Go and save someone's life today.
	Go with food to a family stricken by AIDS today.
	Go and comfort a widow or an orphan today.
	Go and encourage someone who is giving their lives to AIDS ministry today.
	Pray for God's protection on them and for God's provision.
	And you may be part of the answer to those prayers !

, Good Practice in HIV/AIDS Projects

What can we do?  How can you and I make a difference?  Firstly, always start with what you already have.  It's a scriptural principle.  God's work done in God's way never lacks God's supplies, as Hudson Taylor, the famous missionary to China once said.  So what is God calling you to do?  What has he laid on your heart?

, You need neither funds nor a large team to start.  It costs nothing to care for a friend or neighbour, nor to talk to your own children and colleagues about HIV and AIDS, nor to include HIV issues in your church teaching programme, or work training schemes, or school curriculum.  Together we can make a real difference. 

, You may not be able to save the whole world but you can save someone getting HIV somewhere.  You may not be able to help all those with HIV or orphaned by it, but you can give practical help and encouragement to a few, and you can get involved in other projects that are already running.  But do it all in fellowship with others.  Such work can be stressful, draining and lonely and you will need people supporting you too. , , What about larger projects? Thousands of programmes have been developed, countless papers published and millions of dollars expended in the struggle against HIV/AIDS. Yet spread of the pandemic rapidly continues. Many governments and NGO agencies now recognise that their strategies are failing to stem the tide, yet continue to pump money into condom distribution alone and one-off awareness campaigns, neither of which address related problems such as poverty, education, the rights of women, and broader lifestyle questions. 

Here are some stories to encourage you:  remember these are lessons from different countries which need careful adaptation to your own situation.  However the Case Studies illustrate many general points which are vitally important.

Every one of these stories has a small beginning.  An individual touched by the love of God, and deeply affected by what AIDS is doing to the world He made.  People who felt they had to do something, and who began, usually with almost nothing, step by step, following God's calling, in fellowship with others and learning from those around them as they went.  In many cases the road was long because there were few role models for such programmes at the time.  But now the programmes they began are an inspiration and practical encouragement to us, and accelerate us on our own journeys.

In the face of a high level of need and limited formal health resources, those who began FACT (Family AIDS Caring Trust) in Mutare, Zimbabwe, saw the pressing need to mobilise the local community to provide care. Churches were approached who had individuals willing to be trained to provide care to families and neighbours in their communities. FACT home care programmes are co-ordinated by experienced health workers who are responsible for local teams.  Each team is headed by a volunteer, managing other local church volunteers who provide the actual care to those in need in their areas.

Above all it is necessary for volunteers to recognise that the needs of those they visit are not purely physical, but also emotional and spiritual. Volunteers are drawn from the local community and it is often their neighbours they are caring for. The formation of serving relationships are the basis for good practical care and supportive counselling.

The majority of those visited are living with members of their families and the role of the volunteers is also to support them.  They offer advice on ways to deal with different infections common to HIV;  other informal and formal services available and how to access them. Importantly the volunteers also offer emotional and spiritual support to the family carers.

Through this relatively low skill and low cost team a larger number of people are able to receive help, utilising the traditional family and community caring mechanisms.  Through volunteers, each church is able to reach into its community to serve and support families, neighbours and other carers. Volunteers contribute to programme development with data collection and in decision making and planning meetings. This is a good practice: involve people who are closest to those who need help.

Home care helps those most in need of assistance in their own areas. However providing practical care alone only meets physical needs. There are also very real emotional needs as people face prejudice and rejection, and spiritual needs as they are facing death. Care must therefore encompass counselling of the individual by appropriately trained and supported workers.

For Christian organisations, home care and counselling can be opportunities for finding faith, as people with no human hope discover eternal hope through Christ. Care for a PWA is a powerful way of sharing the love of Christ practically within the community and sometimes this can lead to naturally sharing Jesus, our motivation for caring.

