“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”
Defeating HIV/AIDS through
History has placed a great
burden on our shoulders. As members of the human race and as educators,
every one of us here today faces a task that has ramifications for the lives
and well-being of countless individuals—adults, youth and children. Each of
us bears the lives of others in our hands. The understandings we develop
these two days, the decisions we make, the commitment we show, will not be
confined to this auditorium but will have repercussions throughout the whole
of South Africa and will echo from there into other parts of the continent
and the world. Our task is simply described; its execution is difficult and
challenging. Our job in these two days—and in the weeks that follow—is to
establish a dynamic education coalition against HIV/AIDS that will
accelerate the progress of South Africa and the world towards a world
For too long we have been
standing by—timid, confused, uncertain, feeling that we were powerless,
wanting to do something constructive but not quite sure what. And all the
time, men, women and children continued to be infected in their millions, to
fall sick in their millions, to die in their millions. We work in the middle
of the AIDS killing fields (Akukwe & Foote, 2001). We have daily experience
of the passive genocide of our most productive people (Coombe, 2001). We
live through a silent holocaust that makes the Jewish Holocaust in Nazi
Germany pale by comparison (Nyumbani, 2001). We have let two decades slip
through our hands when our response to HIV/AIDS was little more than a
scrappy rearguard action against what we saw as an almost insuperable enemy.
The young people today are
the AIDS generation (Kiragu, 2001). They have never known a world without
HIV or AIDS, no more than they have ever known a world without television or
air transport. But AIDS is of much more recent origin than either television
or air transport. It was on 5th June 1981, almost exactly
twenty-one years ago, that the United States Centers for Disease Control
published a report about a new disease that was hitting gay men. That report
marked the formal beginning of the AIDS era. It ushered in what we now know
as the AIDS pandemic. During the twenty-one years that have passed since
then the disease has grown to nightmarish proportions, with almost every
passing year seeing a revision upwards of dire estimates and predictions.
The challenge to us is to put a halt to this obscene growth of the disease,
to say to it in forceful action-backed terms: "Thus far and no further."
To accomplish this, we must
undertake a threefold task:
We must harness the huge
potential of the education sector to prevent further HIV infection.
We must mobilize the
sector to offer support and care to those within our educational
constituencies who are infected with the disease or are in any way
affected by it.
We must take steps to keep
our own house in order, to protect the education sector itself from the
inroads and ravages of the disease, so that it continues to make
educational provision in the quantity and quality that is required, while
at the same time it exercises its potency to stem HIV infection.
What Has Gone Wrong?
If we are to use the
potential of the education sector to defeat HIV/AIDS, it is important that
we base our initiatives on some understanding of what has gone wrong, why
the AIDS pandemic has got out of hand and why, in particular, the response
so far from the education sector has been so limited.
The Inadequacy of Action
at International, National and Local Levels
It is unfortunately all too
true that in many ways the world, countries and communities, have allowed
themselves to get into the current HIV/AIDS crisis almost by default.
Notwithstanding the urgency with which warning signs presented themselves,
the world (and we as part of it) has stood by and watched a steady,
seemingly unstoppable, drift into crisis, disaster and catastrophic human
tragedy. Factors that have made a major contribution to the ease with which
the disease has spread and the ineptitude of the response include:
Lack of leadership and
vision at global, regional and national levels. In the few cases where
these were available, such as in Senegal and Uganda, the disease made
slower progress or receded.
Silence and denial at
various levels—national, community, and individual. To some extent silence
and denial are a primordial and protective human response to situations
that are excessively stressful. In the words of the poet, T. S. Elliott,
"humankind cannot bear too much reality". But trying to cover up the
existence of AIDS, as still commonly occurs in families and communities,
and even in some countries, will never lead to mastery over the disease or
insidious associations, and adverse social reactions that discriminate
against and stigmatize those with HIV/AIDS and drive acknowledgement of
the disease into an underground of silence, secrecy, shame and
self-recrimination. Fourteen years ago, Jonathan Mann, the Director of the
agency that preceded UNAIDS, spoke of this as the "third epidemic," the
other two being the silent epidemic of HIV infection and the manifest
epidemic of clinical AIDS, and noted that allowing this third epidemic to
go unchecked would ensure that neither of the other two could be
controlled (Walrond, 2000).
Lack of correct
information on how the disease can be contracted, how it can be prevented,
and what those infected can do to ensure that they live a longer life of
better quality. Even today a significant proportion of young people, in
South Africa as elsewhere, do not know any way of protecting themselves
against HIV infection, are not aware that oral and anal sex involve
extensive HIV transmission risks, and think that you can judge by
appearances whether or not a person is HIV infected.
Failure by the
international community and national governments to commit the human and
financial resources needed for a large-scale onslaught on the disease. The
Global Fund for AIDS, TB and Malaria, which the United Nations established
with considerable fanfare in June 2001 has so far raised less than
one-fifth of its target. Doubling the resources currently available to the
Fund would represent only about one cent of each US$100 of income in the
world’s wealthiest countries (Harvard, 2001, p. 18), but in the absence of
a sense of international responsibility and urgency this is not
Weak capacity to design
and deliver response measures.
