U.S. - South African Exchange: NGO Conference Participants Find Common Ground

Although they sometimes face different challenges, people working to prevent HIV/AIDS in South Africa and in the United States have much to learn from each other, as two HIV-positive women discovered during a conference in Johannesburg.

For Belynda Dunn it was the chance of a lifetime: an opportunity to travel to South Africa and share her experience as an HIV/AIDS outreach worker with others. For Prudence Mabele, it was -- at first -- another meeting to somehow fit into a busy schedule.

But as participants in an exchange between South African and U.S. nongovernmental organizations (NGOs) working in HIV/AIDS prevention, both women learned more than they had thought possible -- and left with some unforgettable memories.

Co-sponsored by the U.S. Agency for International Development (USAID) in South Africa (through its intergovernmental agreement with the U.S. Centers for Disease Control and Prevention), the AIDS Control and Prevention (AIDSCAP) Project and the National Minority AIDS Council (NMAC), the exchange was built around a four-day conference held in Johannesburg June 3-6, 1996. Almost 200 people attended the conference, including 14 U.S. facilitators chosen and oriented by NMAC, a coalition of minority community-based HIV/AIDS organizations in the United States.

Assessing Needs

The exchange between NGO personnel from the two countries began three years ago, when ten South Africans attended a skills-building conference for community-based HIV/AIDS organizations held in New Orleans, Louisiana, by NMAC, the AIDS Interfaith Network, and the National Association of People with AIDS (NAPWA). The South Africans learned so much at the conference that USAID decided to sponsor a follow-up workshop in South Africa.

"They found the experience to be very beneficial," said Renee Saunders, HIV/AIDS technical advisor to USAID/South Africa, "but they thought it would probably be more beneficial if it were conducted in-country to address the needs and priorities of South Africans."

The follow-up workshop was eventually expanded to involve representatives of all the community-based organizations (CBOs) and other NGOs that receive grants for HIV/AIDS prevention from USAID, AIDSCAP and the South African Department of Health. Representatives from the NGOs, the South African NAPWA, the health department's HIV/AIDS and STD Directorate, the religious community and a youth organization, as well as USAID and AIDSCAP staff, served on a steering committee to ensure that the conference would address the priorities of South African participants.

In November 1995 steering committee members hosted meetings between participating NGOs and an assessment team composed of Saunders and NMAC Director for Technical Assistance Harold Phillips to determine what kinds of skill-building workshops were needed. As a result, the content of the workshops and the materials NMAC developed for the conference were useful to the South African participants, according to Richard Odindo, a communication officer from AIDSCAP's Africa Regional Office in Nairobi who helped facilitate one of the workshops.

"Everything they brought was relevant to the needs of the people," he said. "In fact, people were pleading for this kind of thing to be done regularly."

Sharing Experiences

Although NMAC's main objective was to build the skills of South African NGO personnel working in HIV/AIDS prevention, the conference was also a learning experience for U.S. participants.

"Sometimes I think that the work we do in the United States is very technical, and we need to step back and look at the whole person," said Belynda Dunn, who manages African-American education programs for the AIDS Action Committee in Boston, Massachusetts, explaining what she had learned. "The healing of AIDS in our communities does not just mean giving medications, but it means giving love. It means giving a part of yourself that you've kept to yourself. The South African people taught me that."

For Prudence Mabele, a community liaison officer with the South African Department of Health's HIV/AIDS and STD Directorate and a well-known AIDS activist, the opportunity to learn new methods and techniques from the U.S. contingent was invaluable. She is hungry for information about approaches to the challenges she faces as a professional health worker, a volunteer counselor and outreach educator, a confidante and supporter of many HIV-positive South Africans -- and as a woman living with HIV/AIDS.

Mabele explained that South African HIV/AIDS workers often feel isolated because they have limited opportunities to learn about how people in other countries are responding to the epidemic. "It helps a lot to exchange, to hear other stories from other worlds about how they are running their programs," she said.

The experiences of the HIV-positive participants from the United States inspired Mabele. "It was really good to see that people with HIV can stand up and work and work and make a difference fighting against AIDS," she said.

Learning from Each Other

The conference featured 25 workshops divided among three tracks: program planning and administration, interventions and strategies, and -- for workshops addressing sustainability -- "vision." "We covered the whole spectrum," said Jacqueline Coleman, NMAC's co-director for technical assistance and training.

Dunn gave presentations and facilitated workshops on preventing stress and burnout among HIV/AIDS program staff, developing printed educational materials, and prevention strategies for people living with HIV/AIDS. Mabele participated in workshops on surviving organizational change, working with the religious community, eroticizing safer sex for women, women-focused HIV/AIDS programs and counseling.

The "Sister to Sister" workshop on programs for women was particularly useful for Mabele, who is responsible for integrating gender issues into the HIV/AIDS programs of the South African Department of Health. As a lesbian who has suffered discrimination because of her sexual orientation and her HIV status, she was heartened by the workshop on working with the religious community, where Carol Johnson of the Harvard University School of Divinity challenged clergy members to reexamine their attitudes toward homosexuals, people of different races and people living with HIV/AIDS.

