"NGOs will come and go but HIV & the Community is here to stay”, says Dr Joyce after her first brush with ACP and then what happened…

[I met this elegant, graceful lady at an ACP learning event in Dimapur last month- Dr Joyce Angami. She is a medical doctor by profession and has vast experience in the field of HIV. Here she shares her experience in the first SALT visit.]

The team went on a SALT visit to Molvom (known as the pineapple Village), which is about 45 minutes drive from Dimapur, Northeast India. It was a hot day but the surroundings were really clean and fresh. The whole community waited for the planned visit, the leaders warmly welcomed us. The initial meeting took place at the church hall, which was built by the volunteers (local builders), after they were trained by two masons from Dimapur on how to bend the iron rods to put up an RCC building (this newly acquired skill was subsequently used for the benefit the neighboring villages). After the formal introduction of the team and the community members we were divided into different groups of men and women for interaction.

I was placed with the young women group. We were told of the heroic feats performed by the community women in curbing the flow of drugs in and out of the village in the 1990s, during the peak of rampant Drug abuse in and around the neighboring villages. During this period the serenity of the community was disturbed, petty theft, conflict within the families/ community was a common feature. The women group with the support of the men folk kept 24 hours vigil over the 5 entrance to the village in rotation. The relentless efforts of the women paid off in the reduction of new entrance into drug use and abuse and serenity in the community restored. This action reflected the strength there is with the people, the identification of the problem, and collective work plan for tackling the problem using the capacity/resource within the community.

Among other concerns, they shared that there were AIDS orphans in the village looked after by the grandparents. Although there is no stigma and discrimination towards people living with HIV, they stressed the need to equip themselves with factual knowledge on HIV by establishing peer networks within the community and seeking avenues to capacitate themselves through agencies versed in HIV, to be followed by conducting seminars for the women groups first and then other groups on how to effectively address HIV issues.

The presence of many young mothers was observed. When asked the reason for this, they replied that falling in love and fearing parental disapproval led to elopement, which is a common practice. Therefore, few church weddings takes place. The young mothers expressed their desire to see more church weddings in the village. How do they plan to do achieve this? They plan to involve their husbands in getting to know their children better & spend quality time with their young children and thus building strong family relationship, involve the church in setting standard teaching on the gift of life and facts of life from the bible, and ask the community leaders to be role models in setting moral standards.

Besides the group specific learning, the team appreciated the leadership and strength of the community, the willingness to learn new skills/ in solving problems within the community from the resources within the community. The best part of the SALT visit was to find the absence of unemployment problem - all persons are employed in agriculture including pineapple fields - which has created work for all.

This initial exposure to ACP– SALT visit, is a new thinking and a way forward to HIV prevention/ care and support. Appreciation leads to realization of strengths of the community, creates ownership of the problems and through collective wisdom of the community finds a solution. It stimulates community to dream of a community free of HIV. The NGOs will come and go but HIV & the Community is here to stay. Therefore, initiating an AIDS Competent Community will complement the existing HIV programmes and Services. In conclusion, AIDS Competence will remain- the other Way to HIV Prevention/ Care.

[The story didn't end here. With support from Fr Joe of PNF, the ACP Team for Kohima was formed on 17th June 2009 consisting of Mr. Khriebu Nakhro, Chairman YARD, Ms Bazo Kire, Project Director, Kekhrie Foundation and Dr.Joyce Zinyu Angami, Projects Manager Nossal institute (India).]

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Comment by Gaston on July 11, 2009 at 2:14am
Dear Magdalene,

I gave your question some more thought (also as I was visiting Kenya Competence last week). Some experiences when applying the process to education or disaster reduction:
1. See this Ning discussion on how Joseph in Sierra Leone and Sirinate in Thailand have applied the method to 'School Competence' http://aidscompetence.ning.com/forum/topics/school-competence-pilot-apex?page=1&commentId=2028109:Comment:8532&x=1#2028109Comment8532
2. SALT and the way of thinking remains quite the same when applying it to other issues. We still look for strengths, we still appreciate and learn from the community and we still facilitate instead of being experts
3. However, the content of the tools often will change. To develop a self-assessment framework for your community and practice it I once put this in 5 steps for a proposal for a partner. I'll copy it here for you:

The Competence process has been successfully adapted to several other issues. Examples are vulnerability of street children (Philippines), community preparedness for influenza pandemic (Liberia), diabetes (India, Burundi), Reproductive Health (Indonesia, DR-Congo), dental hygiene (Thailand) and disability (Belgium, Mozambique). In each case, the nurturing of the community’s capacity to respond was a key success factor. The approach can be applied to issues that ADB deals with, which require change in behavior. An example might be the improvement of road safety in India . The following steps could be taken:

1. Invite specific actors (NGOs, community members, other stakeholders) that currently work on the issue to be trained in the facilitation of ‘disaster reduction or education competence’. The process entails the transfer of a certain way of thinking, facilitation skills and use of tools.

