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Date : 01/12/2003
Source: KwaZulu-Natal Provincial Government
Title: Singh: World AIDS Day: KwaZulu-Natal Premier's HIV & AIDS Indaba


PRESENTATION BY MR NAREND SINGH, KWAZULU-NATAL MINISTER OF EDUCATION AND CULTURE, AT THE PREMIER'S HIV AND AIDS INDABA, 1 December 2003

TOPIC: "SUCCESSES AND CHALLENGES IN THE IMPLEMENTATION OF SUPPORT PROGRAMMES FOR LEARNERS AND EDUCATORS WITHIN THE SCHOOL ENVIRONMENT IN THE CONTEXT OF HIV AND AIDS"

Introduction

The province of KwaZulu-Natal is widely categorised as the worst HIV/AIDS-affected region in the world. Though the Nelson Mandela Human Science Research Council (HSRC) study has made different findings, geographic location along the trucking routes from the Southern African Development Community (SADC) countries to the major seaport of Durban certainly puts the province at risk of becoming an HIV/AIDS hotspot. We have yet to experience the full impact of AIDS-related morbidity and mortality, which will follow over time.

Infection rates in the provincial education sector probably do not depart much from the provincial population norm, where antenatal investigations indicate an infection rate of more than 30%. The education sector therefore faces a steep challenge in terms of survival and continuity of output.

HIV/AIDS is a pandemic of tragic and debilitating consequences, wherever it touches on human society. Apart from physical suffering, the pain of bereavement and the loss of household heads and breadwinners, it threatens to cut a swathe through the productive workforce, doing great damage to the economy. And I believe it is in the education sector that the menace is particularly stark. Leaving aside for a moment the dimension of human suffering, if HIV/AIDS is not contained within the education sector, it threatens to wipe out a significant sector of a generation of school-leavers who should be coming into the economy, plus severely undermine the skills base of those who survive. HIV/AIDS would therefore be a double blow to the economic development on which South Africa's future depends - badly undermining productivity in the existing workforce and undermining it even worse in the succeeding generation of workers.

It follows from the seriousness of this threat that it is incumbent on government - on humanitarian, educational and economic grounds - to take strongly proactive measures to contain HIV/AIDS and minimise its effects. The presentation that follows will highlight some of the successes and challenges in providing care and support for learners and educators within the school environment.

THE EDUCATION CONTEXT

In South Africa, nationally, in 1998 there was a total enrolment in the primary and secondary sectors of 12 300 000 and these were supported by 370 000 educators, directly managed by 5 000 subject advisors and inspectors, with a further 68 000 officials, managers and support personnel.

It has been concluded that, "The indiscriminate path of HIV infection is as likely to cut down scarce mathematics and science teachers and effective principals as it is their less specialised peers. (Source: HIV/AIDS and Human Development in South Africa, UNDP/UNAIDS, 1998)

In the KwaZulu-Natal Department of Education and Culture there are almost 6 000 schools with 2,7 million learners. The province employs over 74 000 teachers and has a total workforce of more than 85 000, including management and support personnel. About 33% of the province's total population of 8,5 million people are either enrolled in school or teaching or managing education. Another 275 000 school-age children - 3% of the population - are not in school.

Moreover, educator salaries account for about 85%, confirming that HIV/AIDS impact in this sector could have a ripple effect of the greatest strategic and budgetary significance. If unchecked, HIV/AIDS could lead to conflated disruptions including: rising morbidity, disability and mortality; increased absenteeism and labour turnover; an increase in orphaned and vulnerable children; rising direct and indirect costs; and loss of institutional memory - the kind of thing that happens when a body of passed down knowledge and practice suddenly disappears with those who held it.

UNDERTAKING SITUATIONAL ASSESSMENT

The province is seeking to establish factual scientific and statistical research rather than global generalisations and anecdotal reports in order for it to accurately report on the state of affairs regarding absenteeism, staff attrition rates, morbidity, mortality, and other related direct and indirect costs. This will allow us to mount the appropriate responses, based on sound evidence.