Basic physical care of sick people is an obvious need that must be met. Destigmatisation, normalisation and inclusion by family, friends and community are also all needs though less immediately obvious. They can all be achieved by low-cost, yet trained and caring volunteer home visitors, who are themselves, well supported and managed.

The relational-based care offered by the volunteers naturally opens up opportunities to raise awareness and understanding more widely about HIV/AIDS and especially how it is transmitted and prevented.  HIV/AIDS prevention that develops out of the context of care often makes it easier to talk about sensitive social and moral issues  People whose friends or family are infected are facing the reality of the disease and therefore tend to listen and subsequently pass on information to others.  For an AIDS organisation working in prevention, one of the best entry points is care, which most often also brings credibility to their work

, Summary on Care

	Community based care reaches more people
	PWAs often prefer to be cared for in their own homes
	Be prepared to care for those with many different illnesses, not only those living with HIV/AIDS
	Families, friends, communities and volunteers are a resource for care
	Communities must own the work and so must be consulted from the beginning and throughout the life of the programme
	Care in the community, provides opportunities for prevention education
	Community based care is most often cheaper than hospital based care.
	Care should be holistic: physical, emotional, social and spiritual
	Effective care in the community is best linked to other services and works in partnership with them e.g. local hospitals
	Communities have many resources within them that can be drawn upon

	Ask the question: is the use of volunteers appropriate, how, where and to what extent?
	Selection criteria must be established at the start. Motivation is key.
	Relevant training at the start and throughout the programme
	Monitoring and support of volunteers throughout the programmes life
	Involvement in decision making and planning.
	Clear parameters for volunteers on what is expected of them and when they should refer to paid staff.
	Regular group and individual monitoring and support of volunteers by the organisation. People are our greatest and most precious resource.

, Issues in Counselling

	A central part of care and prevention.
	Training is critical.
	So is supervision and clear boundaries i.e. Know when to stop and who to pass issues to.

The aspiration in all HIV/AIDS care and prevention work should be the reduction of the spread of HIV.   Here is the greatest challenge to those in HIV-related work:  are you spending as much effort and resource on saving lives, as in caring for those affected.  You only have today to save someone's life and the next 10 years to plan their care.  We must do all we can to fight this terrible problem.  Care programmes, while vitally needed, are no answer on their own to the spread of AIDS.

But changing behaviour is a real challenge. HIV/AIDS awareness campaigns and education alone have limited impact in changing high risk activities of individuals. Information received by an individual does not necessarily mean that the individual understands, relates to or wishes to change their behaviour.

ACET Uganda has developed a three- pronged approach to communication to assist effective and sustainable behaviour change.

People must know the facts. This must be designed to meet individual and local needs. It must be able to fill gaps in information and lay a foundation for understanding the medical, social, economic, cultural and spiritual issues related to HIV/AIDS.  But facts alone will rarely change behaviour.

Assisting individuals to understand high-risk behaviours that they are, or could be, involved in.  Help people make important lifestyle choices to be made based on understanding the options and consequences of particular behavioural practices.  This method is in contrast to the "Fear Method" of many HIV/AIDS campaigns.

Having been shown the choices, the individual is then encouraged to think through the options.  These relate to life-skills that reduce vulnerability to infection, enabling long-term fulfilling relationships, taking personal responsibility for their behaviour, having confidence to make and live by their own decisions, and respecting the worth of others.

As ACET Uganda developed its HIV/AIDS prevention work it soon became apparent that HIV/AIDS could not be dealt with in isolation and it was necessary to deal with general sex education and, importantly, the development of an individual's relationships through developing personal self-worth and a high regard for others. These are skills that are critical not only to HIV/AIDS prevention but also to the general development of every individual. 

ACET Uganda describes lifeskills as "formal and informal teaching of requisite skills for survival, living with others and succeeding in a complex society.  It can no longer be assumed that these skills are automatically learned or that they are automatically passed on, as was in times past."  (Lifeskills Education for Responsible Behaviour among Adolescents, ACET Uganda) Many existing cultural teachings may not prepare people for new pressures.

