Groundbreaking trials in Sweetwaters, Pietermaritzburg
 | | Fieldworkers at the Sweetwaters launch |
The HSRC officially opened a research office in a rural area outside Pietermaritzburg on 29 August, from where three large, multiyear, randomised control trials are being conducted. These trials will continue for the next five years.
The trials are aimed at testing the effectiveness of interventions in communities, in collaboration with health and education services and civil society organisations, working to mitigate the impact of HIV and AIDS on families.
Dr Olive Shisana, CEO of the HSRC, who officially opened the Sweetwaters office, emphasised that "it is critical to conduct studies that generate evidence using randomised control trials of such magnitude. Arising from these studies will be recommendations that will feed into HIV prevention programme development."
Professor Linda Richter, executive director of CYFSD, who leads the studies, said this is arguably the largest research site in South Africa that concentrates primarily on social-behavioural research targeting children, youth and families in their communities.
Grants for R47 million have been secured for the period up to 2013. "These funds enable the HSRC to employ close to 150 staff, most originally from this area - making the development of the staff and the site a financially and academically viable option for the HSRC and for future research development in this country," Prof. Richter said.
The first project began in 2004. "Key to our success are the partnerships we have built with traditional authorities, ward councillors, health and education services, faith and other civil society organisations," said Prof. Richter. "Through these key partnerships we are able to create employment opportunities that retain talented young people in this community, and contribute to the development of the area as a whole. We try as best as we can to source materials and labour from the area."
Ms Heidi van Rooyen, who heads up the Sweetwaters office, explained that the HSRC's work here aims to evaluate various types of interventions that address the wider context of vulnerable children and youth, as well as their families and communities.  | Schoolgirls performing at the launch |
The projects Project AcceptA phase III, randomised controlled trial of community mobilisation, mobile testing, same-day results, and post-test support for HIV in sub-Saharan Africa and Thailand
Project Accept, is one of five sites in a multi-country randomised controlled trial in 34 communities in Africa (South Africa, Tanzania, and Zimbabwe) and 14 communities in Thailand.
The study aims to test the comparative advantage of two approaches to HIV prevention using voluntary counselling and testing (VCT), establishing the number of recent HIV infections (incidence) in the population, together with self-reports about behaviour and attitudes. The trial includes comparisons of costefficacy between the two approaches. The overall aim is to rapidly increase the number of people in the community who know their HIV status.
Project Accept suggests an alternative model to the standard facility-based VCT services in the country, namely community mobilisation for testing, immediate test results made available by mobile services in communities, and linking testing to post-test support services for both HIV-positive and HIV-negative individuals and people in their social networks. The data provides evidence that this community-based approach attracts hard-to-reach target populations that are not serviced by health facilities, including men and young people.
After 25 months of intervention, 5 105 clients have been tested in the mobile VCT services, with a relatively equal number of men (45%) and women (55%), and with more than 72% of the participants falling between in the 16-32 age group.
This multi-site study involves collaboration with four USA institutions (Johns Hopkins University; University of California, San Francisco; UCLA and University of Washington) as well as five non- US institutions (Muhimbili Medical College of the University of Dar es Salaam; University of Zimbabwe; University of Witwatersrand; Chiang Mai University and the HSRC).  | Prof. Linda Richter addresses the audience at the launch |
Project Masihambisane Mentor Mothers: A sustainable family intervention in a South African township
Prevention-of-mother-to-child-transmission (PMTCT) coverage is low in South Africa, with only about 30% pregnant women who need these services, using them. This represents a missed prevention and treatment opportunity for mother, child, father and others in the family circle.
While there is increased commitment to invest in the quality and quantity of PMTCT, evidence is required on how best to improve the programme's reach and impact, and what investments are required to do so. Project Masihambisane, a clinic-based effectiveness trial, attempts to address an important aspect of this evidence gap. The intervention is being implemented in eight primary health care clinics in the Vulindlela District and beyond, all of whom are currently delivering the standard PMTCT programme.