A strong focus on
short-term measures aimed principally at behaviour change, but with
minimal attention in the context of the disease to the enabling
environment of poverty, malnutrition, the powerlessness in many societies
of women and young girls, inadequate health support services, lack of job
opportunities, and the absence of recreational outlets.
Inadequate attention to
developing comprehensive strategies that focus on the physical, social,
economic, recreational and psychological needs of youth (ECA, 2001). The
war against AIDS will be won when it is won among the youth—no sooner, no
Overriding attention to
dealing with the disease at the level of the individual, but with little
recognition that the disease was also undermining the ability of systems,
organizations and institutions to cater for the needs of individuals and
society. Education, health and agricultural sectors have been particularly
at risk. The results are already with us in terms of unanticipated
shortages in educational provision (UNICEF, 2000), health care systems
that are being brought to a standstill (UNAIDS, 2000), and food shortages
coupled with the increased production of easier-to-manage but less
nutritious food crops (FAO, 2001).
Failure in many approaches to
be sensitive to cultural and religious perceptions and values, with the
result that suspicions, intransigence and conflict over peripheral issues
(such as condom use) have tended to overshadow what should be a shared world
and community vision of how to respond to the disease.
The Hesitant, Uncertain
Education Response to HIV/AIDS
The uncertainty up to fairly
recently of the education sector's response to the disease is brought out by
the fact that, early in 1994, the International Institute for Educational
Planning in Paris produced and disseminated a very comprehensive report on
how HIV/AIDS was likely to impact the education sector, but almost six years
passed before education ministries began to take on board the contents of
that seminal work (Schaeffer, 1994). During these lost years, the AIDS
situation in general, and in the education system in particular, grew
The constrained response of
education sectors to HIV/AIDS in the 1980s and 1990s was due, among other
Inability to provide for
the basic learning needs of every child, youth and adult.
Lack of appreciation of
the scale of the epidemic and its potential to undermine the education
Absence of strategic
planning for HIV/AIDS in the education sector.
Considerable piloting of
HIV/AIDS education programmes, but with little coordination between
interventions and few, if any, being brought to scale.
Lack of teacher capacity
to deliver relevant HIV/AIDS education.
by educators and system managers that addressing HIV/AIDS raises questions
about their personal HIV status and social behaviour.
Concern lest teaching
content and activities conflict with community, cultural or religious
practices, norms and values.
The tragedy of the past
twenty years is that education sectors worldwide, but especially in the most
severely affected countries, did not get moving early enough to respond to
the demands of HIV/AIDS. When they did begin to take account of the
epidemic, they adjusted themselves in an almost random way to its demands,
cautiously, hesitantly, timidly. Even today, many have not succeeded in
taking on board either the potential of the epidemic to undermine their
systems or, equally important, the potential of the system to counterattack
and undermine the epidemic. They are still in a state of virtual disarray,
inadequate understanding and piecemeal response. They have a multitude of
projects that address facets of the disease, but few coordinated, strategic
programmes that address the challenges on the scale that is required.
In this climate of hesitation
and vacillation, the Call-to-Action, Tirisano HIV/AIDS Programme of 1999
marked a significant advance. However, much of that programme still awaits
implementation. It is the responsibility of this Conference to move the
process forward and to establish a coalition of partners who will ensure
that the education sector in South Africa forges steadily ahead in the
implementation of this comprehensive plan.
Education and the
Prevention of HIV/AIDS
Against this background let
us recall some of the features of HIV/AIDS so that we can better appreciate
why, as the World Bank says in a recent report, "education matters" (World
Bank, 2002) and why it matters.
Why Education Matters
First, there is no cure for
HIV/AIDS, and many scientists believe that because of the nature of the
virus there never will be a cure. The antiretroviral drugs suppress HIV
activity and influence in the body for as long as they are being taken, but
these drugs raise a host of problems relating to their cost, their continued
effectiveness, the demands of administration and patient monitoring, dangers
of resistance, and the creation of a false sense of optimism. This is not to
decry their use, but just to flag that they are not a universal panacea for
Second, there is no vaccine.
Work on vaccine development is proceeding in several locations, all of them
with relatively small research facilities and funds and with none of the
major pharmaceutical companies being involved. The latest word from the
International AIDS Vaccine Initiative (IAVI) is that we should no longer
think of an AIDS vaccine just as possible but confidently say that it is
probable (Berkley, 2002). But it will still be several years before that
probability becomes a reality. Moreover, unless action is taken in the very
near future to provide the human and physical infrastructure that will be
needed for the production and administration of a vaccine to hundreds of
millions of individuals, it will be several years after that again before an
affordable vaccine becomes universally available.
With no cure available, no
vaccine in immediate sight, and no consensus on how to answer the many
questions surrounding drug therapy, we must, in the words of the United
Nations, make prevention the mainstay of our response (UNGASS, 2001). But
there can be no prevention of HIV transmission without either the
maintenance of behaviour that will protect oneself and others, or the change
of existing behaviour so that it becomes protective of self and others. The
only way of ensuring this is through education, regardless of the
circumstances, age of the individual, or nature of the intervention. To
maintain existing ‘safe’ behaviour or to adopt safe behavioural practices,
some form of education is necessary. Given this education, the other
supports provided by society can be brought into play. In its absence, they
remain useless. For instance,
At the level of practice,
messages about the risks of unprotected sex are essentially educational,
as are messages about abstinence or condom use.
