HIV/Aids epidemic threatens sustainability of our projects

The South African HIV/Aids epidemic is threatening The Mvula Trust's mission to improve the health and welfare of poor and disadvantaged South Africans in rural and peri-urban communities. Mvula does this by increasing their access to safe and sustainable water and sanitation services. Mvula's Project Development Facilitator Nomonde Mnukwa reflects on what can be done.

The Mvula Trust is a Non-Governmental Organisation involved in implementation of water and sanitation projects in seven of South Africa's nine provinces. But with the HIV/Aids epidemic, will The Mvula Trust be able to realise its aims?

Impact of HIV/Aids in projects sustainability

When planning for implementation of our projects we allow for a population growth of 2.5% per annum. According to the Department of Health 2000 National HIV and syphilis sero-prevalence survey of women attending public antenatal clinics in South Africa, 4.7 million of South Africans are infected with HIV, most of them being at the prime of their age. This means the population growth might not be as initially expected.
A lesson from a water project

Nhlungwane water project lies in the jurisdiction of Umzinyathi Regional Council in KwaZulu-Natal and was implemented by The Mvula Trust. In a research conducted in 2000 on community- based operation and maintenance strategies, the participants revealed that there were more deaths amongst people of young and middle adulthood. These people happened to be breadwinners in their families. This does not threaten only the sustainability of The Mvula Trust implemented projects, but the South African economy as well. There are large sums of money that are being ploughed to community development. The question is what can be done to make sure that the HIV/Aids epidemic is controlled so that efforts of developing South African rural and peri-urban communities are meeting their planned objectives.
A lesson from a sanitation project

Siyazama sanitation project lies in the jurisdiction of Indlovu Regional Council in KwaZulu-Natal. It is being implemented by The Mvula Trust who trained the project's community health workers, to further on the community's health and hygiene awareness through household's visits. These community health workers now take care of HIV/Aids patients in the community. The Department of Health provides support in terms of information and compensation to these community health workers.
Mvula's proactive role

Poor sanitation raises particular risks for people with Aids as their weakened immune systems are less resistant to bacteria, infections and disease. This makes poor hygiene and sanitation one of the leading causes of the progression of asymptotic HIV to Aids. The HIV/Aids epidemic is increasing the need to provide sanitation and improve hygiene practices. There is a risk for HIV positive mothers to breastfeed. This risk increases the use of formula feed which increases the impact of poor sanitation and hygiene. Safe disposal of medical waste is imperative to prevent further exposure to the virus.

The HIV/Aids epidemic is making the need to provide sanitation, improve hygiene practices and the need for sound sanitation for HIV/Aids management more urgent.

The Mvula Trust has somehow started to incorporate HIV/Aids awareness to its work. However, this is still not enough, and everyone needs to make sure that the gospel goes on. Bolu Onabolu, The Mvula Trust's Health Manager in East London regional office, says that in some of the surveys they have conducted they have established that people are not very aware of the transmission routes of HIV. This alone means there is a great challenge, especially for field workers to put more emphasis on HIV/Aids awareness. The Mvula Trust is a leading organisation in using participatory methodologies such as the ‘Participatory Hygiene and Sanitation Transformation’ (PHAST). In creating awareness about HIV/Aids, readily available resources such as the PHAST tools have to be utilised. Talking to Shadrack Dau, the Assistant PHAST Manager at The Mvula Trust, he shared information on a workshop held by The Mvula Trust and the Health Systems Trust, to create awareness on HIV/Aids. A PHAST tool called family dynamics (silhouettes) has been used during these workshops. The report of this workshop can be obtained from Shadrack Dau at Mvula Trust Head Office in Braamfontein.
Integrated approach

In trying to address HIV/Aids we might not realise how deeply people are being affected emotionally and economically. There are people infected by the virus and people affected because their families/friends are infected. If we integrate our work with that of the Department of Welfare and the Department of Health, we will make a great impact. This will mean that there will be counseling available to all community members that are affected, and community members that are infected. The Department of Welfare can provide social workers whilst the Department of Health can provide HIV/Aids counselors.

In order to provide sustainable development we have to incorporate HIV/Aids work, and integrate efforts with government departments and non-governmental organisations. Hopefully we can therefor be proud of our involvement in bringing health and welfare improvement in lives of poor and disadvantaged rural and peri-urban communities of South Africa. Mvula Trust cannot afford to ignore this opportunity to be part of the team that has brought about change in this country.

Nomonde Mnukwa, 2001