International Journal of Academic Research in Progressive Education and Development January 2013, Vol. 2, No. 1 ISSN: 2226-6348

HIV and AIDS Awareness among Children with Mental Retardation in Masvingo Urban-A Teacher’s Viewpoint Francis Emson Dakwa Depart ment of Special Needs Education, Great Zimbabwe University, P.O Box 1235, Masvingo Zimbabwe

Absalom George Qawe Bhebhe Department of Special Needs Education, Great Zimbabwe University, P.O Box 1235, Masvingo, Zimbabwe

Regis Chireshe Walter Sisulu University P.Bag XI Mthatha Republic of South Africa, Eastern Cape E-mail: [email protected]

Edward Ntare Rutondoki Department of Psychology, Kyambogo University, Kampala, Uganda E-mail: [email protected] Abstract The study sought to establish the level of HIV and AIDS awareness among children with mental retardation in Masvingo urban of southern Zimbabwe. Openness to the subject of sexuality and HIV and AIDS is considered as “taboo” in many African cultures. To persons with disabilities, let alone individuals with mental retardation, sexuality and HIV are still areas of grave concern, which still require further study and investigation, hence, the interest in the present study. A questionnaire was administered on twenty teachers of children with mental retardation in two institutions. Data was presented in tables and results analysed. The study revealed that teachers agreed that children with mental retardation were sensitized to problems relating to HIV and AIDS. The responses from teachers indicated that the HI V and AIDS sensitization programme in the schools was an effective awareness tool. There is need for more school based awareness campaigns to sensitize the children with mental retardation on the effects of HIV and AIDS transmission and infection. The need for communal participation in the awareness programmes is also highlighted. Background Children with mental retardation, like any other children and young people in our society, are at high risk of contracting the HIV virus leading to AIDS. GROCE (2003), in the findings of the WORLD Bank and Yale Study, strongly agued that people with disability can and should be included in all HIV and AIDS outreach and service efforts and performances. This is also echoed 346

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by Chireshe and Makore Rukuni (2003) who focus on the need to carry out AIDS Education in order to raise the level of HIV awareness in communities. In the light of the above observations, it is the intention of this study to examine the teacher’s views on the level of HIV and AIDS awareness among children with mental retardation in Masvingo Urban in Southern Zimbabwe. The education of children with mental retardation in Zimbabwe is effectted in special institutions as well as resource units within the ordinary school (regular classes). The Education Act (1987) revised (1996) stipulates that every child shall have the right to school education. Hence, the education of children with mental retardation is a recognizable national reality. Article 23 of the Convection on the Rights of the Child, quoted in Grant (1991), confirms that the children with disabilities need education, training, health care and rehabilitation services. According to Kundishora (2006), HIV-Human Immuno Deficiency Virus is a retrovirus that causes AIDS. AIDS –Acquired Immune Deficiency Syndrome is a sexually transmitted disease (STD) that can also be transmitted through blood or from mother to child (Jackson1992). The AAMR definition quoted in Dzviti (2008), refers to mental retardation as substantial limitation in intellectual functioning characterized by significantly sub average intellectual functioning. This exists concurrently with related limitation in two or more of the following applicable adaptive skills area – communication, self care, home living, social skills, community use, self direction, health and safety, functional academics, leisure and work, manifesting before the age of 18 (Hallahan and Kauffmann 2006; Turnbull and Turnbull 1995; Smith 2001). The AAMR definition deviates from the old adage of measuring disability by use of IO scores. The child with mental retardation is, therefore, capable of learning and assessing education. It is with this view in mind that the study seeks to examine the teacher’s perspectives regarding the effectiveness of HIV and AIDS awareness among children with mental retardation. In 1992 the Ministry of Education and Culture demonstrated its concern for the young through the development of a comprehensive national AIDS Education Programme for schools. The AIDS Action Programme for schools was developed by the Curriculum Development Unit (CDU) with assistance from UNICEF. Consequently, textbooks for Grade 4 to Form 6 were developed. (Chireshe and C hireshe 2003; Jackson 1992; Kundishora 2006; Musumhi 1993). AIDS Education is implemented in institutions catering for children with disabilities as well. According to UNICEF (19990, the Ministry of Education and Culture produced a training manual for teachers. This is also used by teachers teaching children with mental retardation in class. The study, therefore, seeks to establish the teacher’s view point on the effectiveness of HIV and AIDS awareness programmes among children with mental retardation in Masvingo Urban. Elwan (1999) stipulates that education is the only weapon in the prevention of HIV and AIDS. In her study on the impact of HIV and AIDS awareness in persons with visual impairment, Kundishora (2006;39) observed that AIDS education had to be taught to all grades – primary and secondary. The social exclusion of people with disabilities from the mainstream HIV and AIDS services makes their situation worse. 347

