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Hey everyone, I am home safe and sound! I have decided to post my final papers for everyone to read if they so choose, they are long...so I won't be offended if you don't read them. I will try to post some pictures soon!

HIV/AIDS in Botswana: an Organizational Analysis

The Botswana Council of Churches (BCC) was started in 1966, the same year Botswana gained independence. The Council was initially made up of four churches: the Anglican Church, the London Missionary Society, the Methodist Church, and the United Free Church of Scotland. Currently the BCC has 22 member churches and Christian organizations, and is still continuing to grow. The purpose of the BCC is to bring different churches and organizations together in order to work to solve problem among the Batswana. The Council focuses on a verity of areas that concern the Christian people, the citizens of Botswana as well as the entire African population.
Over the years the BCC has done work in different areas, managing several independent projects as well as supporting projects run by individual churches. Some of the programs that the BCC have worked on include: clean water projects, human rights programs, educational projects, as well as working with HIV/AIDS. Currently the largest program that the BCC is running is the Adolescent Sexual Reproductive Health Program (ASRH). The BCC is running advocacy campaigns, training sessions and workshops in order to educate parents, religious leaders and members of the community in issues concerning ASRH.
In addition to the ASRH program, the BCC supports several other church programs that deal with HIV/AIDS. Some of the other programs supported include: Orphan and Vulnerable Children (OVC) Care, Home-Based Care, and HIV/AIDS Education. In these areas, there is a wide verity of work being done. The programs offer psychological support, food, medical assistance, transportation, clothing, prevention education, religious support and education, daycare, as well as HIV/AIDS testing. While the projects are run my Christian organizations, most of the services provided are offered to anyone in need of assistance.
In the three weeks that we worked with the BCC, we were able to talk with many different churches and Christian organizations to gain information about various programs dealing with HIV/AIDS. In addition to talking with churches and organizations, we were also able to work hand in hand with programs linked either directly or indirectly to the BCC. For my time with the BCC, I was able to work with the Roman Catholic Church in their Home-Based care program as well as their Orphan and Vulnerable Children (OVC) daycare program.
The first few days with the BCC as well as the last week with the Council was spent on the road visiting and conversing with different BCC supported programs, as well as organizations that work side by side with the BCC. In the days spent interviewing different people, much information was gathered regarding the work of the church in the area of HIV/AIDS. As is always the case, there were both programs that seemed to be effective, and those that were unimpressive. While we did not get into in-depth look of many programs, in most cases, it was evident which programs were more successful than others.
One of the best programs we visited was the Hope Alive HIV/AIDS Training Program put on by Kgolagano College. Kgolagano College is a theological college that offers education by extension in the whole of Botswana. Educational programs are offered both in English as well as in Setswana. While the College is not yet accredited, the Hope Alive program can be described as a truly innovative and progressive HIV/AIDS education program.
The Hope Alive Program was created in 2003 in order to mainstream HIV/AIDS into the lives of everyone at Kgolagano College. The Hope Alive HIV/AIDS Training Program does not focus on educating entire communities, but rather small groups of leaders’ with-in community churches. The idea of Hope Alive is to train the church leaders to go back to their home congregations and teach positive behavior change and Bible interpretation in the modern HIV/AIDS era. Along with training leaders how to educate, they are also taught pastoral counseling as well as how to lead discussions on sexuality. The goal of the Hope Alive Program is to teach leaders how to incorporate HIV/AIDS into every area of the church and the surrounding community.
The Hope Alive Program is different from many of the other programs we were introduced to in several ways. Firstly, is in regard to the communities that Kgolagano College works with. Instead of focusing on just a few communities or cities, the Hope Alive Program is taken all around Botswana, even to the most remote areas. Two different training sessions are ran in each community in order to reach a larger number of people. After training sessions are completed, Kgolagano College makes sure to follow up with each community in order keep track of progress and make sure no additional assistance is needed.
