There are currently approximately 754,000 students enrolled at public universities in South Africa. These students' ages range from 18 to 30 years. There are also 300,000 students enrolled at Further Education and Training Colleges (FET) and approximately 50,000 students in private higher education institutions throughout South Africa (HEAIDS Report, 2010).
Many of these students are in the prime of their lives. Sexual activity is part of their experimentation and this often goes hand in hand with high rates of HIV infection and other sexually transmitted infections (STIs). This often is a result of new found freedom at university and being away from home with no adult supervision. University campuses therefore are ideally situated to offer peer education. HEIs present structured and informal opportunities for all these
students to meet and socialise in the absence of adult and community constraints. These opportunities often lend themselves to substance abuse and alcohol abuse, which might lead to irresponsible sexual activity and unsafe sexual practices. This quite often leads to engagement with multiple sexual partners, which places these young people at risk of contracting STIs and HIV/AIDS (HEAIDS Report, 2010).
On the other hand, students who decide to further their education become more receptive and open to different kinds of health education and health-promotion messages. They develop inquisitive minds and become more aware of a healthy body and mind. Students realise that in order to fulfil a lifelong dream to become educated, it is important to remain healthy, physically as well as psychologically. Being a student includes preparing oneself for a future. Very often this future goes hand in hand with a professional career, hence avoiding high-risk behaviour is part of preparing for this healthy future and a profession (Deutsch & Swartz, 2003).
2.18.1 The current model of peer education at HEIs
Currently the literature shows that peer education programmes on HEIs focus on the following: 1. Preventing the spread of HIV/AIDS and other STIs on HEI campuses;
2. Promoting social norms and providing support for developing healthy attitudes and behaviour on campus;
3. Reducing the stigma attached to living with HIV/AIDS;
4. Providing role models for healthy sexual behaviour on campus;
5. Providing education about human rights with special reference to issues of gender; 6. Encouraging participation in voluntary counselling and testing (VCT);
7. Encouraging participation in the care and support of people infected with HIV and sick with AIDS (Deutsch & Swartz, 2003).
These topics are extensively focused on, and are aligned with, the four roles that Rutanang (Refer to 2.18.2) proposes for peer educators. All HEIs in South Africa adopted this model (Deutsch & Swartz, 2003).
One of the main outcomes for the first phase of HEAIDS was a model for the establishment of peer education. This model has been used extensively by HEIs. It is called Rutanang (meaning "learning from one another" in Sotho) (Deutsch & Swartz, 2003).
2.18.2 The Rutanang model
The Rutanang model, "learning from one another", is a collaborative project of the South African Departments of Health, Education and Social Development, the South African Vice- Chancellors' Association (SAUVCA), numerous non-governmental organisations (NGOs) and selected United States (US) partners. The following sponsors made the materials available: the Harvard School of Public Health; the Association of Schools of Public Health through a cooperative agreement with the Centres for Disease Control and Prevention (CDC) and USAID. This project is intended to support life skills and HIV/AIDS activities within HEIs. It includes a set of documents that has been developed over a period of eighteen months. At least 300 people were involved in developing this material throughout nine provinces in South Africa. Three national consultative meetings were held to verify materials that were developed. At the national consultative workshops the sustainability of the series was also discussed and ensured. The major aim of the Rutanang process is to provide facilitators and participants an opportunity to reflect and evaluate the contents of the series. This will allow for programme improvement by both the facilitators and participants. Rutanang consists of a series of five books. The books include standards of practice for peer education in South Africa, a peer education implementation guide for NGOs, for schools and for HEIs in South Africa, as well as extensive lesson plans (Deutsch & Swartz, 2003).
2.18.3 Book 4: A peer education implementation guide for higher education in South Africa
In the executive summary of this series Dr Simela, Chief Director HIV/AIDS, STIs and Tuberculosis (TB), National Department of Health (2003:111) describes young people as the most vulnerable group to contract these diseases. She believes young peoples' discussions are mostly about sexuality with their peers. They talk, listen and learn about sexuality from one another. Adults therefore are not regarded as credible messengers to teach about abstinence and other responsible sexual behaviours. She said the following:
The necessary outcomes of HIV/AIDS education, including reinforcing accurate and consistent information, helping young people examine and change how they think and behave sexually, building their decision making skills, facilitating violence, require face to face discussion with people who are trusted, knowledgeable, accessible and relatively comfortable talking about sexual matters (Deutsch & Swartz, 2003:111).
