HIV/AIDS Education: Football for Lives

Introduction

            AIDS is a chronic life-threatening disease that affects an estimated 39.5 million people worldwide (CDC 2009). AIDS develops from the Human Immunodeficiency Virus (HIV). This virus significantly damages the body's immune system, affecting the body's ability to ward off viruses and bacteria that cause disease. Treatments are available to help slow the progression of the disease, but currently there is no cure. Our best fight against this epidemic is through spreading education of how HIV is transmitted and how to prevent the HIV infection (AVERT, 2009).

            AIDS was first identified in the early 1980s. Since then, 25 million people have died from AIDS and the disease has progressed to kill an estimated 2 million people in the year 2008 alone (AVERT, 2009). Despite the current treatment options available today, many people living with HIV still progress to develop AIDS. This is mostly prevalent in less developed countries, such as St Lucia. Reasons for this include the lack of money or health insurance to pay for the medications along with infections of drug resistant strains. Also, many people are unaware of their infection because they do not get tested while others simply refuse to comply with the treatment plans due to adverse side effects (AVERT, 2009).

Specifically, in the Caribbean there is an estimated 240,000 people living with HIV and AIDS. It was reported that over 20,000 people became newly infected in 2008 and there were 12,000 deaths due to AIDS (AVERT 2009). Estimates currently show that 360,000 people living in the Caribbean are infected with HIV/AIDS, however due to inadequate monitoring and widespread underreporting of the HIV/AIDS it is thought that more than half a million people are infected with HIV/AIDS (The World Bank, 2000). In the Caribbean, 70% of AIDS cases are found in individuals aged 15-44, and half in individuals aged 25-34 years old. Given the time it takes HIV to progress into AIDS means that a majority of these infections took place in individuals who were in their teens and early 20's (Pan-Caribbean Partnership on HIV/AIDS, 2002). HIV and AIDS rates will continue to grow unless the proper education and resources are provided. In 2004, the Caribbean received $13 million by the World Bank to support their ongoing HIV/AIDS program. St. Lucia will have received US $6.4 million of this money to reduce infections, provide treatment for people living with HIV/AIDS, and to strengthen capacity building efforts to combat this epidemic (BBC Caribbean, 2004).

            Currently, the HIV/AIDS prevalence rate in St. Lucia ranges from .22% to 1.8% of the population. However, the rate is thought to be much higher due to underreporting of the disease. Under reporting is the result of stigmatism. In 2007, 684 citizens were diagnosed with HIV of which 341 progressed to AIDS. Of those 341 cases, 288 people died raising the mortality rate to 84%. Seven students traveled to this country to spread education of how HIV is transmitted and how to prevent infection (AVERT, 2009).

Background:

The government of St. Lucia has implemented policies to help negate the spread of HIV/AIDS and to monitor and manage the epidemic. The government was allotted funds from the World Bank to develop and implement a five-year national HIV/AIDS strategic plan (CIM, 2006). The national HIV/AIDS strategic plan implemented in 2005 was in effect until 2009. The plan was divided into four strategies: “advocacy and policy development, comprehensive HIV/AIDS care for all persons living with HIV/AIDS, preventing further transmissions of HIV and strengthening national capacity to deliver an effective, coordinated and multi-sectional response to the epidemic” (Strategic Plan, 2005). St. Lucia is currently engaged with UNAIDS and the World Bank in reviewing the existing plan and developing a new HIV/AIDS Strategic Plan for 2010-2014. Funding sources for the new plan include the World Bank (using the St. Lucia HIV/AIDS Prevention Program), the Global Fund (using the OECS HIV/AIDS Project), and from the Government of St. Lucia (Flood-Beaubrun, 2009). .

In addition, a National AIDS Coordinating Council (NACC) was created to manage the HIV/AIDS epidemic on the island. The head of this program is the Prime Minister of St. Lucia, which will help guarantee money and support for this program at the highest levels (CIM, 2006). Another NGO that has been established to help relieve the impact of HIV/AIDS is the AIDS Action Foundation (BPOA, 2004). This organization’s goal is to bring together stakeholders in the community and to train local decision makers on the best HIV/AIDS education practices. They have promised funding for peer-based support and discussion, especially for at risk youth and women (CIM, 2006).

These plans, policies, and strategies are a step in the right direction for St. Lucia. Currently HIV/AIDS still remains one of the major concerns for the Ministry of Health (Parris, 2006). HIV prevention programs are a crucial part to building HIV/AIDS awareness around the world. In the case of St. Lucia, lack of education to those who need it most, regarding HIV/AIDS, is one of the most pressing issues. A successful HIV/AIDS education program in the developing world is Grassroot Soccer. Grassroot Soccer is a non-profit organization formed to help combat the spread of HIV/AIDS using the power of soccer. The program uses unique practices that involve fun games, personal discussion, and active play to involve children and community members. The main principles and objectives of Grassroot Soccer are to break down the social barriers and taboos surrounding HIV/AIDS by providing youth with the knowledge, skills and support to live HIV free.