2. Co-create a self-assessment framework on the topic with the participants. Start with building their dream for their 'risk-free community'. Then when consolidating the community dream, ask them what practices lead to this dream? The self-assessment framework is developed from experience and used to provoke discussion and stimulate response. The assessment measures the key practices that lead to road safe competent communities. There are 10-15 key practices each with 5 performance levels from BASIC to HIGH. Groups are invited to assess themselves, set targets for improvement and build their action plan using their own resources. The creation of the self-assessment framework is part of the process which establishes a common vision.

3. Facilitation teams facilitate the process including self-assessment in selected geographical communities for at least 18 months. Experienced coaches can accompany the new facilitators once every three months for continuous learning.

4. Communities take action, measure their own results, exchange with others and renew action plans during this period. Through realizing their progress and a sense of ownership community action is sustained after the project period.

5. Capture progress (i.e. reduction mortality, education improvement etc) and share amongst a wider community the local responses that have led to this progress through Knowledge Assets .

I facilitated meetings to extract new self-assessment frameworks before and it works well if you start from the dream. Take your time for these things and make sure all participants feel ownership of the outcome.

I hope this helps! I'll be in Nairobi on the 24th of July if you want to discuss further.

Kind regards,
Gaston (Facilitator, Transfer. The Constellation)
Comment by Jiji Joseph on June 30, 2009 at 11:28am
Dear Dr. Joyce
It is inspiring to hear frim people like you with great experience and knack to hold on to the essence of what comes your way.


Comment by Joe Ngamkhuchung on June 30, 2009 at 9:29am
Dr.Joyce was our (NGOs) mentor from 2000. She is a convert to ACP but now has become an ardent applicant and promoter. Yopu have shared your lovely experience of ACP village visit. such experiences enrich our knowledsge trrasury! Our journey has just began on ACP road. Congrats Dr.Joyce. We will long long together.
Comment by Magdalene Kelel on June 29, 2009 at 4:56pm
The story is every inspiring, thank you for sharing.

The thought of application of competence proccess to other issues is very exiting. I come from a community where majority are uneducated. we have been toying around wit a friend on how to apply the process on education and disaster reduction as the area is dry and prone to droughts. the community is pure pastoralist (which means movement during droughts).
Any ideas?
Comment by Rituu B. Nanda on June 28, 2009 at 3:43pm
Dear Bazo and Gaston,

The thought of TB-competence is very exciting. The Kohima team can take it up. We can even brainstorm on this in the upcoming ACP event in Mizoram in October 2009.


Comment by Gaston on June 28, 2009 at 2:19pm
Dear Bazo, thank you for the response. As the Constellation we have been invited several times by organisations to support the application of the Competence Process to other issues that require a change in behaviour, such as Malaria, Diabetes, Avian Flu, Pandemic Preparedness, disaster risk reduction, vulnerability of street children and even dental hygiene.

We would be happy to explore this application to TB further with you. There is no self-assessment framework yet, nor a process for TB, but we have a process to extract the right tools and practices from experiences on the ground. Perhaps we could start this in India/ Nagaland and pilot TB-Competence in a few settings? Who would be willing to support such an initiative?

I am excited already. What do you think?
Comment by Bazo on June 26, 2009 at 10:17pm
Thanks Joyce for sharing with us the strength of the community. Specially the strength of Women!! I am so glad to learn from your article that the womenfolks acknowledged the importance of 'Building strong family Relationship'. There is Hope for the Future!
I find ACP so interesting.... got to learn more ... anyone doing CP for TB? saw one for malaria.
Comment by lolia on June 26, 2009 at 9:39pm
Good one! very inspiring and true. NGOs (projects and programs to be specific) will come and go but HIV is here to stay with the community. the government can provide the drugs and services we need need but people initiative is the only tool to curb the spread of HIV and to care for those who are living with HIV. Power to the People, Power to ACP!!


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