Download I am an educational media developer, not an expert in nutrition or an

The relationship between HIV and nutrition
- notes from a SABCOHA business breakfast
by André Croucamp
An introduction
It is unfortunate that the current political debate has polarised antiretrovirals and
nutrition into opposite camps. An example of this rhetoric can be seen in the
following quote from a recent Academy of Science of South Africa study:
''The panel has concluded that no food, no component made from food, and no
food supplement has been identified in any credible study as an effective
alternative to appropriate medication,''
- Barry Mendelow
(Wits professor and National Health Laboratory Services pathologist, a
specialist in blood disorders and chairperson of the Academy of Science of
South Africa study)
The same study tips a very tentative hat to nutrition.
''One of our most important findings has been that nutrition is important for
general health but is not sufficient to contain either the HIV/AIDS or the
tuberculosis epidemic … We need a well-nourished nation. But a well-fed
population on its own is not going to resist HIV/AIDS without anti-retroviral
drugs. ''
- Dr Dan Ncayiyana
(Academy of Science of South Africa study panel member and editor of the
South African Medical Journal)
Even without the polarisation of nutrition and antiretrovirals, the process of creating
reliable and accessible information about the relationship between HIV and nutrition
is a real challenge. Many people have become suspicious about information on
nutrition because the nature of information changes so often. When Eating with Hope
(see box below) was created the international research encouraged people with HIV to
do everything they could to increase their weight. Now we know that it is lean muscle
mass that needs to increase and that a high animal fat diet should be discouraged,
especially in people who are taking antiretrovirals.
Unfortunately, most of the research that is being done is around specific up market
health shop products. When nutrition is researched it is usually in the form of
supplements – single supplements at high doses.
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Most information on nutrition is linked to advertising. Furthermore, very little
research goes into cheap alternatives to medicines or cheap co-therapies as these are
not perceived as having the potential to make a lot of money. Below-the-line, low tech
nutritional strategies have received very little attention.
“Research on drug therapies is traditionally given a higher priority than
research into nutrition due to profit potentials. Put simply, protease inhibitors
generate significantly more profits than bananas”
Romanowski & Zullig (2002)
We need to be doing research that will help us answer the following important
questions:
Can nutrition delay the point at which a person will have to take ART?
Can nutrition play a significant role in managing the side effects of ART?
What micronutrients can make a difference to people with HIV?
… in what quantities?
… in what combinations?
… at what stages of infection?
According to the Payne PEP FAR Investigation that was presented to the US
Congress:
''The mortality rate for malnourished individuals starting an anti-retroviral
regimen is 6 times higher than their adequately nourished counterparts, and the
side effects of HIV/AIDS medication are more pronounced for individuals
who are not receiving adequate nutritional support, which could impact a
patient’s adherence to a treatment regimen.''
We are dealing with three very different research and treatment challenges:
1. providing baseline nutrition where malnutrition is a cofactor in the epidemic;
2. establishing the nutritional needs common to all people with HIV;
3. understanding the relationship between nutrition and medication (drug-food
interactions).
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The relationship between nutrition and ART
You probably already know that antiretroviral therapy (ART) can be dangerous for
people who are malnourished and that most ARVs need to be taken with food, but
there are exceptions that should be taken on an empty stomach before meals. Some
work better on a low fat diet and some work better with some fat intake. Some are
more effective when combined with proteins.
But did you know that by increasing the amount of fresh fruits and vegetables you eat
and by increasing the amount of water you drink (preferably between meals) you can
reduce the toxicity and the gastro-intestinal side effects of ARVs?
Using food for this purpose can help to make the use of ARVs less difficult, increase
adherence and as reduce the risk of becoming resistant.
"It is irresponsible to ignore the issue of hunger and malnutrition particularly
in the battle against AIDS … Why should we write off the benefits of medical
interventions simply because people are too undernourished to absorb and
benefit from the drugs they desperately need?"
- Sheila Sisulu
(World Food Programme Deputy Executive Director)
Certain alternative practices recommend creating a detoxifying drink by boiling
dandelion root and drinking the water like a tea.
More research needs to be done to explore all the possible benefits of combining ARV
strategies with specific foods and plants.
