The CPQ asked respondents to indicate problem areas within their community, firstly in the form of an open-ended question and then by indicating from a provided list. The responses to the open-ended questions and the provided list showed much consistency and relatively few categories had to be developed in which to classify the responses across the open-ended questions. The profile of responses is presented in Table 7.5. It would seem that criminality is a problem in all areas, especially in the rural and township areas where theft was the most commonly reported crime. The abuse of alcohol was also a highly prevalent problem. Having insufficient food is clearly poverty related, and the theft rate may also reflect poverty, illness and HIV/AIDS related conditions were rated separately in accordance with the spontaneously mentioned category in response to the given question.
The mean number of funerals was not accurately obtained as many respondents simply indicated that there had been too many funerals. Of those who did respond with a number, they had attended an average of 8,4 funerals over the preceding two month period, with a standard deviation of 7,34 (see Figure 7.9). This would clearly be an under estimate, when one takes into account the respondents who reported 'too many' funerals.
Figure 7.9: Number of funerals attended over the preceding two-month period:
Peri-urban Rural Township
00 S.O 10.0 ISO 20.0 250 30 0 35 0 40.0 00 25 5 0 75 100 125 110 175 20 0 0.0 50 10.0 18.0 20.0 25 0 10 0 35 0 40.0
FUNERALS FUNERALS FUNERALS
62,7% of respondents recognised that HIV/AIDS was the main cause of recent deaths, with violence, motor vehicle accidents and stabbing also identified as leading causes of death. Most of the respondents had had a family member die of an AIDS-related death, with this mean being 3,47 (std dev = 4,412) (see Figure 7.10).
Table 7.8: Most frequently mentioned problems from the CPQ (percentages):
Identified problem Too many criminals Alcohol
Insufficient food Illnesses
HTV/AIDS Violence
School problems Dagga and other drugs uMuthi, Black magic Other
Child abuse and neglect Too many deaths
Rural 92.6"
90.2++
88.9"
90.7++
74.1 79.6 70.4 55.6 53.7 74.1"
46.3 45.6
Peri-urban 9 2 3 "
84.6 81.5 83.1 84.6 80.0 76.9"
7 5 3 "
7 2 3 "
60.0 58.5"
42.3
Township 65.5"
69.0- 63.8"
603"
72.3 67.2 44.8"
53.3 50 32.8"
17.2"
15.2
Total 83,6 81,4 78 78 77,4 75,7 64,4 62,1 59,3 55,4 41,2 34.4
Key + Notes: Indicates that there were significantly less (p < .05) instances of that community having access to the facility under question than would be expected by chance.
" Indicates mat there were significantly more (p < .05) instances of that community having access to the facility under question than would be expected by chance.
Figure 7.10: Number of people each respondent knew from their own communities who had died from an AIDS-related condition:
Peri-urban Rural Township
0 0 50 100 150 20.0 S O AIDS related deaths
i :Bfcb^
0.0 2 5 50 75 100 1 2 J I S A AIDS related deaths00 2 5 5 0 7» 100 125 150 1 7 * AIDS related deaths
Many individuals are known to be currently suffering from serous health problems, with a mean of 12,4 (std dev = 18,38) people presently known to be ill (See Figure 7.11). A very similar number had people in their family or community were known to be infected with HTV: average of 3,66 people (std dev = 3.02). In general, the positively skewed tail was due to the response patterns in which some respondents said they knew of hundreds whom had died, were ill or HTV+, while others provided a specific number.
Figure 7.11: Number of people currently known to be seriously ill and HIV infected:
Peri-urban Rural Township
0 0 20 4 0 80 80 100 120
HIV.