The same is true for
messages about fidelity in marriage or about reducing the number of sexual
This also holds for the
ensemble of information, appropriate practice and drug treatment for the
prevention of parent-to-child transmission, all of which imply
considerable behavioural changes in the context of some minimal education
In this sense, education is a
crucial and currently essential element in society’s armoury against HIV
transmission. It is a necessary, integral component in all prevention
activities, though not of itself sufficient.
Education, HIV/AIDS and
A second major reason why
education must play a crucial role in preventing HIV transmission is because
its principal beneficiaries are young people, ranging in age from infancy to
young adulthood. It is mostly the young who are in schools, colleges and
universities, developing the values, attitudes, knowledge and skills that
will serve them subsequently in adult life.
But if education is largely
the sphere of the young, so also is HIV/AIDS. About one-third of those
currently living with HIV/AIDS are aged 15–24, while more than half of all
new infections—about 7,000 each day, or five each minute—are occurring among
young people (UNAIDS, 2001).
Recognizing that the young
are especially vulnerable to HIV infection, the United Nations has
established definite time-bound targets for the reduction of HIV
transmission among young people. These targets set clear objectives that
should direct our plans and activities in the education sector:
By 2005, reduce HIV
prevalence among those aged 15 to 24 by 25 percent in the most affected
By 2005, ensure that at
least 90 percent of young men and women aged 15 to 24 have access to
information, education—including peer education and youth-specific HIV
education—and services necessary to develop the life skills required to
reduce their vulnerability to HIV infection; in full partnership with
youth, parents, families, educators and health-care providers (UNGASS,
2001, §§ 47, 53).
In these terms, the challenge
before us at this Conference is to galvanize our education sector to play
its part in bringing about a very substantial reduction in prevalence rates
among school, college and university students from their current very high
Will the sector be able to
achieve this? Evidence from elsewhere suggests that it will. In Zambia, HIV
prevalence among 15 to 19 year-olds in Lusaka dropped from 23 percent in
1994 to 15 percent in 1998 and in Ndola from 21 to 16 percent in the same
period. A significant feature of this decline, which was observed both among
those attending antenatal clinics and those in population-based surveys, was
that it was most marked in those with higher levels of education, whereas
there were signs of continued increase in prevalence among the least
educated—a girl attending school was three times less likely to be HIV
infected than an age-mate who had dropped out of school (Fylkesnes et al.,
2001). Something similar was found in Zimbabwe where a large population
survey showed that those attending school had much lower prevalence rates
than those who were not in school (Gregson, Waddell & Chandiwana, 2001).
Uganda has also registered significant success in reducing HIV prevalence
among young people, with at least some of the credit for this going to the
education sector (Kaleeba et al., 2000).
These achievements show that,
at the minimum, formal education plays a key role in protecting young people
against HIV infection (Bennell et al., 2002, p.21). Even further, they also
suggest that in ways which are not yet clearly understood a general basic
education is making its own specific, intrinsic contribution to the
reduction of HIV prevalence rates among young people (cf. Coombe & Kelly,
2001; World Bank, 2002). Education does work against HIV transmission. It is
an effective "social vaccine".
This has major implications
for the sector. First, there is need to ensure that every child and youth
can have access to education for a certain minimum number of years. The
attainment of the international millennium development goals that refer to
education-for-all (EFA) are crucial to overcoming HIV through education.
Every young person must be enabled to attend an educational institution for
as many years as possible, and within this framework special attention must
be given to ensuring the participation of girls over an extended period of
years. The achievement of the millennium EFA goals will itself go a long way
in responding to the AIDS challenge.
Second, we must ensure that
within all educational institutions real and meaningful learning takes
place. Basically, this is what we are about as educators, regardless of the
level at which we operate. No matter how well attended schools and colleges
may be, in the absence of worthwhile learning, they will not contribute as
they should to economic independence, poverty reduction, personal
empowerment, gender equity. Neither will they promote the knowledge and
understanding that are fundamental to the reduction of HIV transmission.
Those leaving school will remain a prey to the poverty trap which will see
many of them being sucked into prostitution, becoming street children,
living in circumstances of female subordination, and experiencing other ways
of life that will increase their risk of HIV infection. They will also
remain much weaker than they should be in the face of HIV risks. The same
remains true of programmes for those who do not participate in the formal
education system. These will accomplish their goals only if they enable
learners to incorporate the "useful knowledge, reasoning ability, skills,
and values" that will stand by them in life, while enlarging their capacity
to protect themselves against HIV infection.
Integrating HIV/AIDS into
But over and above this,
there must be a wholehearted effort to mainstream HIV/AIDS, sexual and
reproductive health, and lifeskills education into the curriculum of every
learning institution. The objective would be to empower participants to live
sexually responsible, healthy lives. This education must start early and it
must be done well. This has major implications
First, this subject area must
be properly professionalised, with the development of a corps of educators
and teacher educators who are the specialised professionals in this field.
