Co-opting HIV/AIDS: African Youth Fighting HIV/AIDS through Co-operatives
HIV/AIDS continues to ravage the social networks and productive capacity of African co-operatives. In the fight against HIV/AIDS, the role of co-operatives, and especially the role of young people in co-operatives, needs to be identified and acted upon.
Youth in African co-operatives are heavily affected by HIV/AIDS, through both its illnesses and its socio-economic impacts. This paper draws upon the experiences of Kenyan youth, primarily involved in fishing and agricultural co-operatives, to explore the current co-operative response to HIV/AIDS in Kenya. It provides critiques of how co-operatives and others are dealing with HIV/AIDS, and it comments on the role of young people in developing effective co-operative strategies to battle HIV/AIDS. It argues that, while co-operatives have the potential to be a vehicle for fighting HIV/AIDS, their weaknesses and strengths need to be considered when planning for relevant and accessible interventions. Youth within co-operatives need to be encouraged to be potential champions for HIV/AIDS mitigation, prevention and care.
HIV/AIDS is a uniquely destructive pandemic in that it particularly disadvantages young people in both their productive and reproductive outputs and capacities. It is the world’s fourth most common cause of death after heart disease, strokes and acute lower respiratory infections (Dixon et al, 2001). The other three causes primarily affect people in old age, but AIDS deaths are concentrated among prime-age adults who are at their productive and reproductive peak. Globally, women constitute just under half of the adults with HIV/AIDS, but in sub-Saharan Africa more than 55 percent of infected adults are women, and young women are two to four times more likely to be infected than young men (UNAIDS, 2002). Moreover, youth are bearing the brunt of AIDS’ impacts: most people infected are in their twenties and thirties, and they die, on average, around a decade later (UNAIDS, 2004). Recent research predicts that it could get worse (UNAIDS, 2003).
The effects of AIDS in sub-Saharan Africa are worse than anywhere else in the world and the numbers of deaths due to HIV/AIDS are altering population dynamics as well as labour and household structures across sub-Saharan Africa.
Other research has documented how HIV/AIDS has sharply reduced human, social, physical, financial and natural capital within agricultural systems. The Food and Agriculture Organization (FAO) reports that the nine most-affected African countries could lose up to 26 percent of their agricultural labour force within the next two decades (FAO 2002).
Youth are especially vulnerable to the impacts of HIV/AIDS. They are the ones most infected and affected; they are also the ones commonly responsible for helping to mitigate its impacts, such as by contributing extra labour and assets to make up for losses in the household and at the workplace.
Co-operatives and HIV/AIDS
Within co-operatives, HIV/AIDS particularly affects youth participation in both management and production since it increases the number of ill and orphaned dependents, causes the loss of skilled labour, and impairs agricultural and nutritional knowledge networks, all developments that impose continuous and debilitating pressures on young people. In fact, whether it is poor attendance at meetings due to a funeral, or lack of available skilled labour, or widows advocating for their rights to co-operative assets, HIV/AIDS affects many facets of co-operative activity.
Other impacts may also be less direct but even more serious: HIV/AIDS is a terminal illness requiring long-term care that can be a burden on household finances, time and resources, which usually means increased responsibilities for young people. Even more subtly, the stigma associated with HIV/AIDS can prevent openness and honesty about the real reasons behind its transmission, thereby impeding behaviour change, and deepening its impact on families and communities and on the co-operatives that try to serve them.
These pressures add to the problems that many co-operatives in Africa have faced in recent years (such as mismanagement, inadequate marketing expertise, trade liberalisation and unfavourable government policies). They have directly and indirectly forced many co-operatives, like the families of HIV/AIDS sufferers, to sell their assets, thereby risking their future sustainability.
HIV/AIDS’ impacts on co-operatives:
- Loss of labour supply and remittance income.
- Reduced attendance at member meetings (often due to attending funerals).
- Declining participation in savings and credit schemes.
- Reduction in land under cultivation.
- Declining yields and crop variety, and increased fallow fields and pests.
- Decline in livestock production and health.
- Increased food insecurity and an increase in short-term coping strategies.
- Youth suffering insurmountable despondency and hopelessness in relation to economic prospects.
- Impaired income generation and diversification (both farm and non-farm).
