Fighting AIDS in Zimbabwe
with ToP Facilitation

By Gerald Gomani

Zimbabwe, independent of British rule since 1980, is struggling with difficult domestic and international circumstances. The economy is hit by deflation and many nations have withdrawn support for the Zimbabwean government.

In the midst of that, the nation is blessed with exceptionally fine agricultural potential and some of the finest tourism destinations on the planet, Victoria Falls and many Game Preserves, among them.

The HIV-AIDS situation is critical in Zimbabwe, one of the worst hit areas in Sub Saharan Africa. The percentage of children who have lost parents to AIDS is the highest of any country in the area. The UNAIDS estimate of HIV prevalence among adults in their prime economically productive years of 15 to 49 in 2004 was 25%. The HIV prevalence in pregnant women according to District Health Services is 34%. Life expectancy has dropped from over 55 years to less than 40 years in the last 15 years. The epidemic is growing faster in urban areas than in rural areas. Within the urban, densely populated areas are more heavily infected.

HIV/ AIDS in Zimbabwe
Population: 12.9 million
Estimate of adults living with HIV/ AIDS: 1.6 million
Estimate of women living with HIV/ AIDS: 930,000
Estimate of children living with HIV/ AIDS: 120,000
Deaths due to HIV/ AIDS: 170,000
Orphaned due to HIV/ AIDS deaths: 980,000
Estimated HIV prevalence rate: 24.6%
3,000 Zimbabweans die each week of aids related illnesses.
Source: UNAIDS Epidemiological Report 2005.
Stephenlewisfoundation.org/country Zimbabwe
*Adults are defined as women and men aged 15 to 49

The Mufakose district project
The Institute of Cultural Affairs Zimbabwe has focused its project activity in the district of Mufakose since 2003 with funding from American Jewish World Service (AJWS) and Rotary International. Mufakose is a para-urban, high-density area on the edge of Harare, the capital of Zimbabwe. The district has a population of 123,500 and comprises eight communities.

The HIV-AIDS epidemic has been spreading dramatically in the district, one of the hardest hit in the country. Almost every family has been affected or infected, whether through illness itself or the loss of one or both parents. Due to this, the impact on the community, its families and especially children is devastating. This puts a huge pressure on the overburdened family system. Due to the epidemic, unemployment rates have gone beyond 80%. Affected households are trapped in a financial pincer situation as health costs rise and income falls.

ICA Zimbabwe, established in 2001, has been providing training and project leadership to the nation, its government and non-government sectors. It is autonomous but affiliated with the Institute of Cultural Affairs International (ICAI) and its associates in 40 nations. Through that affiliation, research in methods is shared, assistance with fund raising is provided and high-level authorization is developed. In the latter case, an example is ICAI’s consultative status with the Economic and Social Council of the United Nations since 1985.

In Zimbabwe, the focus is on the HIV-AIDS plight. However, it has been our experience that no one problem or set of problems can be tackled in isolation from the entirety of a community’s situation. Keeping this in mind, ICA-Zimbabwe started work in Mufakose District in 2002. The main objective was to build a core group of community stake leaders to spearhead the community toward practical and tangible strategies to deal with the effects of HIV/AIDS. The project included a community home-based care programme, women’s micro-credit finance schemes, a Youth Friendly Corner, and an orphan educational assistance scheme. In 2005, the project was extended to four adjoining communities – Kambuzuma, Budiriro, Rugare and Crowborough North.

Broadening the reach with ToP
Last year, we entered into a new partnership with ICA-USA and the United Methodist Church and have expanded our HIV/AIDS program. The goal is to reach 50 communities by 2017, with an extended impact on 400,000 people.

Using Technology of Participation (ToP) ™ the project focus is on building a core group of people who see themselves accountable to the community for facilitating whatever kind of development is needed. ToP is a comprehensive system of facilitation methods that engages the creativity and commitment of a group in authentic dialogue, consensus-based decision making, and action planning. It promotes the values of participation, teamwork, innovation and action. ToP methods can help any group – citizens, NGOs, government, youth, women and others – discuss issues, create action plans, evaluate progress and celebrate success. The methods also have successful application in the design of long-term, participatory plans.

Communities need tools and methods to prevent and manage HIV themselves. Their efforts need to be sustainable and the template must be replicable and adaptable to individual communities. One-year campaigns in 50 communities over five years will help leaders and villages tackle this problem themselves. The role of ICA is to provide the tool kit and training. Residents will do the work in the way that is appropriate for their community.

Gerald Gomani is director of ICA: Zimbabwe.