1. Introduction

AIDS in a new millennium, a grim picture with glimmers of hope!
(UNAIDS Report June 2000)

The presented work is a unique instrument in the fight against the ”impending disaster” HIV/ AIDS pandemic, gathering together in an overall approach the various segments involved in the prevention of HIV/ AIDS through EIC activities (Education, Information, Communication).

The strategy is to develop a network of points- Basic Modules- distributing information and services where people live.

The Basic Module satisfies functional requirements as defined by the UN. The Basic Module can be a starting point for the development of local school and health care centers.

The Basic Module is given African shape which will signal respect for African cultural integrity and evoke people’s confidence.

This proposal should provide a permanent and sustainable solution able to be easily established in communities and become an integral part of ordinary people’s daily life.

UN FACTS AS A GUIDELINES FOR BASIC MODULE’S DESIGN.
The UN has highlighted steps which should be considered as a part of prevention efforts:

1. End the silence, stigma and shame
2. Equip people with life skills to turn knowledge into practice
3. Provide youth-friendly services
4. Promote voluntary and confidential HIV testing and counselling
5. Work with people, promote their participation
6. Provide people with knowledge and information
7. Engage people who are living with HIV/AIDS
8. Create safe and supporting environments
9. Reach out to people at risk
10. Strengthen partnership, monitor progress
    
    

The UN published facts and findings constitute the basis and guidelines for our design process. Furthermore, based on the nature of HIV/AIDS and society’s possibilities to fight it, the following factors are also considered:

• Flexibility
• Environment
• Strengthening of African cultural integrity
• Technical aspects (water, sanitation, power) and
• Costs

Flexibility. The HIV/AIDS clinic should provide space for all basic functions needed for carrying out necessary tasks. We have designed the “Basic Module” such that it can be enlarged or reduced relative to local demands and conditions. The Basic Module should also accommodate additional, supplementary community activities (health care, school etc).

To address the problems of staff shortage, we suggest that the structures pertaining to the Basic Module be permanent while the medical personnel and equipment will be on rotation or “mobile”.

Environment. Deforestation is a huge and complex problem that also affects many of the African countries hit by the HIV/AIDS epidemic.

One of primary sources of deforestation is wood utilization for fuel and house construction. Firewood and brush provide about 52 % of all energy sources. More than two-thirds of sub-Saharan Africa’s people live in rural areas and rely on agriculture and other natural resources for income. Several sub-Saharan countries have had over three quarters of their forest depleted. Deforestation also has negative implication for he local environment resulting in increased erosion and loss of biodiversity.

In addition to the ever-growing population and energy needs, some of the environmental problems facing this region include pollution of water supplies, massive deforestation, loss of soil and soil fertility, and a rapid decline in biodiversity. Destruction of forests, fisheries and agricultural land leads to poverty and famine, which in turn can create breakdowns in civil society and governments, leading in some cases to armed conflict.

Given the magnitude of the environmental problems facing sub-Saharan Africa, this project has adopted the following strategy:

Strengthening of African cultural integrity. The Basic Module will be based upon the concept of traditional African house design that has been developed through generations in accordance to African conditions. Since these houses require a lot of trees to build, we believe that complementing the traditional African design with modern, forest saving structures will signal respect for African cultural integrity. Additionally, the site layout for the Basic Module will involve the use of units arranged in clusters since many African villages are built in this manner. Building of the Basic Module will involve the community working together for their own benefit.

We believe that using the above strategies, will contribute to smoother integration and good-will regarding the AIDS Clinic in rural communities.

Technical aspects. In connection to the establishment of the Basic Module, we will also ensure that proper sanitation, water- and power supply be considered. Solar energy is proposed supply refrigerators and lighting of the Basic Module. But the type of solutions used should be accommodated to local conditions.

Costs. The spread of HIV/AIDS is enormous. The mobilization of effective assistance is dependent upon a network of previously established clinics in the countries and districts hit hardest by the decease. If the proposed strategy of establishing a network of clinic structures is adopted, the cost of the individual clinic must be extremely low. In this proposal the use of an inexpensive load bearing structure of heavy duty aluminium combined with readily available renewable local materials and labour gives a logical, durable and sustainable solution for the clinic facilities.