In January of 2008, UVM students implemented an educational campaign in St. Lucia using the curriculum of Grassroot Soccer called Football for Lives (FfL). UVM has since repeated this project yearly, and our group is the third consecutive group to partake in this project. FfL addresses stigmatization, and gender related issues while enhancing HIV/AIDS education in St. Lucia. Every year the FfL group reflects, and makes suggestions future groups to improve, expand, and further develop the program. The primary goal of the project is to continue UVM’s FfL program, and to educate government officials and local sports coaches about the program. Once these stakeholders are educated in the program and have been through a Training of trainers’ session, they can adopt it into their community.

 

Previous Work

            Football for Lives was established three years ago by Chris Wardell, April Orleans, and other UVM students. The pilot project began in January of 2008 at the Micoud Primary School and Vieux Fort Secondary School Campus A. During this initial visit, the group tested a sample of the programs using four of the games from the GRS curriculum, and led two training of trainers sessions. With much support from people in the community, the full FfL program was initiated during the summer of 2008. Wardell and Orleans returned to St. Lucia along with other students from New York University and University of Illinois to run the summer program at Patience Combined School and Mon Repos Primary School in Mon Repos.

The following January, Wardell, Orleans, and four other UVM students went back to Mon Repos to expand the program in Patience Primary and Mon Repos Combined Primary schools. The decision to return to these schools was heavily weighed upon the support of the project partners, which included a Peace Corps volunteer living in Mon Repos, the president of the youth and sports council, local coaches, and P.E. teachers. The program was successfully implemented. After speaking with the P.E. coaches while we were there this year, we learned that the coaches used the games from the curriculum in their classes and after school program. Our program was adapted to fit their schools and sustained through the coaches, which is the goal of the project.

This year our group changed locations to Choiseul. We were fortunate enough to have another Peace Corps volunteer, Kelli DePriest, assist us in starting the program in two primary schools in the area. While helping to facilitate the camps, she also helped us to coordinate between the ministry and the principles of the schools. We were able to successfully train many P.E. coaches in the district and at the schools. By making such strong bonds with the coaches and teachers at the schools, we have enabled a strong future partnership for the program in the future.

 

 

Millennium Goals

The Football for Lives program aims to accomplish two U.N Millennium Development Goals including that to combat HIV/AIDS, Malaria and other diseases and to develop a global partnership for development. Football for Lives was developed by modeling after a very successful HIV/AIDS education program called Grassroot Soccer. Ten evaluations in seven countries have shown “positive impact on knowledge, attitudes, stigma, and communication related to HIV” as a result of the Grassroot Soccer Curriculum ("Grassroot Soccer," 2010). The program also works to developing a global partnership by using a curriculum that originated in South Africa but now operates in multiple countries around the globe including: Botswana, Ethiopia, Kenya, Lesotho, Malawi, Namibia, Sudan, Tanzania, Guatemala and the Dominican Republic ("Grassroot soccer," 2010).The program empowers local community members to take over the program, once established, and continue the spread of knowledge.

Project Description

Football for Lives completed its third year in St. Lucia this winter. This year the project was focused in two primary schools, Saltibus and Reunion, in the Choiseul area. A modified version of the curriculum was also facilitated at an afterschool program at Patience Combined school in Mon Repos. The program was facilitated by six University of Vermont students, one Peace Corps volunteer, and local physical education teachers. The week began with a training of trainers where the University of Vermont students passed on the Football for Lives curriculum to physical education teachers in the area along with other interested community members.

After the training, students and teachers worked at the schools, beginning with Saltibus, and followed by Reunion. The program was conducted each morning with fifth and sixth grade students over the course of three days. The program consisted of playing eight games, four games each day for two days. Students were broken up by gender and divided into small groups so that they felt comfortable talking about sensitive subjects including smart decision making and stigma surrounding HIV/AIDS. The games are designed to facilitate learning and discussion about HIV/AIDS prevention and stigma. After each game, there were discussions that allowed the students to ask questions and learn about HIV from each other and the coaches. On the third day, we held a graduation ceremony that the whole school attended.

One important aspect of the Football for Lives program is the opportunity for discussion. A majority of the program is designed to create a comfortable, open and honest environment for students. Within this environment students are able to field questions which are answered by coaches, giving them positive and accurate feedback. These questions range from physical changes, to drug use and peer pressure. The discussions generated by games and this supportive environment allow children participating in the program to have honest discussions about topics that may otherwise be taboo in their communities and homes. These discussions are synonymous with the success of the program.

The goal of the program is to get students actively talking amongst their peers about important issues, learning vital information to protect themselves from HIV/AIDS, and to communicate to their community what they have learned. The program begins with a distribution of surveys to students to learn the level of knowledge they have about HIV and AIDS. At the conclusion of the program, students take the surveys again to reflect what knowledge they have gained from the program.

Implications and results

The general feeling upon completion of our project was one of success and encouragement. After working in the schools, talking with adults in the community and analyzing pre and post program surveys, we felt strongly that Football for Lives was a program that merits continued efforts in St. Lucia. Through our experiences in the program we have concluded that fundamental changes will be unnecessary, however we were able to recognize a need for some augmentation in certain areas of our program. Specifically we feel that there is a need for revision to the surveys that are administered to students at both the beginning and completion of the program, and emphasize what age groups and time of day are most effective.

