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Grassroot Soccer: Moving the goalposts in the fight against HIV/Aids

Grassroot Soccer: Moving the goalposts in the fight against HIV/Aids

This week, HIV/Aids has undoubtedly received more media attention than it ordinarily would have. But for the men and women working at Grassroot Soccer, World Aids Day is not much different to any other: it is simply one of the 365 they spend per year, fighting the disease through a language most of us speak – sport. By MARELISE VAN DER MERWE.

It is an amazing feeling to see how much can be done with so little,” says Ondela. “I have the power to change someone’s future and I’m making that difference every day. Now, I see the game so differently. Every day feels like a victory.”

Ondela is one of the players featured in Grassroot Soccer’s #iamafootballer series. The series tells the stories of just some of the people involved in this expansive project, which is active in Zambia, Zimbabwe, South Africa and the United States. In a nutshell, GRS relies on hundreds of young role model educators (coaches, teachers and peer educators) to connect with young people most at risk of developing HIV/Aids through the medium of soccer, with a side dish of testing, awareness raising and, of course, social support.

Most recently, you may have run into them at the inaugural #IAMAFOOTBALLER World Aids Day soccer tournament, which was held at Cape Town’s Century City with Fives Futbol to raise awareness for HIV prevention. The 5v5 tournament hosted 40 teams – 32 male and eight female – who competed for a number of prizes and the chance to give proceeds back to their communities. The money raised was ploughed back into Grassroot Soccer’s preventive work in South Africa.

It’s a little confusing at first to try to put together exactly what GRS does. It’s explained very nicely that they harness the power of soccer to reach at-risk youth to try to prevent the spread of HIV/Aids, and their website has a wealth of funder-friendly phrases laying out the theory. But that doesn’t really answer the question of how. There is information aplenty on the success of the programme – and it must be said, the statistics are impressive – but the actual mechanics on the web are fuzzy.

We recruit young people from the communities where we work to join us for a two-year programme,” explains managing director James Donald. “They are trained as coaches, in the sense that they are caring adults and community role models. They don’t have to be soccer coaches, but many are. These young people are between 18 and 25 and have matric.” The coaches are all screened thoroughly, with background checks for criminal records, and basic training in counselling and referrals.

The coaches work in pairs, one male and one female, and they are assigned schools and communities to work in,” says Donald. “Often they are able to work in the schools they themselves attended. We then present to school governing bodies and community leaders and look for opportunities to set up interventions.” These interventions are run through schools, existing soccer clubs, or through leagues set up by GRS.

Each intervention, Donald explains, will have between 10 and 20 children assigned to a coach. Coaches then work with their ‘team’ for weekly ‘practices’ of between 45 and 90 minutes each. These practices alternate between actual soccer practices and life orientation sessions. Often, the coaches actually work with Life Orientation teachers in schools, during class, although they tend not to limit the contact time between teachers and learners. The outcomes of the programme remain closely aligned with those of the national curriculum, so there is no conflict of interests.

The programme is not only beneficial to learners, says Donald. It also offers a much-needed opportunity to many of the coaches, who do not always have access to further education or other employment. “While many join us before attending university because they want an opportunity to serve their community, the reality is that there are limited opportunities for young people without access to resources, so our two-year programme also has strong employability and leadership components,” Donald says. In fact, just under 70% of educators who have left the programme are now gainfully employed.

One of GRS’s recent interventions, Skillz Street, is aimed at girls only, working with 100 grade sevens at a time. The girls are divided into teams of 10, and each has a dedicated coach for the whole school term. The coach meets with the team twice a week, alternating between soccer practice one day and life skills the next. Another, the Champions League programme, formerly relied on incentivisation of healthy behaviours, but has since evolved. “Simple small incentives like airtime have been used, but we’ve phased those out. We’ve found that simply creating a space where young men are expected to arrive on time, where through their team they have a sense of importance and identity, the team becomes its own incentive and the results in reduction of alcohol and drug use, and self-reported violence, are staggering,” Donald says.