2. Strategy

Prevention through EIC activities combined with voluntary, counselling and testing programs are the most important tools in fighting the decease. Information must be distributed where people live - in their local communities. This proposal brings the clinic to people thus providing easy access to the services the clinic provides.

Our approach is to develop a network of points- Basic Modules- which are easily constructed and expanded, and when necessary easily transported to new locations. The Basic Module will consist of segments able to be developed step by step. Our network of BMs is easily deployed and expanded to become a part of anti-HIV/AIDS structure based on countries own health strategies, training centers for key staff, central stores for equipment and responsible implementing bodies.

3. How to reach people - Best practice

HIV/AIDS is still feared and stigmatised in the districts the proposal intends to reach. People afflicted by the decease are ashamed and prefer to remain silent about their predicament.

A new HIV/AIDS clinic should not be an institution, which just comes, tests and then leaves. A new clinic must be regarded as friendly, and familiar, and at the same time must evoke people’s curiosity and confidence.

This proposal therefore proposes to give the clinic an African shape - one which people intuitively feel confident with and can trust. By engaging local people in the building of their own clinic, the essential feelings of ownership and responsibility are fostered.

We wish to utilize constructions and solutions, which have been tested and proved in Africa before - we will offer the best practice.

		1. An African house has been developed for African conditions through generations and its features are superior to other types of housing.
		2. But its life span is limited because of termites which also causes the high rate of consumption of wood.

1. Aluminium structure is long lasting and light-weight structure, easy to transport, easy to erect and dismantle for move to new locations. Erection method of this structure is similar to the traditional African one.
2. In arid and/ or semiarid districts the structure can be covered by canvas or ventilated heavy duty polyester/ PVC tarpaulin. This solution can be used also in situations where a fast erection is needed.
3. For savannah or rain forest districts traditional solutions of cover is preferred, combined with local materials for walls. The aluminium structure is especially designed to be combined with local materials. The method used, when completing the construction with local materials, will be similar to the traditional one. This will help preserve the local traditions and local building techniques, which constitute a vital aspect of the cultural heritage.

The size of HIV/AIDS clinic will probably vary from location to location, corresponding to the size of the district, which is intended to be served. Therefore the clinic should be flexible in size, and function. Our solution is based on the use of the Basic Module (BM) which satisfies functional requirements as defined by the UN Study. The Basic Module’s functions can be increased in accordance with local needs. If the needs for any of Basic Module’s function cease, the structural elements can easily be moved to another place and utilize again.

	1. Information Unit. Theme courses, info/exhibition, special courses for pregnant women, free will testing of pregnant women. Contains classroom, store - 50 m2.
	2. Counselling Unit. Pre-/postcouncelling, prepardness. Contains entry room with info, conversation room, store - 20 m2.
	3. Laboratory. Testing. Contains laboratory, room for risky trash - 20 m2.
	4. Ward. Treatment of deceases related to HIV/AIDS (TB, bowel/stomach, etc.).
	5. Doctor’s Office. Health check, out-patientxs department. Contains registration, room for health check- 20 m2.
	6. Staff House. Meetings, relaxation. Contains room for relaxation, meetings - 20 m2.
	7. Mother and Child Unit. Functions as health station, medicine distribution, testing, weight control. Contains examination room with necessary equipment - 20 m2.
	8. Store. Storage of equipment (medical supplies etc.), solar refrigerator. Contains store, room for batteries - 20 m2.

The Basic Module consists of units 1 through 8 and is clustered around a central courtyard similar to the traditional African village. The BM is supplemented with technical core containing water supply, sanitation - and kitchen units. The BM's different functional units can be added to according to changing needs. The Basic Module can be built close to existing school/health station.

The establishment of educational/ health care services can be appropriate in communities where these kinds of services are lacking. The BM’s Information Unit can be starting point for the development of school- and skill building centre as well as the BM’s health specialized units can be a starting point for the development of a local health care centre.

An important element of the extended Basic Module is area used for educational games and sport activities- essential supplementary activities in the education of young people.

