Keywords: gender mainstreaming, community organisations, southern Africa gender mainstreaming, HIV/AIDS community organisations, southern Africa Word count: 3, 914

Gender Mainstreaming Practice: Considerations for HIV/AIDS community organisations

Gender is well recognised as a critical consideration for HIV/AIDS organisations. Since the 1990s, HIV/AIDS policymakers, donors, non-governmental organisations (NGOs), and transnational corporations have adopted gender mainstreaming as the process for integrating gender into development programmes and institutions. There is an increasing body of literature on the successes and challenges of practicing gender mainstreaming within organisational environments, however, little has been said about this practice within HIV/AIDS-specific organisational environments. As a contribution to this gap, this reflective paper aims to generate debate about some of the considerations for gender mainstreaming practice in HIV/AIDS organisations. It draws on the author's experience conducting a gender mainstreaming review with a southern African HIV/AIDS capacity-strengthening organisation, as well as a review of the development literature on gender mainstreaming. The paper looks at three key issues facing gender mainstreaming: (1) donor requirements on disaggregating data by sex; (2) connecting gender mainstreaming with the priorities of community HIV/AIDS organisations; and, (3) the role of resistance to gender mainstreaming as neo-colonial. Preliminary understandings of these issues suggest that current approaches to gender mainstreaming may not be flexible enough to consider the multiple ways gender and HIV/AIDS interact in different socio-cultural contexts. There is an urgent need for further debate and in-depth research into these issues, given the challenge they pose for HIV/AIDS organisations and donors that have chosen to make gender mainstreaming a criterion for HIV/AIDS funding.

Introduction

Gender is a critical consideration for HIV/AIDS programmes. Socio-economic inequalities between men and women throughout the world give rise to inequalities in AIDS-related health status and health care. Studies have shown how traditional gender roles and power relations negatively impact on the ability of women to negotiate safe sex thereby increasing their vulnerability to the pandemic [START_REF] Shefer | Gender, power and resistance to change among two communities in the Western Cape, South Africa[END_REF]. Similarly, linkages have been made between women who experience sexual or physical abuse and an increased risk of HIV [START_REF] Kalichman | Sexual assault history and risks for sexually transmitted infections among women in an African township in Cape Town, South Africa[END_REF][START_REF] Wechsberg | Violence against substance-abusing South African sex workers: intersection with culture and HIV risk[END_REF]. In terms of care for the sick, scholars have explored the consequences of the comparatively higher burden of care held by women for those suffering from HIV/AIDS [START_REF] De Waal | New variant famine: AIDS and food crisis in southern Africa[END_REF].

In recent years 'gender mainstreaming' has been widely recognised as the process for ensuring that gender is a key consideration in all aspects of health and development organisational planning and programme implementation. Bilateral and multilateral organisations alike have supported the implementation of gender mainstreaming for southern governments and civil society [START_REF] Moser | Gender mainstreaming since Beijing: a review of success and limitations in international institutions[END_REF], and a significant number of case studies have appeared in recent years that explore the organisational intricacies of its implementation. These include reviews of gender mainstreaming in a variety of contexts, including multilateral and bilateral donor organisations [START_REF] Howard | Beyond the 'grim resisters': towards more effective gender mainstreaming through stakeholder participation[END_REF][START_REF] Jahan | The Elusive Agenda: Mainstreaming Women in Development[END_REF][START_REF] Kardam | Bringing women in : women's issues in international development programs[END_REF][START_REF] Moser | Gender mainstreaming since Beijing: a review of success and limitations in international institutions[END_REF][START_REF] Razavi | Gender Mainstreaming: A Study of Efforts by the UNDP, the World Bank and the ILO to Institutionalize Gender Issues[END_REF], as well as specific country contexts [START_REF] Fonjong | Fostering women's participation in development through non-governmental efforts in Cameroon[END_REF][START_REF] Tiessen | Everywhere/nowhere: gender mainstreaming in development agencies[END_REF][START_REF] Wendoh | Re-thinking gender mainstreaming in African NGOs and communities[END_REF].

This paper seeks to contribute to this literature by exploring the implications of gender mainstreaming specifically within community HIV/AIDS organisations. While many of the experiences of gender mainstreaming can be applied to all types of organisations, HIV/AIDSfocused organisations have certain considerations that arise from the specific nature of the disease. I focus on three AIDS-specific considerations in this paper, which are pertinent in the southern African context, namely: 1) female-focused burden of care, 2) links between gender and sexuality, In order to accomplish this, I draw on two sources of information in this paper. In the first instance, I reflect on my experience conducting a review of gender mainstreaming activities for a southern African HIV/AIDS organisation that works in partnership with over 120 small communitybased organisations, thus representing a subsection of community organisations in the region.

Secondly, I draw on my review of the gender mainstreaming debate in the development literature, how it should be defined, and some of the challenges around its implementation in other organisational contexts. The hope is that this paper will generate further discussion around how gender might be tailored to ensure its ongoing relevance to the field of HIV/AIDS in specific socioeconomic contexts.