We know that ARVs commonly cause a dangerous rise in cholesterol (lipodystrophy),
an increase in blood sugar (ARVs affect glucose metabolism and cause insulin
resistance), and decreased bone density. All of these side effects can be managed, to
some degree, with food.
Food can also be used to deal with the loss of appetite, loss of taste, nausea and
diarrhoea related to ARV use.
The right food intake can also enhance the absorption of ARVs and other anti-HIV
medications. The wrong foods can actually interfere with the absorption of
medication.
Like most medications ARVs use up nutrients (especially vitamin C) in the process of
being metabolised and give rise to certain nutrition deficiencies. These deficiencies
can be dealt with through changes in a person’s diet.
Certain nutritional strategies that are useful to HIV positive people need to be avoided
when they are on ART:
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like eating garlic, may increase gastro-intestinal side effects of certain ARVs;
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St John’s Wart, often used as an anti-depressant, can reduce the effectiveness
of certain ARVs;
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Grapefruit interferes with the absorption of certain ARVs;
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The African potato, or Hypoxis hemerocallidea, that may be useful in small
amounts to people with HIV, interferes with the chemical pathways needed to
process ARVs effectively;
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The cancer bush, or Sutherlandia frutescens, recently renamed as Lessertia
microphylla, is also contraindicated. It developed a reputation for its ability to
reduce cancerous tumours. Tea made from this bush has been used for
hundreds of years to treat cancer, fever, poor appetite, indigestion, colds and
flu, cough, chronic bronchitis, stress and anxiety.
This means that certain HIV specific diets may have to change when people begin
taking ARVs.
It is advisable that people using ARVs reduce the amount of alcohol they are drinking
for the reasons already mentioned above. Heavy drinkers are four times less likely to
achieve a low viral load on ARVs.
For all the reasons above, nutrition is an important co-therapy in any ARV
programme. Specific dietary management is required. A recommended practice is that
a health care worker or counsellor draws up customised food and drug timetables for
people on ARVs. Do you know how to do this? A little new information and skill can
make all the difference to the people in your care.
The information is not always readily available because it is based on new research.
You may have to do some of your own research. Ask the questions! Do the research!
Ask your institutions to make the effort to get the right information! Make ARVs
work in your community by adding the miracle of food.
The middle ground in the ART vs. nutrition debate
It is important to try and find the middle ground in the unfortunate, polarised, political
debate has forced antiretrovirals and nutrition into opposite camps.
The role that good nutrition can play in managing HIV infection is a significant and
not a marginal one. Good nutrition can offer low-tech and cost effective alternatives
to expensive treatment programmes and can play a major role in complementing any
treatment programme.
Medicinal and edible plants can be used to:
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boost the immune system,
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deal with deficiencies caused by HIV infection,
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treat opportunistic infections,
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deal with the symptoms of HIV and opportunistic infections,
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increase appetite,
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build muscle and prevent wasting,
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provide energy,
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improve emotional states,
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detoxify medication (crucial in the use of anti-retroviral medication),
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deal with the side effects of anti-retroviral medication,
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facilitate better digestion of both nutrients and medication, and
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create a positive sense of taking action rather than being passive.
"Food is often cited by people living with and affected by HIV/AIDS as their
greatest and most important need. Nutrition interventions for HIV programmes are
often overlooked in the international HIV policy debate and they remain critically
under-funded."
- Elizabeth Mataka
(UN Secretary-General's Special Envoy for AIDS in Africa)
Nutrition needs change from the moment of infection
From the moment your are infected with HIV your nutritional needs change:
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You have greater energy needs than most other people, because your body is
using up a lot of energy in its attempts to fight HIV;
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HIV infection also causes specific deficiencies (A, C, E, B6 and B12, as well
as zinc, iron, copper, magnesium and selenium salts). B12 deficiency, for
example, increases the risk of all sorts of illnesses, especially tuberculosis.
o The easiest way to combat these deficiencies is to eat more fresh fruit
and vegetables and to use fresh herbs in your cooking whenever you
can. Some nutritionists suggest that you try to eat one fruit or vegetable
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high in vitamin C (like oranges, naartjies, lemons, guavas or mangoes),
a dark green vegetable, which is high in calcium (like baby marrows,
spinach or morogo), and a yellow vegetable (like pumpkin or
butternut) every day. Over and above this, eat as many other fruits and
vegetables as you like. At least half of your diet should consist of fruit
and vegetables. These fruit and vegetables should be eaten as close to
their raw state as possible.
