Empowering young South Africans with virtual HIV counselling

When strict COVID-19 lockdowns had immediate and dangerous impacts for communities in Durban, South Africa, Blue Roof Life Space knew they had to take their vital youth-focused HIV programming online. “Everything happened so fast,” remembers Hombisa Ntsikanye from Blue Roof. “Everything was a shock, in our work and also the country as a whole.”

In South Africa, home to one of the highest HIV prevalence rates in the world, community-led organizations like Blue Roof are the heartbeat behind life-saving HIV interventions for young people and their families. Six thousand people take part in their multi-disciplinary programming each year, and more than 200 young people living with HIV rely on their youth-friendly in-person clinics. And while South Africa is seeing a gradual decline in HIV transmission rates overall, young people are acquiring the virus at an alarming rate, especially adolescent girls. Finding, testing, and linking young people to treatment from a distance hit peak urgency during lockdowns.

With funding from the SLF, Blue Roof fast-tracked a pilot for a digital platform: Talk, Test, Treat. People can access age-appropriate and reliable advice on mobile phones, at home or from internet cafes, get a self-screening kit, watch how-to videos, and link to treatment and counselling through a coordinated referral system. Blue Roof is finding new ways to help young people overcome barriers, take control of their futures, and build thriving communities, because the worst HIV status to have is ‘unknown.’

With funding from the SLF, Blue Roof fast-tracked a pilot for a digital platform: Talk, Test, Treat. People can access age-appropriate and reliable advice on mobile phones, at home or from internet cafes, get a self-screening kit, watch how-to videos, and link to treatment and counselling through a coordinated referral system. Blue Roof is finding new ways to help young people overcome barriers, take control of their futures, and build thriving communities, because the worst HIV status to have is ‘unknown.’

Hombisa Ntsikanye/Blue Roof Life Space

Photo Credit: Blue Roof Life Space

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Home-based care for Ugandan students and their grandmothers

When COVID-19 lockdowns suddenly disrupted life in rural Uganda, where SLF partner Nyaka AIDS Orphans Project operates schools for children who have lost their parents to AIDS-related illnesses, the organization found itself pivoting to being a provider of home-based care.

Children who normally boarded at school were suddenly without food and health care. When national borders closed, grandmothers whose gardens were in neighbouring Democratic Republic of Congo were cut off from their food source. But thanks to uninterrupted funding from international donors, including the SLF, Nyaka continued to support students and their families during two years of lockdowns. Nyaka staff delivered food, school supplies, masks, soap, sanitizer, and COVID-19 information on motorcycles, to cover the vast, rural area where students live.

Nyaka staff provided COVID-19 education to grandmothers whose long history with the organization had built an unshakable trust. They translated government-issued COVID-19 materials from English to local languages. The school’s clinic, designed to treat students with coughs, colds, malaria, and antiretroviral medication for students living with HIV, suddenly had to prepare for vaccinations. Nyaka brought in graduates who’d gone on to nursing and medical school for their support, and when vaccines became available, Nyaka grandmothers were first in line. Nyaka’s founder Twesigye Jackson Kaguri knew the organization’s twenty years of work in the community had built a solid foundation on which they could respond to this new pandemic. “I’ve always told people,” he says, “when you empower communities, they will be there for themselves.”

Photo Credit: nyakaglobal.org

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Rebuilding grandmothers’ lives in rural Zimbabwe

In 2021, grandmothers supported by SLF partner Midland AIDS Service Organization, or MASO, started to recover from the devastation of COVID-19 in Zimbabwe. Women who normally rely on selling local products for an income had seen their savings dry up through lockdowns, and with no national social security program to rely on, they worried about their survival. They were carrying the stress of seeing a rise in drug use, sexual abuse, and unplanned pregnancies among the grandchildren in their care, who were also not allowed to travel or leave home. Many grandmothers who’d already lost family members to the HIV pandemic were now losing family to COVID-19, including a grandmother named Gladys Win. The 60-year-old, who is living with HIV, raised her nieces and nephews after her sister died of AIDS-related complications. Tragically, Gladys also lost a daughter to COVID-19.

Amid so much turmoil, MASO staff remained committed to the grandmothers. With the help of emergency funding from the SLF, they delivered masks, sanitizer, and food parcels to homes, and pamphlets to counter misinformation about COVID-19. Today, with MASO’s support, Gladys and others are returning to their in-person support groups that help provide the strength to continue raising multiple generations, and the skills to earn an income. They have started a savings and loan collective where grandmothers pool funds for groceries to help counteract fluctuating prices in Zimbabwe’s unstable economy, and they learn income-generating skills such as chicken rearing, gardening, and craft work.