Defining gender mainstreaming

Gender mainstreaming was developed as a response to the limitations of previous approaches to gender in development. Specifically, it was felt that gender had been siloed into isolated departments with little potential to impact broader organisational objectives and that while gender work was targeting women's specific needs it was not addressing the underlying gender inequalities that perpetuated these needs [START_REF] Jahan | The Elusive Agenda: Mainstreaming Women in Development[END_REF][START_REF] Kabeer | Targeting women or transforming institutions?[END_REF][START_REF] Moser | Gender Planning and Development: Theory, Practice & Training[END_REF]. Associated with what has been called the Gender and Development (GAD) approach, gender mainstreaming was lauded as a potential paradigm shift in the way gender was being done in development and health; as a means of putting gender concerns at the centre of all aspects of development practice. This shift towards gender mainstreaming as the way forward was concretised at the United Nations Fourth World Conference on Women in Beijing in 1995. However, it is the UN Economic and Social Council (ECOSOC) definition of gender mainstreaming drafted two years after Beijing that has been most frequently utilised by scholars and development professionals alike:

Mainstreaming a gender perspective is the process of assessing the implications for women and men of any planned action, including legislation, policies or programmes, in all areas and at all It is a strategy for making women's as well as men's concerns and experiences an integral dimension of the design, implementation, monitoring and evaluation of policies and programmes in all political, economic and societal spheres so that women and men benefit equally and inequality is not perpetuated. The ultimate aim is to achieve gender equality. (ECOSOC, 1997, p. 3) Organisations have had a variety of successes and challenges turning this definition for gender mainstreaming into practicable and measurable objectives, which have been explored in the literature. In their review of gender mainstreaming in the international health literature, Ravindran and Kelkar-Khambete (2008) point to two dimensions of mainstreaming practice that have been raised: institutional mainstreaming, encompassing internal dynamics such as goals, agenda-setting, governance and procedures; and operational mainstreaming, encompassing the integration of gender into programmes and projects. This categorisation helps to clearly delineate the specific activities that are considered part of gender mainstreaming practice within organisations.

Examples of institutional mainstreaming activities include ensuring that human resources policies do not discriminate on the basis of gender, the development of organisational gender policies, the allocation of financial resources to promote gender equality within the organisation, and the sensitisation of staff to gender inequalities in order to promote a gender-sensitive organisational culture. On the other hand, operational mainstreaming activities focus on the specific aspects of designing, implementing and evaluating programmes or projects delivered by an organisation, which may include disaggregating evaluation data by sex in order to inform programme planning, training programme and project staff on the gendered dynamics of health and development issues, or analysing the extent to which programmes and projects challenge or perpetuate unequal power relations. [START_REF] Ravindran | Gender mainstreaming in health: looking back, looking forward[END_REF] note that institutional and operational mainstreaming are interrelated processes, and "both are essential for achieving health equity, which is the ultimate goal of gender mainstreaming" (p.123). Following this, both institutional and operational gender mainstreaming activities are discussed in this paper. The challenges of mainstreaming gender in community HIV/AIDS organisations This paper draws largely from reflections on my own personal experience conducting a review of gender mainstreaming activities for a southern African NGO. The NGO's primary mandate is to strengthen the capacity of small community organisations through providing training and funding for organisational development and programming. In 2008, I spent four months collecting qualitative interview data about the institutional and operational aspects of gender mainstreaming within the organisation, among its community partner organisations, and on good-practice throughout the region. This included 16 in-depth interviews with staff at the regional southern African level and 13 interviews with staff in three countries: Malawi, Mozambique and Zambia. In order to supplement this primary interview data, I conducted either interviews with Directors or staff focus groups with 10 community organisations. In addition, I interviewed representatives from six additional organisations that had been identified at the country-level as having a particularly good track record in gender issues, as well as three government representatives working in gender policy (two in Malawi and one in Zambia).

This regional NGO has a strong track record in gender mainstreaming that primarily follows an international model of gender-based analyses in language and approach. It is an independent capacity-strengthening NGO that supports small community-based organisations with financial support, workshops, training sessions and other skills-building techniques to enhance community HIV/AIDS competence. It uses a myriad of innovative approaches to facilitate south-to-south cooperation and knowledge-sharing, including facilitating partnerships between community organisations, transferring skills through workshops led by their community partner organisations, and sharing community organisation successes across the region through publications.

My organisational study highlighted many tensions around gender mainstreaming by the organisation and the community-based organisations it supports, which I reflect on in this paper.

Below I outline three key challenges faced in balancing the directives from donor agencies on gender mainstreaming, with community priorities and knowledge related to gender and HIV/AIDS. These include observations that: (1) donor requirements on disaggregating data by sex may undermine the ability of community organisations to address structural gender inequalities related to HIV/AIDS; (2) there appears to be a disconnect between gender mainstreaming and the priorities of community HIV/AIDS organisations; and, (3) resistance to gender mainstreaming as neocolonial may inhibit consideration of gender.

Challenge No. 1: Disaggregating data by sex

For several multilateral donors including Canada's CIDA (1999) and Swedish Sida,1 gender analysis that includes the disaggregation of data by sex is a process requirement. Donors are increasingly requiring organisations to assess the statistical differences between men and women for outcome indicators including HIV/AIDS case statistics and the burden of care, as well as programme indicators on how many men and women are being targeted by particular interventions.

The rationale for this approach is that disaggregation of programme data by sex are expected to enable HIV/AIDS programmes to consider their impact, or lack thereof, on both women and men in a community. Programmes can thus be designed to better meet women's needs, and to address gender roles.

