SUMMARY:

The Greater Mpumalanga Rape Intervention Program (GRIP) provides holistic services which include

prevention and care for survivors of sexual assaults and domestic violence and for people infected and

affected by HIV and AIDS. GRIP is involved in Abstinence and Being Faithful (AB) activities through

community outreach programs. The emphasis areas are gender and human capacity development. The

target populations are school children (boys and girls), teachers, and the community at large.

BACKGROUND:

GRIP was initiated by volunteers and established in 2000. GRIP started by offering services to all rape and

sexual assault survivors. GRIP started empowering women, men, and children through the process of

preventative education, counseling and testing, post traumatic care, and community outreach. Realizing

the importance of HIV prevention and the need to address sexual assault and domestic violence in the

community, GRIP is involved in two direct prevention services: peer education and teacher training. The

prevention strategies include creating awareness on HIV and AIDS with special emphasis in addressing the

plight of sexual assault and domestic violence survivors. This program will protect children, teachers,

communities, and will uphold the rights and dignity of sexual assault survivors.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Peer Education

The aim of the peer education intervention is to encourage abstinence and to delay sexual initiation for

youth aged 10 -14, before they start sexual activity. The program will target boys and girls in schools

between 10 and 18 years old, who come from disadvantaged backgrounds, vulnerable to crime and

experiencing socio-economic challenges within their communities. These children will be identified in

targeted schools by teachers, principals and peers. For the Be faithful component of the AB program, older

youth aged 15 -24 engaging in sexual activity, will be encouraged to adopt secondary abstinence and

reduce number of sexual partners. Full information is provided on correct and consistent condom use for

youth who are already sexually active.

At the beginning of the activities, individual sessions for boys and girls will be conducted separately for

period of three months to identify their needs. After the three months, group sessions for boys and girls will

be conducted separately for a period of six months. At the end of six months, both groups of boys and girls

will be brought together to share what they have learned. GRIP will link this activity to an ongoing

community-based support program and provide guidance to all the children. The children will also

participate in camps, where boys and girls will take part in life skills.

The program is expected to empower children with information, problem-solving techniques, and life skills,

which will lead to enhanced self esteem, and responsible behavior regardless of peer pressure or social

problems. Through role modeling, participants in the program will with others pupils in the school who have

not been through the program with a view to transference of knowledge gained. A monitoring and evaluation

system will be in place for pre and post test of children who have participated in the program.

ACTIVITY 2: Training of Teachers

The goal of the GRIP program is to promote effective, accountable, and sustainable support systems in the

schools and the surrounding communities. GRIP has realized that teachers and school management are

usually reluctant to get involved in sexual assault issues that affect their pupils hence limited support is

given to the victims of sexual assault in schools and the community. FY 2008 funding will therefore address

HIV prevention, sexual assault, cross-generational sex, multiple concurrent relationships and domestic

violence information. Training will equip teachers with the skills to identify, support and conduct referrals for

the affected children. The program will enhance community support as all children and youth will be linked

to a support mechanism through community-based forums to ensure that HIV prevention and support is

sustained. Additionally this program will be linked to community and government stakeholders to ensure

ownership and collaboration.

Through this program GRIP aims at improving teachers' abilities to communicate their values and

expectations regarding their pupils' behavior and individual social problems. This will increase awareness

and sensitivity regarding sexual violence and HIV among teachers, pupils, and community. The program will

reinforce the adoption and modeling of prevention behaviors among adults, and engender social sanctions

against risky practices such as cross-generational sex, multiple concurrent partnerships and sexual assault.

GRIP will train teachers selected from identified schools in Mpumalanga. Training will enable them to

identify vulnerable and abused children within their environment, and empower them to report such cases.

GRIP has found that during past trainings, teachers were committed to referring children to GRIP's

intervention. Apart from caregivers, teachers are the most constant adults within the school child's sphere of

reference. Expected results from this program are teachers who are better equipped to identify, support,

and refer affected pupils a community-based support system. This includes providing parents with

continued support and counseling to minimize post-traumatic effects of abuse and to ensure complete

recovery. This activity will be closely monitored and continuously assessed to ensure quality assurance in

the effort to achieve intended results.