After a difficult two years, as her community continues to recover, Gladys can finally say, “I feel like I have my life back.”

Photo Credit: Siyano Photography

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Out of the shadows: reaching sex workers under curfew in Kenya

For sex workers in Nairobi’s informal settlements, government-imposed dusk-to-dawn curfews during the height of the COVID-19 pandemic were more than an inconvenience; they stole women’s livelihoods. The 19,000 sex workers supported by SLF partner Bar Hostess Empowerment and Support Programme, or BHESP, were forced to find alternate places to meet clients, often working in the shadows at risk of violence and arrest.

For the 8,000 workers BHESP serves who are living with HIV, disruption turned to despair. The government lengthened wait times between deliveries of antiretroviral medication, leaving many in fear of not receiving their treatment. Access to condoms and pre-exposure prophylaxis, or PrEP, critical tools in HIV prevention for sex workers, was limited. Some women chose to return to their homes in rural areas, which meant relying on government health facilities where stigma against women doing sex work runs high. Government aid packages that included emergency funds and rent relief did not include sex work, which is widespread but criminalized in Kenya.

With limited access to BHESP’s four drop-in centres, staff found alternate ways to provide essential services. They delivered medication to people’s homes on motorcycles, and partnered with local bars to distribute medication outside of curfews. Zoom and WhatsApp became meeting spaces for mental health support, and workers could call BHESP for support and reverse the charges. For women who’d retreated to rural areas, BHESP staff would locate health care facilities that provided sex worker-friendly services. Despite the many barriers, BHESP found ways to continue their peer-led services for the thousands of sex workers they serve, guided by their mantra, “Nothing about us, without us.”

Photo Credit: Wambui Gathee

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Back to class after world’s longest lockdowns in Uganda

On January 10, 2022, when millions of Ugandan children returned to school after COVID-19 lockdowns, SLF partner St. Francis Health Care Services was ready. St. Francis staff ensured schools fees were paid, bought uniforms and books, and sent village health teams door-to-door to verify how many children were returning. While children in urban areas might have benefitted from government lessons provided through radio and newspapers during lockdown, the 300 rural primary students St. Francis supports had received no formal education in two years.

Lockdowns had taken a toll on the families, 30 per cent of whom are headed by subsistence farmers already struggling with food and financial insecurity. St. Francis’ programs teams feared that after two years away from school, and with a taste of the small income that comes from casual labour, some families would choose to keep their children at home to work. Others, headed by grandmothers caring for their orphaned grandchildren, sent them to live with other relatives for support.

For girls who missed two years of the security and meals that school provides there was another challenge: the lure of predatory older men who promised them a path out of poverty, and St. Francis health teams saw an increase in teenage pregnancies during lockdown. St. Francis monitored attendance records and worked with officials to create safe spaces for students who needed them, including girls who might need to breastfeed. Thanks to St. Francis’ persistence, about 94% of students returned to school. After the world’s longest COVID-19 shutdown, St. Francis laid the groundwork for a well-supported transition back to the classroom.

Photo Credit: St. Francis Health Care Services

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Fleeing hate in Democratic Republic of Congo

In March 2022, Jérémie Safari, executive director at SLF partner Rainbow Sunrise Mapambazuko, or RSM, noticed an unsettling presence outside her house: police. As the leader of an organization that supports LGBTIQ people in the Democratic Republic of Congo, Jérémie is no stranger to threats from authorities.

But this time the threat didn’t pass. Jérémie was soon summoned to court, accused on a hate-fuelled charge of “recruiting people into homosexuality.” Wary of neighbourhood vigilantes, Jérémie went into hiding while her lawyer, a defender of LGBTIQ human rights, appeared in court on her behalf. Despite homosexuality being legal in the DRC, the country’s penal code is routinely used to criminalize community members under public decency laws. LGBTIQ lives are not widely accepted, and are commonly thought to be linked to witchcraft and mental illness.

Jérémie’s lawyer successfully argued to the court that RSM is an organization serving vulnerable people living with HIV, not an association to recruit people into homosexuality. But authorities continued to look for Jérémie, who was forced into hiding for months while her lawyer looked for a resolution to the charges. Finally, with the help of emergency funding from the SLF to cover legal fees, Jérémie’s lawyer successfully argued her case and the charges were dropped. Today Jérémie continues to lead the work at RSM while staying vigilant about her and her colleagues’ safety. “Activism is very important to me,” she says. “I really care about my fellow human beings who are victims of rights violations every day. I have made it my goal to defend their rights, our rights.”

Photo Credit: Rainbow Sunrise Mapambazuko

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