The regional NGO studied in this case collects a range of sex-disaggregated data about the activities of their community partner organisations, specifically on measures of the sex of children affected by HIV and AIDS, home-based caregivers and those receiving HIV and AIDS counselling services. As a support organisation the regional NGO is not directly involved in the programming decisions of their community partners; programmes are planned and executed by the small community organisations themselves based on the needs of their respective communities around HIV/AIDS. It would therefore be inappropriate to use the sex-disaggregated data being collected at the regional level to inform the programmes or interventions of supported community organisations.

Yet, in terms of international donor organisation requirements, this represents a failure of the Gender protocols that insist on the use of sex-disaggregated data in programme planning often fail to account for the ways in which this particular regional organisation does support gender-related programming. For example, the organisation has widely shared with its community partners the positive experience of a home-based care programme that successfully increased the number of male caregivers to address the social and cultural limitations of care faced by female caregivers in Malawi.

The expectation from donors to disaggregate data by sex was also apparent in interviews conducted at the community organisation level. In interviews, when representatives of community organisations were asked how they implemented gender mainstreaming, they typically discussed a process of counting the number of men and women in programme planning activities or as targets of interventions. This is not inherently negative since, as mentioned, recognising the gender bias of a programme may help design programmes that address this bias. However, as Evaline and Bacchi (2005) suggest, seeing gender as something that can be understood exclusively as sex-disaggregated data and seeing it as developed through social relations reflect different ways of understanding gender, which inform different programme objectives.

While critical and post-structural scholars understand gender as a process whereby particular roles are consistently re-established through social interactions, the collection of sex-disaggregated statistics supports a view of gender as something people have (Evaline & Bacchi, 2005, p. 503).

Seeing gender as an unchangeable quality of an individual body and relying on sex-disaggregated data alone limits a programme's ability to acknowledge deeper power relations, how they are constructed, and how they can be deconstructed through effective programme planning. For example, a programme that identifies the fact that more women than men are involved in caregiving roles for people living with AIDS may lead to programmes that provide supports within the home and during the day, acknowledging that this may be the location and time that women are most available to receive these supports. However, while this acknowledges women's needs in caregiving Putting requirements on organisations to disaggregate data according to sex may undermine strategic thinking around relations of power by focusing on the way things are, the gender roles that exist and how to work within these differences to address short-term goals; rather than the potential for programme interventions to tackle structural inequalities in the long-term. For example, ensuring that an equal number of men and women are present during community meetings, the appraisal of community needs, or participatory evaluation sessions does not ensure that women are given an equal voice in all of these activities, nor does it do anything to challenge structural inequalities that may deny women an equal voice. It is also important to consider the ways in which ensuring equal involvement in terms of numbers of men and women may actually reaffirm these gender inequalities. Putting women in a position where they do not have an equal voice may concretise the power dynamic that exists between men and women in these situations. This can be seen in participatory evaluations without strong facilitation, for example, where bringing together groups of equal numbers of men and women may create a platform for men to speak and reaffirm the experience of female silence in group dynamics. This is not to say that collecting sex-disaggregated data does not serve a purpose. Certainly, considering that women in southern Africa are disproportionately affected by HIV/AIDS is critical to addressing the pandemic. However, finding sustainable solutions for effectively addressing this disparity in the long-term requires acknowledgment of the structural inequalities that make it a reality in the first place. This is particularly relevant for HIV/AIDS organisations because the potential for effectively addressing sexual behaviour that contributes to HIV risk is intimately connected to these structural gender inequalities. As an example, Meyer-Weitz et al.'s (1998) women result in both women being blamed for sexually transmitted diseases and male denial of their personal risk. In light of this, and other evidence that HIV/AIDS interventions have failed when they do not have supporting social inequality strategies [START_REF] Campbell | Letting Them Die: Why HIV/AIDS Prevention Programmes Fail[END_REF], the potential implications of collecting sex-disaggregated data need to be carefully considered.

Challenge No.2: Disconnect between gender mainstreaming and the priorities of community organisations

Through a 'lessons-learning' approach, the regional NGO reviewed seeks out innovative community solutions for dealing with the HIV pandemic across the southern African region and then actively shares these approaches through a capacity-strengthening programme that facilitates the transfer of knowledge, skills and experience of successful community approaches with other community-based organisations. The underlying principle of this approach is that lessons should come from the communities themselves and that the role of a capacity-strengthening organisation is to disseminate this knowledge through facilitating south-to-south partnerships.

The challenge in this approach is that gender (as it has been framed by international donors) has not always been a primary consideration for community-based organisations trying to address various facets of the HIV/AIDS pandemic. This is not to say that gender inequality is not of concern for communities. In fact, many of the community organisations this regional NGO supports have substantial initiatives to address gender in their communities. However, the community methodologies for tackling gender and understandings of the concept itself may not always be consistent with donor methodologies or conceptualisations. This can result in a constant struggle between systematically ensuring gender relations are being considered within community HIV/AIDS initiatives while still preserving and supporting community ways of knowing. As a capacity-strengthening organisation, the NGO reviewed in this study provides an excellent example of managing a middle ground. It attempts to do this by facilitating participatory workshops that emphasise gender 'sensitisation,' drawing from a conviction that sensitising individuals involved in programmes will allow for gender to be raised as a consideration without taking a top-down or directive approach to programme planning.