We invest heavily in the multilevel preparation of teachers for mathematics,
science, initial literacy, languages, the arts, and other areas—subject
areas that prepare children and young people for life. We must also
invest heavily in the multilevel preparation of educators for HIV/AIDS,
sexual and reproductive health and lifeskills—subject areas that enhance the
likelihood that children and young people will live. For too long we
have toyed with this discipline and in doing so not only have we
marginalized it but we have also failed to equip children and the young
people who are at grave risk with knowledge, skills, attitudes and values
that could mean the difference between life and death for large numbers of
Further, as a professional
discipline in its own right, HIV/AIDS, sexual and reproductive health and
lifeskills education must be fully integrated across the curriculum (Tirisano
HIV/AIDS Programme, Project Two) and into the educational system. It is not
an optional extra. It is not an add-on. It is not something that can be
picked up in spare moments of a biology or social studies lesson. It is a
crucial stand-alone area that necessitates separate timetabling, the support
of appropriate materials, and the provision of all the backup guidance,
training, teacher support structures, monitoring and evaluation that other
subjects receive (Bennell et al., 2002).
Finally, because HIV/AIDS,
sexual and reproductive health, and lifeskills education transcend more
freely than any other discipline the boundary between what goes on inside
and outside an educational institution, this subject area calls more
strongly than any other for the involvement of communities and parents on
the one hand and social and health services on the other. This is where
coalition, the unifying principle of this Conference, must come in.
Educators cannot do everything alone. They need the support of parents and
communities and the assurance that they approve of the contents and methods
of what they teach. They do not want to be in uneasy conflict with them or
with their cultural or religious perceptions. Educators also need to have
health and social service providers working alongside them in this area,
providing guidance, counselling, testing, services, supplies and referrals
that go beyond what educators as such can be expected to provide.
There are two further reasons
why partnerships involving these various constituencies are of such
importance. They bridge the divide between school and community or home,
thereby making what is incorporated through education more real and relevant
to life outside of school; and, secondly, they ensure that everybody speaks
with one voice—no matter what its source, the message to the young is always
the same, a factor that continues to be critical to the success Senegal and
Uganda have experienced in coping with HIV/AIDS.
Clearly, going down this road
of wholehearted integration of HIV/AIDS and lifeskills education into the
curriculum entails massive changes. It also entails major sacrifices, such
as foregoing curriculum time for other subjects, and new ways of doing
things, such as bringing the community more purposefully on board when
designing the curriculum and possibly even for certain teaching activities.
If this leaves some of us feeling uncomfortable, let us remember the words
of the United Nations Secretary General, "this unprecedented crisis requires
an unprecedented response" (United Nations, 1999).
For us in education, radical
curriculum overhaul is part of that unprecedented response. The world with
AIDS is not the same as the world without AIDS. Education and the
curriculum, in a South Africa that is reeling under the massive impacts of
HIV/AIDS, cannot be the same as in an AIDS-free South Africa. And it may
well be that we will never see an AIDS-free South Africa unless we take the
bold steps needed to adjust our education and curriculum systems. Education
can cure us. It is the social vaccine that can lead us progressively to a
world without AIDS—but not in its present form, not unless we make the
necessary changes, not unless we adjust it purposefully for use as a channel
for preventing the transmission of HIV infection.
From Prevention to Support
Prevention alone is not a
complete response to HIV/AIDS. Prevention may be the mainstay of our
response since successful prevention education will reduce the numbers who
become HIV infected and eventually cause them to taper off. But we still
have to face the legacy of the past two decades of confused and inadequate
response. Our heritage today is one of broken lives, distressed people, and
orphaned children. The grief and the anguish of the men, women and children
of our time surround us on every side. Our milieu is one of physical and
psychological pain and suffering, multiple bereavements, mourning and
heartbreak, dehumanizing poverty, lost opportunities, unfulfilled hopes,
The education sector cannot
stand aside from this. Those who are suffering are its own clients and
providers, whether they are themselves infected with the disease or whether
they are members of the great multitude of those who have been affected by
it in one way or another. Let us remember that unlike other sectors in
society, the education sector is highly person-intensive. Its fundamental
technology of one teacher with a class of fifteen to fifty students has
remained the same for thousands of years. Educators and education support
personnel constitute the largest proportion of public service employees. The
vast numbers of students to whom they reach out constitute a significant
proportion of the population. All told, an education sector may well involve
a quarter or more of a country’s population. Because it is so
person-intensive an education sector is particularly vulnerable to the way
HIV/AIDS can scythe its way through its personnel and operations, affecting
the present adult generation in the persons of educators and support
personnel and the coming generation in the persons of learners.
The outcomes are there for us
to see. There may be debate about precise numbers and percentages, but none
of us can deny the reality that HIV/AIDS is having a catastrophic impact on
educators and learners. We see this in
The increased mortality of
teachers and education support personnel.
The discontinuities in
classroom and learning activities because of teacher and learner sickness.
The anxiety so many
experience regarding their HIV status, yearning to know about it, fearing
to hear about it.
The trauma and distress
brought into the classroom by children who are in daily contact with the
dehumanizing illness of a parent or other loved adult.
The termination of studies
by older students who have progressed to clinical manifestations of AIDS.
The sense of
disorientation, catatonic detachment and second-rate status of orphaned
children who have never known the "time of joy and peace, of playing,
learning and growing" that the World Summit for Children saw as being
their prerogative (UNICEF, 1990).