- Loss of productive land and assets (women often lose access to land).
- Loss of agricultural, technical and nutritional knowledge.
- Decrease in environmental management (e.g., soil conservation).
- Diversion of co-operative resources (such as sale of assets or diverting credit to care for sick and dying).
We can use Kenyan co-operatives as an example of how co-operatives are responding to the pandemic. Because of their membership bases, community influence, and local leaderships, co-operatives have been widely used for prevention education and behaviour change programmes. While this is an effective component of fighting HIV/AIDS, it has its weaknesses when implemented in isolation from other components, such as care and mitigation, and the nature of the livelihood activities of the communities.
Prevention education aimed particularly at young people is a popular tool in the battle against the pandemic for a variety of reasons. First, the donor and development agencies and faith-based organizations popularly advocate it in their efforts to stop the spread of HIV. Second, it requires low intensity planning for integration into other existing activities since AIDS can be easily integrated into programming by setting aside a few days a year for outreach. Training of trainer programs, another popular tool of prevention education, requires little change in programme design, monitoring and evaluation. Finally, it can reach large numbers of people at one time and in one repeatable way. Seminars can be replicated in various areas without much change in information or the way that information is presented.
How effective, though, are prevention education strategies in fighting HIV/AIDS in co-operatives? Is the level of knowledge gained adequate or is behaviour modified? It is difficult to know the impact of general “AIDS 101” talks on communities already infected with and affected by HIV/AIDS?
The following section debates these issues by first looking at the potential of co-operatives to fight HIV/AIDS, and second at the critiques of the current approaches to mainstreaming HIV/AIDS in co-operatives. In the process, it shows how youth involvement is essential to long-term success.
This approach, though, is only part of what co-operatives – and particularly the young people associated with them – could do. They could help address the socio-economic circumstances that contribute to the spread of the pandemic and cases in point can be found in Kenya. For example, fishing co-operatives around Lake Victoria in Kenya often pay fisherman on a daily basis, thus creating “hot money” that is regularly spent promptly on sexual partners, alcohol, and drugs. They could help counteract this by encouraging strong and reliable savings and credit options for members, thereby reducing the amount of “hot money” available. They could provide information and leadership on the problems associated with multiple sex partners, drug and alcohol abuse. They could show members the impact of such practices on the number of fish caught and sold, and their effects on sustainability and profit. Doing so could encourage members to become active participants in fighting the pandemic while simultaneously helping them improve their livelihood and to develop the co-operative.
The co-ops could also encourage programmes to help fish traders, who are usually female. They are in constant interaction with fishermen who are members. Fish traders, caught in fierce competitive situations and with low incomes, not uncommonly resort to having sexual relations with fishermen as they compete for the day’s catch. “Sex for fish” is the result of their poor bargaining power and weak financial organisation. Co-operatives could help by providing fish traders with training in savings and credit, good business practices, and improved financial management. They could also help provide economic alternatives for women in situations of domestic violence and provide information on the critical connections between patriarchy, HIV/AIDS and business.
In short, co-operatives, as some in Kenya, Uganda and India, are doing, could more fully integrate HIV/AIDS into their regular training programmes and address more completely the problems stemming from HIV/AIDS on their business activities (see Box 2). Doing so would allow the co-operatives to help communities address the complexity of issues associated with the pandemic.
Integrating HIV/AIDS concerns into co-operative business practices:
- Incorporate business and HIV/AIDS information into training of trainer programs for co-op committee members and managers.
- Train managers on how to calculate the impacts of HIV/AIDS on business.
- Discuss workplace HIV/AIDS policies to promote institutionalization of HIV/AIDS awareness and support.
- Recognize the impacts of HIV/AIDS on women’s income generating activities.
- Understand the impacts of HIV/AIDS on co-operative development activities, such as income diversification strategies.
- Understand the impact of HIV/AIDS on marketing, productivity and labour supply.
Another example can be found in the Nyanza province of Kenya, where the Sondu Widows’ Group carries on its work according to principles and activities that are very much like those of a co-op. The province has the highest HIV/AIDS prevalence rate in Kenya, currently at 24.5 percent (Ministry of Health statistics, Kisumu District 2004). While prevention education is still valuable in this context, of greater importance is the kind of support these women need in fostering the orphans of dead relatives and maintaining their small businesses. Women need to secure inheritance rights to the land and to learn how to mitigate the impacts of lost labour on their farms. Their greatest needs are land rights for widows, community vocational training for orphans, and start-up savings and credit organisations with services that respond to households caring for sick members.