Participants in four clinics will receive the PMTCT programme, while in the other four clinics the PMTCT programme is being supplemented with a mentor mother support programme. The impact of the intervention is being assessed over 12-18 months. The premise is that mothers living with HIV and who receive good information and helpful support from HIV positive mentor mothers will have better outcomes than mothers receiving routine services, in terms of parenting, health practices, HIV prevention, mental health, and their baby's health and development.  | Nkosi N. Zonda and Dr Olive Shisana unveil the plaque at the new HSRC office in Sweetwaters |
The study is being undertaken in collaboration with the Semel Institute and the Department of Psychiatry, UCLA as well as other local and international collaborators. Going to Scale<em class="pn-bolditalic">A research project to test income interventions to improve the well-being of South African children affected by HIV/ AIDS and poverty Going to Scale (GtS) is a study of about 6 000 children and their families, which aims to generate scientific and policy-relevant knowledge about how South Africa's children are being affected by HIV/AIDS and household poverty - 60 communities are being randomised to receive a variety of interventions to improve access to social grants and services. Children's outcomes are being examined on a community level (for example, community resources and norms) and on the household level (for example, household poverty and harmful childhood experiences) as well as at the level of the child (for example, growth, health, school attendance and performance). Children will be followed up for three years through schools and communities. The study is being undertaken by a research team from the HSRC, New York University in the USA and local and international collaborators.
Media session inspires spirited debate
"People working in the media don't really like thinking about themselves. They report about what other people are thinking. But the South African media has changed radically in the past 14 years. It's become very necessary to think about what role media players are taking in relation to power and identity," said Adrian Hadland, opening up a spirited session at the third Cape Town International Book Fair.
Under the banner ‘Holding us together or pulling us apart? The role of the South African media in the creation and mutation of identities', six panellists plus media veteran Denis Beckett as chair looked at a range of ways that a changing media is currently engaging with a changing society.
Adam Haupt of the University of Cape Town (UCT) focused on how local producers of culture piece together black male identity through television series, music and film. By analysing the scripts, the imagery and the music of three specific productions - Yizo Yizo, Hijack Stories and Tsotsi - Haupt found a view that rewards violent, heterosexual thuggery. But, asks Haupt, what of the unfortunate men like himself who are not gangsters, or misogynists, or criminals? Who is rewarding them in the media?
Tanja Bosch (UCT) spoke of exploring online racial identities through social networking sites such as bruin-ou.com. Her research probes notions of coloured identity as expressed on the internet. She has found that online commentary is often a reflection on a disappearing identity, and that websites help draw people together to try and make sense out of this. Ian Glenn, head of the Centre for Media and Film Studies at UCT, leapt to the defence of the tabloid press in South Africa, which frequently bares the brunt of criticism from media academics. He reckoned that not only do the tabloids promote literacy, expand newspaper sales and give a voice to people who are often marginalised in the mainstream press, but they are staffed by strong professionals. Glenn said the tabloids were hiring his best graduates at a time when the broadsheets were cutting back on staff. During the lively discussion thoughts were raised on corporate influence on the media, whether tabloids were African and patriotic or un-African and unpatriotic, and whether the expansion of media channels via blogs and the like had turned the general public into media producers. Also, if this was the case, whether there was a definite need for good editorship to ‘guarantee some quality amidst all the noise.' A visitor from Germany said he had lost faith in South African media which he described as a yellow press which had lost its credibility. The media was also criticised as being ‘deeply homophobic and sexist', with some panellists themselves called to task for their throwaway lines about ‘moffies' in the tabloid press. Ian Glenn responded by saying that the tabloids may be politically incorrect in using headlines like ‘Moffie hooker shot in gat', but they reflected the authentic voices of the Cape Flats. Adam Haupt pointed out that in South Africa the tabloids and the broadsheets were owned by the same companies. He asked: Who was making money out of ‘a pathology that was like Jerry Springer gone local'? Ultimately, chair Dennis Beckett concluded that while the session may not have provided specific answers to questions, it had certainly provoked a whole set of new and exciting ideas.
Adrian Hadland is the editor, together with Eric Louw, Simphiwe Sesanti and Herman Wasserman, of Power, Politics and Identity in South African Media (HSRC Press). Haupt, Glenn, Bosch and Narunskey-Laden are all contributors to this volume.