The education sector has a
responsibility to take account of this multi-faceted situation of distress
in which so many of its learners, educators and support personnel find
themselves. It must position itself to respond to the special need for care
and support that HIV/AIDS is creating in learners. Likewise it must respond
to the need for care and support that the epidemic is creating in educators
and education personnel. But in both cases it must do so in accordance with
its own proper character as an education sector. Because it is so
person-intensive, the education sector cannot separate itself from health
concerns. Neither can it divorce itself from the provision of social
services. But it must make its own characteristic response, as a provider of
educational services and as a major employer, to the differing needs for
care and support that learners and educators infected with or affected by
Regarding learners, the
sector must above all else make a coherent response to the challenges
presented by orphans and those experiencing the trauma, discrimination and
financial difficulties that all too frequently arise when there is AIDS in a
family. It must also take account of the needs of learners who are HIV
Responding to the Orphans
HIV/AIDS is bringing a
massive increase in the number of orphans. Currently there are some 12.5
million learners in all learning institutions combined. One projection is
that in a few years time, there will be more than 3.5 million children under
the age of 15—more than 30 percent of this age group—who will have lost one
or both parents, mostly because of AIDS (Hunter & Williamson, 2000). It can
be expected that social and financial problems will make it difficult for a
significant of these to participate in schooling in the ordinary way. As
they grow into late adolescence, many will not have family structures for
their support through higher education, as we are experiencing to our cost
in Zambia. The learning capacity of those who participate in educational
programmes may be severely impaired by their sense of personal loss, their
uncertain status in the households of relatives or friends, and their
experience of being set adrift in life before their due time.
Faced with so great a
challenge, which is escalating by the day, the education sector must be
prepared to guide a rapid extension of actions directed towards immediate
and long-term solutions that respond to the educational and human rights
needs of orphans and other vulnerable children. This should be done right
now, when there is time, before the dimensions of the problem grow so large
that they become unmanageable. We have let AIDS become virtually
unmanageable. We should not let anything similar happen with orphans. This
is a special challenge at the moment not only for the Department of
Education but also for universities, colleges of education, and individual
schools. Collectively they must devise an adequate educational response to
ensure that in imaginative and creative ways children orphaned by HIV/AIDS,
or vulnerable for any other reason, can be educated in a way that will help
to compensate them for their human loss while preparing them for a full and
satisfying human life.
For the education sector,
this means paying attention to the following:
Ensuring that children of
school age in communities seriously affected by HIV/AIDS have the
opportunity and financial means to receive education of good quality.
attention to the school and education needs of girls who are frequently
required to assume a disproportionate share of the responsibilities
associated with caring for siblings and parents who are ill.
pre-school facilities and programmes, with a view to giving older siblings
the time and opportunity to attend school.
schools and other innovative forms of educational provision for orphaned
and disadvantaged children.
Making use of information
and communication technologies, including interactive radio and other
forms of distance education, with the twofold objective of bringing
education out to children who are unable to come in to school and of
providing some compensation for the AIDS-related loss of qualified
Putting ‘orphanhood’, the
strengthening of family and community caring/coping capacity, and coping
with HIV/AIDS trauma at the centre of the research agenda in universities
and social research units. It is estimated that at least 99 percent of the
children who have been orphaned and otherwise made vulnerable by AIDS are
living within their extended families and communities, though often with
great hardship (CID, 2001), but the scientific understanding of coping
strategies and tolerance limits is not commensurate with the scale of the
Determining whether it
would be desirable and productive to establish orphans and vulnerable
children desks at central, provincial and district levels to maintain the
momentum of the response to the orphans challenge.
Some further observations are
in order in relation to responding to the orphans challenge. One is that
here, possibly more than in any other area, there is need for a dynamic
coalition of all partners. This is not something that the education sector
can address all on its own. The response must be based on the collaborative
involvement of central and local government institutions, NGOs, faith-based
organizations, and communities themselves. Second, there is need for a
bottom-up approach to dealing with orphans and other children made
vulnerable by HIV/AIDS. Very rightly, the majority of orphans live in
communities and so must be supported by community-based initiatives. The
various partners, including the education sector, should promote and support
such initiatives. But these must remain initiatives of the community,
developed at the local level and not in central or local government offices
or in the offices of NGOs or faith-based agencies.
Thirdly, the education sector
could contribute to forestalling growth in the magnitude of the orphans
problem by spearheading a campaign to keep mothers alive. In the
circumstances of HIV/AIDS, keeping mothers alive means being prepared to
provide antiretroviral treatment not only to HIV positive pregnant mothers,
but also to all HIV positive mothers with young children who still stand in
need of their mothers' care. Without the mother the family falls apart. It
is essential that mothers be enabled to stay alive and thereby prevent the
disintegration of the family and the burgeoning in the number of orphans.
The provision through life of antiretroviral therapy for these mothers will
be at significant economic cost. But it is a cost that will pre-empt even
more costly economic and social outlays if families fall apart and orphan
numbers continue to swell.
