Friday, July 13, 2007
Initial plans are underway! Lifelong AIDS Alliance will be sending me to South Africa with the Association of Nutrition Services Agencies (ANSA) to help develop community-based nutrition interventions for HIV/AIDS programs there. I'm honored, flattered, and (honestly) a bit nervous about the challenges ahead. While Lifelong's food program, Chicken Soup Brigade, is able to draw on the incredible support of our community, it seems that the needs in South Africa far outweigh the available resources.
Yesterday, our delegation had an initial phone conference with our partners in South Africa, Ikamva Labantu (http://www.ikamva.org/). This is an incredible organization with programs serving more than 50,000 annually throughout the country's impoverished townships. Their passion, and their strength, comes from their commitment to empowering communities to care for themselves and their neighbors--hearteningly similar to our experiences here in Seattle with Chicken Soup Brigade. Our initial meetings with Ikamva Labantu will be to understand the environment in which they work, and to discern what we as ANSA member organizations might be able to contribute to their efforts.
I fly out in a week! Wish me luck. More to come.
Wednesday, July 25, 2007
Ikamva Labantu: South Africans helping their Neighbors 
South Africans have a strong sense of pride about their country, and a passion for their communities. In our first few days here in Cape Town, learning about the work of ANSA's partner organization Ikamva Labantu, we have, firsthand, seen many incredible challenges facing residents of South Africa's Western Cape. We have also seen how one wise organization strengthens existing community responses through careful investments of available resources—resources such as facilities, food, health care, information, and people.
South Africa is one of the hardest-hit countries in the AIDS pandemic, with an estimated 5.5 million people--20% of the adult population--living with HIV/AIDS. HIV/AIDS permeates every social and public health issue in the townships just outside Cape Town, where many Black and "Coloured" (mixed-race) Western Cape residents call home. Prevalence is highest in the informal settlements, which are areas of townships where narrow dirt pathways weave through acres of makeshift sheet-metal shacks.
Housing, hunger, poverty, child care, health care, transportation, gender inequality, sexual violence, education, and racism are issues affecting and affected by HIV/AIDS here. The disease challenges community members at every life stage. An estimated 17% of young women ages 15 to 25 are HIV positive, and in some high schools up to 16% of girls are mothers. When parents die of HIV/AIDS, they leave grandparents to care for young children. With insufficient access to health care, working families are disrupted by multiple crises. Tuberculosis is common, and people being treated for TB may discover they are HIV positive in the course of their treatment—with co-infection rates up to 50% for TB and HIV.
The lives of children, working adults, and older adults are all affected by HIV/AIDS, and by issues that are exacerbated by HIV/AIDS. In response, our friends at Ikamva Labantu offer programs that help communities address their challenges. They support senior centers where older adults can socialize, have a nutritious lunch together, access information and resources, and let their grandkids play. Other community centers offer daycare facilities for children 2 months to 6 years old, whose parents and foster parents either work or face other challenges in providing adequate care. And, at these sites, Ikamva’s "Development through Play" programs help introduce young children to classroom learning—an environment they might otherwise be completely unprepared for.
Ikamva’s many programs benefit from shared resources. For example, daycare centers share space with the Food Garden project, where community members help grow fresh vegetables. These vegetables are used for daycare lunches as well as for feeding programs at senior centers. Vegetables are also made available for community members in need of fresh produce.
While our contribution here will very likely involve assisting with nutrition education, it’s immediately clear that conventional dietetic mandates such as "eat five fruits and vegetables a day!" are unrealistic in the impoverished townships, where perishables are difficult to distribute, refrigeration is not ubiquitous, and the vast majority of residents qualify as malnourished. Instead, feeding programs strive to produce food items and prepared meals that are basic, economical, and as nutritious as possible. For example, Ikamva Labantu delivers supplemental food parcels to many foster homes and creches (home-based daycare centers) throughout the townships they serve. The parcels include culturally appropriate foods, such as samp (coarsely crushed corn kernels), flour, maize meal, lentils, pasta, dried beans, canned fish, oatmeal, soup mixes, and rice.