The national/provincial/HSRC research initiative on the incidence of HIV/AIDS among educators is a first step. A pilot investigation in the province is close to completion. Another need is to carry out a rapid assessment of the impact of HIV/AIDS on labour resources and in particular on the KwaZulu-Natal Department of Education and Culture. We need to:
* Assess the effects of absenteeism caused directly by higher staff morbidity (and indirectly by sickness of family members and relatives, attendance at funerals, care-giving duties, etc.)
* Assess exceptional mortality among different classes of workers in the education sector so as to identify the probable losses among skilled, professional and other employees that have already taken place
* Assess the direct costs to the education sector of the impact of the epidemic on human resources due to absenteeism, labour turnover and replacement (including costs of disruption of services as well as costs in recruitment and training and medical costs, support for dependants, benefits and so on)
* Assess the indirect effects of the HIV/AIDS epidemic on the performance of all KwaZulu-Natal educational institutions due to loss of experienced and skilled human resources. This should include qualitative evaluation of the effects of morbidity and mortality on morale, institutional memory, and cultural cohesion
* Estimate the probable effects of HIV/AIDS on the education sector's capacity over the next five to ten years, and how it will differentially affect communities
* Conduct a continuous evaluation of existing policies and programmes to address the impact of HIV/AIDS on the education sector, as well as of joint problem-solving and collaboration
* Make recommendations for future action by government, donors and other interested groups including religious organisations, trade unions, professional associations, non-governmental organisations (NGOs), community-based organisations (CBOs), etc.

EDUCATIONAL SERVICES - ASSESSING THE NEEDS AND PERFORMANCE

At least five aspects of the issue of educational needs and performance deserve attention in detail. They are:
* The effect on the quantity and quality of the educational services that the sector is able to supply as a result of erosion of human resources; also the consequent effect on institutional capacity in schools
* The changing needs of children, students and employers which will reflect in part the direct and indirect effects of the HIV/AIDS epidemic (Families have fewer resources to meet the costs of education and this will affect the gender balance of those seeking education, with fewer girls and young women at all levels of education). Already, declining enrolments in Grade 1, and the extent of the withdrawal of the girl-child, warrant urgent investigation
* Changing priorities and needs in education due to the fact that employers across the economy will increasingly attempt to substitute staff with less education for those with more training, given the likely losses of labour due to HIV/AIDS. There will also be a changing balance of labour needs generally in our education sector, as well as in all other sectors, as expenditure and output are adjusted as a result of the impact of the epidemic on incomes and thus on the pattern of demand, relative to the problem of reduced system quality, output and volume of qualified entrants to the world of employment. The real impact will be on consequent economic growth and provincial/national development
* The need to monitor the extent to which the private sector will filch the education sector for manpower needs, and ways of working out agreements and rationalisations
* The important role of communities in taking over the running of schools so as to provide minimal literacy to children in their communities. This is a factor for attention and developmental earmarking.

All the above are actually and potentially researchable although some elements are easier to research than others, and both the national and provincial Departments of Education are already looking into the needs, and have in some instances initiated the relevant research processes.

THE ROLE PLAYED BY THE KWAZULU-NATAL DEPARTMENT OF EDUCATION AND CULTURE IN MITIGATING THE IMPACTS OF HIV/AIDS

The department is vigorously involved in two kinds of rational solution. They are:
* Preventing the further spread of HIV/AIDS
* Mitigating against the effects of the disease as it has so far progressed. There is no known cure, and the medicines that would prolong the lives of sufferers are not yet available
* In every step, the legal and policy framework of the country, and the specific provincial frameworks guide all our interventions. Copious research findings on the provincial Department of Education and Culture have emerged from universities and other institutions in the province. It is fortunate that several studies have been conducted on HIV/AIDS and the education sector.

Education Management Information Services (EMIS) is playing a critical role in capturing data for some of the researchable elements above. It is possible through quantitative and qualitative analysis to undertake assessments of the changing capacity in the education sector.

Practical responses include:
* Sector specific actions to prevent incidence and to mitigate impacts and effects
* Co-ordinated and collaborative inter-departmental clustering of services for children and youth
* Multi-sectoral partnerships with SGBs, NPOs, Business, emerging faith-based organisations (FBOs) responses and donors
* Ongoing research and monitoring.

Four priorities have been identified for sectoral responses and an amount of R26 624 000 has been allocated through a National Conditional Grant to the fight against HIV/AIDS. Key activities are advocacy, training, learner support material, monitoring, support and evaluation and management and administration. The objective is Awareness, Prevention and Support.

PRIORITY 1: PREVENTING THE SPREAD OF HIV

Since the year 2 000 more than a million people have been reached in workshops, special events - including AIDS observance days - cultural and sports events, briefings and talks. They include senior officials of the Education and Culture, Health and Agriculture and Environmental Affairs departments; SGBs; parents; traditional leaders; and traditional healers.

Activities include advocacy for the programme through inter-sectoral collaboration. There have been workshops for SMTs and SGBs on legal and policy frameworks promoting human rights and dignity.

