1963-2013 - 50 years of Research for Social Change

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Back | Programme Area: Social Policy and Development (2000 - 2009)

HIV/AIDS and Development: The Chikankata Experience (Draft)



HIV/AIDS is one of the most pressing health problems confronting the world. Africa, especially, is experiencing the impact of the disease and its multiple effects. HIV/AIDS has exposed the gaps in public health care systems. While some of those gaps existed prior to the early 1980s, others emerged under pressures to reform national economies and social services in the 1980s and 1990s. The international response to create national AIDS control programmes, along guidelines laid out by the World Health Organization (WHO), did little to meet the needs of communities attempting to deal with the impacts of HIV/AIDS. In response to this fast-growing epidemic, which has permeated even the strictest traditional values, many non-governmental organizations (NGOs), community-based organizations and religious organizations have joined in efforts to mitigate the impact of HIV/AIDS and to foster prevention.

In Zambia, the Chikankata Health Services, run by the Salvation Army, has developed a response that is community based. This paper discusses the work of the Chikankata Health Services AIDS Programme to foster a community empowering response that is appropriate, affordable, applicable and sustainable to the people it serves. The response has evolved over time and after other approaches were tried. In large part, the Chikankata approach reflects the basic principles long advocated for effective community development: consultation, facilitation, and building on communities’ own needs, ideas and multiple resources.

The hospital at Chikankata and other health facilities across Zambia are unable to cope with the demands for services of people infected and affected by HIV/AIDS. While hospital facilities are failing to provide quality care, especially as a result of reduced funding, communities have responded in unique ways to develop and run care, support and prevention assistance. At least from the early 1990s, community spokespersons and NGOs have argued for national and international programmes to support a continuum of prevention and care, this being the only way to achieve advances in both. These care programmes provide anything from toothpaste to food, clothing to shelter. The capacity of the neighbourhood is still a big strength in care and prevention of HIV/AIDS. The Chikankata experience reinforces the community development concept of linkages between families, communities and social services, such as hospitals and other health care institutions. The approach seems to be the only developmental way that allows families to continue with daily chores and life when a family member is ill and in need of care, as other community members feel for and are involved in the whole care process. The community is engaged in the care process, and this affects behaviour and attitudes that lead to prevention.

Communities do have the capacity to respond to HIV/AIDS, in spite of the overwhelming number of HIV/AIDS infections at present. While externally supported programmes that seek to alleviate the suffering of orphans, vulnerable children and people living with HIV/AIDS are needed, what should not be ignored is the inherent capacity to care that exists in neighbourhoods and communities. Care programmes should seek to create an atmosphere of hope, healing and wholeness. This arises from a respect for and appreciation of the internal strengths and skills of communities to identify and address a variety of problems. As seen from the Chikankata situation, community counselling can foster care, prevention and development in the context of HIV/AIDS.

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