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Limpopo-based NGO readies for financial reductions triggered by Trump's decision

Foreign assistance reduction strategies, particularly the slash-and-burn method, have significantly impacted HIV programs. This Limpopo clinic shares its strategies for navigating such reductions and the insights gained from two decades of resilience.

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Foreign assistance, particularly through a destructive, short-term method known as slash-and-burn,...
Foreign assistance, particularly through a destructive, short-term method known as slash-and-burn, has significantly impacted HIV programs, adversely affecting numerous clinics. This article focuses on a clinic in Limpopo, detailing its strategies for navigating aid reductions and sharing the valuable lessons accumulated over two decades of endurance.

Limpopo-based NGO readies for financial reductions triggered by Trump's decision

Why Sindy Nkuna's World Turned Upside Down

Dynamic Sindy Nkuna awoke to an alarming email in January - the US government had decided to temporarily halt foreign aid. "It was terrifying," she admits. "I felt like I was going to lose everything - my job and my kids."

Working at the Hlokomela Clinic, located 200km from Polokwane in South Africa, Nkuna was responsible for tracking HIV data within the Mopani district, a fruit and game farming community. As a data capturer, she noted new cases, tests conducted, and patients on treatment. Her job, and those of six HIV testing counsellors, a site coordinator, and part of the financial manager's salary, were funded through a grant from the Anova Health Institute - the HIV organization that received the most President's Emergency Plan for Aids (PEPFAR) funding in South Africa.

PEPFAR is a U.S. government AIDS fund that supports HIV projects run by non-profits across various countries, including South Africa. Sitting at home, Nkuna anxiously awaited news about her employment. By the end of February, she heard that nearly all USAID funding, including many PEPFAR-sponsored projects, would be permanently axed.

Hlokomela was left without its HIV testing team responsible for fieldwork, and funding for equipment such as cooler bags and transport for mobile testing clinics. HIV field services at 50 sites across Hoedspruit farms and communities, which tested around 1,000 people for HIV each month, were shuttered.

"The loss of our HIV outreach was catastrophic, worse than Covid," lamented Christine Du Preez, Hlokomela's founder. Du Preez and her team had to rethink their business model to accommodate their reduced resources and staff while continuing to offer essential health services to the 25,000 farmers, workers, and their families.

Despite being caught off-guard, Hlokomela demonstrated remarkable resilience, resourcefulness, and determination. Here are the strategies that have kept them afloat, offering invaluable lessons for similar organizations facing unexpected challenges.

Make the Most of What You've Got

Issue: Lack of field HIV testing staff due to funding cuts

Action: Utilized community health workers for testing while working with HIV testing staff from other projects to help out.

Hlokomela operates three clinics, staffed by nurses, data capturers, lay counselors, community health workers, and volunteer doctors. Some of their paid staff, such as those who ran the mobile testing clinics and were paid by Anova, were affected by the cuts. Despite the loss of 2% of their budget, Hlokomela has maintained a robust team to address the high HIV rates among farmworkers in Hoedspruit.

As of 2008, 28.5% of farmworkers in Hoedspruit were HIV-positive, compared to 17.64% of adults nationwide in 2007. Du Preez notes that their latest data shows the percentage of HIV-infected farmworkers has dropped to 6.5%. However, when funding stopped, testing plummeted by nearly 90%, according to Nkuna.

This tragedy prompted Hlokomela to innovate by focusing on their community health workers, known as nompilos in isiZulu, meaning "mother of life." Hlokomela has trained approximately 75 farmworkers in health education and monitoring various health indicators, like blood pressure and heart rates, and chronic conditions, including HIV and TB. As a result, they have been able to overcome obstacles and continue providing essential HIV services.

  1. Sindy Nkuna, working in the field of science, specifically focusing on HIV data in South Africa's Mopani district, faced a challenging situation when the US government temporarily halted foreign aid, threatening her job and the future of her family.
  2. The permanent axing of nearly all USAID funding, including many PEPFAR-sponsored projects, left Hlokomela Clinic without its HIV testing team and essential equipment for their mobile testing clinics, a significant blow to their space-and-astronomy education and self-development initiatives.
  3. In response to the loss of funding, Hlokomela demonstrated resilience and resourcefulness by utilizing their community health workers for HIV testing and collaborating with staff from other projects to provide essential health services, following the teaching of education and self-development.
  4. Despite facing a crisis that was almost as catastrophic as the Covid-19 pandemic, Hlokomela managed to maintain their focus on crucial health services for farmworkers in Hoedspur, ensuring the stipend they provide continues to support the community, with the hope of reducing HIV rates in the future.

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