknowledged the value of working together, supporting one another, encouraging the youth to change their lifestyles, and suggested the introduction of virginity testing for boys.
KwaLanga (Western Cape)
On May 10, 43 community members supported the region’s first community conversation of the month, with the number growing to 67 at a subsequent meeting held two days later at the Guga S’thebe Cultural Centre. The fact that most attendees were male was heralded as a great achievement by the facilitators as men and boys traditionally avoid meetings dealing with HIV/AIDS.
Three significant issues – alcohol and substance abuse, early pregnancy and discrimination – were discussed at the first meeting.
The community reported widespread use of drugs and alcohol by women who trade sex for money, with which they buy Mandrax, cocaine and dagga. These women were described by community members who attended the conversation as “sex objects who throw themselves all over men.”
Concerns around drug and alcohol abuse extended to high school girls who reputedly drink and take drugs over weekends, and indulge sugar daddies in exchange for money, often ending up pregnant as a result. This was highlighted as a major catalyst to the spread of HIV among youths in particular.
The lack of confidentiality practised by health care workers when testing for HIV was reported as distressing and disadvantageous, especially when nurses live in the same community as those receiving counselling. As a result, many community members are discouraged from taking HIV tests at the clinic.
Mthatha (Eastern Cape)
Nearly 70 community members, comprising a mix of youths and adults, arrived for a community conversation held on June 9 at the Mthatha Rotary Hall in Ngangelizwe.
Attendees were representative of Ngangelizwe location, Waterfall, Stwayi, Mbuqe Park Extension and Khwezi Extension.
Community stakeholders such as the Sesethu Home Health Care workers, traditional healers and representatives from the King Sabata Dalindyebo Social Development organisation also supported the meeting in person.
Burning issues raised at the gathering included poverty, unemployment, clinic health services, sanitation, HIV/AIDS, drug and alcohol abuse, need for a mobile clinic and insufficient doctors.
Personal reflections raised a host of issues specific to health care in the local facilities, such as queuing all day at the clinic only to be told that there is no medication available; nurses verbally abusing those who are HIV-positive; doctors only seeing a few patients per day; no ambulance availability – even for emergencies; and being referred to the hospital which provides pharmacy prescriptions that are unaffordable.
Lusikisiki (Eastern Cape)
Community members from Emantlaneni and Gcuda in Lusikisiki met on May 3 and May 17, with 66 attendees recorded at each meeting.
Tools used to identify key community concerns were explained again when it became clear at the meeting that general misunderstanding prevailed. Storytelling was then used to broach questions of rape, both of women and children, and re-testing for HIV.
Community issues raised during the first meeting centred on the link between alcohol abuse and rape, as well as on the inconvenient distance of the clinic. An emotional storytelling session dealt with the ripple effect of rape within the community, including the risk of suicide, family stigma and reporting the crime to the police.
As part of their vision for an AIDS-free future presented at the conversation on the 17th, youth present at the meeting urged parents to tell the community when a child died of an AIDS-related illness, furthermore encouraging parents to tell their children about HIV/AIDS and its associated risks.
In response adults agreed to talk about HIV/AIDS in churches and at the chief’s weekly imbizo (“gathering”).
A total of 75 members of the Giyani community were in attendance at the first May conversation held on May 10. A second meeting followed on May 24, 2010.
Pertinent issues for Giyani included needs for a police station, community policing, a doctor and social worker for the clinic, as well as requests for a sports centre and monthly prayer meetings. Task teams were then elected from within the community and plans of action specific to these issues were adopted.
Each of the teams was scheduled to meet with the various stakeholders on May 19 and to report back to the community at the next meeting, on May 24.
One task team met with the station commander to hand over a letter of request for a satellite police station and Community Policing Forum (CPF) for Khakhala village.
A second team presented a request to the local clinic committee for a social worker and doctor to be appointed to Khakhala Clinic.
Another task group met with MEC for Sports, Arts and Culture Joe Maswanganyi to discuss the establishment of a sports centre in the village, while a fourth task team met with local cleric, Pastor Mabunda, to organise community prayer meetings.
At the feedback meeting, attended by close to 100 community members, action implementation of the framework was scheduled for discussion.
The station commander promised to take the request for a satellite station further on behalf of the community, but recommended the use of the Moyeshe village police station – located 15km away – as an interim measure. The request will be monitored by the task team.
Following requests to the clinic committee, a social worker started at the clinic on May 24. The request for a doctor has been referred by the clinic committee to the Department of Health for consideration, and the community awaits feedback in this regard.
On the issue of a sports centre, Maswanganyi advised that requests for such facilities had already been submitted for the Integrated Development Planning (IDP) process, but since there was no funding available for such a project, the municipality would clean the existing playing fields. He added that Khakhala village had also requested a cattle dip.
Pastor Mabunda has agreed to facilitate monthly prayer meetings with the community, starting in June 2010.
The task teams and Khakhala residents have pledged their proactive support in following up on outstanding issues.
Lerome (North West)
May 13 and May 28 marked the dates of community conversations in Lerome, with 75 in attendance at the first meeting and 69 at the second.
Tribal leaders and shop owners joined the meeting to discuss concerns that focused on discrimination against and emotional abuse of women, and cultural beliefs which preclude discussions about sex.
The community decided to celebrate Women’s Month for a week during August and the Moses Kotane Local Municipality’s Gender desk was invited to address gender equality at the next meeting.
The second meeting explored the methodological tool “envisioning the future” to understand better how it might be effectively employed within the Lerome community. The meeting concluded with an agreement to apply the tool in groups at the July meeting.
Group 1 was tasked with creating a DVD to illustrate the realities of HIV/AIDS for the residents of Thaba Nchu, including those of providing condoms to taverns, clubs and households; encouraging abstinence from sex outside of marriage; and approaching the Department of Health for assistance with resources.
Group 2 discussed the possibility of lobbying for the abolishment of free medical services for people under 25 years of age who are pregnant or suffering from HIV/AIDS. Their stated motivation was that such a law would make people take greater responsibility with regards to HIV and AIDS.
Galeshewe (Northern Cape)
Two conversations took place in Galeshewe, the first on May 12 and the second on May 19. Close to 100 residents were present at each of the meetings. Also in attendance were the Tholulwazi Youth Organisation and loveLife.
Storytelling and reflection were used to broach issues surrounding HIV/AIDS and the many different ways of coping with being HIV-positive – lying, being truthful, consulting the elders, non-disclosure, getting married and giving up hope.
Perspectives emerging from the session confirmed the continued stigmatisation and victimisation of those living with HIV/AIDS, the need for NGO support of care initiatives and wider promotion of the availability of HIV counselling and testing.