Responding to Trauma
HIV/AIDS also affects
learners through the trauma, silence, prejudice and discrimination
frequently associated with it. Trauma and psychological distress may arise
from the experience of seeing a parent or other loved adult enduring
remorseless suffering and a dehumanizing death, from anticipatory grief in
the face of one’s impending orphan status, from observing the physical
deterioration of a teacher or fellow-student, from the repeated occasions
for mourning and grieving in the school or community. Prejudice, frequently
symptomatic of fear, and discrimination arise from the negative and
judgmental attitude shown by some towards HIV/AIDS and those affected by the
disease. Even in the absence of any overt discrimination, learners from
affected families may experience subtle forms of prejudice manifested in
their being isolated or in having to bear the taunts and derision of their
The experience of trauma or
discrimination may lead some young people to discontinue their education or
be erratic in participation. Others may find that they are not able to learn
as they ought. Educators and school heads may be at a loss as to how they
should cope with the emotional, psychological and resulting behavioural
problems that students may present.
Clearly, there is great need
for an enlarged cadre of guidance and counselling personnel, qualified to
provide the assistance that is needed, and with the space and time to do so
in the way that is required (Bennell et al., 2002, p. 46).
Appropriately qualified professional counsellors in educational settings
should be enabled to extend their services both to learners in distress and
to educators who need assistance in school-related matters or who are
themselves enduring AIDS-related psychological turmoil.
Expanding the cadre of
counselling personnel will require enlarged and possibly revamped programmes
in universities and training institutions. It will also require national and
provincial education departments to re-examine their staffing norms. Hard
decisions may have to be made that give priority to this area, ahead of more
traditional concerns. The education departments and the training
institutions may also need to consider the appropriateness of including
training in counselling skills (and ability to provide lifeskills and
HIV/AIDS education) as an integral part of all pre-service teacher
preparation programmes. The crisis situation in schools and institutions
calls for some such crisis response.
Responding to the Needs of
It is necessary to face the
sad fact that already many students, in institutions of learning at all
levels and perhaps even more so in non-formal educational programmes, are
HIV-infected. Moreover, these numbers will increase. A small percentage of
those to whom their mothers transmit the virus perinatally may survive to
school-going age and beyond, carrying infection with them through school
days and further. The unfolding picture of extensive child abuse reveals
another potential channel whereby children and minors can become infected
with HIV. In addition, the Human Watch and other reports have documented the
extent of coerced sex and rape to which girls are exposed, the heavy
involvement of teachers and male schoolmates, and the way this can be linked
to HIV infection (George, Finberg and Thonden, 2001; Coombe, 2002; Jewkes
et al., 2002). There has also been some documentation of the incidence
of HIV in tertiary institutions, in addition to evidence of its progression
to AIDS in certain cases (Chetty, 2001; Kelly, 2001).
The picture that emerges is
of a significant number of children in primary and secondary schools who are
infected with HIV, a relatively small number (mostly in secondary schools)
who show signs of AIDS, a comparatively high percentage in tertiary
institutions who are HIV positive, and because of the time lapse between HIV
infection and clinical AIDS, a much lower percentage who have progressed to
What response can the
education sector and institutions make to the special needs of these
learners? Perhaps the first need is to establish an atmosphere of acceptance
and welcome where there will be no suspicion, no anxiety on anybody’s part,
and certainly no stigma or discrimination. It may take considerable skill to
educate all members of a school community, as well as parents and other
stakeholders, to this, but the human dignity of infected learners cannot be
upheld with anything less. The full integration of HIV infected learners
into the life and affairs of a school or college affirms in a powerful and
natural fashion the principle of inclusion of people living with HIV/AIDS
enunciated at the African Development Forum in 2000 (ECA, 2001).
There will also be need to
make special provisions to enable those whose learning is interrupted by
illness to make up for lost time and catch up on lost opportunities.
Responding to this need can be a very practical expression of acceptance.
Since this makes its impositions on educators and, through them, on other
learners, it may also be the touchstone by which the humanity of an
institution can be gauged.
Educational institutions can
also use one specific curriculum area to manifest support for those who are
HIV infected. This is by putting emphasis in appropriate parts of the
curriculum on the importance of a healthy lifestyle. Healthy living is one
way of slowing down the progression from HIV to clinical AIDS. All other
things being equal, infected persons who maintain a healthy life style are
likely to enjoy more years of life than infected persons who do not take
balanced nourishing meals, who smoke, take alcohol or use drugs, and who do
not take adequate exercise and rest. Information about the significance of
living in a healthy way is an important message that educators can always
communicate, without fear of giving any offence to parents or other
stakeholders. It is also a universal message, which is of value to all
learners, irrespective of their HIV status. But for the infected, it could
also be a life-saving message since, given the developments in vaccine
technology, living in a healthy way might help keep a learner alive until
such time as a vaccine applicable to infected persons becomes available.
Finally, having ascertained
that this is what parents or guardians would want, the school or college
should establish systems that would allow the social, welfare and medical
providers play their proper role when their services are specifically
needed. It would be valuable to explore the possibility of involving the
wider community of parents, and of community and faith-based organizations,
in aspects of these services, such as in providing transport. This would be
integral to the education coalition against HIV/AIDS.