The process of gender sensitisation used by the organisation involves a participatory approach to identify gender roles and the ways in which men and women are unequal. Despite a focus on participatory methodologies and taking a non-directive approach to facilitating workshops on gender, this methodology for gender sensitisation may still establish certain objectives about how gender equality is framed and which are the important issues to address. For example, gender sensitisation methodologies are often based on the assumption that gender roles are stable and persistently unequal. They ask participants to identify gender roles in society, and then work to 'sensitise' these same participants to different gendered experiences. This does not account for the possibility that one's understanding of gender may change over time (at different ages for example), or may be different in different social environments. This prompts an important question: To what extent does the approach taken enable participants to recognise actual realities of how gender relations are structured in their communities, and to what extent does it impose one particular understanding of gender equality as a priority for community HIV/AIDS interventions? Are community organisations able to 'own' the concept of gender through this approach?

Post-colonial feminist scholars have argued that gender equality as a concept is, in and of itself, an imposition on the cultural complexities of southern communities. In the African context, this critique is perhaps best supported by Oyewumi's (1997) landmark study of the Yorùbá of Western Nigeria. Oyewumi argues that the Yorùbá, prior to colonisation, had developed systems of authority based on age-based hierarchies rather than gender differentials. According to Oyewumi's study, the Yorùbá are an example of a society that does not conflate social differentiation with biological determinants and therefore avoid the reification of gender along biological lines as is done in the North. Oyewumi argues that the concept of gender equality may not be a relevant approach across all societies. Top-down approaches that seek to teach communities about gender inequalities in this case may actually be creating the categories of gender they are seeking to undo. In an article in the IDS Bulletin in 2004, Prudence Woodford-Berger makes a similar point by contrasting the Swedish model of gender mainstreaming with observations from her many years of experience researching gender identity in Ghana. She highlights the ways in which the Swedish gender framework inadequately captures the complexities of 'female-ness,' the instability of gender identity, and the nature of gender alliances in the context of the particular district of Ghana in which she has worked. For example, Woodford-Berger points out that while there are ideas of maleness and female-ness, these conceptions are not necessarily attached to physiological sex, are not necessarily perceived in opposition to one another, and can shift over the life course (p. 69).

This has important implications for gender mainstreaming in the context of HIV/AIDS in southern Africa. In attempts to 'sensitise' individuals to gendered power relations and encourage gender equality, capacity-building organisations as well as donors need to examine the underlying assumptions they may be making. Woodford-Berger suggests considering the possibility of multiple 'mainstreams' rather than seeing gender roles as static and fixed (2004, p. 70). This would entail going beyond asking community organisations to identify persistent inequalities in gender roles.

Instead, it poses questions about how gender roles have been constructed in the context of HIV/AIDS. Gender inequality may be a different proposition for the same person at different ages, for people who are HIV positive versus those who are negative, or within different social environments. Training that approaches gender from this perspective may be better suited to mitigating some of the underlying reasons why gender has not been raised as a priority.

Challenge No. 3: Resistance to gender mainstreaming as neo-colonial

In the interviews, several participants discussed the notion of a foreign 'feminist movement' that had been received with hesitation and backlash within communities. Organisational staff observed that there was resistance within 'traditional' communities and community leadership to gender as a Northern and foreign concept, and that they had faced several difficulties in convincing communities of the importance of gender awareness. There were essentially two main explanations for the resistance to gender mainstreaming arising from the interviews: (1) that traditional African men were unwilling to give up power to women, and (2) that gender mainstreaming was seen as part of a Northern feminist notion that is not relevant to the African context. This theme of resistance to gender mainstreaming found in the interviews is confirmed by other empirical studies of NGO and community environments (see for example Palmary and Nunez, 2009;Tiessen, 2005). In these studies, resistance is almost always explained (as in the first explanation outlined above) as resistance by men to what they see as challenges to male power and privilege. However, explaining resistance exclusively as an attempt to maintain patriarchy and male privilege may have some consequences for HIV/AIDS organisations. It fails to acknowledge any resistance to gender mainstreaming as a foreign concept, despite a long history within HIV/AIDS organisations of arguing for the need for local interpretations of illness, sexuality and culturallyrelevant approaches. It is important to consider the ways in which understandings of gender mainstreaming as neo-colonial practice may impact on the ways in which gender initiatives are adopted or rejected.

In the first instance, this runs the risk of ignoring ways in which the concept of gender might be tailored for a particular community or context in more appropriate ways. Secondly, resistance to ideas that are seen as colonial or inappropriate for the context in which community HIV/AIDS interventions take place means that important conceptual ideas, such as the greater incidence of HIV among women as a result of structural power imbalances, may not be taken up by communities at all, let alone is a way that is meaningful for their particular context. As a result, many of the gender-related issues in HIV interventions may be ignored and the existing power inequalities may remain unchallenged by the interventions taking place.

Conclusions

Despite the challenges facing gender mainstreaming in HIV/AIDS organisations, this paper does not suggest that it should be abandoned. Dismissing the entire notion of gender mainstreaming runs 13 the risk of neglecting the disparity between the impact of HIV/AIDS on men and women, and leaving efforts to address these gender inequalities without clear objectives or defined goals. I have looked at three broad challenges facing gender mainstreaming in HIV/AIDS resulting from my personal experience and the available literature in order to generate further debate on how to tailor gender mainstreaming for HIV/AIDS organisational environments and objectives. Rather than suggesting the abandonment of gender mainstreaming in any case, I see these challenges as providing important insights for HIV/AIDS organisations and donors seeking to consider gender in programming and AIDS-related funding requirements.