Other options and strategies for co-operatives are to:
- Create resilient production systems.
- Participate in savings and credit schemes and other co-op partnerships.
- Share good practices with other co-ops and similar institutions.
- Respond to changing agricultural needs, such as providing lighter and stronger tools for use by women and youth.
- Diversify production to maintain environmental and financial sustainability.
- Create partnerships with training, counselling and awareness services.
- Lobby for extension and co-operative services that are youth and gender friendly.
- Diversify household income.
- Understand and respond to the double burden on young and old women caring for orphans and sick in households.
- Promote urban-rural networking (for example market linkages).
- Mobilize youth and elders to reduce the stigma around HIV/AIDS.
- Increase access for women to technology, credit and supportive networks.
- Promote youth networks and sharing of agricultural and management knowledge.
- Promote youth leadership.
- Advocate against gender-based violence and abuse by youth of drugs and alcohol.
- Increase training for managers on HIV/AIDS sensitization.
- Understand the link between HIV/AIDS and the bottom line (measuring financial impacts, planning for business continuity, business mentoring, writing wills, how to develop a sustainable and effective co-op workplace HIV/AIDS program).
- Help manage STDs amongst youth through information, treatment and increased nutrition, particularly of women and children.
- Increase access to clean and sanitary water.
- Promote youth participation in urban and household agriculture (including small animal husbandry).
Gender and HIV/AIDS
Co-operatives could also help in coping with the fact that young women and girls disproportionately suffer from the impacts of HIV/AIDS. In several Africa countries, infection rates among young women (under 24 years) are two to six times higher than among young men. Many women experience sexual and economic subordination in their personal relationships and at work, and so cannot negotiate safe sex or refuse unsafe sex. The traditional domestic and nurturing roles of women mean that they bear most of the burden of care – this not only adds to their workload but also undermines the vital productive, reproductive and community roles they play. A 2003 UN Population Division study in Tanzania found that women whose husbands were sick spent up to 45 percent less time doing agricultural or income-earning work than before illness struck.
How do we address gender, co-operative business and HIV/AIDS?
- Train young women and girls on income diversification, savings and credit.
- Create spaces and opportunities for young women to participate in meaningful leadership.
- Address sexual exploitation in business practices (e.g., Sex-for-food).
- Diminish cooperative policies that are gender biased or gender blind.
- Ensure inheritance rights (of assets and land) for women and girls.
- Training on personal/household budgets.
- Increase economic empowerment of women and girls.
- Addresses gendered aspects of cooperative organization and activity (i.e. market and credit access).
- Take a no-tolerance stance against gender-based violence.
- Involve young men in gender sensitivity training.
- Support gender integration as good business practice.
- Increase the participation of women and girls in sensitization and TOT seminars.
- Support group initiatives by women outside of formal business employment (i.e. spouses of workers, young women, traders and marketers etc.).
- Gendered HIV/AIDS analysis of business to determine how HIV/AIDS is impacting.
- Determine how changing households and labour forces are affecting gender divisions of labour and household food and economic security.
- Advocate women’s sexual rights as human rights supported by the business and it’s employees.
- Address alcoholism, drug abuse, domestic violence and other social problems in business community that are increasing vulnerability of women to HIV/AIDS.
The co-operative workplace mirrors, and sometimes exacerbates, gender inequalities and discrimination present in society as a whole. Co-operative programmes for HIV/AIDS need to be sensitive to the gendered impacts of the disease. Co-operatives should be aware of harmful business practices that encourage or condone risk to HIV/AIDS. Co-operatives could exert leadership by showing zero-tolerance for violence and harassment against women at work (e.g., by having procedures for complaints that are simple and accessible). Mainstreaming gender issues in HIV/AIDS programming within organisations can result in more effective responses to the pandemic.
