| SAPLER Population Trust | |
| Splendidly Alive People Within Limited Environmental Resources | |
Part III: The Winterveldt Project
This is SAPLER's attempt to put a grassroots plan into action here. We concentrate mostly on family planning, teenage sexuality and STD prevention, but include other problems which fit in naturally such as relationships and oral rehydration.
Winterveldt Progress Report and Assessment
by Caroline Argent
Description of Project
The pilot project in Winterveldt started on Sunday 9 November 1994 with the first of eight community meetings. The project is designed to be community initiated and directed. As this project involves nompilos who work within the community, it is essential that they have the full support of the community and all its structures. The process of organizing the project involved: community liaison, meeting relevant community organisations (civics), approaching health facilities, finding relevant training organisations to train the nompilos (preferably an accredited training organisation), and setting up the relevant structure for the project to be community organised and directed.
The project employs nine nompilos and one trainee coordinator. The nompilos' job involves doing community education in concepts of family planning, the practicality of family spacing, teenage sexuality, sexually transmitted diseases (including AIDS), first aid and some mother and child health.
Their job is purely promotive health education and does not involve any curative procedures. The nompilos are trained to refer people to the clinic and to promote better attendance at the family planning and STD clinics.
The main aim of the project is to see a decline in unwanted pregnancies, especially in teenagers, a growing usage of the clinic for family planning contraceptives, and a drop in the occurrence of sexually transmitted diseases within the communities where the nompilos are working.
The trainee coordinator was employed to learn the skills necessary for running the project once the SAPLER project coordinator had set up the project and felt the project needed no more assistance in achieving the aims described above. The trainee coordinator is a community member from the area in which the project is run.
The project is designed to be self-sustaining. This means that apart from creating a project which is successful in reducing unwanted pregnancies and STDs, and increasing family planning attendance at the clinics, there needs to be some form of income generation for the project so that in the long run large amounts of external funding do not need to be sought. Creating income also helps alleviate poverty.
The project therefore has two distinct functions and is designed as such.
There is a coordinating executive who will assess and co-ordinate the funds of the project and help fundraise for the community to start businesses the community members feel are viable. The other function of the project is the community education on reproductive health issues.
The pilot project was initiated with a discussion about nompilos who would be specifically trained in reproductive health issues with the women's executive of the Tum61ong nutrition centres.
The women's executive liked the idea of family planning nompilos and were keen to have them in the communities around the nutrition centres.
There are eight nutrition centres in the project - five in Winterveldt and three in the Hammanskraal area.
Community meetings were then organised in these eight communities. The process of advertising the meetings and negotiating with the relevant community civics took a lot of time and consultation. It was found that each community is different and it depended a lot on the organisation of the local area committee and civic as to how successful the attendance was at the meeting. Some meetings were initially very poorly attended and had to be reorganised. Some communities had six or seven meetings before a fair amount of people attended the meeting.
The poor response by the communities is indicative of distrust and disillusion with the idea of improvement in living standards in most of these poverty stricken areas. Most of the work in this period of the project was to create the feeling that tackling the health issue at a grassroots level would actually make a difference.
The project is designed to be run on three different levels:
Level one - the nompilo.
Level two - the committee of five.
Level three - the executive committee.
At grassroots level, level one, there is the nompilo who does house-to-house and group education in reproductive health issues. The nompilo also does initiation and discussion on community development.
Level two is a group of five community-chosen community members whose job it is to handle community complaints about the nompilo, to co-ordinate the community job-creation part of the project and liaise with the executive committee.
Level three is the executive committee which consists of one representative from each community and the project coordinator or trainee coordinator. Their job is to control the funding of the project and to ensure that the job-creation part of the project is working.
Nompilo Training
The nompilos were trained by Boskop Training Centre. They attended a two week training course in Winterveldt run by two trainers who came from Boskop Marble Hall training centre. The course included training in:
1. Contraceptives: advantages and disadvantages.
2. Family planning motivation.
3. Concepts of family spacing.
4. Relationships and communication (different types of relationships).
5. Sterilisation (techniques and procedures).
6. Natural family planning techniques.
7. Menstruation.
8. Reproductive organs.
9. Fertilisation.
10. AIDS and other sexually transmitted diseases.
11. The different stages of pregnancy.
12. Oral rehydration.
13. Basic first aid.
14. Communication skills.
This training occurred in the second and third week of January. Continued training for the nompilos takes place every Monday and includes:
Literacy
Training in Facilitation
Report Writing
Lesson Preparation
Community Liaison
Cancer of the Cervix
Problem Solving
Capacity Building (for the community and for the nompilos themselves)
The training on a Monday has proved to be a very beneficial support structure for the nompilos as they are able to discuss with the other nompilos their problems of the previous week. The nompilos then workshop solutions and support each other. It seems that this teamwork approach is one of the most valuable contributing factors to the success of the project. The nompilos feel more secure in their decisions and actions. They also sometimes work together in training larger groups. This cohesiveness also allows the nompilos to learn from others' experiences and therefore be more prepared to tackle a similar problem if it arises in their community.
History: Boskop Training Centres was established in 1976 as a small service supplier who catered mainly for the needs of agriculture.
Boskop has since broadened out to include other sectors besides agriculture.
Its mission is to "strive towards optimal growth and financial independence as well as the upholding of professional norms and standards."
Boskop Training Centres adheres to the Christian system of values and undertakes to provide quality services in all its activities.
Boskop has centres in Marble Hall, Tzaneen, Nelspruit, Krugersdorp, Somerset West, Ceres, Upington, Port Elizabeth, Potchefstroom, Baynesfield and Kroonstad.
Community Health Care Workers in SA"It has been indicated that the health and fp services of this country are not meeting the needs of rural people. If we are to meet our objectives, alternatives have to be found."
Boskop offers the full primary health care course based on GOBIFFFF. (A UNICEF concept,):
1. Growth and Development
2. Oral Rehydration
3. Breast Feeding
4. Immunization
5. Female/Family Education
6. Feeding
7. Family Planning
8. First Aid
9. Record Keeping
10. Personal Development
The SAPLER-nompilos of Winterveldt did a two-week course through the Marble Hall centre. In addition to Family Planning they did Oral Rehydration.
As they free up the other women in their area from constant child-bearing, these other women will be able to tackle the remaining phc skills.