            During the second week, we held an afterschool program at Patience Combined. We attempted to run the same program that we did at the previous schools, however we had difficulties. This was due primary to the age range and time of day. The students were from grades 1 to 6. The information was too difficult for the children under grade 4 to understand the games and material. The time of day also created challenges because the children were not as focused in the afternoon as they are in the morning. Also, the time of day impacted all grades and especially the younger children.

A component of the program that we feel needs to be changed is the surveys. These surveys are intended to assess the information that students already have about HIV/AIDS. We believe that these original surveys were written for students at a high school level. Because the program focuses primarily on middle school students aged 9 to 12, we feel that the survey needs to be at their reading and comprehension level. This means that some of the questions should be rewritten and simplified to be more age appropriate. With these changes, we feel that the survey would more accurately represent the student’s knowledge both before and after the program.

Other than this small structural change no further augmentations are necessary. This is due to the overall success of the program as a whole. Football for Lives has proved to be an effective and engaging program for increasing knowledge and awareness about HIV/AIDS and prevention in St. Lucia.

 

 

Future Recommendations

From our experience during the first two weeks of January in St. Lucia, we realized several things that can improve the program for the future years. It is important not just to plan the activities but the graduate ceremony must be thoroughly planned out well. The ceremony done at the first school, Saltibus Combined Primary School was somewhat unorganized. We found the ceremony at the second school, Reunion Primary School went much smoother after we did more planning regarding who would speak when, who would distribute the certificates, and when the surveys would be administered.

We also hope that future groups do the training of trainers before beginning to work at the schools. We found this helpful in that it allowed coaches who attended the training to come and see the program in action when working with children. Another important thing we noticed is that it was helpful to finish the games before lunch rather than having to continue after lunch. The children seemed very distracted after the groups broke up for lunch. It was difficult to regain their attention toward the messages of the games after lunch. The children simply wanted to play and it disrupted the flow of the program.

From our experience working at the after school program at Patience Combined School, we found that the age group of 9-12 years old is ideal for this program to run successfully. Working with children younger than 9 years old was challenging because they were less focused because of their age and the time of day. We do not recommend working with children under the age of 9 nor do we feel that it is beneficial to run the program after-school. The children tend to be less enthused doing the program at that time of day.

Maintaining contact with the Ministry of Education is important because they can provide information about schools or coaches we may be interested in working with in the future. They are a key partner, helping us spread the program to more schools. To enhance the sustainability of this project, we feel that it would be advantageous to get into contact with policy makers and other important people involved in the St. Lucian government. If the Minister for Education and Culture or the Minister for Social Transformation, Human Resource Development, Youth and Sports were aware of the FfL program and its success, it could be a program implemented into all the primary schools. This would help us achieve the goal of having FfL become a sustainable project on the island.

 

 

References

 

Avert. (2009).  Statistics.  Retrieved January 25, 2010.  Website:
http://www.avert.org/caribbean.htm.


BBC Caribbean. (2004, July 17). Caribbean gets HIV/AIDS funding. BBC Caribbean.com

CDC HIV/AIDS. (2009, December 16). Retrieved January 25, 2010, from Centers for Disease
Control and Prevention: http://www.cdc.gov/hiv/default.htm

 

Flood-Beaubrun, Sarah. "Saint Lucia." Commission o the Status of Women. Issue 53. (2009).

 

Inter-American Commission of Women (CIM) Thirty Third Assembly of Delegates. (2006).
National Report: St. Lucia (CIM/doc 38/06).  San Salvador, El Salvador November 13 to 15,
2006

Pan-Caribbean Partnership on HIV/AIDS. (2002).  The Caribbean Regional Strategic
Framework for HIV/AIDS 2002-2006.

Parris, J. (2006). United Nations General Assembly Special Session on HIV/AIDS (UNGASS)
St. Lucia Country Report 2006. Retrieved October 5, 2007. Web Site:
data.unaids.org/pub/Report/2006/2006_country_progress_report_st_lucia_en.pdf -

St. Lucia Country Report 2006. Retrieved October 5, 2007. Web Site:
data.unaids.org/pub/Report/2006/2006_country_progress_report_st_lucia_en.pdf -

St. Lucia National Report. (2007). To review the implementation of the Barbados Progamme
of Action (BPOA) 10-13.

The World Bank. (2000). HIV/AIDS in the Caribbean: Issues and Options. Human Development
Sector Management Unit, Latin America and the Caribbean Region, Report No. 20491-LAC.

 

 

 

 

 

 

St. Lucia Grass Roots Soccer Budget.
Iteam	quantity	cost	source
Checked Luagae on Charges		$100.00	Burlington AirPort
Certificates	100	0	CALS printer
Pre Sureveys	100	0	CALS printer
Extra training manuals	10	0	CALS printer
Post Surveys	100	0	CALS printer
Balls	30	$7	Tom Holms
Pumps	2	$15.00	Tom Holms
Cones	50	$0.50	Tom Holms
Ball Bags	2	$10.00	Tom Holms
Total		$400.00