International Journal of Academic Research in Progressive Education and Development January 2013, Vol. 2, No. 1 ISSN: 2226-6348

(http//org/en/resources/articles). Therefore, the exclusion of children with mental retardation from HIV and AIDS campaigns awareness places them at risk of contracting HIV and AIDS (Russo , 2003). Chireshe a nd Chireshe (2003) in their study on advanced level students’ perceptions of the causes of HIV and AIDS highlighted the role of teachers in assisting students to acquire accurate factual information about HIV and AIDS. Teachers also needed to set good role models for children to emulate. In his research on HIV and AIDS related knowledge and self reported behavior of secondary school students, Maluwa-Banda noted that the world over, young people were central to any discussion about sexuality and Acquired Immuno-Deficiency Syndrome (AIDS)(Maluwa-Banda 2004). The study therefore, seeks to determine teachers’ views on the degree of HIV and AIDS awareness among children with mental retardation in Masvingo Urban of Southern Z imbabwe. Methodology A questionnaire was administered on 20 teachers who had been randomly selected from 2 institutions – a special school and 2 units for children with mental retardation. Closed and open – ended questions were employed. Permission to conduct the research had been granted by the Ministry of Education, Sports and Culture. The data collected are presented in this paper in tables and subsequently analyzed. Results Questionnaire for teachers N=20 Table 1 Distribution by gender Gender Male Female Total

Frequency 3 17 20

% 15 85 100

The table indicates the distribution of teachers by gender. Most of the teachers teaching the children with mental retardation were female (85%). The low percentage of male teachers could be a reflection of the low level of interest in teaching children with special needs by the male teachers.

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Table 2 Mounting campaigns in the school Responses Yes No Total

Frequency 9 11 20

% 45 55 100

The table shows the teachers ‘ responses on whether the school was mounting campaigns on HIV and AIDS. 55% of the respondents indicated that there were no campaigns mounted by the schools whilst 45% responded in the positive. The teachers who responded in the negative indicated that campaigns were only held in the classes by teachers because it was a requirement by the Ministry of Education, Sports and Culture. The respondents cited lack of resources by school to mount campaigns in the rural areas. Some teachers indicated that the school authorities may have thought such campaigns were unnecessary. Some respondents revealed that some nurses came to their schools to talk about HIV and AIDS. They also indicated that children participated in gatherings for HIV and AIDS awareness programs like dances, poetry, traditional activities and drama. Table 3 Sensitizing children in class Responses Yes No Total

Frequency 17 3 20

% 85 15 100

The table shows the teachers responses on sensitizing children in class. The majority of the respondents indicated that they sensitized children in class (85%). A few revealed that they did not sensitize the children in class (15%).