These activities, through the variety of approaches will all contribute to the overall PEPFAR goal of averting

seven million new infections.

SUMMARY:

Greater Mpumalanga Rape Intervention Program (GRIP) provides basic health and care services to

sexually assaulted/domestic violence survivors and people living with HIV (PLHIV). GRIP is involved in

palliative care by supporting care rooms in hospitals, courts, police stations, and providing community-

based support. The emphasis areas are gender and human capacity development. Primary target

populations are survivors of sexual assault including children and adults, and PLHIV and their families.

BACKGROUND:

GRIP was established in 2000 in response to the high levels of sexual assault and domestic violence and

the concordant high levels HIV and AIDS infection transferred to survivors. GRIP was initiated by volunteers

and seeks to empower women, men, and children by providing comprehensive basic health care services.

GRIP's approach to providing care services was established in consultation with volunteers, survivors,

PLHIV, and community, to offer the services that best meet the needs of the community.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Hospital Care Rooms

GRIP will support care rooms in hospitals to provide clinical and psychosocial support to survivors of sexual

assault including children and adults. The medical care rooms are maintained by GRIP and open twenty-

four (24) hours, 7 days a week. With support from the Department of Health, care rooms have a full time

forensic professional nurse during the day alternating with the doctor on-call in the evening. Survivors

undergo examination, are screened for STIs and OIs, receive treatment and cotrimoxazole as appropriate,

and receive post-exposure prophylaxis and other necessary medication. In addition, survivors receive

psychosocial support, counseling and testing, and are also referred to support groups to assist with

recovery.

ACTIVITY 2: Police Care Rooms

GRIP will open care rooms in police stations where victims can report their cases and receive

comprehensive care services including protection. GRIP has existing Victim-Friendly Facilities in some

police stations which also operate 24 hours, 7 days a week. At these facilities, J88 Forms (police dockets)

are completed to open cases against the perpetrator, and psychosocial support and practical assistance is

offered. Each care room has an Area Manager who oversees the daily operations to ensure that necessary

procedures are followed and services are offered to the survivor once the case is reported. These care

rooms are an initial entry point for psychological support and survivors are referred to hospital care rooms in

Activity 1.

ACTIVITY 3: Community-based Support for Survivors

The community-based support for survivors is integrated with the Care Rooms operations. Survivors are

allocated counselors who offer them service in the care room and conduct follow-up thereafter. These same

counselors will remain the support counselors to the survivor throughout the program. These counselors will

then visit survivors at home for the provision of psychological and social support. A holistic approach is

employed, an integrated approach to holistic social welfare intervention, where survivors of sexual assault

and domestic violence needs are addressed in collaboration with other stakeholders, for example the

Department of Education, Health and Social Services, Justice, Safety and Security, and Home Affairs. GRIP

acts as the eyes and ears of each community. By conducting these home visits, GRIP accesses each

family's and individual's unique care needs, and can refer and act upon accordingly. Confidentiality and

privacy is respected.

ACTIVITY 4: HIV and AIDS Support Groups for Survivors

The goal of the HIV and AIDS support group is to establish, build and facilitate area-specific sites for an

ongoing support system, catering to HIV-infected persons, which offers a forum for continuous information

and sharing of life experiences, for mutual benefit to those needing or requesting it. These groups are

facilitated by trained counselors and have more or less 15 persons to meet on a twice a month basis for a 6

month period. The venue for the meetings will be sourced through collaboration with traditional leaders or

community halls. These meetings will enhance the psychological, spiritual, and social aspects of palliative

care.

Through the support groups, a major component will include the following activities: acceptance, disclosure,

prevention with positives, opportunistic infections, adherence counseling, treatment literacy, nutrition, and

counseling.

Through the provision of clinical, psychological, social, spiritual, prevention and victim empowerment

interventions, these activities contribute to the PEPFAR goal of reaching 10 million with care.