The other positive aspects of the Hope Alive project include working to fight against stigma, self-esteem and sexuality training starting at a young age, as well as a comprehensive HIV/AIDS prevention education program. Working with Christian communities can be a challenge when dealing with the above issues, but Kgolagano College recognizes the importance of these areas in fighting against HIV/AIDS. The successes of the Hope Alive Program include getting more and more people to participate in HIV/AIDS testing, getting more churches to start HIV/AIDS programs (i.e. OVC programs and Home-Based Care programs), as well as bringing church leaders together.
As with most NGO programs in Botswana and in the world, the Hope Alive Program does have its challenges. The biggest challenge to the Hope Alive Program is also a challenge of every other HIV/AIDS prevention program in Botswana and that is the issue of harmful cultural practices. The examples of the harmful traditional practices given were polygamy and traditional medical practices. Since Hope Alive works in more remote areas than other programs, they are faced with these issues more often. The other challenges include reluctant leadership within many churches as well as low program attendance. Surprisingly enough funding was not an issue as it is with most other programs in Botswana.
I was very impressed with the Hope Alive Program, because I think they recognize the biggest issues in fighting HIV/AIDS and they work to correct these issues. I think that many churches let their personal religious philosophy stand in the way of effective HIV/AIDS prevention teaching, and the Hope Alive Program is a good example of a program that has the peoples’ best interest at heart. Like every program Hope Alive does have its areas that could use improvement, such as offering more than six workshops a year, but as time goes on, I am fairly certain Hope Alive will only continue to improve and grow.
The Hope Alive program was not the only program that I was impressed with, as there were several other programs we visited that do important work in different HIV/AIDS areas. Of the programs that I found to be efficient and successful were the: ASRH program at the M. Joan Cousin Women and Youth Empowerment Center in Lobatse, the Tsholofelong street kids program at Old Naladie, and the Kamogelo Orphans and Vulnerable Project in Mogoditshane. Several of these programs only work with HIV/AIDS minimally, but the work being done is still very important in HIV/AIDS prevention.
The Tsholofelong project was one of the first programs we visited with the BCC, and the only program run directly by the BCC that we were able to visit. The Tsholofelong project is found in one of the most impoverished areas of Gaborone, and works with at-risk youth from a wide verity of backgrounds. Many of the youth found in the program are orphans, social orphans, full-time street kids, part-time street kids, and kids who formally profited from the streets. Many of the students found in the program live in provided housing, while many of the students live in the surrounding area and come for the various programs offered.
The Tsholofelong project helps children in many different areas. For the children that are still attending regular schools, after school programs (i.e. football and aerobics) and housing are offered if needed. For the students who have been out of school for an extended period of time, vocational training is provided. For all students counseling and life-skills training is provided. The children are fed three meals a day depending on their need, and school uniforms are provided to those still attending school. The students are instructed in traditional dance, and performances are arranged in order to help the kids raise money.
The Tsholofelong project uses a unique program model in order to best help each individual child who attends the program. The model starts off with entry point and ends with students finding their own identity, employment and/or being re-united with their family. In between the entry point and “graduation” from the program, there is a lot of work being done including: education assessment, home-visits, psycho-therapy, remedial education for slow learners, health education, and religious instruction. The goal of the program is to get at-risk youth off the streets, and help them to become fruitful members of the society.
At first this program may not appear to have much to do with HIV/AIDS work, but in reality this project is very important to HIV/AIDS prevention. Not only is HIV/AIDS prevention taught to the students, but the students are also being given love and support. For at-risk youth, love and support is crucial in helping youth to make educated decisions that lead to healthy living. If a young person loves themselves, they will be more likely to use the HIV/AIDS education they are given which therefore leads to the reduction of HIV/AIDS. The population of those being assisted may be small, but every youth helped could be a life saved.
The Tsholofelong project is very important to the fight against HIV/AIDS in Botswana, but unfortunately it faces several challenges. The largest obstacle the project face is the issue of funding. Funding is the biggest issue that most NGO’s face in Botswana, because of the recent declaration that Botswana is a middle income country. There are few international donors that give to the Tsholofelong project and government and local funding is minimal. If the program is to continue giving assistance to all the youth that need assistance, additional funding will need to be found.