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Table 4 Comments on sensitization of children in class Item They seem not to understand simple things since they are reception class. It’s a bit complicated to them. It’s an abstract subject. Lessons on Friday every week planning and scheming. Lessons very difficult because most of the children do not cooperate in the discussions. Some are deaf Children taught whenever applicable Providing basic information on ways of preventive measures and causes By asking them what they know about HIV and AIDS They should know about HIV and AIDS because they stay in the community where they are vulnerable

Frequency 7

% 35

8

40

1

5

1

5

1

5

1

5

1

5

The table indicates teachers’ comments on the sensitization of children on HIV and AIDS in class. Several subjects indicated that lessons on HIV and AIDS were conducted every week on Fridays (40%). A number of respondents revealed that children seemed not to under stand simple things as the subject on HIV and AIDS was abstract (35%). Children received basic information on causes of HIV and AIDS and ways of prevention. Teachers also asked children what they knew about HIV and AIDS. Subjects agreed that children had to know about HIV and AIDS because they stayed in the community where they were vulnerable. Table 5 Whether children are aware of HIV and AIDS Response Yes No Total

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Frequency 16 4 20

% 80 20 100

International Journal of Academic Research in Progressive Education and Development January 2013, Vol. 2, No. 1 ISSN: 2226-6348

The tables shows teachers’ responses on whether children were aware of HIV and AIDS. The majority of the subjects responded in the positive (80%). A few responded that children were not aware (20%). Teachers indicated that children talked about HIV and AIDS in their play. They sometimes discouraged each other from playing with children of the opposite sex for fear of HIV and AIDS. Some subjects revealed that the answers provided by the children during question time showed that they were aware of HIV and AIDS. Sexual intercourse with a positive person was also cited by pupils as a cause of HIV and AIDS. Respondents who doubted the level of awareness indicated that the subject HIV and AIDS was an abstract issue to children with mental retardation. They have not attained that level of awareness (who they were) and most of the children did not have speech and so could not respond freely. The teachers also indicated that the children could not master simple things. Hence, it would be more complicated for them to gain from HIV and AIDS discussions. Table 5 Methods of HIV and AIDS awareness employed Item Drama Music Poetry Lessons on HIV and AIDS in class Conversation between class and teacher Picture reading/pictures Pamphlets Assembly teaching Children talk about experience Art Use of TV Role play Movement and dance Games

Frequency 14 14 8 7

% 70 70 40 35

6

30

6 4 3 2

30 20 15 10

2 1 1 1 1

10 5 5 5 5

The table shows the teachers’ responses on the methods (strategies) of HIV and AIDS awareness employed at the school. The majority of subjects cited drama and music as the most popular strategies (140%). Several respondents indicated that lessons on HIV and AIDS were taught in class where there were conversations between the teacher and the pupils (65%). Poetry and picture reading were also cited by respondents (70%). Some respondents revealed that children were taught about HIV and AIDS during school assembly and they also talked

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about their experiences (25%). Use of pamphlets, art, TV, role play, movement and dance as well as games were some of the strategies employed (50%). Table 6 Success of strategies on HIV and AIDS awareness Response Yes No Total

Frequency 17 3 20

% 85 15 100

The table indicates the teachers’ responses on the success of the strategies used on HIV and AIDS awareness. Most of the respondents agreed that the strategies employed were successful (85%). The teachers indicated that some children‘s answers to questions on HIV and AIDS revealed a higher level of awareness. They talked about the subject and were aware HIV and AIDS is incurable. The children could sing and dramatize on HIV and AIDS. It was also cited that mature students reported others to the teachers when they engaged in sexual activities. Pupils who were aware of who they were as well as their surroundings had some comprehension on the subject. However, teachers suggested that there was need to teach students on a daily basis to reinforce knowledge gained. Subjects who responded negatively (15%) indicated that students did not fully benefit from the awareness campaigns because most of them could not ex press themselves. Children could interpret messages conveyed through posters and poems. It was also revealed that children got raped and abused at home. They were only safe at the school because people at home took advantage of their disability. Children with mental retardation needed more media materials, concrete aids and repetition messages. More activities such as drama were needed. Table 7 Benefit of awareness campaigns to the children Response Yes No Total