All three of the challenges raised in this paper speak to the importance of establishing a concept of gender mainstreaming that resonates with the lives and worldviews of real men and women fighting HIV/AIDS in local contexts. Although they have been framed as challenges in this paper, they should also be seen as opportunities for investigating local understandings of gender that will support HIV/AIDS organisations in addressing the multiple interactions between HIV/AIDS and gender in community settings. It is only through gaining a better understanding of gender in these local contexts that HIV/AIDS programmes stand to make any impact on the gendered nature of the AIDS pandemic.

  the importance of socio-cultural contexts. I consider the ways in which these three considerations interact with gender mainstreaming in an organisational context.

  terms of gender mainstreaming, showing the often static nature of genderbased protocols.

  does not work towards changing the power relations that lead to women taking on a larger burden of care for those with HIV/AIDS in the community.

  study of the socio-cultural contexts of HIV/AIDS in South Africa makes connections between male denial of the role of their own sexual behaviour in the cause of HIV and male supremacy/ female submission in sexual roles. Meyer-Weitz et al. highlight how social inequalities between men and

See Woodford-Berger

for a discussion of the gender requirements of Swedish Sida. Canada and Sweden share a similar approach to gender-disaggregated data requirements.

http://mc.manuscriptcentral.com/ac-phm-vcy Health Sciences


Catherine Campbell

SOUTH AFRICAN CASE STUDY

Keywords: HIV/AIDS, Political will, Leadership, Traditional leaders, Gender Political will, Leadership, Traditional leaders, Gender, HIV/AIDS, South Africa

d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

INTRODUCTION

Growing attention is being paid to leadership and 'political will' as key contextual factors shaping the outcomes HIV/AIDS management efforts in sub-Saharan Africa (UN AIDS, 2006;WHO, 2008). To date such discussions have tended to focus on national leadership [START_REF] Bor | The political economy of AIDS leadership in developing countries: an exploratory analysis[END_REF][START_REF] Parkhurst | The political environment of HIV: lessons from a comparison of Uganda and South Africa[END_REF]). Yet many of the settings in which HIV/AIDS flourishes are geographically distant from the reach of national leadership and policies -in the context of relatively weak state structures. Furthermore local leaders often play a key role in shaping how national policies and decisions are interpreted and implemented in local areas.

We present on a case study of a community-led HIV/AIDS programme in Stoneyridge, a rural South African community, where local leadership style emerged as a key influence on how AIDS was perceived and managed. Rural areas are home to 65% of people in Sub-Saharan Africa, and 45% of South Africans. Whilst HIV-prevalence rates tend to be lower in rural than urban areas, rural households carry the burden of care of migrants returning home to die. Furthermore, rural people often have restricted access to hospitals, clinics and treatment. The demands of AIDS care often lead to the physical and psychological burnout of carers, family breakdown and destruction of household economies.

The Stoneyridge Project

Stoneyridge (a pseudonym) is a remote area covering 300 square kilometres, located some distance from towns and workplaces. Its 21 000 inhabitants struggle against poverty and drought, low literacy and few opportunities for paid work. Distance and transport costs limit access to formal health services and anti-retroviral treatment, in a context where 35% of pregnant women are HIV positive. Unpaid and poorly trained health volunteers provide the only help and support available to many dying of AIDS. Whilst AIDS deaths are The wider context of this paper is the Stoneybridge Project, a three-year intervention (2004)(2005)(2006)(2007) which sought to strengthen the capacity of local residents to respond more effectively to AIDS. Run by an external NGO with foreign funding, its goal was to build local initiative and capacity to deliver HIV-prevention and AIDS-care services through a three pronged project:

firstly to train volunteers in peer education and home-based nursing skills;

secondly to build support structures for the volunteers, both within the community and with appropriate government health and welfare agencies and NGOs in the wider region; thirdly to use project involvement in the project as a springboard for the more general empowerment of women and youth participants (disproportionately affected by HIV/AIDS) through enhancing their project management skills, their ability to access support and resources from outside government agencies and appropriate NGOs, and their capacity to participate in wider community decision-making.

These goals were framed by a wider commitment to developing an 'AIDS competent community' [START_REF] Campbell | Building contexts that support effective community responses to HIV/AIDS[END_REF]Nhamo et al., this volume) in which local people would be most likely to work collaboratively for behaviour change, stigma reduction and optimal support for people with AIDS and their carers. Such a setting provides opportunities for the development of appropriate knowledge and skills, as well as 'transformative social spaces' [START_REF] Campbell | forthcoming) Mediated health campaigns: from information to social change[END_REF]

Leadership in Stoneyridge

Stoneyridge is one of 270 South African areas governed by a dual leadership system, with power shared between elected municipal officials and an unelected traditional chief. Central government distributes most of the public money available to rural areas through municipality structures, giving them power over essential services (water, roads) and social development.

Traditional chiefs hold the power to allocate land, resolve disputes and govern the daily lives of residents.