There are several organizations that work with vulnerable youth, and another successful program that we visited is the ASRH program found at the M. Joan Cousin Women and Youth Empowerment (MJCWYE) Center in Lobatse. The program is run by the African Methodist Episcopal Church, and it does a lot of positive work with youth. The ASRH program at the MJCWYE Center was started in 1999 with funds from the Women Missionary Society. Today the center only offers programs for youth, as the funding is limited. Currently the center has 65 children in its after-school program with 35 females and 30 males.
The ASRH program used at the Center is quite comprehensive and works with children in every stage of development. The youth are broken up into different age groups according to different stages of life. The groups are divided into Pre-puberty (under the age of ten), Early Adolescence (ages ten to fourteen), Middle Adolescence (ages fifteen to nineteen) and Young Adulthood ages twenty to twenty-four). The youth are then given ASRH education according to their needs. The children are taught about the on-set of puberty, the recognition of sexual abuse (as well as prevention techniques and how to report sexual violence) and in-depth comprehensive HIV/AIDS prevention education.
Health Education is not the only focus of the shelter. After-school activities are also offered for the youth. Scouting, quilting, bead work, music, games, drama, bible study and nutritional meals are also offered. The center is also equipped with a snooker table and a T.V. to keep the older youth out of the bars. These after school programs are important in the same way the Tsholofelong program is important, because it keeps at risk youth off the street. Self-esteem education and counseling is also offered to everyone in the program. Weekly visits to the parents and care-givers of the children are also conducted, to address any issues that the families may have.
The ASRH program in Lobatse is very well organized and is run by very competent and able women, but there are a few issues with the program. The ABC’s of prevention are taught to the youth, but a heavy emphasis is put on abstinence. While abstinence is an important component of HIV/AIDS prevention, with young people sex is a natural part of life. Telling people to resist their sexual urges until marriage is not always practical, and there fore focusing more on condom use could make the program more successful.
As stated above, the Center has a snooker table to keep the older kids out of the bars, but the Center is only open daily until five. The snooker table may keep the older youth out of the bars during the day, but to be more effective in keeping the youth out of the bars it would make more sense for the Center to open during the evenings and during the weekends. When popular football matches and rugby matches are being shown on T.V., the center does open for the youth, but that is only on special occasions. Despite these obstacles however, the program is one of the better ones I have seen.
The last successful youth program I will talk about is the Kamogelo Orphans and Vulnerable Children Project ran by the Roman Catholic Church. This is the program that I spent the most time with, and therefore I have unique relationship with this project. Kamogelo is located outside of Gaborone in the small village of Mogoditshane. Kamogelo is a project that works mainly with the local OVC population, but also with the families and caregivers of the OVC. Kamogelo runs both a daycare center for young children (aged 2 to 6) in Mogoditshane as well as an after school for children attending secondary school. Kamogelo has 150 children in the daycare program, and 280 children in the after school program.
The Kamogelo program is one of the most efficiently run programs that I have seen in Botswana. Sister Margaret, the woman who is in charge of the program is a remarkable woman. Sister Margaret makes sure that all of the children have warm clothes, two hot meals a day plus a solid preschool education. When the children are first brought into the daycare center, Sister Margaret urges the caregivers and parents to allow for their children to be tested for HIV/AIDS. So far most caregivers and parents have allowed testing, and have even come to the daycare to be tested themselves. Currently 17 of the children at the center are HIV positive. The HIV positive children are given extra counseling, and when needed extra nutritional food to keep them healthy. Their status however, is kept a secret from the other children.
When we were at the center, Sister Margaret held the monthly meeting for the caregivers and parents. Most of the children at the center are being raised by caregivers, therefore monthly meetings are scheduled to help educate the caregivers on how to best care for the children they are in charge of. The meeting dealt with issues the caregivers were facing, as well as the issue of fundraising for Kamogelo. These meetings I feel are of the utmost importance to ensure the wellbeing of the OVC. The other teachers and volunteers told us that there is always noticeable improvement in the health and happiness in the students after a few months attending Kamogelo. Working with the children, I would have to say Kamogelo is a success, as all of them seemed well cared for.