Providing Support for
In addition to counselling,
the education sector must consider what other forms of support it can
provide to educators who are affected by AIDS. The sector is the largest
employer in the country. There is no reason to think that its employees are
less infected with and affected by HIV/AIDS than those in other areas of
formal employment. In fact there are some grounds for thinking that they may
be more so. What support can the sector offer in a situation of personal HIV
infection, or where this is occurring in educators’ families, or where they
encounter it in the classroom?
Perhaps the basic thing is
for the sector to demonstrate care and concern through its regulations,
procedures and systems. These range from those governing absenteeism and
time off, through those that relate to the workplace, to those concerned
with medical schemes, disability, retirement and death benefits. Clearly
every one of these may need to be adjusted in the light of what HIV/AIDS is
doing or could do to sector employees. It would not be appropriate for an
outsider to go into details on any specific area, but the following broad
issues deserve consideration:
The desirability of wide
consultation and the involvement of educators and support staff in
AIDS-occasioned reviews of regulations, procedures and systems. Of
particular value here would be inputs from educators who are themselves
living with HIV or AIDS.
Measures to protect
educators against burnout due to AIDS-related work overload or stressful
Making provision for the
speedy appointment of replacements and substitutes when staff are ill or
die so that, among other things, an undue burden will not be placed on
institutional managers and other surviving staff.
Express recognition of and
allowance for the way women employees remain responsible for providing
much of the health and child care in the home and for holding a family
together in time of crisis, death or financial difficulty.
Ensuring that local
administrators and institutional heads have sufficient autonomy to make
humane staff-related decisions in response to the potentially surprising
or unexpected effects of HIV/AIDS.
The provision of credible
HIV/AIDS education-in-the-workplace programmes for staff in all
institutions and education offices.
The development of every
education establishment as a health promoting and health affirming
institution with systems in place to ensure access to treatment for
opportunistic infections and tuberculosis.
The possibility, including
the cost-effectiveness, of providing educators with antiretroviral
treatment, or of having this included in medical schemes, in view of the
scarcity value of many of them and the crucial role that all of them play
in the prevention through education of HIV transmission.
Vigorous and sensitive
public relations efforts to ensure that every educator perceives the
sector as caring and concerned.
Caring for the Education
The Threat to the Sector
HIV/AIDS places every system
and institution under profound threat. The epidemic and the variety of its
impacts have the potential to overwhelm them, debilitating them in somewhat
the same way as they debilitate individuals. When a person is infected with
HIV, the immune system slowly but inexorably breaks down, leaving the
individual vulnerable to the hazards of several opportunistic illnesses. The
disease does something similar to institutions and systems. In the absence
of appropriate protective measures, these are likely to experience various
problems that can develop to the stage where institutions or systems are no
longer capable of functioning in the way they ought. Ironically, the very
system that should be strengthening society’s ability to protect itself
against HIV/AIDS may itself be in danger of succumbing to the disease, as
the following considerations show:
HIV/AIDS has negative
effects on learners. Numerically they are fewer. Financially, they are
less able to support their education. Psychologically, they are less well
able to learn and may not even want to be educated. Socially, many of them
are orphans, some of whom may be heading households.
HIV/AIDS has negative
effects on educators. Deaths are very numerous. Many experience frequent
and progressively more extended bouts of sickness that prevent their
proper functioning. Many experience sickness in their family. In
institutions where deaths are numerous and replacements inadequate, morale
HIV/AIDS has negative
effects on departments and agencies responsible for the provision of
education services. It does not spare technical, supervisory and
managerial staff. Dealing with it absorbs a disproportionate share of the
scarcest and most valuable resource possessed by these bodies, the
expertise and time of their staff. In addition, because HIV/AIDS creates
new and competing resource demands at national community and household
levels, resources for education are under threat.
HIV/AIDS has negative
impacts on the quality of education provided. Learning achievement, the
very touchstone of quality, is rapidly eroded by frequent teacher
absenteeism, shortages of teachers in specialised areas such as
mathematics or science, intermittent learner attendance, considerable
educator and learner trauma, inability to concentrate on learning
activities because of concern for those who are sick at home, repeated
occasions for grief and mourning in school, in families, in the community,
a widespread sense of insecurity and anxiety among both educators and
Taking Action to Safeguard
Faced with the immense task
of responding to these and other negative impacts, the education sector has
the formidable task of ensuring adequate levels of quality education that
take due account of the epidemic. Protecting HIV/AIDS-threatened education
systems, so that they can continue to provide and, where necessary, expand
education and training, requires efforts directed at stabilizing the system,
mitigating impacts on learners and educators, and responding creatively and
flexibly to the varied, demanding and surprising imperatives of the disease
(Coombe & Kelly, 2001).
Stabilizing the system means
that departments and providing agencies must ensure that even under attack
by the pandemic, the system works so that teachers are teaching, children
are enrolling and staying in school, older learners are learning, managers
are managing, and personnel, finance and professional development systems
are performing adequately.
Mitigating the pandemic’s
potential and actual impact on all learners and educators (and therefore on
the system as a whole) implies ensuring that those affected and infected by
the disease can work and learn in a caring environment which respects the
safety and human rights of all. Of major concern here would be efforts to
make the system fully and patently inclusive by challenging all forms of
AIDS-related stigma and discrimination, providing for the most extensive
possible participation by persons living with HIV/AIDS, and rooting all
provision in strong human and child rights frameworks. A further concern
would be to bring it about that each and every learning institution is a
haven of safety for all who are associated with it, with zero tolerance for
violence, harassment or sexual abuse.
