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Community projects

The Diana, Princess of Wales HIV Research Foundation maintains a commitment to strong community involvement. The Sizophila Project, in Guguletu Township on the outskirts of Cape Town, trains people living with HIV as counsellors and assists in enabling productive lives. Both Guguletu and Langa, a second township site, are active areas for community based operational and epidemiological research. This is done in close collaboration with other Non-Governmental Organisations (NGOs), the primary health sector and community leaders and members.

Sizophila Project

The rate at which people are becoming infected with HIV (Human Immunodeficiency Virus) in the Western Cape, South Africa is increasing daily. Coupled with an enormous Tuberculosis (TB) problem, the Western Cape faces immense social, health and economic problems in the immediate future. Indeed it has been said in sub-Saharan Africa, HIV has decimated an entire generation. These are usually the potential breadwinners and young parents of society and the implications for the social fabric and economy of South Africa in this context are disastrous. There is no doubt that this urgently calls for

  1. Increased primary and secondary prevention programs.
  2. Cost effective health management
  3. Applied relevant research
  4. Training and equipping of professional and lay people to deal with the complexities of HIV and AIDS.

The context
HIV in Africa is predominantly a heterosexually transmitted disease and in Cape Town occurs predominantly in high-density periurban settlements known as townships. Low-income and previously politically disadvantaged communities populate these settlements. Guguletu is one such township, situated approximately 15 km from Cape Town. Guguletu has a population of approximately 90 000 people who live in both formal brick housing and informal shanty dwellings. There is some basic infrastructure with tarred roads, clinics, schools and community centers. In Guguletu, both the HIV and the tuberculosis (TB) prevalence are estimated to be particularly high. (TB: highest rates in Africa; HIV: 15-20%).
The Sizophila Project, under the auspices of The Diana, Princess of Wales HIV Research Foundation, is a community-based organisation that attempts to address some of needs of Guguletu. "Sizophila" means "we will survive" in Xhosa.

Background
The Sizophila Project was initiated in 1998 when it was recognised that with burgeoning numbers of people being infected and diagnosed as HIV positive, the demand for counselling had far outstripped the services of social workers and hospital chaplains. Groote Schuur Hospital has a group of six social workers who have voluntarily undertaken training in HIVcounselling and are committed to working in the HIV clinic at Groote Schuur Hospital. The staff from this clinic, together with other lay volunteers and related care organisations, formed a concerned group to look at the critical need for more effective HIVcounselling and support.
Phase 1: Initiation of training course
In 1998, the first cohort of ten women volunteers were trained. They completed a 12-week course that provided factual knowledge about HIV/AIDS and related issues, group work technique and counselling skills. The course was supervised by trained social workers at Groote Schuur Hospital and co-ordinated by two final-year social work students from the University of the Western Cape (UWC). This will be continued in future as it is felt that this kind of sensitisation of the students to the problems of HIV/AIDS early in their careers is essential and valuable. After graduation, the training course was followed by a three-month apprenticeship period in conjunction with the social workers at Groote Schuur Hospital. One year later, the first group of volunteers runs a daily office in the Uluntu Centre in Guguletu. They provide a telephone counselling and support service and members attend and conduct workshops, give talks in workplaces, schools, etc. A group co-ordinator is paid a stipend for taking care of the office, the telephone and other administrative duties. The other members are given a nominal fee for hours of service given.
Phase 2: Self-help projects
A second group of 16 men and women living with HIV completed their counselling training and care course coordinated by a UWC student in August 1999. They will commence their supervised counselling under the guidance of the qualified social workers and members of Sizophila 1.
During this second counselling course a training manual was compiled and will in future be printed and distributed at course commencement. This group has been proven to be an exceptionally motivated and enthusiastic group despite the fact that many have faced discrimination, are not employed, have very little income and live in very poor social circumstances. They have, however, undertaken as a group to find ways to generate income and keep themselves busy. They have been given free access to two acres of arable land in Philippi (belonging to a local farmer) and are currently developing a market-gardening project where produce will be for their own nourishment and to generate income. It is envisaged that after initial capital outlay this will become a self-sustaining project. The farmer has agreed to supply water for irrigation.
In addition to the two acres of land there is a small plot of adjacent land for temporary buildings where the group can meet daily and develop crafts and skills to generate income. The group already boasts a basket weaver, a seamstress, photographer and artist and the members have a willingness to learn other skills such as computer skills, typing, etc.
It is hoped that funds generated will go to financing more formal courses and training for some of the members as well as providing general income. It is envisaged that the group will be self-governed and responsible for their own treasury.
Phase 3: Sizophila House
Many of the Sizophila volunteers have little or no income and live in very poor dwellings. They often share crowded rooms and living arrangements lack permanence. It is well known that in South Africa, people living with HIV still experience tremendous discrimination and are ostracised from their communities. Phase 3 of the Sizophila Project will involve procuring a safe house for members with no accommodation. Members will be encouraged to be self-governing, financially independent and to acquire self-help skills. It is envisaged that Sizophila House will become self-sustaining with income generated from home-crafts and cottage industry. It will not be run as a hospice but may provide counselling services to other hospices.

Community research

Much of the recent research on HIV and TB has been hospital-based. This limits the type of information obtained - there is a pressing need to study individuals within their home communities. The ideal solution is to find a periurban community that can be studied over long periods of time and to facilitate investigation of HIV/AIDS issues in real life settings.
This type of research will be carried out under the auspices of The Diana, Princess of Wales HIV Research and the Infectious Diseases Clinical Research Unit (a collaboration between the University of Cape Town Lung Institute and The Diana, Princess of Wales HIV Research Foundation).
The Sizophila project is based in and works with the community in Guguletu in which this operational research will occur. Already approval in principle has been sought and received from community leaders for the project. The community cohort will be further demographically defined and then followed up with regards to the HIV and TB epidemics and related diseases. It has been agreed that this will be done in partnership with the community and the next steps will encourage community participation with education and awareness and commencement of gathering baseline data. It is clear that much counselling and education will be required in any projects undertaken - the trained Sizophila counsellors are earmarked for this.
There will also be more formal input into the community in the form of structured talks and workshops in schools, churches, community centers and continuing medical education for general practitioners and clinic staff in the area - again utilising the Sizophila counsellors and thereby giving them opportunity to generate an income.
The type of research will span epidemiologic, social science and anthropologic, basic science, health economics, as well as intervention studies. It is hoped that dynamic two-way dialogue will develop with findings being fed back into the community as often as possible with the assistance of Sizophila counsellors.
The basic science research will be in the field of HIV, TB and other infections covering pathogenesis of disease and host protection, many of which are ongoing and in collaboration with international and local scientists.
Should you wish to contribute your time or basic equipment to the Sizophila Project or should you wish to make a donation, please call +27 (0)21 402-6393, fax +27 (0)21 425-2021 or e-mail here.


Copyright 1999. The Diana, Princess of Wales HIV Research Foundation. All rights reserved.
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