An uneasy tension often exists between municipal and traditional authorities, especially because municipalities are often governed by the ruling African National Congress (ANC), with most chiefs supporting the opposition Inkatha Freedom Party (IFP). [START_REF] Beall | Emergent democracy and 'resurgent' tradition: institutions, chieftancy and transition in KwaZulu-Natal[END_REF][START_REF] Beall | Cultural weapons: traditions, inventions and the transition to democratic governance in metropolitan Durban[END_REF] outlines three ways Chiefs have negotiated this tension. Some support the ANC and work comfortably with local municipalities. Some, less favourably disposed to the ANC, take a pragmatic approach, reluctantly co-operating with municipalities to maximise their access to resources for their local areas. Others, including the Stoneyridge chief, actively work to limit their subjects' access to municipal services and resources, hoping that they will eventually win the wider fight by traditional leaders to control what are currently municipal resources [START_REF] Oomen | Chiefs in South Africa: power and culture in the postapartheid era[END_REF]. [START_REF] Ntsebeza | Democracy compromised: chiefs and the politics of land in South Africa[END_REF] roots the authority of chiefs in their power to allocate or withhold land from their subjects. Land is obviously a vital resource where

The Chief's Direct Support for the Project

From the outset, the Chief welcomed the Stoneyridge Project, allowing it to operate freely on the strict condition that it was apolitical. The Project had many achievements. Volunteers were trained to deliver home-nursing, young people to deliver peer education. Some progress was made in linking local health volunteers to public sector and NGO support agencies outside fo the community. Given the chief's supreme power to control every aspect of access to and life in Stoneyridge, these achievements would have been impossible without his active support, and his nomination of a trusted local headman to facilitate project activities on his behalf.

For the Project's first two years, he supported the project from a distance. In its third year he arranged for the Project to support his five wives in AIDSawareness, and attended their 'graduation ceremony' (the formal distribution

of training certificates at a high profile social event), and attended the opening of the Project's drop-in centre. This was a key boost for project activities in the face of the stigma and denial which constantly challenged its progress. At both events he gave eloquent speeches praising the Project's work.

However, whilst project workers were jubilant at his involvement, it was also clear that his style of engagement was at variance with the project's empowerment goals. A key goal was to build the capacity of local people, especially women, to take control of their own lives and their own sexuality.

Yet it turned out that he had not consulted the wives about participating in the Project workers, who battled to involve headmen and adult men in project activities saw the Chief's ability to engage male interest through jokes about masculinity as a useful way of getting men to start talking about AIDS.

However a more analytical perspective suggested that his humorous discussions of AIDS sent out confusing messages that contradicted the project's goal of getting men to take greater responsibility for their role in spreading it, and empowering women to be more assertive about using condoms with polygamous or unfaithful husbands. To quote further from the Fieldworker diary:

In his speech, the Chief also referred to his four girlfriends, saying this was the first time he had referred to them openly in front of his wives……. He said he doesn't encourage any of them to do family planning, saying: 'When I am dead, I don't want God to say I still have unborn children inside me.'

He frequently aired his views of 'correct behaviour': sexual abstinence for young people, faithfulness of wives, and multiple partners for men (who would not be at risk of HIV so long as their virtuous wives and girlfriends were faithful to them). He disapproved of condom use by youth, saying that they should protect themselves with 'good behaviour', and advocated frequent virginity testing of girls as the best method of HIV-prevention amongst youth. His commitment to a highly conservative interpretation of culture and tradition shaped the focus of his messages about AIDS. Its heavy emphasis on the control and submission of youth and women stood at variance to the Project's interest in promoting women's empowerment.

Indirect Impact of Community Leadership on the Project

The project did not achieve its goals of involving widespread participation of local people in its work, or of using AIDS service work as a springboard for the social development or empowerment of youth or women. After three years, there was no increase in women's confidence to negotiate safer sexual encounters, even amongst health volunteers. The project continued to be dominated by a powerful older man, although nearly all the volunteers were younger women. Clearly many factors fed into such disappointments, including the peoples' growing unwillingness to act as unpaid volunteers, and the poor support of external health and welfare agencies. These fall beyond the scope of this paper, which is limited to how the local style of leadership impacted on project efforts. We now turn to examine the strategies used by the Chief to consolidate his power, and how these framed the social environment in which the Project was located. Another way the Chief 'shares' power with people is through delegating responsibility for the development of electricity, irrigation plans and so on to committees of local people. Yet these committees had unskilled and poorly networked members. Furthermore people repeated said that those ideas that were generated by the committees didn't ever see the light of day. Ideas were taken to the Headmen to relay to the Chief, but never heard of again. However, here again there was a strong gap between rhetoric and reality.

Exclusion of 'ANC elements' from

Youth frequently expressed their frustration with this situation in interviews and focus groups: Youth attendance at meetings did not automatically mean they would be allowed to speak.

They hold community meetings at the Tribal Court to discuss important matters. When we as youth raise our hands to say something, the chairperson says: 'Put your hands down, you are spoiling the meeting.' (Young man)

Adults and community leaders frequently cited tradition as their justification for high levels of adult control of young people:

This is a good place to live because of respect and traditional customs -youth are under the control of adults. (Headman)

Young people repeatedly said any criticism of the status quo was suppressed not only by traditional norms, but also by parental fear that rebellious children would lead to the Chief evicting the family from the community.