The vicious cycle of malabsorbtion and malnutrition
Medication causes further deficiencies, as the body uses its store of nutrients
to process and detoxify medication.
The body also uses up its nutrients to fight opportunistic infections and deal
with stress.
HIV infection, related opportunistic infections and the side effects of
medications can produce a vicious cycle of malabsorbtion and malnutrition.
If the T cells that line the gut are infected with HIV they can cause the lining
of the gut to become inflamed and lead to malabsorbtion. Malabsorbtion is
also caused by infections in the gut as well as secondary infections, like sores
in the throat and mouth, preventing intake of nutrients. Appetite loss adds to
malnutrition.
Loss of muscle weight can significantly reduce the body’s available nutrients
because nutrients are stored in the muscles.
Medication can also causes nausea and vomiting, negatively affecting
absorption of nutrition. Under-nourishment eventually lowers tolerance of
medication and impacts on the immune system. Under-nourishment also leads
to hormonal deficiencies. This vicious cycle can be broken with the right kind
of nutritional intervention – especially if it is implemented early on.
Food can also be used to treat symptoms
The example of diarrhoea
As you probably know, when someone has diarrhoea they should eat a
squashed ripe banana. This is because banana contains a lot of potassium,
which is good for fluid retention and helps stabilise digestive enzymes. Foods
that contain soluble fibre will help bind fluids in the gut, such as oats, peeled
and grated apple or pear, mashed ripe banana, beans and lentils (well cooked
and mashed).
Starchy alkalising foods such as rice, oats and potatoes will also help.
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People experiencing diarrhoea should also avoid coffee, alcohol, raw
vegetables, milk, fatty foods and spicy foods.
They should sip a rehydration drink.
And after a severe case of diarrhoea they need to eat yoghurt, amasi or dik
melk to replace some of the “friendly” bacteria they have lost.
We have used the example of diarrhoea here, but Taste for Life gives many other
suggestions of how food can be used to treat nausea, vomiting, heartburn, constipation
(one of the most common causes of pain in invalids), bloatedness, fever, thrush, loss
of appetite and fatigue.
The role of nutrition in managing HIV infection
Good nutrition can offer low-tech and cost effective alternatives to expensive
treatment programmes and can play a major role in complementing any treatment
programme. Here are just some examples of valuable foods.
Beetroot promotes the production of white blood cells and helps replace the
folates (important chemicals for cell function and division) that are lost when
people take Bactrim.
Pilchards contain protein for building muscle; calcium for “nerve food” and
for reducing acidity; as well as Omega-3 fatty acids which reduce cholesterol
reduce the risk of heart attack and stroke, decrease insulin resistance in
diabetics and ARV users; are anti-inflammatory; prevent cancer; are great
brain food; treat depression, hyperactivity and other mental health conditions;
and keep your skin looking younger and calcium
Pumpkin seeds contain immune boosting zinc and help get rid of intestinal
parasites.
Ginger stimulates appetite, treats stomach infections, is anti-viral and helps
treat depression.
Turmeric, that spice that some people use to make rice yellow, kills bacteria,
kills fungus like Candida, treats high blood pressure, and has anti-HIV
properties.
Papaya helps treat a number of digestive disorders, is an anti cancer agent and
reduces acidity of the body making it more difficult for opportunistic
infections to survive.
Broccoli helps detoxify the liver and, according to some studies, might slow
down HIV replication.
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Dark green vegetables like spinach and other kinds of morog have high
levels of calcium which is natural antidepressant.
Thyme can help fight bacteria and fungi, relieve bad coughs, treat stomach
spasms and reduce mucous.
Some of the key nutritional objectives for people with HIV
One of the most important objectives for people with HIV is to build lean muscle
weight to prevent wasting.
This can be done by combining proteins and exercise. Remember it is muscle
weight we want to see not fat!