Mitigation efforts should
also be addressed to providing counselling services; making provision for
voluntary counselling and testing; working with social welfare and health
ministries to provide learner-friendly services and adequate supplies; and
ensuring responsiveness to the special needs of infected or affected
learners and educators.
An education system responds
creatively and flexibly to HIV/AIDS when it continues to provide meaningful,
relevant educational services of acceptable quality to learners within and
outside the formal system, in complex and demanding circumstances. This
creative response will require a policy and management framework that can
make things happen. Key components of this framework include:
Committed and informed
political and educational leadership.
management partnerships with other government sectors, non-governmental
organizations, faith groups, community groups, and the private sector.
A policy and regulatory
framework that includes common understanding about the nature of the
pandemic and its potential impact on education, as well as guidelines,
regulations and codes of conduct which clarify the responsibilities of
Strategic and operational
planning processes which lead to realistic and realizable operational
The appointment of senior
full-time mandated HIV-and-education managers at all levels and within
Capacity building at all
levels of the system, and adequate provision for personnel replacement and
research agenda that can develop understanding of the multi-faceted impact
of the disease on the system and that provides for the regular monitoring
of a set of benchmarks and crisis indicators.
provision with streamlined access to resources.
In essence this means that at
central and provincial levels the Department of Education must commit itself
to a major exercise in strategic planning for its response to HIV/AIDS. The
same holds for non-governmental bodies that provide educational services,
whether through formal or non-formal systems, as also for universities and
other major semi-autonomous educational bodies. In the absence of a
strategic framework, the response to the epidemic is likely to be haphazard
and ad hoc. The strategic approach ensures better coordination and more
comprehensive incorporation of issues, while the process of developing a
plan generates understanding, ownership and commitment to outcomes.
The Way Forward
On the basis of the
considerations raised in this paper, a number of principles and activities
emerge that can constitute a powerful and dynamic response from education
and training sectors to HIV/AIDS. Doing something about all of these would
see an education system really doing something about AIDS. Likewise, acting
in the ways that are proposed would protect the education system so that it
does not collapse under the onslaught of the pandemic.
The principles and actions
are as follows:
Get every child,
especially girls, into a school or appropriate educational programme, and
keep them there for as long as possible.
Expose learners to a
curriculum that takes full account of HIV/AIDS realities, be these in the
sphere of life skills, sexual and reproductive health, cultural,
traditional and moral imperatives, changing economies, the loss of skills
by society, the need for school leavers to engage in economic activity at
a very young age, or wherever.
Take steps to ensure that
each class has a teacher, that arrangements and resources are in place to
cover replacements and substitutes, and that all serving and new teachers
come to be comfortable with the curriculum modifications which must be
made in a total response to HIV/AIDS.
At the school or
institutional level, work very closely with communities and parents,
arranging for the school community to serve the HIV/AIDS needs of the
local community and for the local community to participate with the school
in the delivery of its HIV/AIDS-responsive curriculum.
At district, provincial
and national levels, form broad-based partnerships that will bridge the
gap with NGOs, the private sector, faith communities, and relevant
government departments, and that will ensure the participation of every
part of society in supporting the efforts of schools and communities.
departments at central, provincial and lower levels, establish AIDS
management units that will have the authority, resources and time to get
Get good information on
what is happening in the system, through impact and response assessment
studies, and through the regular collection of HIV/AIDS-related data.
management and financial systems that will incorporate HIV/AIDS-related
projections and data from the sector.
Review and update all
legislation, policies, regulations and procedures to ensure that they are
relevant to the HIV/AIDS situation and that they are friendly to people
living with HIV/AIDS.
AIDS-in-the-Workplace training, information and support programmes at all
levels and within institutions, basing provision and activities on a
continuum that runs from prevention to care.
Expend considerable effort
in building capacity at all levels for planning, management, resource
management, resource mobilization, and speedy but transparent financial
disbursement, in response to identified HIV/AIDS priorities and needs.
Coordinate, monitor and
evaluate all that is going on, and disseminate to practitioners
information about HIV/AIDS in the system and about good practices for its
Three further simple
principles provide guiding frameworks for these activities and
interventions: be open, be committed, be confident:
Be open to what is new,
untried or unusual. Recognize that the disease and its impacts can be
surprising. Be prepared to question and adapt all that already exists,
since an education system with AIDS differs greatly from an education
system without AIDS.
Be committed. Recognize
that the gravity of the situation requires dedication and commitment,
often beyond the call of duty, from every educator and official, but most
especially from those of senior or executive rank.
Be confident that
education can do it. Education can make a difference. The future need not
be the same as the past (Whiteside and Sunter, 2000, p. xi). The future
can be brighter and better, and education has a significant role to play
in making it so. The statistics are bad, so bad that this may be our
darkest hour. But remember, after winter summer comes, after the night day
comes, after the storm a perfect calm ensues. Be confident that education
can usher in this new bright, calm, era of an AIDS-free world and be proud
that you can be part of such a movement.
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