We depend on our parents for survival. If you talk the truth, perhaps express frustration at the local leadership, your parents will throw you out. We are forced to keep quiet because we need a place to sleep, we have nowhere else to go. (Unemployed young man)

A teacher commented that there was no space to challenge the status quo: As a result, youth who are able to leave the community for the relative freedom of the urban areas -those with education and job skills -tend to do so. With youth unemployment at 53%, many lack such options. Many young people said this situation served to paralyse any independent activity on their part:

People are not free to do things. At one time we considered going to the municipality offices for help to get a soccer field. But we feared the Chief would think we were undermining him rather than appreciating the initiative we were taking. (Young man)

The only youth involvement that was encouraged in the HIV/AIDS arena was tradition-linked. Thus for example in the only ward where the Headman allowed youth to hold AIDS-related meetings related to plans to revive the Reed Dances, traditional ceremonies celebrating young girls' virginity.

The exclusion of women:

The Chief had a strongly expressed commitment to the formal education of girls. Despite this, various factors served to exclude young women from public life. Young girls were expected to prioritise household chores over education, and their participation in community life was very restricted. Such attitudes often inhibited their development of economic independence, and limited their freedom to resist sexual advances by older men. As one schoolgirl commented in a focus group:

The Headman force us to love them. We can't even complain to our parents. If a man has many cattle, they say we must accept his proposal (of sex). Our fathers are the worst here. If He was also vocal about the importance of female leaders. However he defined their roles very narrowly in terms of women-specific issues, such as organising Reed Dances, training girls to 'behave themselves' and helping male leaders adjudicate in disputes that involved women. Restrictions on women were keenly felt by the Project's women volunteers, who repeatedly spoke of their work being undermined by their gender at every turn.

In short, it appeared that day to day survival Stoneyridge depended on the efforts of women. Yet, as many interviews suggested, the power of these very women was constrained by 'cultural' and biological interpretations of their rights and roles, which defined any power that they might have as subordinate to men: The impacts of his direct involvement were complex and contradictory in many ways. On the one hand, he provided the project with vital community access and support, enabling it to function in the community and appointing a respected community elder to facilitate its progress. He attended project events in a way that strongly boosted its profile in the community, serving to engage the attention of headmen and men, two important and hard-tomobilise groups.

On the other hand, some might describe him as a negative role model for a sexual health project through his celebration of his own polygamy.

Furthermore it could be argued that his insistence that polygamy does not facilitate the spread of HIV/AIDS, his opposition to condoms, and his strong commitment to the values of outdated and unrealistic 'traditional' values of sexual abstinence by youth people (where regular AIDS deaths of young people reveal their unrealistic nature) did not contribute to the project's goal of creating a social climate where sexually active young people and women in polygamous unions would feel confident to seek out information about how to protect their sexual health -and insist on their rights to safer sexual relationships. Such views also feed into the stigmatisation and denial of HIV/AIDS due to their association of HIV/AIDS with 'bad behaviour', undermining the project's efforts to create a humane and supportive climate for people living with AIDS and their carers, and increasing their reluctance to seek out the help and support that might be available to them.

The paper has also highlighted the indirect impact of his leadership style on the project's goals. These included his dislike of political opposition and debate, his top-down and authoritarian approach to his subjects, the gap between the rhetoric and reality of female and youth empowerment, and his self-styled role as champion of conservative traditional norms. These stifled the debate and innovative thinking needed to tackle an epidemic, and the development of confidence by youth and women (the most seriously AIDS-

  ISSUE -POLITICAL WILL, TRADITIONAL LEADERS AND THE FIGHT AGAINST HIV/AIDS: A SOUTH AFRICAN CASE STUDY

  is rife, deterring many from seeking what little help is available.

  subsisdence farming for survival. However, much of Stoneyridge is hilly and stony, particularly difficult to farm in recent years of drought. There is growing discontent, particularly amongst the youth. In such a context, the Chief has fallen back on his role as 'custodian of tradition' to hold power and authority. His celebration of traditional social relations including polygamy, bridewealth, obedient women, disciplined youth and the absolute authority of the chief and his headmen, is enthusiastically embraced by many subjects, particularly older people and men.MethodologyOur three-year longitudinal study of the Stoneybridge Project took the form of 134 interviews and 57 focus group discussions (including 279 participants) with a wide range of local residents, as well as 70 fieldworker diaries.Research informants included volunteer health workers, traditional and religious leaders, young people in and out of school, local men and women, and members of local community groups (including groups relating to church activities, sewing, gardening, football and youth clubs). These interviews were conducted, audio-taped and translated into English by two experienced Zuluspeaking fieldworkers. Data analysis was conducted by the author of this paper and a research assistant, and involved a detailed reading and rereading of the large dataset in the interests of identifying information on the following three broad topics: the Chief's leadership style, its direct impact on Project progress, and its indirect impact on project progress. These topics form the headings of our 'Findings' section below.FINDINGS The Chief's Leadership StyleMany Stoneyridge residents spoke proudly of the Chief as educated and charismatic man, articulate, worldly and wealthy, a descendant of a chiefs. Particularly older people and men spoke approvingly of his strict authoritarian style, and his effective control of crime.They cited his emphasis on traditional culture as a tremendous source of positive social cohesion in an uncertain social world. The Chief was associated with positive social development in his two particular areas fo interest: schooling and football. As a result of all these factors he commanded huge respect as a unifying force.