Most influential women award for Dr Shisana
| |  | | | Click on thumbnail
to view larger image |
Dr Olive Shisana, CEO of the HSRC, received a CEO Magazine’s award for South Africa’s most influential woman in business and government in Cape Town on 25 August. She won in the category Public Sector and Utilities. CEO magazine has embarked on a campaign since February to salute women who are trying to transform South Africa socially and economically as well as to honour extraordinary women who have had an effect on other women. Annalize Wepener, CE of CEO Holdings, said that in choosing winners they were more concerned with looking at the impact of the work of these women, not only in their organisations but also in transforming South Africa.
How successful is racial redress?
Adam Habib got straight to the point at the HSRC Press discussion on racial redress at the 2008 Cape Town International Book Fair. Addressing a capacity crowd, Habib, deputy vice-chancellor of the University of Johannesburg, identified a key challenge facing South Africa that of advancing racial redress while simultaneously building a national identity. While acknowledging that racial redress, in certain areas, had been a success, redress in terms of gender and disability has been bad.
Moreover, redress in the form of BEE initiatives has largely benefited the black middle class. In order to achieve redress which would impact on a broader scale, particularly on disadvantaged communities, Habib advocated a class-based strategy supplemented by racial initiatives. In this way, he proposed, South Africa could move closer to the ideal of a cosmopolitan nationality.
Jeremy Seekings (UCT) took the debate further when he argued that ‘not all forms of redress are about race, nor do they address poverty, but they can create a Patrice Motsepe'. He proposed that BEE policies might be re-racialising society at the same time as making it possible for some people to become super-rich, superfast. There was something profoundly inequitable in this, he said. What was clear was that questions of redress - of what and for whom - had not been fully addressed in either the public or the academic domain.
Thiven Reddy (UCT) confessed to feeling disappointed and disillusioned at the lack of debate around redress, and in examining whether or not we have reached the goals of a post-apartheid South Africa. He posed that redress, as managed by the state, had been largely couched in the language of affirmative action. Instead, he argued, we should have been more creative and innovative. South Africans would probably never attain full emotional or psychological redress, but attempts at material and political redress could be better, he said.
Ivor Chipkin (HSRC) focused specifically on redress within the public service to evaluate the successes and failures of redress. Based on research he has done, his findings revealed that while on the surface the numbers looked good - 73 % of the public service is now black - there were worrying trends underneath the veneer. Specifically, posts were kept vacant in a ‘perverse incentive' to meet equity ratios, and there was a high level of movement among posts, largely due to impossible job descriptions which set black managers up for failure. Chipkin concluded that there was an immediate need to address white racism, in general, as an inhibiting factor regarding redress.
This was echoed from the floor when the debate was opened up. Dr Zimitri Erasmus of UCT said that ‘the wrongs of apartheid needed to be put at the centre of the problem, and then white racism could be addressed.' She added that ‘the question then is, who is to do this white work', raising the issue that black people are often expected to ‘help' white people with their racism. This was followed up by author Christi van der Westhuizen, who said ‘white denial and white privilege was a huge problem', and that what was needed was ‘a national debate on what racism means'. Other points from the audience included the need to address racism and redress at school levels, and the negative stigma attached to affirmative action, including that it was seen as being ‘not about the pursuit of excellence, but about the pursuit of a big salary'. Continuing on this theme, it was noted that often the focus of redress has been on acquiring wealth, but that at the same time it has resulted in vast discrepancies between rich and poor. On a more controversial note, the discussion also touched on the issue that white racism has become an excuse for policies that aren't working. It was also noted that disability, as a focus of redress, was largely ignored. While disability policy was ‘wonderful', people were not getting access to the services they needed. It was argued that educational institutions and civil society need to see disability as a human rights issue.
In conclusion, Habib proposed that the discussion clearly showed that what was needed was more nuanced debate around redress and racism. The challenge now, was to look at how to create the spaces where such debate could take place, in the spirit of a cosmopolitan nationalism.
Adam Habib is co-editor with Kristina Bentley of Racial Redress and Citizenship in South Africa (HSRC Press). Ivor Chipkin and Zimitri Erasmus are contributors to the publication.
|