Despite the many challenges facing township residents, an incredible sense of joy and hope infuses their work and their relationships. Pre-meeting prayers begin with spontaneous songs that fill the room with four-part harmony from a program coordinator, foster mothers, and the head gardener. A child who has lost both parents mugs for the camera and teaches you a new handshake.
And Ikamva staff who are township residents share tea, sandwiches, and laughter in a daycare facility-turned-office, where they discuss their homecare program’s SWOT analysis, and tease each other as they troubleshoot their PowerPoint presentation on the agency’s laptop computer.
This is truly an amazing country. There’s a lot of work to do here in South Africa, and many passionate local leaders have created strong and effective community programs. Our partnership with Ikamva Labantu has only begun. I feel incredibly fortunate for Lifelong and ANSA that we have this opportunity.
Wednesday, August 1, 2007
Many divergent and striking scenes dominate the city of Cape Town. Table Mountain, Devil’s Peak, and Lion’s Head tower over the city center that curls along the shoreline of Table Bay. The small houses within the city’s Bo-Kaap neighborhood are painted in bright colors, home to the city’s Muslim population. And whitewashed mansions hug the hillsides behind locked gates and barbed wire fencing, securing million-dollar views of the Atlantic Ocean.
Out in the townships, though, the thing that’ll really get you is the kids.
As part of ANSA’s team in South Africa, I had the opportunity to tour several preschool facilities and crèches (home-based daycare centers). HIV/AIDS threatens the stability and security of many households here, and children—some of whom are themselves HIV positive—have a valuable ally in ANSA partners Ikamva Labantu.
Ikamva Labantu supports many programs for kids, but leaves much of the ownership and operations in the hands of the community. Founder Helen Lieberman, Chief Operating Officer Ishrene Davids, and Field Managers Mala Makan and Barbara Stemmert wouldn’t have it any other way. They recognize that their work would be undermined by too much organizational visibility in the townships, where big-name efforts and external influences are often (and, I think, rightly) viewed with suspicion.
While visiting daycare facilities with Ikamba staff, I was initially a bit concerned that our visit would be disruptive or intrusive. But the kids were so darn cute and curious, smiling and saying hello, I simply had to take their picture. 
Their response was overwhelming. A giggling swarm of children poured over the ANSA team, posing and then demanding to see themselves on our cameras.
For all the complexity surrounding the HIV/AIDS pandemic, community members are in agreement here that kids should simply not bear the brunt of hardship that follows in the wake of poverty and illness. Ikamva’s programs support children and families in the townships outside of Cape Town through complementary programs such as Early Childhood Development, Family Services, Food Security, and Home-Based Care:
Ikamva’s Early Childhood Development Program served 440 children in the past six months with preschool facilities, nutritious meals, and Ikamva’s Development Through Play program, which prepares young kids for the classroom learning environment.
Ikamva’s Family Services Sector helped 700 children in the past six months by assessing need, making referrals to care, providing financial assistance, and supplying school clothes and supplies.
Ikamva’s Food Security Program distributes approximately 340 food parcels each month to foster homes, daycare centers, and families in need. Parcels include basics such as pasta, beans, corn meal, flour, cooking oil, lentils, canned fish, and other items. These items are distributed mid-month, when household food insecurity is highest.
With 30 paid and volunteer carers in three townships, Ikamva’s Home-Based Care Program serves hundreds of homebound patients—largely those living with tuberculosis and/or HIV/AIDS. With cultural and linguistic fluency, Ikamva’s carers are able to access those in need who live deep within the townships—far away from clinics and, in some cases, with limited access for ambulances.