More than 15 000 primary and secondary educators (Grades 3 to 9) have been trained in life skills and 300 have been trained in care and support. Eighty educators have been trained in lay counselling (and this activity continues). The training takes place at workshops focused on the curriculum life orientation/skills, as well as care and support for vulnerable educators and learners.

About 5 000 secondary school learners have been trained as peer educators, modelling good behaviour in a positive role.

Quarterly inter-sectoral collaboration meetings are held, as well as workshops about three times a year.

About 1 000 schools have been visited to monitor and support the implementation of life skills and offer support. Research seeks confirmation that implementation is actually happening.

Meanwhile, the department supplies teaching and learning support material connected with the fight against HIV/AIDS, as well as IEC and first aid kits. About 2 000 kits have already been supplied.

I must emphasise that all these activities are on a continuing basis.

PRIORITY 2: CREATING A CULTURE OF CARE AND SUPPORT
The following activities are promoting care and support in our schools:
* Support of infected and affected learners and educators
* Training on precautionary measures e.g. first aid
* Training on peer education care and support
* Establishing community policing forums
* Observing HIV/AIDS Day e.g. World AIDS day and candle light
* Strengthening of Life Skills Programme
* Training of RCLs on counseling and care and support
* Monitoring and reporting skills
* Training and development of business plans to order to access funding
* Training of SMTs and SGBs on Human Rights and HIV/AIDS
* Development of HIV/AIDS policy for SGBs
* Advocacy workshops to target all stakeholders
* Partnership with Department of Health, Department of Welfare, NAPWA, Home Affairs, Traditional Healers, FBO, Agriculture and others
* Self-help projects, e.g. vegetable gardens
* Adopt an orphan programmes
* Poverty alleviation projects
* Home-based care
* Inter-sectoral networking
* Wellness programmes

PRIORITY 3: WORKING TOGETHER TO PROTECT THE QUALITY OF EDUCATION

The department is involved in putting in place:

* Multiskilled educators
* Well resourced and safe environments
* An interdepartmental support network
* A strengthened Employee Assistance programme
* Learner & teacher support material
* Extra mural activities
* Responses to absenteeism, late coming and non performance
* Policies toward poverty, especially the orphaned and vulnerable children
* Policies toward sexual abuse and harassment, child abuse and dropouts
* Diversity Management
* Funding

Implementation Of Framework

The department supports existing structures and creates and strengthens others. This includes:
* Human resource management; Human resource development; Skills development and EMGD
* Teacher development
* Curriculum development and enhancement
* Support services for the infected and affected learners and workers, including the disabled, women over-burdened with caring duties, and the plight of the girl-child
* In and Out of School Youth, Arts, Culture and Sporting Activities
* Most importantly the Monitoring and Support of each structure, its delivery capacity, continuous capacity building.

ADVOCACY

This involves:
* Communication
* Acknowledging initiatives done in communities. Partnering through assistance in establishing CBOs is an initiative that will be worked through with other departments
* Access for ABET learners
* Mobile Libraries/Teaching
* Support & Coordination

PRIORITY 4: MANAGING A COHERENT RESPONSE

The department sets out to:

* Identify a strong team to co-ordinate process, with a dedicated budget
* Convene workshops with relevant directorates (e.g. PGSES, GET, FET, ABET, ECD, EMIS, PLANNING, HRA, HRM, Special programmes) workshop should include middle management
* Workshops should deal with information sharing, the HIV/AIDS National medium term strategic framework, as well as current activities of directorates' existing programmes
* Identify major focus of department
* Develop strategies to implement policies
* Clarify roles of each directorate
* Establish transversal HIV/AIDS Unit based on current line functions: share resources and common programmes.

NETWORK
* With communities (per directorate) through community structures with co-operation of district officials
* With Social partners, e.g. Department of Health, Social Services, Transport, Arts, Agri, Local Gov. Housing, Home Affairs, NGOs, HEIs, Religious groups, CBOs

SHARING RESOURCES
* The department strives for common programmes utilising the expertise and resources of the different partners

CHALLENGES
The planning of delivery and services will in future have to integrate the impact of both HIV and AIDS in every aspect of activity and budgeting, with mid-level impact scenarios the probable default position until more reliable data is available. The planning of the renovation and building of classrooms and schools will require fresh appraisal of local demographics, for example, as will the rationalisation and merger of under-utilised facilities, such as small and farm schools. The provision of potable water, sanitation and health and counselling services will take on a new significance and may reorder planners' traditional priorities and goals.