Our solution is especially well suited especially for African rural areas. Building of educational and health care facilities is subordinated to local needs and can never be under- or overestimated. If needs cease, the facilities can be relocated.

a. Housing Unit of 20 m2 living area is proposed to contain BM’s individual or service functions.
b. Housing Unit of 50 m2 living area contains collective functions.
c. Water Distribution Unit is supposed to supply BM’s facilities with domestic water.
d. Combined Sanitary Unit (WC, showers, washing basins).
e. WC Unit
f. Shower Unit
g. Solar energy is proposed for lighting and refrigerators. Can be supplemented with generators if extensions of BM occur.
h. Kitchen Unit. Equipment must be based upon local sources and traditions.

The load bearing structure is made of aluminium. A system of poles, rafters, horizontal and tie beams are fixed together in a way that allows for rapid erection and dismantling. The structure is complemented with roof and walls of readily available renewable local materials such as grass, mats of palm leaves, mud blocks, bricks, or made of different types of tarpaulins.

8. Transportation- Mobility

The HIV/ AIDS clinic is supposed to serve even remote and difficult accessible districts. The transportation is easy. One complete Basic Module of 220 m2 living area can be loaded on one truck. All components are light-weighted and suitable also for alternative transportation by camel, bull cart and even by manpower. There are no needs for lifts during loading or unloading.

The engagement of local people and local participation in early stages of the clinic establishment is extremely important. The construction proceeds rapidly and local people’s own skills can be utilized. A team of workers will spend not more than 3 days to construct the structure of 220 m2 of the Basic Module (BM). Both women and men can contribute with their skills. Local participation is not limited to the erection process. There is also the opportunity to utilize local production of bricks or mud blocks, furnishing metalwork or thatching.

One of the most important features of the Basic Module is its extremely low cost, efficient and cost effective use of the staff.

11. Spin Offs

This proposal involves several elements which foster the development of active local communities.

1. Involvement of the people creates active local communities
The establishment of the health/ educational centre will stimulate local people’s participation from the very beginning, when the centre is first introduced. They will be able to address the problem of HIV/ AIDS and other related issues- in ways adapted to their own community and with their own solutions. This will also support the decentralisation process in these countries and the development of active local democracy.

2. The use of African inspired architecture, while improved with modern structural elements respects the integrity of African cultural heritage. The concept integrates well-established local knowledge and creates an important alliance for building a centre that is environmentally friendly and best adapted to the local culture.

3. A new hope for the future, and a feeling of empowerment and independence will be raised from participation and local involvement which is activated during the process. People will naturally feel confident, willing to commit themselves and will together contribute con towards the health and well-being of their community.

4. Educational and skill building activities are of the utmost importance especially for young people. Skill training gained through EIC activities, will ensure that they learn new methods which will assist them all to reflect on risky situations, let the young girls get new argumentative skills, to assist them when they are at risky places etc. This will be assimilated via participation and can eventually inspire the establishment of small income generating activities and development in rural areas.

5. New work opportunities will be created for local population. The construction of the educational and health care centre will engage a number of local workers, strengthen existing local production (e.g. furnishing), and increase needs for education of professional staff. It will also give new ideas for Youth in the rural areas- on how they can develop their own business.

6. Effect of less HIV-positive people will contribute to regional and country development. Those people willing to go for VTC will contribute to a more correct picture of the spread of the decease in different areas. They will also contribute to decreasing the stigma the HIV positive people. This is vital in the fight against HIV/ AIDS.

7. Conservation of the environment
Many of the countries in the sub-Saharan region face deforestation, which is a significant and complex social and geographic problem. The use of modern construction materials combined with traditional African building styles, will signal the necessity of the education about the importance of conservation of people’s environment. It will create awareness regarding how the state of the environment influences one’s health particularly amongst young people.

8. Alternative energy sources
Our proposal involves utilization of solar energy for lighting and operation of BM`s refrigerators. This solution enables the storage of medicines where people need it and is optimal in African rural regions. Through this connection to fighting the HIV/AIDS decease, international attention is concurrently directed toward the important need of solving energy problems in Africa, thus propelling the development of alternative energy technologies such as solar, geothermal and wind power.

9. Global effects
There is no doubt that HIV/ AIDS is one of the most serious disasters attacking the international society. Prevention of HIV/ AIDS through the use of HIV/ AIDS fighting programme designed for African conditions will effect local economic activities and yield significant economic stimulation. Consequently, the needs for different kinds of aid will cease. It should attract the attention and good will of potential donors.