Food insecurity and malnutrition are common in the townships, and nutrition plays a role within virtually every program at Ikamva Labantu. At the Rainbow Center, one of Ikamva’s preschool facilities, I watched the head cook prepare meals for over a hundred young children. Looking at the menu on the wall, it was great to see a nutritious lunch on the menu, with fresh vegetables from the garden adjacent to the building. As part of Ikamva’s Food Security Program, the Food Garden Project helps provide good nutrition for hundreds of township residents. Food Garden Coordinator Monica Duda oversees 43 food gardens throughout the townships, producing fresh vegetables for senior centers, daycare centers, and foster families. Vegetables are grown year-round, and include beets, carrots, kale, peppers, and broccoli (I hear the kids here actually like broccoli!).
In keeping with Ikamva’s intent to “care for the carers,” cooking classes at Ikamva’s community centers help local parents learn how to prepare fresh produce properly for their families. And, in addition to creating good nutrition for program participants and beneficiaries, Ikamva staff are also exploring opportunities for gardeners to sell surplus produce in local markets—an economic boost to households trained in gardening skills by Ikamva Labantu staff.
As the ANSA team departed from one crèche, a chubby little kid walked up to me, gave me a “thumbs up,” and then walked away. I decided to take that as an endorsement of ANSA’s efforts here to strengthen Ikamva Labantu’s nutrition resources, though it’s a bit premature. There’s still much to do. This week, we are meeting with Ikamva’s leadership team to identify key areas in which ANSA’s resources would be most beneficial. Throughout this planning process, I’m going to keep these kids in mind.
More to come.
Monday, August 13, 2007
Back Home, the Work Begins
Having returned from South Africa, it's easy to fall back into one's old routine. There's e-mail to get to. Projects to resume. Reports to write. Yet ANSA's work in Cape Town with partners Ikamva Labantu is only beginning, and I am heartened by the commitment of my colleagues at Lifelong AIDS Alliance to this project.
It makes sense that this effort resonates with my co-workers here in Seattle. Like Ikamva Labantu, Lifelong's food program, Chicken Soup Brigade, was founded by community members who saw an unmet need and did something about it. People prepared meals in their homes and in church kitchens, delivering food to people with HIV/AIDS. As our organization grew, we drew on the strength of the community to help formalize our processes. Now, Chicken Soup Brigade improves the nutritional health of more than 1,400 people in the Seattle area who are low income and homebound due to life-threatening illness or disability.
At Ikamva Labantu, the scope is different, but the spirit is remarkably similar. Ikamva helps more than 50,000 people annually through the programs they support, which include senior centers, childcare centers, home-care workers, community gardens, and other programs. The crisis of HIV/AIDS is an issue in every program they offer, and nutrition is often a part of the solution when working in townships where large numbers of residents qualify as malnourished.
Like Chicken Soup Brigade, Ikamva Labantu is an organization where neighbors lead programs that help other neighbors. Now, Chicken Soup Brigade's South African "neighbors" Ikamva Labantu will help our community understand the issues facing people living with HIV/AIDS in South Africa. And Chicken Soup Brigade will help Ikamva Labantu strengthen their community-based response to HIV/AIDS, hunger, and poverty.
ANSA's South Africa team--George Ayala from AIDS Project Los Angeles, Rosario Dominquez from Community Servings in Boston, ANSA Deputy Director Mary Reed, Registered Dietitian Cade Fields-Gardner, and myself--identified four focus areas in which to frame our pending collaboration with Ikamva's Founding President Helen Lieberman, CEO Ishrene Davids, and other members of Ikamva's management team. The focus areas will be: Research, Monitoring & Evaluation; Leadership & Management; Resource Development; and Enhanced Nutrition Services. Our next step will be to designate specific tasks to team members and their respective agencies.
To my friends at Ikamva Labantu--Helen, Ishrene, Mala, Barbara, Jo-Ann, Lynn, Crystal, Bridget, and Gibby--thank you so much for making our visit educational, informative, helpful, and fun. You are doing some amazing work. The staff of Lifelong AIDS Alliance is truly excited to participate in this project. We will be talking with you soon!