Frequency 18 2 20

% 90 10 100

The table shows teachers’ responses on whether HIV and AIDS awareness campaigns were of benefit to the children. The subjects responded overwhelmingly that children benefited from the awareness campaigns (90%). They agreed that HIV and AIDS awareness conscientised children on effects of AIDS and also on boy/girl relationships. The children were more at risk due to abuse, hence, they needed to be on the safe side through awareness. Teachers revealed that children with mental retardation were like all other children, they got infected or affected. If pupils comprehended what HIV and AIDS were, to some extent they would be capable of protecting themselves. The subjects who responded in the negative (10%) agreed that HI V and 352

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AIDS awareness campaigns were of benefit only to the children with mild, mental retardation but not to those who were in a severe state. Most of the children did not understand the subject. Consequently, were prone to abuse by people who pretended to love them and, maybe, gave them sweets. Table 8 Problems encountered in attempting to implement HIV and AIDS awareness campaigns Item Forgetfulness (easily forget). Need for repetition Lack of under standing. Cannot express themselves. Language and communication problems They need some resources that are secure Lack of information relevant to the level of children Lack of relevant media. Some of the children are shy. No participation. No response Low mental capacity. Confusion about what happened to them, especially regarding sexual abuse Issue too abstract to most pupils School has no awareness campaigns Parents not open on the abuse of children No outreach programs with relevant organizations Lack of well implemented program for AIDS School does not check whether we are teaching the subject or not

Frequency 8

% 40

10

50

7

35

4

20

3

15

3

15

2

10

2

10

1

5

1

5

1

5

1

5

The table shows teachers’ responses regarding problems encountered in attempting to implement HIV and AIDS awareness campaigns. Subjects cited children’s lack of understanding due to language and communication problems. Hence, they failed to express themselves (50%). Several respondents indicated that children with mental retardation displayed a lot of 353

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forgetfulness (40%). Hence, there was need for repetition of issues to be taught and messages to be conveyed. Teachers indicated that there was need for resources that were secure (35%). It was also revealed that some children were shy hence, they failed to respond and participate. Some subjects indicated that the issue was too abstract for the children. They had low mental capacity and sometimes displayed confusion about what happened to them regarding sexual abuse. Parents were also not open on the abuse of children. Respondents cited lack of awareness programs at school as well as outreach programs with relevant organizations. There was also lack of well implemented programs on AIDS. Table 9 Measures to over come the problems

Item Community should assist in the education. Work hand in hand with organizations. Organizations to come to the school. Involvement of specialists in compiling information. Emphasis on repetitionenhances comprehension. Need for constant reminding. Improvisation (locally available resources) Discussion with parents whenever they visit Campaigns on HIV/AIDS Increase more materials Holding of workshops Inviting of drama groups Introduce stories in between so they can pay attention Breaking the teaching

Frequency

%

17

85

6

30

3

15

3

15

3 1 1 1 1

15 5 5 5 5

1

5

Materials into sample parts Encourage children to 1 respond to gestures Involvement and integration 2 with other pupils in regular schools whenever HIV and AIDS campaign are being 354

5 10

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done. Consulting teachers on the 1 need to assist the children Children should be taken to 1 real places where people with HIV and AIDS live so that they actually see people living with the disease.

5 5

The table shows teachers’ responses on the measures to be taken to overcome the problems of implement ting the HIV and AIDS awareness programs. The majority of the respondents cited the role of the community in the education of the children (85%). Schools should work hand in hand with organizations which should also visit the schools. The involvement of specialists in compiling relevant information was also highlighted. Some subjects cited the need for repetition as it enhanced comprehension. Children with mental retardation needed constant reminding. Teachers also recommended the improvisation of locally available resources as well as the increase of more materials to be utilized in the awareness campaigns (30%). Respondents cited the relevance of discussing issues pertaining to HIV and AIDS whenever parents visited the institutions. Awareness had to be extended to the home. Workshops and campaigns on HIV and AIDS had to be conducted. Subjects also recommended involvement of pupils with mental retardation with their colleagues in the regular schools whenever HIV and AIDS campaigns were held. Respondents referred to the need to invite drama groups and the conscientisation of teachers on the need to assist the children. Regarding the teaching of the children, some respondents recommended the introduction of stories in between to arouse the children’s attention. Teaching material had to be broken into simple parts and children should be encouraged to respond to gestures. Teachers also cited the need to take children to real places where people with HIV and AIDS lived so that they actually see people living with the disease. Discussion Although AIDS education was implemented at class level, it was clear that school organized programs were not a common feature. Respondents cited lack of resources to mount such programs. The need for resources is cited by Chureshe and C hureshe (2003;25), who recommend that the Ministry of Education should provide resources aimed at enhancing the teaching of HIV and AIDS. Without the relevant and adequate resources schools become incapacitated. According to Coleridge (1993;6) it is children’s right to get access to materials, HIV awareness programmes and services. Regarding the sensitization of children in class, it was evident that teachers interacted with children on class on HIV and AIDS. Such an interaction can lead the children to increase self learning and understanding of messages pertaining to HIV and AIDS (Chireshe and Chireshe 2003;25). To enhance effectiveness in the sensitization process, the Ministry of Education has 355