You can think of interventions as a different kind of ‘medication’, delivered at a certain ‘dose’,” he explains. “If you have a headache, you take Panado once a day for a day or see a doctor. If you have an infection, you take antibiotics three times a day for a week.” The interventions are administered at different “doses” according to the need, he says.

Of course, behavioural interventions are more complex, but we apply the same methodology and the same level of rigour in our science. We work hard to test and evaluate the impact of each intervention type and once we have shown one works, we are rigorous in delivering it at the same quality level over the same period of time.”

Grassroot Soccer essentially operates on two levels – global and in-country – with the global workers focusing on curriculum development, measurement and evaluations, strategic development and financial management, while the in-country workers take the more hands-on route, actually executing the strategy on ground level.

The programme is subject to rigorous monitoring and evaluation and, according to the most recent feedback, GRS graduates in Zimbabwe were six times less likely to report early sexual debut, four times less likely to report sexual activity in the last year, and eight times less likely to have had more than one sexual partner.

The scale, too, is encouraging. “Two hundred coaches a year across the country deliver these types of interventions to an average of 30,000 children a year,” says Donald. “Furthermore, community-based organisations are able to apply for training and support to use our methodologies. We’ve worked with over 600,000 children in more than 20 countries across Africa in this way since we started in 2002.”

Evaluations of GRS have been done by Stanford University’s Children’s Health Council, consultants from The Population Council and the Harvard School of Public Health, and researchers from Dartmouth College, Johns Hopkins University and the University of Cape Town. Unanimously, these evaluations have found that GRS is effective in reducing risky sexual behaviour, decreasing stigma, and improving students’ level of knowledge and awareness around HIV/Aids.

Perhaps most importantly, there has been a documented improvement in their decision-making and perceived level of social support. One Zimbabwean study found that the percentage of students who could list three people they could talk to about HIV increased from 33% to 72%; the percentage of students who knew where to go for help for HIV related problems increased from 47% to 76%; the percentage of students who said they would feel comfortable providing emotional support for an HIV positive classmate increased from 52% to 73%; and the percentage of students who believed condoms were effective increased from 49% to 71%.

So why soccer? “Soccer is a powerful way to challenge gender norms, and reinforces the same lessons on sexual reproductive health that they do in the life skills components, for example the importance of self-image,” says Donald. “Generation Skillz [one of GRS’s programmes] is delivered in high schools and has been shown to challenge negative gender norms, reduce self-reported incidence of partner violence and build healthy relationships between participants and their coaches.”

It’s important, however, not to fall into the trap of sentimentalising the Beautiful Game or sport-based interventions in general, says Donald, who is at pains to point out the scientific rigour behind developing – and measuring the success of – every intervention.

Many believe that sport is some kind of magic dust – that if you play, somehow everything is better,” he says carefully. “There is some evidence that sport has positive health outcomes, especially for girls. But if you want to challenge big, systemic problems like HIV or gender-based violence, you need to be far more deliberate.

For us, sport is a Trojan horse. It means we can build relationships with children in a safe space that they are proud of participating in. It also provides a plethora of ready images, metaphors and analogies that children can relate to. Also, with soccer in particular, it is a powerful way to challenge norms and stereotypes around gender. But most important to all this work is the coach.”

In the end, says Donald, the recipe for success may be soberingly simple after all – something which should so easily be attainable, and yet remains out of reach for so many. “Our belief is that children need three things to make healthy choices,” he says. “One: the facts in a non-judgmental way. Two: a sense of the future for themselves. Three: A caring adult in their lives.

The most important thing we can do is inject a caring adult into the lives of at-risk youth and use sport to build a trusting and caring relationship…to refer people to support, and intervene where there is a need.” DM

Photo: Grassroot Soccer Founder and CEO Dr Tommy Clark in Khayelitsha, South Africa, June 2014. Clark conceived of the idea for Grassroot Soccer after playing soccer professionally in Zimbabwe, where he witnessed first hand both the devastation of HIV and the fanatical popularity of soccer. Tommy and his co-founders developed and piloted an interactive, soccer-themed HIV prevention curriculum that was first implemented in Zimbabwe in 2002-2003. (Photo by Jasyn Howes)

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