Kamogelo like many of the other programs has faced its share of issues. Funding has been a major issue in the past, but recently it has received funds from outside sources. While we were there, there was a ceremony for a Motswana bishop, because he had donated a large sum of money. There is also funding coming in from Candada that has been given to pay for the salaries of the teachers. Before a few years ago, the teachers had been working for no pay. Another challenge of Kamogelo is the location of the center. The center was only built recently, but it was built some miles away from the original location. This means the after school program is still being held in the old location, because the new center is too far for the students to go. Kamogelo hopes to expand its center facilities and buy a new bus for transport in order to move the after school program in order to offer more services to the secondary school age children.
The Roman Catholic Church does not just support the Kamogelo project; it also works with other OVC programs as well as many Home-Based Care programs. As we were partnered with the Catholic Church for a week and a half, we were also able to see several of the Home-Based Care projects that are currently in operation. The Home-Based Care programs are situated in different Catholic Churches or even homes in different communities. The people from the surrounding community who are either affected or infected with HIV/AIDS gather at the Church or Home during the day one day per week. Those who are unable to attend the gathering are taken a hot meal, and are prayed for by the volunteers.
The Home-Based Care program is very important for several reasons. The program offers a hot nutritious meal, healing exercises, a support system as well as prayer. While I am not sure if prayer helps everyone, the support, food and exercise has been very important in keeping those suffering from HIV/AIDS healthy. We were told that before the program started, there were many people unable to leave their beds and many people were dying. Now everyone’s health is much improved, and the survival rate is higher. When many people think of HIV/AIDS work, they think only of the prevention side, but the care-giving side is also important. While I don’t always agree with the teachings of the Catholic Church, I do believe this is a good program.
While I have talked a lot about several of the successful programs that we have worked with the past several weeks, there are also many programs that I found very poorly operated or very poorly designed. There were usually two reasons that led to the programs being unsuccessful, and that is the mismanagement of funds/lack of funds or the philosophy of the church. Three programs come to mind when I think of the unsuccessful programs we visited, and they include: the program ran by the Bible Society of Botswana, the program by the Evangelical Fellowship of Botswana as well as the Samaritan Kitchen program ran by the Methodist Church.
The HIV/AIDS program that is operated by the Bible Society of Botswana (BSB) is a relatively new program, only developed in the last few years. The BSB focuses on the Christian perspective of HIV/AIDS work, and has programs for stigma reduction, Home-Based Care, OVC and youth abstinence. On the surface the BSB sounds much like the other programs described above, but there the BSB educational programs are quite different. First of all most of the literature is only offered in English, which is a problem for those who predominantly speak Setswana. The BSB would like to purchase more literature in Setswana, but the funds are not available.
The second problem with the BSB education program is also with the literature in addition to the other materials used, they are too outdated. In order to keep people engaged and involved it is important to offer the information you are trying to relay in an interesting manner. With the problem of message fatigue in this society, keeping people entertained is especially important. Condom use is also not taught, which I find to be terribly behind the times, especially when you are talking about the difference between life and death. HIV/AIDS is a life or death issue; therefore personal philosophies should not stand in the way of using successful teaching methods. The other programs ran by the BSB may be more effective, but unfortunately I was only able to see the educational materials. From the surface the other programs sounds good, but unless seen in action it is really hard to accurately critique a program.
Another program that looked good on the surface was the Samaritan Kitchen operated by the Methodist Church. While talking to the woman in charge of the program, everyone in our group was very impressed. The program takes care of thirty individuals from the surrounding area, in addition to one entire family. The Samaritan Kitchen gives them a monthly food basket that is supposed to be used for the entire month. When asked of the challenges of the program, the woman in charge did mention a small problem with the lack of food, but she seemed to be very pleased with the overall results of the program.
When we went to the storeroom that housed all the food for the thirty plus individuals, there was not enough food to feed one family for a month. Individuals would only get enough food to feed themselves for a week, and that’s if they are lucky. The program could be quite successful if the proper funds were available, but as of now the program is spreading itself to thin. The U.S. embassy as well as members of the congregation are the only people giving donations, and the program organizers have little hope for more funding anytime soon. Individuals in need however, are still being accepted into already failing program.
