Inspiring Futures: Learning from Memory Work in Africa

This 32-page learning paper, published by HealthLink Worldwide, looks at experiences of applying memory work as part of broader strategies to mitigate the impact of HIV/AIDS in five African countries: Ethiopia, Kenya, Tanzania, Uganda, and Zimbabwe. The experiences occurred through the International Memory Project which was started in 2004 and was funded by Comic Relief. The paper explores how six non-governmental organisations (NGOs) in sub-Saharan Africa established memory work as a key component of their community-based HIV programmes and suggests that memory work can be a successful way to encourage communication and reduce stigma, when integrated into existing support programmes.

According to the paper, memory work was first developed by the children's charity Barnardos in the 1990s as a way to help African families living in the United Kingdom (UK) who were affected by HIV/AIDS. Memory work is rooted in oral history approaches that value the transmission of knowledge between generations as a way of building cultural identity. The experience in the UK showed that it can play an important role in supporting families and communities to become more effective and responsive to the needs of their children.

Since 2004, The International Memory Project has been using memory work to help improve child, family, and community coping strategies related to HIV/AIDS. It focuses on using memory work to encourage families to communicate about HIV. Over the years, IMP partners have developed a range of activities to support the aims of memory work. Through these activities, parents and guardians receive training and support in: child development; improving communication with children; and making plans for the future. Children are also involved in activities designed to: increase their knowledge of HIV/AIDS; develop and strengthen life skills; and develop peer support groups.

Country partners have systematically integrated memory work into their HIV programmes. Each partner adapted the approach and applied it in different ways depending on their local context. Through these experiences, and as the paper points out, memory work needs to be rooted in existing HIV programmes and services, and is generally only effective when it works alongside other services which offer treatment, support to generate income, and other health care provisions. Integrating memory work has shown that it can increase communication in the family, reduce stigma, and encourage openness in all sections of society. The authors state that, so far, the most significant impact has been on the well-being of parents, and the implementing partners hope that this will bear dividends in the future as parent-child relationships continue to improve.

The report looks specifically at memory work's impact on children and on families, noting that the main impact on children has been the start in increasing children's participation in communication within the family. Their HIV knowledge has also increased and children are learning not to stigmatise their parents and others living with HIV. The biggest impact on families has been seen in the lives of parents and guardians living with HIV. According to the author, the training and ongoing support group activities have consistently increased the quality of life for parents.

The paper also includes brief reports from each of the five countries involved in the memory work project, citing specific challenges faced and lessons learned from each. For example, in Kenya, one of the main challenges was related to preparing wills and succession plans. These activities faced cultural resistance, as they are perceived to be appropriate only when an individual is close to death. Women wishing to write wills faced additional challenges as they are considered men's property and are unable to make or participate in decisions about the family's future. To counter these issues, the project in Kenya began engaging more men in memory work in order to debate these issues within communities.

The report also includes a number of recommendations for practitioners and policymakers. For practitioners, the authors recommend developing good linkages with other organisations to support components of memory work and ensure the existence of strong referral systems. Partnerships with legal organisations are proving crucial. It is also recommended that practitioners should increase activities and support for children participating in memory work, and consider extending memory work to the whole community, not just families affected by HIV/AIDS. The paper recommends learning from other areas where psychosocial support is practiced, such as in situations of conflict, and ensuring that memory work participants are also having their basic needs met.

For policymakers, the paper states that memory work needs long-term involvement with partners, children, and communities to ensure that the initial positive impacts of the work can be maintained until children reach adulthood. This means that either long-term funding formats or a very low-cost approach which can be supported by communities themselves is needed. Further research and evaluation needs to be carried out with existing memory work programmes over a minimum ten year period, to increase knowledge and understanding about the long-term impact. The authors recommend that children be placed at the centre of memory work, with a genuine commitment to facilitating their involvement and leadership in the work. The experience of implementing memory work across the five countries currently involved shows that there is potential for social change, but that the approach needs committed investment and support. In addition, memory work does not work in isolation. Successful memory work is either integrated into other programmes such as home-based care, economic strengthening, orphan support, or treatment provision, or works closely alongside programmes that offer this support.