It can no longer be business as usual, given that in some districts enrolments may decline to less than half their historical levels in some grades, yet still exhibit unacceptably high learner/educator ratios due to teacher morbidity and mortality. The way in which educators are posted for example, often far from home districts and separate from a teaching spouse, requires that a revised code of planning practice be developed and adopted, to minimise the exposure of the system, first to traditional management and administrative failure and, second, to the increase in these problems stemming from HIV/AIDS impact.

While enrolment, and therefore demand, is set to decline for the foreseeable future, the supply of trained educators will decline even faster due to existing attrition, direct AIDS impact and the indirect effect of increased competitive demand in the wider workplace due to AIDS-related deaths in the workforce. Thus KwaZulu-Natal may even anticipate worsening learner/educator ratios in many areas over time but, as importantly, declining quality due to the loss of qualification and experience. Even where these ratios may appear acceptable, educators may not be functioning effectively. This may mask deeper problems of contact and quality. Ironically, learner/classroom ratios may also worsen due to small school rationalisation and the inevitable effect of multi-grading, necessitated by the temporary or permanent absence of educators; in these circumstances, community and other unqualified or under-qualified volunteers may also make an appearance in the classroom, particularly in rural areas, to assist until such time as replacements are available.

The ratio of qualified to unqualified or under-qualified educators may also not improve as expected, for the reasons outlined above, not least because educators - including scarce specialised subject educators - appear to be equally at risk irrespective of their qualifications.

Orphaning

Perhaps the greatest challenge to the system will be in the number of orphans projected in the province: Of the estimated total of two million orphans (defined as children under the age of 15 who have lost either a mother or both parents) in South Africa by 2010, some 500 000 are expected to be in KwaZulu-Natal. This equates to between one in four or five learners in school, although it is reasonable to expect that many of these children will fall out of the system for a variety of reasons, principally economic. Impact on this scale is beyond the experience of anyone in the system and certainly beyond the capacity of the limited counselling and support services available. This will arguably constitute the largest of the management problems to be faced and has implications that spill over into the health, welfare and social service sectors.

Budget Implications

The fiscal impact of educator training on the scale described above has yet to be understood or factored in, but this is merely a line item relative to the problem of reduced system quality, output and volume of qualified entrants to the world of work. The real impact will be on consequent economic growth and national development, and will be felt - even if a vaccine were to be discovered tomorrow - for two to three decades to come. The key budget implication, both within education and in the wider provincial and national context, is that HIV/AIDS must be factored in every aspect of recurrent and capital expenditure, and must anticipate reduced income revenue and a slowing in anticipated rates of economic growth. What is therefore required is that management of the education budget is reviewed and redesigned to account for these impacts, at every level of the fiscal process.

Personnel implications

At this time, given the present and projected levels of HIV infection, very large numbers of learners, educators and managers will be infected, and many will begin to succumb to full-blown AIDS. It is important to recognise though, that infected educators and managers have legal and constitutional rights, and may continue in the system - at declining levels of productivity - for another 10 or 15 years, dependent on levels of health care and support.

To illustrate the effect this could have: The current Budget is under severe stress because 912 substitute educators are in the system, replacing permanent educators who are on sick leave. The budget provides for only 300 such substitutes. Also, a large number of educators are, for whatever reason, employed above the Post Provisioning Norm. A budget which is meant for 73 513 educators is paying for more than 80 000.

It does not require much imagination to realise what would happen to post provisioning and budgeting if the probable HIV infection rate - possibly 30 % - were to translate into full-blown AIDS, with the absenteeism and mortality which would result.

However, our interventions must take place within a legal and constitutional framework. The legal and constitutional rights of employees are contained in a number of statutes as well as the Common Law. I list them briefly: the Constitution itself; the Labour Relations Act; the Basic Conditions of Employment Act; the Compensation of Occupational Injuries and Diseases Act; the Employment Equity Act

This body of law seems to establish certain principles, among them: non-discrimination on the basis of HIV/AIDS; compensation for occupational infection; a prohibition on mandatory HIV/AIDS testing; encouragement of voluntary counselling and testing; and confidentiality as a work ethic on the individual's HIV status and his or her right to acceptance and support. All of this creates new demands in terms of human resource management.

Ultimately the loss of educators and managers to HIV/AIDS will require the accelerated training of replacements, which will bring with it increased risk due to the lower average ages of these replacement educators and their comparative inexperience. This new generation of educators is likely to advance through the same cycle, and so impact the quality and continuity of the learning and teaching process for two to three decades.