The final program that I found to be quite unsuccessful is the program operated within the Evangelical Fellowship of Botswana (EFB). The program, which is also fairly recent, has many major failings. The first issue with the organization also has to do with funding. Before starting an HIV/AIDS program, research was conducted with 100 church communities in order to see what their biggest area of need was regarding HIV/AIDS work. The program was initially planned to set up one of four programs in every one of the 100 churches, depending on the findings of the research. The programs included at Home-Based Care Program, an OVC program, a prevention program or a counseling program. After the research was completed however, it come to light that the only funding available was from PEPFAR. All of the 100 churches were forced to adopt only a prevention program, despite what their initial need was.
Having prevention programs is an important aspect to fighting HIV/AIDS, but that is only if the program is successful. From what I have heard of the program offered by the EFB however, I would have to say their program is quite a disappointment. The stance of the EFB in regards to HIV/AIDS prevention is that it is 100 percent possible for everyone to abstain from sex until marriage. And once a person is married, it is 100 percent possible to remain faithful to his or her spouse. The idea of a spouse cheating on their partner, or the idea of a person having premarital sex is not discussed. Not having comprehensive HIV/AIDS prevention education is ridiculous in this day in age, especially in Botswana. As stated before, this is an issue of life and death, and therefore it is of the utmost importance to do everything in one’s power to prevent the spread of HIV/AIDS.
Working for the BCC proved to be very interesting, and allowed me to explore a variety of organizations and programs. I feel that I learned a great deal about HIV/AIDS in Botswana, including the struggles that the people of Botswana are continuing to face. Several of the organizations, while not perfect, did a very good job in working with HIV/AIDS and HIV/AIDS prevention, but many organizations still have a long way to go.


Final Impressions: Botswana

When I look back at the last six weeks, I have a lot of mixed feelings. On the one hand I feel like I have had a valuable learning experience, but on the other hand I just feel frustration. I have had a great deal of conflicting thoughts about the experiences I have had. I will try to keep my paper organized and concise, but as my emotions are mixed, a long rambling paper would be a more accurate reflection of my current state.
I will start by writing on the people of Botswana. The people I have worked with, the people I have interacted with and the people I have lived with have been a huge part of my experience. As in any society, the Botswana people are all very different and my interactions with them have all been very different. During my time in Botswana I have made several friends, but most of the friends I have made I have met through the program (i.e. Lerox, Thabo and B.K.). I have met other friendly people, but mostly it didn’t seem like people were interested in getting to know me or even talking to me. I felt like most of the time it was an inconvenience for me to be here. In Botswana, it is hard not to feel like an outsider.
I think much of the unfriendliness I have experienced has a lot to do with the culture. The culture of Botswana is very different from the culture of anywhere else I have traveled to. Having a unique culture is a good thing usually, but aspects of the Botswana culture are difficult to deal with. The Botswana people are so proud, and they act like they don’t need anyone else, but yet they adopt a great deal of the culture from elsewhere. Western influences as well as influences from South Africa are seen everywhere. The western influence that is here is a negative influence I feel, and doesn’t accurately represent the western culture. People here do not seem to care about how their actions affect other people. In regards to politeness, timeliness, and customer service, the Botswana people are lacking.
The HIV/AIDS issue is also important to take note of. In everyday life, it is sometimes very easy to see why HIV/AIDS is so prevalent. Living is such a patriarchal society; I could see how sex would be very important to many people. Just from my own observation, had I lived in this culture I would find it difficult to be assertive and demand a condom when the time came. The issue of message fatigue is also a big part of the problem. Sadly the message that is out there isn’t a very informed or comprehensive message and there is still much misinformation in the society.
Sex is a huge part of life, but yet here it is not talked about within families. When sex is talked about it is only talked about in a round about way. Many people are trying to make sex less of a taboo, but it seems like there is still a long way to go. Young people seemed to be more informed than the older generation, so it will be interesting to see if the HIV/AIDS trend continues in the same way, or if there is an improvement. Unfortunately it will be several years before it will be evident if current HIV/AIDS prevention efforts are working.