Successful and sustainable HIV/AIDS prevention involves more than strategies for encouraging positive individual behaviour change. While personal behaviour modification is a critical component of a comprehensive HIV/AIDS program, it should not be regarded in isolation. The environment in which behaviour change occurs is crucial in understanding the values, pressures, and rationale behind actions. Activities in the co-operative sector for HIV/AIDS mainstreaming have usually included such activities as sensitisation seminars, training of trainer programs, prevention education, and encouraging VCT and condom use.
A deeper kind of HIV/AIDS mainstreaming would make use of the mass mobilisation networks that co-operatives are built upon. It would effectively utilize the comparative advantage and expert knowledge that already exists in the development programmes associated with co-operatives. It would utilize the mobilisation capacity of co-operatives to situate the struggle against HIV/AIDS within other crosscutting issues common in co-operative development strategies, such as gender, youth and human rights. It would encourage consideration of other marginalized and vulnerable groups, such as widows, orphans and female-headed and child-headed households.
In short, helping to mitigate the environmental causes of vulnerability and susceptibility is ultimately the most promising way for co-operatives to help fight HIV/AIDS. Co-operatives need to think more about the impact of gender, youth, and people living with HIV/AIDS and to understand how special attention and differential treatment for such groups will affect co-operative development. Co-operatives need to understand more fully the diverse and complex ways in which the pandemic is affecting them, including the loss of labour and market opportunities. They need to be sensitive to the double burden of care for women and girls in their communities.
Using an HIV/AIDS-lens requires careful planning, gender sensitivity and community participation at all stages (from design, to implementation, to evaluation) in the development of a comprehensive approach. In combating HIV/AIDS, it is important that co-operatives are inclusive of marginalized and vulnerable peoples, such as young women and girls, and people living with HIV/AIDS. There is a need, which co-operatives could help meet, to develop specific indicators for success with HIV/AIDS mainstreaming. HIV/AIDS indicators should become part of the larger indicators of any development programme in which co-operatives are engaged, so that everyone will understand both the intended and unintended health successes arising from community economic empowerment strategies.
How can we effectively mainstream HIV/AIDS into cooperatives?
- Conduct a baseline study on HIV/AIDS prevalence at co-op project sites prior to project implementation.
- Create success indicators that capture intended and unintended results of general health.
- Design indicators to reflect the unique challenges of both men and women living with and affected by HIV/AIDS.
- Increase relevance and accessibility of information to marginalized groups
- Increase inclusiveness of youth living with HIV/AIDS.
- Determine how specific activities/initiatives are different in a context where HIV/AIDS has changed dynamics of households and labour forces.
- Determine the risk and/or vulnerability of groups benefiting from the project.
- Communicate with the community to determine the need for HIV/AIDS training, level of awareness and social attitudes around sexuality.
- Coordinate with other NGOs that are providing HIV/AIDS information to cooperatives.
- Evaluate the impact on employees (e.g., trained members are dying, funerals interrupt meetings).
- Develop monitoring tools that map the outcome of other partners also working at project sites.
- Evaluate HIV/AIDS mainstreaming as part of overall health, livelihood and ecosystem improvement, as opposed to just infection or prevalence rates.
- Encourage youth to become involved in leadership positions.
- Appoint youth focal persons to monitor HIV/AIDS activities.
- Mobilize youth around fighting discrimination of people living with HIV/AIDS and stigmatization.
In this context, the support and engagement of youth is particularly important. Co-operatives can be effective instruments for mobilizing young people to understand and to work against the immediate and contextual causes of the HIV/AIDS pandemic. They could help significantly in combating the social, legal and economic contexts that contribute markedly to the deepening crisis. Their energy, vitality and knowledge should serve as an important root for co-operative sustainability in the face of the pandemic.
Nicole Ghanie graduated from the Environmental Studies programme at York University and was an intern at the International Development Research Centre in Ottawa in summer 2003. Her honours thesis explored the issue of AIDS in Africa and sustainable development. She completed a York International Student Exchange at the University of Amsterdam in 2001-02 and was one of fifty York students chosen in 2003 by York International to participate in the conference titled "Emerging Global Leaders." She has worked extensively with the Alliance for South Asian AIDS Prevention (ASAAP), a non-governmental organization (NGO) dedicated to outreach and education about healthy sexuality for South Asian communities in Toronto. Currently, she is furthering her work on HIV/AIDS prevention in Kenya.