As clinics began reporting an alarming increase in STDs and the local hospital was receiving more patients diagnosed with AIDS, key community leaders held consultations about the numbers of people already ill in their areas. The community also reported that many people were returning from the cities to die at home. Initially, there were calls to "educate" the people and Tsungirirai was tempted to "intervene" quickly with an information campaign. However, the project workers were advised to step back, listen and find out more about the problem, to begin with what the people know, not what the workers thought they knew. This meant a slower start to the project, whose objectives were threefold:

1. identify the key leaders of the area;
2. determine the setting in which HIV was spreading;
3. consult widely with the community to prepare a joint plan of action.

To begin, Tsungirirai held a series of workshops for key leaders, followed by community workshops for women, men and adolescents.  It trained project workers to facilitate workshops using a range of participatory techniques, including the LADA method (Listening Appraisal  Dialogue  Action), whose techniques generate dialogue around questions people want to ask and need to ask about HIV prevention.

Key leaders attended the workshops and participated in appraising the situation. They placed the HIV/AIDS problem not so much within a context of personal behaviour, but more within the context of existing laws that contradict traditional mores. In particular, they held the Legal Age of Majority Act responsible for empowering young people to deflect from acceptable norms that may have protected them from HIV infection. The women said that gender norms constrain decision making and that for them the threat of HIV is peripheral to a much greater fear of violence if sex is denied.  The youth said that the problem of HIV was closely linked to the issue of unemployment and a lack of recreation. The solution, they said, should be linked to employment creation and not necessarily to confronting obstacles to communication with their elders about reproductive health.

Within a year, traditional leaders had called for action to support orphaned children by evoking an ageold tradition of "Zunde Ra Mambo" (the Chief's Field) whereby the community takes responsibility for cultivating crops in fields set aside for the disadvantaged. Two satellite project offices have been built in the community and the community has started AIDS Action clubs with community members taking responsibility for awareness meetings and posters. Workers from a large company donated wooden sheds to house orphan caregivers in training. Land has been leased at a nominal sum for a dropin centre for children in difficult circumstances. Community members have made individual commitments to assist in lifeskills training for orphans. Other initiatives such as Youth Friendly Centres are currently being developed and advisory services are offered free to the project.

Lessons learned include:

• Stop talking and listen;
• Start where people are at, instead of telling them what they already know;
• Let the people decide;
• Turn a dream into reality
• Facilitate the awareness process instead of leading it.

Dr. Susan Laver (Project Advisor), University of Zimbabwe, Department of Community Medicine, Medical School, Box A178 Avondale, Harare, Zimbabwe; Tel: +263-4-791631/744209; email slaver@healthnet.zw; Tsungirirai address: Mrs Pippa Henderson (Director) Tsungirirai, P.O. Box, Norton, Zimbabwe; Tel: +26362-2996/29942; Fax: +263-622390.