"It was so interesting to see that happening because in South Africa you don't talk about those things in church groups," Mabele said. "It's not acceptable."

Working with clergy and church leaders is important in South Africa because most people will turn to them rather than to a psychologist or social worker when they need support, she added.

"In South Africa people depend on the church -- that's the only place where they would go for counseling," Mabele said. "Many people still believe they should not talk to strangers about how they feel."

The workshop on eroticizing safer sex for women was another eye-opener. Mabele was amazed at the frank and often humorous discussion of sexual techniques and strategies. "It's not in my culture to talk about sex," she said.

Another participant thought the workshop could have been better adapted for a South African audience. Noting that some South African cultures do not allow women to even look at male sex organs, Aadielah Maker of the National Progressive Primary Health Care Network recommended that future workshops on eroticizing safer sex include sessions on cultural norms and knowing the body.

Other cultural differences arose during the workshops. However, the teaming of U.S. facilitators with at least one South African facilitator for each workshop enabled them to bridge those differences. "The South African counterparts helped us tailor our workshops to look at the South African experience," Dunn said.

In fact, despite the differences in culture, resources and the way the HIV/AIDS epidemic has evolved in the two countries, participants were impressed by how much they had in common.

"What was interesting was meeting with people who were grappling with a lot of the same issues," said Peter Busse, a counselor and volunteer coordinator at the Community AIDS Center in Johannesburg. "It was quite reassuring to see that in South Africa, the debate over HIV and prevention is as advanced as it is in the States."

"Obviously there are substantial differences, but each difference was met by three or four similarities," NMAC's Coleman said. "One of our main resources is the human energy that we bring to the epidemic, and that provided enough common ground."

Safety and Solidarity

One of the differences Dunn noticed was the silence about HIV/AIDS in South Africa, where an estimated 2 million people are infected with HIV. Both Mabele and Dunn say they have experienced discrimination and stigma as HIV-positive women in their countries, but they agree that South Africans are much less open about HIV/AIDS than people in the United States.

"I had several women come up to me during my workshop on prevention strategies and say that they'd been living with HIV for five and six years, but had not told their children, the people they work with -- they hadn't told anybody about HIV," Dunn said. "But because I disclosed my HIV status, it made it easier for them to come out."

"Meeting other people from outside helps," Mabele agreed. "It isn't enough to have one or two or three role models in South Africa."

During the closing ceremony, one South African NAPWA member publicly acknowledged her HIV status for the first time, and the U.S. participants living with HIV/AIDS stood with her at the podium. Afterward, the South African participants sang their national anthem, "Nkoki Sikelel'i/Africa" ("God Bless Africa")."

For many, this emotional moment was the highlight of the conference. "I was pleased that we had created an environment where people felt safe and confident enough to disclose their status without fear of being stigmatized," Saunders said.

Taking Stock

The results of an evaluation conducted by NMAC suggest that the exchange between U.S. and South African NGOs worked. The majority of respondents said that the goals of the conference had been met and that the meeting had been well organized. One South African respondent wrote that participating in the conference "has changed my life and given me focus, ideas and hope for the way forward."

Saunders says the conference "exceeded my hopes about what could be accomplished," but acknowledges that reaching consensus on the organization and content of the conference was a challenge. Another challenge mentioned by several participants was the need to overcome some South Africans' reservations about the role of the U.S. facilitators.

"There was a sort of resentment about us coming to South Africa to teach what we know, like we know better than the people who live there," Dunn said. "And it was a struggle in the first couple of days to get the people from South Africa to understand that we weren't there to tell them what to do, we were there to share our experiences."

By the end of the conference, most participants agreed that the opportunity to exchange ideas, experiences and skills had been rewarding. "The camaraderie that developed between the groups was phenomenal," noted Jacquelyne Conley, AIDSCAP's resident advisor in South Africa.

Participants' main criticism of the conference was that they needed more time to work together. "In terms of skill building, you need much longer, more intensive sessions," Busse said.

"People needed more time to be able to explore all the ideas they had," agreed AIDSCAP's Odindo, adding that because three different workshops were scheduled for each morning and afternoon, people had to miss some of the sessions they wanted to attend. "They were all so good, it was difficult to choose between workshops."

Both Mabele and Dunn say the NMAC conference has had a lasting impact on the way they approach their work. While Mabele cites practical information she learned in each of the five workshops she attended, Dunn treasures less tangible benefits of the NMAC workshop. She marvels at the resilience of the South Africans she met and at their strong faith in God despite years of hardship and repression.

"Before coming on this trip I had a sense of frustration after working in the field for five years," she said. "I thought, 'Why am I doing this? I should just be taking care of myself.' And the South African people let me know that I was taking care of myself."

-- Kathleen Henry