International Journal of Academic Research in Progressive Education and Development January 2013, Vol. 2, No. 1 ISSN: 2226-6348

been holding workshops to educate teachers about the disease in order to effectively assist pupils to understand the AIDS epidemic. On the issue of children’s awareness of HIV and AIDS, most teachers were convinced that children got the message. This was evident from their interactions with each other and from responses they provided in class. Children with mental retardation, like all other people, need to be well informed about HIV and AIDS so that they will understand how the virus is transmitted and what activities and transmission are safe. (Jackson 1998). Maluwa-Banda (2004) asserts that the AIDS education programme should address the gaps in the student’s AIDS related knowledge on basic information required in order to protect themselves against AIDS an d HIV transmissions. Although some respondents indicated that the subject of HIV and AIDS was an abstract issue to the children with mental retardation, the children still needed the awareness that was consistent with their level of disability and understanding. Lack of awareness would definitely expose them to the vagaries of HIV and AIDS transmission (Kundishora 2006;30;Russo,2002). Of the strategies employed on HIV and AIDS awareness in their classes, activities where the children were actively involved e.g drama, music and poetry featured the most. The other methods like teaching, conversations picture reading and use of TV were not high on the agenda. (Groce 2003) recommended that children with mental retardation should be afforded the opportunity to learn and participate in issues affecting their lives. They need to be involved so that they can identify needs properly and decide to address them appropriately (http://www.worldbank.org/AIDS) The teachers responded overwhelmingly that HIV and AIDS awareness campaigns were of benefit to the children. It emerged that HIV and AIDS awareness programs conscientised children on the effects of HIV and enhanced healthy boy/girl relationships. Kundishora(2006) affirmed that lack of relevant information and sexual abuse placed persons with disabilities at high risk of contracting HIV and AIDS (WHO, 1990). In their study, Groce and Trasi (2004) indicated that people with disabilities were viewed as sexually inactive, hence, women and girls were often raped to satisfy the belief of virgin cleansing, hence, the need for HIV and AIDS awareness. The major problem confronting teachers as they attempted to implement HIV and AIDS awareness campaigns centered on children’s forgetfulness and lack of understanding. The children had a language and commuinication problem and would fail to express themselves. This lack of communication hampered progress in implementing HIV and AIDS awareness programs. According to WHO (1992), education about HIV and AIDS should start early and target all levels of society. Jackson (1988) also emphasizes that all people need to be well informed about HIV and AIDS, how it is transmitted, if they are to protect themselves. Repetition of information will lead to awareness by children with mental retardation on issues relating to HIV and AIDS.

