Data collection an effective weapon in anti-HIV/AIDS arsenal

A new information gathering programme will soon provide an essential database of medical and other humanitarian needs in the agricultural heart of Swaziland to fill gaps in the national records and bring much needed insight into how to best counter the spread of HIV/AIDS. "This is about stopping AIDS at its source and providing assistance to HIV-positive people, but nothing can happen without information: Where are the people in need, and what do they require?" said Futhi Msibi, who helped set up the Total Community Mobalisation initiative in Malkerns, 30 km southeast of the capital, Mbabane. Malkerns Valley is the pineapple growing district of the country and the centre of the canning industry, which produces one of Swaziland’s chief exports. HIV/AIDS is seriously affecting Swaziland's agricultural sector. Even more than drought and an outmoded land use policy, national food security is being compromised by a shortage of both commercial food producers and subsistence farmers supporting families on communal land. During the past year, a third of the population was assisted by World Food Programme (WFP) donations, and a ministry of agriculture report has stated that the food crisis is likely to continue even if good rains return, because households now headed by children and the elderly will not have the labour to cultivate fields. "The effect on the food processing industry is also acute," said an executive from a meat processing facility based at Matsapha, 30 km east of Mbabane. At Swazican, the giant canning company at Malkerns, there are no official records on which, or how many, employees are infected with HIV, but company officials admit the absentee and mortality problem, attributed to HIV/AIDS, is severe. "We need to know which households are infected by AIDS. We need to know where the orphans are. Who may require institutional care, or foster care, or if it is better for them to stay where they are in their communities, in familiar surroundings, and assistance should be brought to them?" Rudolph Maziya, national coordinator for the Alliance of Mayors' Initiative to Combat AIDS at the Local Level (AMICAALL Swaziland), told IRIN. "Sometimes, we won't want to add to the trauma of uprooting children from their school and friends after their parents die of AIDS. The Total Community Mobilisation initiative will tell us the situation of all the household members," said Maziya. AMICAALL-Swaziland is a grassroots initiative by town officials but the HIV/AIDS crisis is undermining their developmental efforts by decimating local populations. The central government seems overwhelmed by the crisis, and the health ministry has been criticised for its culture of denial about the scope of the epidemic. "We have limited data on the effect of AIDS in Swaziland," said Isabella Hlope, chief statistician at government's Central Statistics Office. "This frustrates international donor organisations that need such information to coordinate assistance efforts." Beginning in Malkerns this month, the Total Community Mobilisation programme aims to create an "intimate relationship" with every household in the country of approximately 970,000 people. "The information collectors are all trained and ready to go," Zelda Nhlabatsi, Malkerns community coordinator for AMICAALL, told IRIN. "Youth volunteers are working under information supervisors, using standard questionnaires. They will be spending an hour at each household, farm or homestead, getting to know each family. That is not a lot of time, but they will be returning every month," Nhlabatsi said. A comprehensive picture of a family's needs will emerge over the course of time. Information collected locally will be used to build a national database to facilitate AIDS containment efforts by government, and health and social services NGOs. The initiative is being funded by the National Emergency Response Committee on HIV/AIDS, a government unit headed by former finance minister Derrick von Wissell. Von Wissell this week stunned an audience at a health conference when he told them the average life expectancy for a Swazi would be reduced to 27 years by 2010 as a result of HIV/AIDS. Life expectancy rose to 61 years in the early 1990s, when the HIV infection rate was an estimated 2 percent. The data collectors will not function merely as passive information gatherers, but will also have an advocacy role. "The information gatherers will establish close relations with families. They will become friends. They will encourage household members to take blood tests," said Nhlabatsi. "The traditional community system is not what it used to be and with urbanisation and AIDS mortality there are fewer long-term neighbours to look out for each other," Maziya explained. "If someone is sick, our information gatherers will assess the medical situation, the condition of care at a house and medical supplies there. They will organise medical assistance." The data collectors will be dispensing as much information as they receive. They will distribute AIDS prevention literature and condoms, and also direct families to health facilities and social welfare NGOs. AIDS containment efforts have suffered from a lack of reliable information and the current food crisis has illustrated how dangerous that lack of data can be. Famine was avoided this year because the National Disaster Relief Task force and WFP established a community-based information network, run mostly by women volunteers. The process used - gathering information on each member of each household in affected areas - was so successful that it will be duplicated, first in the new AIDS initiative in Malkerns, and then nationally. "We are harvesting information, which will be used to address not just AIDS containment efforts, but food security, child welfare and other needs," said Msibi.