On the evidence, learners will likewise graduate or drop out of this high-risk environment with a significant number already infected, and with an equivalent number likely to be infected within one or two years of leaving this system. Curriculum change, materials development and condom distribution, while apparently contributing to high levels of awareness, have shown little evidence of influencing behaviour to date. There are signs of improvement, including a nominal reduction in prevalence rates for girls of 15 to 19, according to the 2002 HSRC study, but prevailing social dynamics, peer pressure, economic circumstances and lack of positive role models, suggests that at least another generation may pass through the system before this pattern changes to any marked degree. The knock-on effect of this cycle on tertiary education and entry into the world of work does not require further elucidation, save to say that this will be the group from which future student educators will be recruited, with predictable consequences in many cases.

Various preliminary impact assessments have been conducted: on employees and service delivery; with unlinked, anonymous HIV testing, where a pilot programme has been completed; in monitoring orphans; and in monitoring supply and demand in Education.

As set out above, the department has in motion various HIV/AIDS programmes focused on prevention, treatment, counselling, care and support. They include a flagship programme in life skills; an HIV curriculum programme, part of the NIP; a strong Peer Education Programme linked to life skills; SGB and SMT initiatives; an EAP initiative for the different levels of employees; teacher training in school-based care and support, with lay counselling due to begin next February; liaison with HIV/AIDS school committees and school and district-based teacher support teams; employee medical aid schemes; and a school nutrition programme which is vitally important as it has become clear that the successful treatment of HIV/AIDS - which means warding off the deadly full-blown effects - is very much dependent on a healthy, balanced diet and a healthy lifestyle.

It is clear that the order of magnitude of the HIV/AIDS problem is beyond the experience of everyone involved; it is also clear that there are major psychological barriers obscuring its resolution and creating levels of personal stress and trauma that leave officials at every level apparently impotent in the face of an unquenchable pandemic. What is not quite so evident, but is in fact the most important article of faith in this bleak scenario, is that the overwhelming majority of learners, educators and managers will survive the disease, and will go on to play a productive and positive role in the post-AIDS environment - inside and outside education.

This said, the challenge is to see beyond the system turbulence that lies ahead and plan for the kind of change that can only be countenanced in crisis; in short, to recognise in this "state of emergency" the opportunity to review and redesign the way we teach and learn, and redirect the education system to new and higher ground. There is widespread recognition of the shortcomings of the system and even greater recognition of our inability to do much about it - in normal circumstances. We are doing the best to grasp this "opportunity in crisis", precisely because the national trauma that will develop around the impact of HIV/AIDS must be counterbalanced with the "good news" of improvement and reform by ourselves.

If I might summarise the challenges, I see them as: Securing the communication, co-operation, co-ordination and collaboration of all stakeholders; achieving clear analysis within government; setting up reporting and communication lines across departmental demarcations; avoiding rivalries in delivery; creating supportive environments influenced by mentors.

Overcoming constraints in the school environment and correcting past imbalances; strengthening and extending the Nutrition Programme; continuing to collect accurate data on orphaned children; setting out to capture data on vulnerable children who are continually exposed to the sick and dying; addressing the problem of overwhelmed and traumatised educators. And better use of the resource base of psychologists in a crisis which has a psychological almost as much as a physical dimension establishing sound policy on indigent learners, non-payment of fees, uniforms and the right to free education; establishing the right to care and support; monitoring human rights violations which, in some schools, could be fuelling the pandemic. There are gender enrolment issues to be addressed, the subservient status of women which can increase risk-prone behaviour.

I see a need to develop monitoring milestones; to develop an evaluation plan and identify key indicators. Accountability has to be monitored and strengthened; we need to affirm an openness to outside evaluation. We must include in our effort donor agencies, where appropriate, and draw on their expertise. We do not need to reinvent the wheel.

The issues of HIV/AIDS, which are bearing down on us, are so multi-faceted that the response has to be holistic. The approach has to be systemic and collaborative, well defined and dedicated duties established between District Health Teams and all partners. The closest co-ordination must start at topmost management level and trickle down as an attitude to all stakeholders. We need to inculcate genuine co-operation, which is not the same thing as co-optation. We need to engender discipline, collegiality and mutual respect between the communities at risk and all who involve themselves in combating HIV/AIDS. There has to be accountability from top management level downward.

The HIV/AIDS pandemic is going to test the KwaZulu-Natal Department of Education and Culture as it has never been tested before. However, I have a faith in the calibre of our personnel, as well as in the calibre with the other departments, which are our partners in this struggle. I believe that if we adopt the guidelines set out, we have the best chance of minimising the depredations of the pandemic and providing a skilled and educated workforce with which to build a better future.

I thank you for your attention.

Issued by: Department of Education and Culture, KwaZulu-Natal Provincial Government
1 December 2003

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