For example, with the increased urbanisation, people are facing new economic and social pressures, while traditional social structures are breaking down.  Development of life-skills by people (in particular those most vulnerable, such as young people and women) can equip them to respond more positively to the challenges that they face in life.

ACET Uganda uses interactive teaching methods to provoke people to think and discuss issues that affect them, assisting them to analyse situations they will face and their responses.

Peer pressure is very effective in developing individual thinking and social understanding. This can be both negative and positive. The role of the education team is to develop peer-group thinking that will help reinforce and sustain of positive and healthy behaviour.

	Focus group discussions.
	Debates and Panel Discussions.
	Films, reels, slides and video. "Do not expect films to speak for themselves" but they can form the stimulus for good discussions.
	Questionnaires.
	Talks, not long lectures, but short and dealing with contemporary issues

, There are common principles for educators/facilitators to employ during the learning process:

,

	The issue is not primarily raising awareness, but assisting personal and community behaviour change.
	Attention to vulnerable groups, in particular women and young people. Research their needs.
	Commitment to people.
	Respect for the listener and their views.
	Co-operative not competitive learning.
	Importance of peer education.
	Interactive methods of learning.
	Time for reflection.
	Clarity of the message.
	Relationship building.
	Training of others to assist in the process e.g. peer educators.

, The Gospel - a framework for life. 

, For Christians involved in lifeskills education the gospel can be brought in naturally when appropriate, for many it offers them a framework for life.  It is the news of Jesus Christ who can help people face the challenges of life.  It may not always be appropriate to be evangelistic, but often educators are asked where they receive the strength and purpose to face life's challenges and can legitimately testify to their faith.

, The integration of HIV/AIDS Prevention with other issues.

, Addressing HIV/AIDS prevention education should form part of a more comprehensive teaching on lifeskills. The educators of ACET Uganda have gained credibility, in part because they are dealing with many of the other pressures people are facing. For other organisations such as FACT, involvement in the care of people living with HIV/AIDS has given them the basis and opportunity from which to undertake prevention education.

A church which serves the community It is of course important that the church serves the local community. But part of serving means handing power and decision making to the community, and even to people living with HIV/AIDS. The central verse in Mark's gospel, Mark 10 verse 45 describes Christ as a servant "For even the Son of Man, did not come to serve, but to serve and to give his life as a ransom for many" Not only a servant, but a servant who gave his life.

, The Salvation Army hospital at Chikankata, describe their education work  'community counselling' as "an activity expressed through dialogue, directed towards genuine transfer of responsibility for prevention - from health personnel and other concerned 'helpers' to individuals, families and perhaps most importantly, communities" (AIDS Management An Integrated Approach Campbell I.D, Williams G).  Such a community wide interactive approach is essential in the context of AIDS in communities with high rates of HIV infection. The task of prevention is very great and communities must own the desire to change. Instruction alone is not enough. They need education, information and training from people they respect. The church must serve in order to mobilise the community.

, The Word of God The size and moral nature of the epidemic has left many programme implementers uncomfortable with the slow pace at which the church, missions and Christian NGOs have responded. Church leadership is key in the mobilising of HIV/AIDS programmes.  If church leadership remains unmotivated or, worse, prejudicial about church involvement, time needs to be invested to help influence a change in this attitude before sustainable action is expected from a church or group.

, When you have support and encouragement of the church leadership the resources within the church can easily be mobilised. The key appears is the power of the Word of God with the Holy Spirit to motivate, to care, and to give people a framework for life. Christian care must model that of Christ, which was not restricted to the physical needs of people, but went way beyond this to their emotional, relational and ultimately spiritual needs. Christians have an opportunity through HIV/AIDS care and prevention education to practically express the love of Christ for the marginalised, but also for all in the community living under the threat of AIDS. 