Peri-urban
0.0 10 20 30 40 50 80 7.0
HIV contract
L]
0.0 2 5 5.0 7.5 100 125 15 0 175Rural
HIV contract
Township
1 1 "1 1 "Mjj
I afc • J f .M^*u-J 1 fl^ -
0 0 20.0 40 0 00.010.0 30.0 500 700 00.0 BOO 100.0 .-, Q 1 0 0 ^ n M n ^ n M 0 0.0 204) 40.0 00.0 004) 100.0
People Experiencing Health Problems
0.0 10.0 20.0 300 400 500 0.0 15.0 250 35 0 450
People Experiencing Health Problems
800 800 100.0 10.0 10.0 500 70.0 00.0
People Experiencing Health Problems
7.8.4. Summation
It seems that the major defining characteristic of the nine partnering communities is the extreme poverty in which they live and survive. Despite the fact that many have achieved their grade 12 educational status, the shortage of employment opportunities greatly impacts on their lives and the nature of social problems that beset them. Crime and substance abuse were ranked the most frequently occurring problems in nearly all of the communities, with HrVAMDS being more likely to be acknowledged within township communities than in the peri-urban and rural communities. Despite the negative circumstances that prevailed in the partnering communities, few had access to the services of NGO's or had formed CBO's. Although most of the respondents were highly spiritual and attended religious services on a regular basis, the churches and other FBO's were not regarded as organisations that work with social problems. There was certainly evidence to suggest that there is no duplication of services within these partnering communities, with there being a dismal paucity of service organisations within all nine of the partnering communities. The most neglected areas were the rural ones, who also seemed to experience the most difficulties in accessing social services and grants.
The nine partnering communities are carrying the burden of extreme poverty with intolerably high unemployment rates, and they are experiencing numerous problems created by the onslaught of HIV/AIDS and other factors that are usually associated with dysfunctional societies.
The Bible tells us that "You have the poor with you always" (John: 12.8), but the degradation of human life experienced by those who do not have basic necessities nor food security is a problem that needs urgent attention. It is difficult to isolate the causes of the current unprecedented societal stress and suffering. However with the HIV/AIDS pandemic, one can reliably predict an increase in the problems unless steps are taken to intervene and start to remedy the situation. The high levels of community cohesion suggest a way forward in terms of ameliorating these difficulties in a sustainable manner, in that it clear that communities are committed to the well-being of people within their community and are willing to offer help and assistance.
Section IV
The Evaluation of the Sensitisation Programme
In this section, the methodology, results and discussion on the evaluation of the Sensitisation Programme are presented. The overall objective of this research programme was to evaluate the holistic community-based intervention that aims to offer psychosocial support to the vulnerable children affected by HIV/AIDS, poverty and violence. It has thus been imperative that the author situate the context carefully as the partnering communities had specific qualities that may help future users of this programme in deciding if the programme would be applicable within their own contexts.
The focus at this stage, shifts to a more detailed evaluative one, in which the sensitisation programme is subjected to a qualitative evaluation. It is logical to present the methodology, results and discussion of these results in the next two chapters, so that the reader can follow the sequence of ideas for this aspect of the evaluation.
Chapter 8
The first unit of analysis: Methodology
Strengthening capacity in high prevalence HIV/AIDS communities
The first unit of analysis was at the community level. The aim of the research was to consider the effectiveness of the sensitisation programme in sensitising adult community members to the psychosocial needs of vulnerable children and to enable them to offer psychosocial support (PSS) and ameliorate the impact of the risks associated with the HTV/AIDS pandemic. Offering PSS has been identified as one of the most appropriate and accessible means through which communities can be strengthened to support vulnerable children (Germann, 2002; Hunter & Williamson, 2002). The purpose of the SP therefore was to create greater awareness, understanding, compassion and care at microsystemic levels within the partnering communities. Consistent with action research (Patton,
1990), the assumption was made that increased awareness and knowledge of the psychosocial needs of children would motivate communities to offer PSS to their vulnerable children.
In developing the sensitisation programme there was recognition of the fact that all of the partnering communities had faced various hardships including extreme poverty (Richter, 1994) and a history of political discrimination and violence (Dawes & Donald, 1994; Higson-Smith & Killian, 1999).
Furthermore, it was presumed that certain children within the partnering communities would have been exposed to especially difficult life circumstances and as such could be regarded as being particularly vulnerable. Consideration of community-based conceptualisations of this and other key variables formed part of the sensitisation programme, so that community members could identify those children whom they regarded as being especially vulnerable. It is important to note that no distinction was made between children rendered vulnerable due to factors directly associated with the HIV/AIDS pandemic and other risks such as poverty, violence, abuse and neglect. Ethical considerations precluded offering an intervention intended only for those children directly affected by or infected with HIV/AIDS.