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The need for community involvement in the campaigns on HIV and AIDS emphasized. Subjects responded that schools should work hand in hand with experts and organizations well versed in the awareness campaigns. The specialist would be involved in the compilation of information relevant to the children’s needs. Grant (1991) refers to AIDS Education as the key strategy which should be implemented through all possible strategies - religious and community organizations, women’s groups, the mass media, the health services, schools and colleges, artist and entertainers. For awareness campaigns to be effective, experts on HIV and AIDS should visit schools to talk about AIDS (Katsinde and Katsinde 2007). Thus, HIV and AIDS awareness programmes among children with mental retardation should be a shared responsibility, communal involvement Conclusion The study concluded that children with mental retardation were aware of the HIV and AIDS scourge. The respondents cited the conversations held among children themselves on the subject as well as children’s responses to questions asked in class during scheduled lessons on HIV and AIDS. The study concluded that HIV and AIDS awareness campaign were of benefit to the children, given the overwhelming responses by the subjects on the issue. It was concluded that HIV and AIDS awareness programmes conscientised pupils with mental retardation on the effects of AIDS and enhanced health boy/girl relationships. More school organized campaigns should be mounted, where organizations and experts will be involved in conscientising children and providing the much needed resources and relevant information on the effects of HIV and AIDS preventive measures. References Chireshe, E and Chireshe R (2003) Advanced Level Students’ Perceptions of the Causes and Effects of HIV and AIDS. A Case Study of Masvingo Urban Schools. Zimbabwe Journal of Educational Research. Vol 15 No 1 Mar 2003; 11-27 Chireshe, R.U and Makore–Rukuni, M (2003) HIV and AIDS Councelling. Module CD312 Harare Zimbabwe Open University Dzviti, V.Y. (2008) The Effectiveness of Including C hildren with Mental Retardation in Primary Schools in Masvingo Province. Unpublished M.Ed Dissertation, Great Zimbabwe University. Education Act (1987) (Revised 1996) Ministry of Education and Culture, Harare, Government Printers. Elwan, A. (1999) Poverty and Disability A Survey of the Literature. Washington, World Bank. Grant, J.P. (1991) The State of the World’s Children 1991. Published by UNICEF, Oxford Universities Press. 357

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Groce N (2003) HIV and AIDS. People with disability. The Lancet Vol 3614026 Groce, N and Trasi, R (2004) Rape of Individuals and Disability. AIDS and the Folk Belief of Virgin Cleansing. The Lancet Vol 363 Hallahan D.P. and Kaujffmann, J.M. (2006). Exceptional Children An Introduction to Special Education. Boston/Lo ndon,Allyn and Bacon Http//org/en/resources/articles Http//www.worldbank.org/AIDS Jackson, H (1992) Action Now Information, Prevention and Support (2 nd Ed) Harare, AIDS Counselling Trust Jackson H (1988), AIDS Action Now New Information, Prevention and Support in Zimbabwe. Harare.AIDS Counselling Trust Katsinde T .J. and Katsinde, C.S. (2007) HIV and AIDS Awareness Among Secondary School Pupils in Bindura District, Zimbabwe. Zimbabwe Journal of Educational Research Vol 19, No 1, Mar 2007; 99 – 112 Kundishora M. (2006) The Impact of HIV And AIDS Awareness in Persons with Visual Impairment. Unpublished M.Ed Dissertation. Masvingo State University, Zimbabwe Maluwa-Banda D (2004) HIV/AIDS Related Knowledge and Self Reported Sexual Behavior of Secondary School Students in Southern Malawi. Implications for AIDS Education and Councelling. Zimbabwe Journal of Educational Research. Vol 16 No 2, July 2004;85 – 100 Musumhi; E.J. (1993) Chief Education Officer Circular Minute No 16 of 1993, Harare, Ministry of Education and Culture Russo, H (2003). Education for all, A Gender and Disability Perspective. Unpublished Report Prepared for the World Bank. Smith D.D.(2001) Introduction to Special Education, Teaching in an Age of Opportunity. Boston/London, Allyn and Bacon Turnbull A.P.; Shank, M; Turnbull III, R and Leal, D. (1995) Exceptional Lives. Special Education in Today’s Schools Upper Saddle River, New Jersey Merrill. UNICEF (1999) Children in a World of HIV and AIDS. Harare, UNICEF WHO (1999) Is the Law Fair to the Disabled? Copenhagen, WHO Regional Publications 358