Under the leadership of Pastor Sam Mugote a number of the members of Deliverance Church, Jinja, formed a group to offer physical and spiritual care to people in their community living with HIV/AIDS. They were motivated by the many needs of their neighbours but also by the call of God's Word to care sacrificially for those in need, without prejudice or judgement. The programme grew through other churches seeing the positive impact upon the lives of individuals, the community and the church itself, and requesting to become part of the programme or to be allowed to replicate the work.  The Deliverance Church formed TAIP, The AIDS Intervention Programme, to enable and assist churches to respond to the HIV/AIDS epidemic in their communities.

, The aim of TAIP is to assist churches to develop sustainable support to people living with HIV/AIDS. Churches are facilitated to plan and manage both care and prevention programmes through volunteer-based work to their immediate communities.  The foundation for these programmes is a spiritual premise that Christians should take initiatives in the HIV/AIDS epidemic.

, The implementers of the care and prevention work are individual volunteers from churches.  The majority of them are untrained in formal health care, but have been equipped to provide the basic physical care that people living with HIV/AIDS need in their homes. Furthermore the volunteers are trained to provide counselling intended to meet the emotional needs of both the PWA and their families.  They also offer advice on nutritional matters and other services available to individuals and families.  At the heart of the provision of this practical care the love of Christ is shared.

, Generally, the TAIP team works with churches that approach TAIP for guidance.  In the words of Pastor Sam Mugote, he sees the role of TAIP as assisting Churches "to develop work that churches are already doing ", that they care bout people and the Biblical model for life.

, The churches that seek assistance and are selected to receive training share two key qualities.  Firstly, they see the need of people in their community infected by HIV and the effect this has on their families and community.  Secondly, the church is active in the verbal and practical proclamation of the gospel i.e. has recognised and is already practising a response to the call of Gods Word to tell people of the good news of Jesus Christ in word and deed. These are fundamental building blocks, without which it is difficult to then start an HIV/AIDS programme. The role of TAIP is to offer guidance on how a congregation may direct their vision and skills to offer effective care and prevention.

, As stated above the experience of TAIP is that a local church must already show evidence of commitment to and practical outworking of, the biblical teaching cited above. From this starting point it will be more of a natural development for churches to then make a local response to the HIV epidemic. ,

The TAIP team begin by making an initial visit to a church to meet with the minister, church leadership, and interested individual members in the congregation. It is important that the leadership not only agrees to the development of a programme but is also actively involved in the work. The church may meet a number of challenges through which the active support of leadership is needed. Volunteers may face prejudice and will certainly need regular support and understanding when involved with chronically ill people and their deaths.  The TAIP team train motivated and selected members of the church to become a Support Action Group (SAG) to visit people with HIV/AIDS. This group of volunteers is also equipped to be able to review its activities and support one another by meeting together regularly.

The emphasis of the TAIP training and of the SAG volunteers is to develop relationships with individuals.  This meets one of the central needs of people, to realise that they are loved and have worth and it is from this base of emotional support that the other elements of care can be supplied.

It is important to note that the experience of TAIP has been that the mobilisation of a church can take between six and eighteen months as volunteers are selected, trained and learning practically applied between training sessions.  Training is then followed up by supervision, support and update training visits by TAIP.  Another important factor in the development of the church's programme is clear liaison and communication with the local community.  The community should agree to and own the initiative and this will often require time and resources dedicated to developing relationships, even training in the development of surveys and planning with communities.

It is the experience of TAIP and other organisations that volunteer-based projects can be developed with less difficulty in rural areas compared to urban areas. The main reason for this is the availability of volunteers with time to care for people outside of their own families. In urban areas there are often reduced family structures and the need to earn a wage can severely restrict the time volunteers have to offer. A solution has been to mobilise those who do have some available time. Furthermore training has often concentrated on the training of families to provide more of the care needs of people living with HIV/AIDS.

TAIP have seen that a programme developed naturally by one local church provoked other neighbouring churches to catch the vision.

	Biblical lifestyle of the church members must be in evidence
	Leader must be supportive and involved
	Quality and relevant training
	Regular support for volunteers
	Emphasis on developing relationships with PWAs and the community
	Include support for families
	It can take up to eighteen months for an effective programme to develop
	Clear liaison and communication with the local community
	More difficult to develop in urban areas