It is 2pm in the afternoon and the previous quiet of the clinic is suddenly filled with the sounds of excited children pulling off their school sweaters in order to prepare for the afternoons football tournament. As a practising clinical psychologist in the UK it takes a bit of getting used to the idea that football games are a completely normal event in this exceptional clinic which is the only one of its kind on the African continent. Here, football is an integral component to the way clinical and psychosocial services are considered and delivered. Football is utilised as the mechanism to encourage participation in the Life Skills programme. Young people are taught about the importance of setting goals, developing strategies to achieve those goals, knowing ones strengths and working with others in mutually respectful ways. I have been working with the staff for two weeks from the 15th to the 26th of November about how basic counseling skills can be incorporated into the work of all the staff so that this unique clinic can further develop its approach to HIV care for both HIV+ and HIV- youngsters.
The clinic emphasizes specialist training and development for all staff because unlike the pediatric specialty, for example, adolescence as a medical or psychological speciality is underdeveloped. The WhizzKids United Health Academy aims to address the specific issues of HIV care and prevention for this particular age group and to date specialist training has focused on topics such as psychological stages of development, advanced counseling skills with adolescents, the use of motivational interviewing techniques to address issues of adherence, counseling for sexual behavior change and the particular developmental challenges for young people who are already HIV+. Training sessions have been held in the morning when the young people are at school and the approach has been a mixture of teaching, role plays and group discussion. The staff have embraced the sessions enthusiastically and have brought many of their clinical issues for consideration and discussion. The interface of HIV, poverty and deprivation and the threat of, or actual sexual violence present huge challenges for the Health Academy staff but they face these issues with a mixture of skill, determination to make a difference and good humour. However, in the face of such difficulty staff burnout is a real concern and mechanisms require development to ensure that well trained staff are supported to carry out this vital work.
The scale of the HIV epidemic in South Africa amongst young people is enormous but the model of psychosocial care developed by the WhizzKids Health Academy is one which can be replicated across the country. Skills already exist within the South African health and NGO communities to further develop and deliver this approach. However, the biggest challenge faced by both organizations and staff members is adapting to a youth centred clinical focus. Adolescents are neither children nor mini adults and the pace of physical, emotional and cognitive change during this period of life requires that HIV programmes adapt to meet their specific needs. WhizzKids Health Academy is a beacon of hope and expertise with regards to what CAN be achieved by innovation, flexibility and the will to make a difference to the lives of South Africa's young people.