Briefing Paper
Foyeke Tolani (Health Adviser & HIV and AIDS focal point, Humanitarian Dept.)
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Zimbabwean woman said: It is
Why mainstream HIV and AIDS better to get AIDS than to watch
your kids starving.
in rapid or slow onset - Some men/boys may engage in
emergencies? work that can entail mobility and
1. In some emergencies, there is the family disruption (migrant labour,
potential for increased vulnerability to truck driving, fishing etc).
infection with HIV and to the impacts - Loss of labour due to illness or
of the HIV and AIDS epidemic, due to increased caring and it may lead to
the following factors selling of productive assets.
- Breakdown of family and social - Disruption and displacement may
values and networks, with lead to separation of the infected
increased vulnerability and person and their carer
susceptibility especially of women - Lack of medical services,
and children; especially access to antibiotics and
- Increase in rape cases/sexual anti-retrovirals, will seriously
violence often by military or
paramilitary or due to poor siting of
affect the health of HIV positive
water and sanitation facilities e.g. people.
in dark unlit areas
- Breakdown in supply chain for
Essentially, consider the needs of both
condoms leading to more
people infected by HIV and those
unprotected sex
affected by it!
- Population movement/ increased
mixing of populations with different
HIV prevalence
- Decreased availability/ utilisation Who should mainstream HIV and
of reproductive health and other AIDS?
services/means to prevent Every staff member is expected to
transmission etc mainstream HIV and AIDS both internally
and externally in programmes. HR
2. HIV can worsen the emergency together with the programme manager
situation (depending on the should ensure internal mainstreaming e.g.
prevalence in the country before the initial assessment, rolling out HIV work
emergency) by: place policy, and providing staff with
- Undermining existing positive information and an enabling supportive
coping strategies in HIV-affected environment to prevent HIV and AIDS.
households, and over-burdening
carers On external mainstreaming, it is expected
- Causing the host community or that all programme technical and support
other cultures and ethnic groups to staff should mainstream HIV and AIDS
discriminate against people living and the programme manager should
with HIV and AIDS (PLWHA) in the delegate and make this happen. Some
new environment health promoters may have background
- Increasing the vulnerability of information on HIV and AIDS prevention
orphans and other vulnerable and they may be useful resource person in
children affected by HIV, old the process but the responsibility lies with
people and child headed everyone. Nominating a focal point will
households etc ensure adequate dissemination of relevant
information, monitoring and feedback on
3. Increased vulnerability of potential progress made.
vulnerable groups (women, men,
children, older people, disabled Where do we mainstream HIV
people, PLWHA, ethnic minorities etc) and AIDS? (Slow/rapid onset or
to HIV transmission. For example: high/low HIV prevalent areas?)
- Women may turn to commercial
sex work or sex for subsistence as There have been different arguments on
a coping mechanism, or because whether it is necessary or not to
their lives have been disrupted by mainstream HIV and AIDS in rapid onset
war, widowhood etc. As one emergency especially when there are lots
of life saving activities to do; or why bother
Foyeke Tolani (Health Adviser & HIV and AIDS focal point, Humanitarian Dept.)
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to mainstream in areas with low For details, see section 3: How to
prevalence? Based on the importance of mainstream HIV and AIDS in
how an emergency may: emergencies in Humanitarian
Impact negatively on vulnerable programmes and HIV and AIDS by
groups, increase transmission of the Walden et al (2007).
virus from high prevalence to low
prevalence areas, Things to consider for minimum
Make PLWHA (if they exist) more response
vulnerable to opportunistic diseases
due to lack of water, food, clean water, Keep the focus of your humanitarian
general hygienic facilities etc. programme
It is worth taking the first step in Avoid stigmatisation during
mainstreaming which is assessment assessment (especially in the way
and analysis of possible risk to information is collected), program
increase in transmission of HIV (to staff analysis, implementation, monitoring
and beneficiaries) and how the and evaluation
emergency has impacted on those Find out about the HIV situation in the
infected and affected by the virus. This emergency affected country and
will ensure that the most vulnerable are amongst the affected population
heard, represented and their needs met Based on assessment and analysis:
accordingly. It will also contribute to - Use vulnerable households or
meeting Sphere standards, promote chronically ill as a criteria in order
Oxfams right-based approach and the aim to avoid stigmatisation
of Do no harm in addition to fulfilling our - In water and sanitation work,
corporate objective. consider the safety and protection
of vulnerable groups as well as
need for closeness of water and
Oxfam has a mandatory objective to sanitation facilities to persons with
mainstream HIV and AIDS in all disability/long chronic illness
programmes by 2010 and in the year - Livelihoods work should be suited
2007/8 it is expected that 40% of all to the special needs of both those
emergency responses mainstream HIV affected and infected
and AIDS effectively into their Consider issues of gender and
programmes protection
Make sure your staff are informed
about HIV facts
How do we mainstream HIV and Make sure that there is good two
AIDS? way communication and flow of
Like gender it is expected that programs information between the emergency
mainstream HIV and AIDS throughout the affected community and your
emergency project cycle. i.e. organization. Use participatory ways to
Pre emergency: Collect specific also involve PLWA in discreet non-
information to map susceptibility and threatening ways.
vulnerability of population to HIV and
AIDS, create enabling and supportive Some practical examples
workplace environment. Uganda IDP and flood responses
Assessment: Integrate with PH/EFSL Trying to ensure vulnerable (including
assessment (determine predisposing families with a chronically ill member)
factors to HIV transmission, needs of people are exempt from water user
people with long chronic illness, fees as well as avoid the queue
access to health services, condoms Training to community outreach
etc) workers and awareness raising with
Implementation Minimum response contractors on HIV.
Do no harm e.g reducing Protection in shelter special
opportunities for sexual and gender provision for girls and young women
based violence (SGBV), mainstream as well as HIV education
gender, raise staff awareness, During the 2007 flood response,
coordinate with others Oxfam distributed Jerry cans (white
Monitoring and evaluation and wide mouth) that were similar to
Foyeke Tolani (Health Adviser & HIV and AIDS focal point, Humanitarian Dept.)
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the ones MOH was providing to
families with PLHA. The blanket
distribution helped to de-stigmatise
those who already had but could not
use them due to the government
targeted distribution to PLHA
Foyeke Tolani (Health Adviser & HIV and AIDS focal point, Humanitarian Dept.)
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