WITHIN THE SOCIAL WORK PROFESSION
4.1 Introduction
4.2.4 HIV IAIDS Pandemic
for this challenge or whether this increase in crime and violence will result in a situation that is unwieldy and hopeless, exacerbating the 'brain drain' in the country.
practice context. Social workers in South Africa need to be able to respond to these challenges and to recognise HIV and AIDS as multifaceted problems that are more than just medical conditions. Social workers dealing with the problems surrounding HIV and AIDS in South Africa are called upon to deal with a unique mix of people and cultures in the context of a unique time and place in history.
In 1994 the National AIDS Convention of South Africa (NACOSA) adopted a national strategy programme for HIV/AIDS. This included welfare as one of six main components where urgent action was needed (White Paper for the Transformation of the Health Systems in South Africa, 1997). The White Paper for Social Welfare (1997) also recognises the need for action.
It spells out the need for partnership between government and non- government organisations to devise "appropriate and innovative" welfare services for people affected by HIV/AIDS. It again underlines the principle of community-based care strategies as the "preferred options for coping with the social consequences of HIV/AIDS".
Social workers in South Africa dealing with the problems surrounding this pandemic are likely to discover that creativity and innovation become key qualities in devising methods of intervention. It would also be true to say, however, that there are certain challenges posed by HIV and AIDS that are universal. HIV/AIDS forces people in all communities to confront issues relating to sexuality seriously, which under normal circumstances are often left unattended. These include the wide variety of possible sexual behaviours, the incidence of multi-partner sex, the young age at which sexual activities begin, and the complexity of power relations between men and women, people of different ages and people of different sexual orientations. Further, HIV / AIDS forces communities and individuals to confront human mortality and, in particular, the illness, the death and dying of young, economically active people. It highlights the limitations of human medical interventions and reminds people of their ultimate
powerlessness in the face of death, despite current belief to the contrary (Woods, cited in Gray, 1998: 194).
Social workers, operating as they do in the wider human sphere from the interpersonal through to the level of social policy-making, cannot ignore challenges such as those outlined previously. According to Woods cited, in Gray (1998:194), in many ways, social work's response to AIDS can be, in this period of the pandemic, a reasonable indicator of the state of social work itself.
Saloner (2002) refers to the comments of Pincus & Minahan in 1983 that social work practice may vary in its method (casework, group work or community work), in its orientation (primary, secondary, tertiary prevention) and in terms of the system which is worked with (resource system, change agent, client, target and/or action system). However, Saloner (2002: 155) maintains that in the South African context characterised by the high HIV / AIDS prevalence, social workers might increasingly experience an inability to continue in their current roles with the same effectiveness. With changing external demands there is a greater pull on social work resources and, of course, a negative but common reaction to change is fear, defensiveness or resistance.
Social workers would need to allow themselves to move in the same direction as these forces. Social workers need to reassess their own resources and perform an audit of the various skills, knowledge and attitudes that they possess.
Currently, there are fewer than 10 000 registered social workers (South African Council for Social Services Profession, 2001) working in a context where 4,2 million South Africans are infected with HIV. Even though some social workers may not choose to work directly in the field of HIV/AIDS, there is no way of avoiding the epidemic. It is becoming imperative that
social workers' roles involve an education and training component in service delivery. The stresses placed upon the social worker dealing with the challenges of HIV/AIDS are great.
According to Sa loner (2002: 158-159), in order to play an effective role in the HIV/AIDS struggle, social workers in South Africa need to ensure that they face the following challenges:
• the development of relationships between the social worker and other professionals in order to strengthen networks and inter- member communication;
• an awareness of trans-cultural aspects such as approaches to discussing sex and sexuality in order to be able to discuss sexual issues openly;
• discussion on the use of language of emotions, vulnerability, sexuality and mortality;
• confronting their own stereotypes and intolerance with regard to intellectual abilities and education levels of auxiliary services and their potential. In view of the fact that the majority of South Africans are illiterate, social workers are required to be creative in the service methods/programmes they draw upon.
• confronting their own biases and prejudices about specific HIV/AIDS related issues;
• confronting the challenge of death, human mortality and loss; and,
• constantly monitoring and evaluating the social worker's role and the programme. Social workers need to be aware of not transplanting their programmes as a standard package to each community group. It is essential to ensure that the programmes meet the indigenous character of each unique community.
From the aforementioned challenges, it is clear that social workers can be at the cutting edge of HIV/AIDS interventions and should continue to be
proactive by placing themselves in such positions. Social work can also facilitate communication between various sectors by using the social work focus on person-in-environment transactions, on interventions process as well as outcome, and on a wide range of practice methods. If social workers work together and focus on networking, then social work as a profession can make a worthwhile contribution to the war on HIV/AIDS.
In accomplishing these challenges, it is important that all social workers involved in HIV/AIDS-related work give consideration to their own levels of stress and well-being. According to Woods, cited in Gray (1998), the epidemic consistently addresses each person's vulnerability, mortality, security level and power potentiality. Sherr (1995) adds that as the number of AIDS cases grows so, too, will the strains on service providers as they watch the devastating impact of this disease. A study by Horstman and McKusick cited in Sherr (1995) finds that, for all the therapists in their study, the higher the percentage of time they spend in contact with AIDS patients, the more likely they are to experience psychological distress. Stress and burnout appear to be more a function of concentrated exposure to, rather than longitudinal contact with, the disease. It appears that the intensity rather than the chronicity of work contributes to AIDS care workers' morbidity (Sherr, 1995).
In summary, social workers need to recognise the need to care for themselves. Organisations in which they work should encourage and support this recognition. Woods, cited in Gray (1998: 208 -209), claims that this might contribute to "preventing burnout and limiting the sad situation of South African social workers rapidly dropping out from active practice".
Within this environment of societal problems, it is clear that social work in South Africa is at a very critical stage in development. Concerns are for other occupational groups also providing counselling, group care and
social development, and the marginalisation of social work in development. Social work is faced with a major challenge to make its many potentially useful contributions to the country's development efforts. But, at the same time, we need to acknowledge that these social workers themselves, while being challenged to make developmental contributions to the country, are like their clients, being exposed to the harsh realities of social problems such as crime and violence. Dilemmas for the social worker are therefore both professional and personal.
The long-standing massive problems of unemployment, homelessness, crime, violence, HIV/AIDS and poverty in South Africa are subjecting social agencies and social workers to wrenching adjustment in their outlook and responsibility. Social workers in South Africa can no longer afford to allow themselves to see only the singular problems of the individuals who seek their assistance and need to stand back from time to time and bring into focus the larger picture these individual problems combine to form. Luvhengo (1996: 186) aptly comments, that "social workers can no longer afford to just shake their heads and wring their hands in the face of these societal problems". However, at the same time, it is argued that social workers have invaluable knowledge and skills, and the success of the developmental welfare model depends on their commitment. The crisis is that the profession is losing workers; many are disaffiliating themselves and leaving the country to seek social work jobs internationally.