8

  He played an active role in policing and punishing young women who wore jeans, justifying his determination to control their attire as part of his commitment to culture, tradition and respect. As discussed by a group of health volunteers:If we wear jeans, the Chief chases us and beats us with a whip. He says its only prostitutes that wear jeans…………. Older people and the headmen report us to him if they see us wearing jeans.(Health volunteers focus group)

  The Chief frequently spoke of the importance of youth involvement in community projects:I ensure that the youth play a big role in this community.(Chief)

  challenged the strict adherence to traditional culture would be like a drop in the ocean. Those who live here accept this way of life. Those who do not, leave.(Teacher)

  our mothers support us in disagreeing with what the Headmen are doing, they threaten to chase us out with our mothers. (Schoolgirl)In interviews, the Chief repeatedly spoke of the pivotal role of women in community survival.

  this area are initiated by women. As long as there is a woman in the house the family survives and the children thrive. When a woman leaves or ideas, the family suffers.(Chief)

  to develop understandings of the ways in which unfavourable social circumstances undermine their sexual health, and to develop a confident vision of how they might resist or at least ameliorate the negative effects of these circumstances on their well-being.Epidemics spread because existing social understandings and practices, and existing public health systems, are inadequate for stemming the processes through which they spread. One important aspect of challenging them requires innovation and change to frameworks of understanding, action and intervention in affected communities. Traditional leaders need to be involved in AIDS management in rural areas. Yet the goals of AIDS projects may contradict constructions of 'traditional' values from which they derive their power in ways that limit the types of 'thinking outside the box' that characterise AIDS competence.

  They were extremely agitated when the Project trainer arrived to discuss the timing of the course. Furthermore, in his speeches at project events he frequently referred to his five wives and four girlfriends in a humorous celebration of his masculinity:

	training. In his speech at the wives graduation, the Chief said they needed to be taught about AIDS so
	they should not blame him when any of them got infected. He confidently asserted that
	polygamy had nothing to do with AIDS: 'If I am faithful to all of my wives and they are faithful
	to me, who is going to infect any of us with HIV?' he asked. He also said that it was mostly the F youth, and gay men, that were infected and they didn't practice polygamy. So people must stop saying polygamy increased the chance of infection. The headmen and other men agreed o r with him, laughing at his clever way of justifying himself. (Fieldworker diary)
	P
	e
	e r
	R
	e
	v i e
	w
	O n l
	y
	7

  The Chief likes development but he won't accept ideas coming from other areas, saying that they are 'politically motivated'. Before anything can be done here it has to be studied very carefully to make sure it won't further the interests of other political parties.(Health volunteer) Whilst he expressed strong commitment to the rhetoric of democracy, the empowerment of youth and women and social development through delegation of power to headmen and local development committee's, his style of delegation ensured that none of these groups became a significant force in the community. This point was emphasised in a focus group with local men:

	Fear of being 'accused' of being an ANC supporter limited the development of
	initiative by local people, and of the development of critical debate about how
	the local status of women and youth undermined their opportunities for sexual
	F o r Ideology of self-reliance: One of the ways in which the Chief steered his health. subjects away from seeking out municipal resources was through his ideology In reality, the headmen have no real power. In reality its only the Chief who can take any initiative. (Adult men) F o r Many community members revered the Chief and scapegoated the Headmen
	P of 'self-reliance'. As he stated in an interview: P for lack of progress.
	e e
	e r e r
	R R
	e e
	v i e v i e
	w w
	O n l y O n l Selective use of democratic consultation: Whilst the chief exercised strict control over peoples' personal and political lives, he was a model of y
	consultative democracy in relation to economic and social development. As a
	headman reported in an interview, the chief frequently said that the reason for
	the poor development of Stoneyridge related to lack of initiative by his
	subjects:
	9 10

Stoneyridge: As repeatedly reported by the health volunteers, the historical rivalry between the ruling ANC, and the Chief's more traditional IFP, impacted on the Project in many indirect ways:

My vision for this community is one of self-reliance. People need to pick themselves up out of their poverty rather than waiting for help to come to them.

(Interview with Chief)

This ideology works well in some areas of community life. Local people had worked for no pay to build schools and football fields. However health volunteers suggested it was less appropriate in other settings:

Our chief says people should survive through growing food. But its dry, nothing grows. He hasn't visited the households or seen the poverty affecting us.

(Volunteer)

He refused to allow us to accept food parcels from the municipality for people with AIDS, saying people should be given seeds, not handouts. Yet some people are too sick to grow seeds. (Volunteer)

Our Chief likes development, he wants to know peoples' views on how to achieve it. He says he finds it difficult to lead a community where people don't say what they want. (Headman)

If you have a good idea for community involvement, you can't go directly to the Chief. He will tell you to approach him through the correct channels -the headmen. However the Headmen have destructive attitudes. If they think your idea is not a good one, they don't pass it on. And lacking knowledge, they feel threatened by peoples' demands.

(Volunteers)

Interviews with headmen themselves supported the claim that they lacked skills and confidence:

Most of us are illiterate. If we were more educated, the community would have a lot more development.

(Headman)

(Where is the drought relief people applied for?) We don't know. We are just blank, nobody explains anything. We just distribute the forms people must fill in. (Perhaps the Chief has information about this?) Nobody has asked him. We are just signing something we don't know anything about.

(Headman)

  Youth are included by name, not in practice. They don't let youth get involved in real issues that would empower them with skills and knowledge. I am one of the five youth reps on the agriculture project. But they haven't given us any opportunities. One of the adults has done all the work we should have been included in.(Young man)