Collaboration between Faith-based Communities and Humanitarian Actors when Responding to HIV in Emergencies

This Overseas Development Institute (ODI) Project Briefing explores the "unexploited capacity" that faith-based communities (FBCs) have in delivering HIV prevention, treatment, and care. It is based on the observation that FBCs may be the first port of call for local people during a crisis, and often continue to provide HIV services when others do not. However, misconceptions may have been hampering humanitarian organisations from engaging with FBCs - e.g., due to the worry that FBCs are unable to provide HIV prevention services without a religious agenda. This briefing presents key findings and recommendations for the faith community and humanitarian actors.

A collaborative study between ODI, World Vision, and Tearfund that was conducted in 2009 involved a global literature review followed by field studies in Democratic Republic of Congo (DRC), South Sudan, and Kenya. A qualitative methodology was used; informants included people affected by the emergency, people living with HIV (PLHIV), and members of the FBC. The study focused only on responses within the Christian community.

The study found no systematic HIV training for the clergy, and highlighted the fact that there is a wide spectrum of faith-based approaches to HIV. In terms of the added-value that churches can bring to HIV-programming, responses included the following: they can use their structures and networks to obtain emergency funds; they can spread messages; they can provide access to HIV prevention and treatment services for rural or marginalised communities; they can maintain projects during insecurity because their staff tend to be local volunteers; and they provide higher-quality and more consistent services than government facilities. However, HIV initiatives managed by the local religious community can have shortcomings. For example, there are reports from Kenya and DRC of them encouraging members to stop taking antiretrovirals (ARVs) to allow God to heal them. Also, interdenominational competition has been found to limit collaboration and learning. In addition, the demands on local people to participate and volunteer are sometimes too great, and staff rarely have the skills required for HIV interventions, proposal writing, and reporting.

The study found insufficient preparedness for HIV responses during emergencies among FBCs. That said, there were reports in all 3 case studies of mission clinics and hospitals staying open when other facilities had closed due to the conflict. Furthermore, the study found that the continuous presence of churches during conflict builds trust amongst local communities. Churches acted as mediators between communities and aid organisations, helped mobilise groups to implement activities, and negotiated safe passage for humanitarian actors. Churches are also identified as having a role in bolstering community participation in the form of volunteerism, which is described here as fostering project sustainability; many volunteers saw their work as a religious calling and social duty. Also, respondents felt that the church has a role to play addressing gender discrimination, which leaves women and girls vulnerable in general, and particularly in emergencies. This is mirrored by women describing the church as a place to receive hope and comfort: "We may feel ashamed to share our stories of rape or living with HIV, or husband dying of HIV, but we know the pastors will listen", was one comment from a focus group discussion in DRC. In camps for refugees and internally displaced persons (IDPs), the local religious community often engages youth in recreational activities. According to study respondents, this gives youth the chance to discuss sexuality, HIV, and faith. However, messages about adolescent sexuality and faith may be inconsistent; some churches insist on abstinence, while others talk openly about abstinence, faithfulness, and condom use.

Communication-related recommendations outlined in the report include:

• Humanitarian actors need to help FBCs build up their emergency capacity on HIV services by engaging youth, unemployed men, and female heads of households in sustainable livelihood initiatives, alongside HIV community service projects, with a strong focus on PLHIV. Further training for FBCs should include disaster risk reduction, emergency preparedness and how to incorporate HIV and AIDS into humanitarian planning responses.
• The church needs stronger skills and resources to address gender dynamics, domestic violence, tribal reconciliation, and the involvement of men in HIV testing and treatment - "using proven Christian-based facilitation tools to tackle misconceptions of HIV, address stigma and discrimination towards PLHIV, enhance family dialogue, and improve relationships with humanitarian actors."
• Humanitarian actors should work with FBCs to develop a comprehensive strategy for children and youth, focusing on their rights to survive, be safe, belong, and develop. Components could include life skills training, peer education, mentorship, family dialogue, basic education, vocational training, and adolescent-friendly reproductive health services.
• Humanitarian actors should draw on the fact that, as identified here, "Trusted members of the local religious community are well placed to initiate dialogue on gender roles and social norms, work with households to promote rapid response to and reporting of violence against women; and become a voice for women."
• "Building local skills in HIV prevention, care, and counselling is possible through religious networks. The uniform building of capacity for faith-based youth outreach workers will create an interface between health facilities and communities, and local human resources to call upon during crisis." International humanitarian FBCs can draw on their global experiences to develop a Christian-based training programme along these lines, as suggested here.
• "There is a need to promote inter-denominational coordination to combine resources, improve coverage and expand disaster risk reduction programmes."

In conclusion, this report notes that "It is crucial that humanitarian stakeholders collaborate with FBCs by understanding their role in the community and their skills in leadership, influence and key services."

For more information contact:
Fiona Samuels
f.samuels@odi.org.uk

Fiona Perry
fiona_perry@wvi.org