This is also the rationale behind peer education in schools, NGOs, CBOs and in HEIs in South Africa.
Another tool that was developed by HEAIDS is a CD-ROM, which was widely distributed to all HEIs for use in peer education programmes. A discussion on this tool will now follow.
2.18.4 "YOURE MOVES: A game of love and life" – CD-ROM
This educational CD-ROM was developed in 2003 by HEAIDS. All institutional officers responsible at the time for HIV/AIDS activities on their respective campuses were issued with a hundred copies. At the time of the development of this tool I was the institutional officer at my HEI. I distributed the CD to all faculties and departments and put some in the library. My copy I still use for educational purposes when I do HIV/AIDS education with youths at school or church level. This CD-ROM consists of games, which could be played by both male and females. It includes topics such as dating and relationships, hetero-, bi- and homosexual. It also speaks extensively to the abuse of alcohol and drugs. Lastly it spells out the dangers of contracting STIs and eventually HIV/AIDS. It also allows young people to test their own knowledge with regard to STIs and HIV/AIDS by doing the various quizzes on the CD-ROM. The CD-ROM ends with an extensive resources list, where these young people could access more information when required.
Examples of Quiz Questions are:
"Young people between the ages of 15-24 are particularly at risk of contracting HIV True
False" (Your Moves – CD-ROM, HEAIDS, 2003).
At the end of each question the correct answer is given with an extensive explanation. These young people also get a chance to score themselves. By doing the quiz and the scoring, they are able to assess their own level of knowledge.
This CD-ROM is utilised in the HEI where the project is being done. It is used with the integration of the HIV/AIDS module into the curriculum (Your Moves-CD-ROM, HEAIDS, 2003).
This initiative from HEAIDS seems to have been very popular on HEI campuses Some libraries installed booths where students could access the CD-ROM in their own time and in this way expand their knowledge on sexuality, STIs and HIV/AIDS issues.
Story telling became another means of allowing young people to gain more knowledge and to deal with so many issues that they might have to cope with regarding to their own sexuality and HIV/AIDS.
2.18.5 Story telling
Story telling could be used by peer educators to relate stories about themselves, family and friends who are all affected by or infected with HIV/AIDS. One of the HEIs also used story telling as a means for young people to express themselves and to gain knowledge. This was particularly helpful in the child-headed households where the parents had died of HIV/AIDS. Some children also are left to grow up with elderly grandparents. By the time they reach HEIs they have so much "baggage" to deal with, particularly as they become more knowledgeable about HIV/AIDS and realise that's what their parents died of (Digital Story telling Project: Voices of the Youth-Soweto, 2006).
Many non-governmental organisations (NGOs) emerged that also contributed to HIV and tuberculosis education, not only in the communities, but also in HEIs. One of these NGOs is Mindset.
2.18.6 Mindset outreach programme
Mindset Health provides free digital health education. This content is presented in video, multimedia and print formats. It is also produced in various local languages, including Zulu, Xhosa, Sotho, English and Afrikaans. The major goal of Mindset is to promote health through the empowerment of health care providers and health workers. Together with Johns Hopkins University and USIAD, they produced eight 10-minute video case studies with facilitation guides for pre- or in-service training of health care providers in HIV/AIDS and tuberculosis. I was very fortunate to have the team come and do training on our campus. These facilitation
guides and videos are extremely educational and are also used in peer education training programmes.
This training material consists of different modules. Examples of modules are:
Module 1: Introducing Mindset network
Module 2: Overview of the Mindset health technology and content Module 3: Facilitation skills and your role as facilitator
Module 4: Various HIV/AIDS-related topics, e.g. How to adhere to ARV treatment; Women
and violence etc.
Mindset Health also has an extensive focus on outreach programmes, with a particular emphasis on peer education. The facilitators do peer education programmes at schools and amongst sports communities. Case studies consist of various topics on STIs and HIV/AIDS as well as tuberculosis (Mindset Health Facilitation Guide, Series 1, 2007).
2.19 UNIVERSITY OF WESTERN CAPE (UWC) AND UNIVERSITY OF ZAMBIA