SUMMARY:

In March 2007, the Greater Nelspruit Rape Intervention Project (GRIP) established a walk-in HIV voluntary

counseling and testing site at its headquarters in Nelspruit, Mpumalanga. A professional nurse was

appointed to offer free HIV counseling and testing (CT) and awareness to any community member who

visits the site. The nurse is also involved in creating awareness on HIV and AIDS throughout the business

community in Nelspruit. Individuals who test negative are given guidance and information on how to prevent

the transmission of HIV. Through this CT site, GRIP promotes CT through advertising and community

mobilization campaigns. The professional nurse follows up and links clients into referral systems to ensure

they receive appropriate and timely care and treatment services. GRIP will use FY 2008 funds to appoint a

second nurse who will offer CT to the community. This will involve counseling and testing of survivors and

vulnerable children in their homes, and will include providing guidance, advice and assistance, where

necessary. The community nurse will work with a team of counselors to provide in-depth individualized

counseling tailored to survivors' needs. The team will reach out to survivors in areas where there is

inadequate numbers of healthcare workers and poor transportation infrastructure. The emphasis areas are

gender and workplace programs.

BACKGROUND:

GRIP was initiated by volunteers and established in 2000. GRIP started by offering services to all rape and

sexually assaulted survivors. GRIP seeks to empower all women, men and children through the process of

preventative education, counseling and testing, post traumatic care, advocacy and lobbying. Due to the link

between rape and HIV/AIDS, GRIP is now also focusing on HIV prevention and Voluntary counseling and

testing.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: HIV Counseling and Testing at the Walk-in Facility

The GRIP non-medical walk -in site offers CT, information on HIV and AIDS, and HIV-related referral

services. The referral system focuses on active follow-up, tracking of clients, and linking HIV-infected clients

with prevention, care and treatment services. Clients who test negative for HIV are linked to other

prevention services. The walk-in facility operates from the GRIP Head Office. The professional nurse

conducts voluntary testing on any community member that wishes to know his/her status in a private and

confidential yet comfortable and friendly room. The rapid finger prick test is used and test results are

immediate. A follow-up test is done to confirm the original results. People who receive HIV testing in this site

will receive pre-test counseling to prepare for the implications of the test, and post-test counseling in order

to deal with the emotions regarding the result.

ACTIVITY 2: Community-based Counseling and Testing

The community nurse will be responsible for HIV counseling and testing to survivors of rape or sexually

assault, and who may be at risk for being infected with HIV. The community nurse's duties are distinct from

those of the Walk-in-Facility nurse's duties. The community nurse will travel to survivors' homes in rural

areas where there is limited infrastructure and no public transport. Testing and counseling will be conducted

in the familiarity and safety of the survivors' own homes. The rapid finger prick test will be used and if a

survivor tests positive, a follow-up blood test and CD4 count will be taken. Each survivor has individual

needs and each survivor who tests positive will be monitored while the professional nurse will ensure follow-

up tests and medication.

The community nurse will be accompanied by the survivor's counselor on home visits. The counselor will be

there to provide additional support and guidance if the test is positive. The community nurse will conduct

home visits to all survivors and offer HIV counseling and testing, whenever it is needed. GRIP will also

assist those infected with HIV to adopt positive lifestyles and offer entry into treatment programs, when

needed. Through this intervention, GRIP aims at empowering the community with information on HIV and

AIDS and the opportunity to know their status.

ACTIVITY 3: Corporate Testing and Awareness Raising

GRIP also assists in debunking myths and "instant cures" by providing correct and factual information on

appropriate lifestyle changes. This activity is supported by language-relevant booklets and facilitating

access to relevant treatment programs. Beyond the suffering HIV imposes on individuals and their families,

the epidemic is profoundly affecting the social and economic fabric of societies and is affecting the most

productive segment of the labor force. Therefore, GRIP would like to reach out to the corporate sector that

includes businesses and the farming community. GRIP will offer employees HIV testing, information,

preventative talks and referral to immediate counseling if tested positive. The methods to be used in this

activity will be very interactive and participatory, and attendance of participants should be seen as part of

work obligations. Some of the activities will include assessments of high-risk behaviors, information about

transmission, support to vulnerable young women, information on the effects of the virus and emotions

thereof and information on prevention and management of HIV infection.