Lentils, beans, soya, peanuts (without the red skins) and organ meats are
excellent cheap sources of protein. You can also eat cooked mopane worms!
Cooked comfrey, which can be eaten like spinach, helps with building muscle
and with tissue repair, because it promotes the binding of proteins.
A high level of sugar in the blood suppresses the immune system and causes
insulin resistance.
You can control blood sugar by reducing your intake of refined sugar and by
eating fruit instead of sweets.
You could also eat smaller meals more often rather than large meals less often
(this also stabilises moods), and by experimenting with less refined forms of
carbohydrates like potatoes, brown rice, sorghum and millet.
Refined sugar is particularly dangerous for people on ARVs – who can
experience diabetes-like side effects.
If you have HIV you need to manage your levels of “bad” cholesterol.
You can do this by reducing the amount of saturated fat (animal fat) and
hydrogenated fat (margarine, processed foods and fried foods) …
… and by increasing your intake of soluble fibres. The highest soluble fibre
foods are beans, most fruits (especially dried fruits), vegetables, nuts, seeds,
and whole grains, especially oats, barley, sorghum and brown rice.
Vitamin C can help to make “bad” cholesterol water soluble.
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You should also increase cholesterol reducing Omega 3 fatty acids (found in
the flesh of oily fish).
Where possible, use more monosaturated fats like olive oil, canola oil, grape
seed oil, avocados, nuts and seeds. This is especially important for people on
ARVs – who can experience problems with metabolising fat.
Avoid fried foods, because they increase cholesterol but also because heated
oil releases chemicals (“free radicals”) that cause unnecessary tissue
degeneration.
Reducing the acidity of the body improves digestion and makes it difficult for
opportunistic infections to survive.
Reducing acidity is very important. Lactic acidosis can be fatal.
To prevent or treat this condition people need to increase their intake of
calcium, as well as magnesium, potassium, and sodium. These are all minerals
that are most abundant in vegetables (sprouts, broccoli, carrots, celery,
dandelion greens, beetroot, parsley, garlic,) and fruits (grapes, lemons,
peaches, papayas, apples, apricots, bananas, avocados, dates, melons, pears),
whole grains like millet, oats, nuts, seeds, and low-fat dairy like yoghurt –
these are the most potent alkaline-forming foods.
If you want to experience an immediate reduction of acidity try making
vegetable juices in a blender.
Deep breathing exercises also have an alkalising (reducing acidity) effect on
the blood. Remember that rooibos tea increases acidity, so don’t drink too
much of it.
Avoid foods that carry infections or promote infections.
Candida and other yeast infections can be fed through other yeasts, so avoid
bakers yeast and yeast related products like bread.
Animal products that are raw or only partially cooked carry the risk of microorganisms that is dangerous for people with a weakened immune system. So
avoid runny eggs as well as raw or undercooked meat.
To further protect against infection wash all fruit, vegetables, herbs, medicinal
plants and eggs in a weak solution of bleach (one tablespoon to a litre of
water).
You should also boil all river and rain water before use.
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It is important to say a few words about alcohol and how important it is to reduce
alcohol.
Alcohol can affect judgement;
cause unnecessary dehydration;
put unnecessary stress on the liver (especially in people whose livers are
already struggling to detoxify medication);
interfere with blood sugar levels; break down medication too fast (“enzyme
induction”);
and cause depression.
Like tobacco, caffeine and sugar, alcohol is an “anti-nutrient” which uses up
your body’s store of nutrients.
The role of exercise
Exercise:
- helps to build lean muscle;
- prevents wasting;
- helps with the process of detoxification;
- increases the level of oxygen in the blood;
- gets nutrients to the cells;
- helps get rid of cholesterol;
- burns off excess adrenalin;
- helps treat depression;
- it also increases your body temperature, which helps the healing processes;
- it keeps the immune system’s lymph glands working well.
Nutrients are stored in muscle. The more muscle you have the better store of nutrients.
In people who are experiencing lipodystrophy as a result of taking ARVs, exercise
can:
- help to reduce triglycerides;
- decrease insulin resistance;
- decrease abdominal fat.
Muscle makes more use of glucose than fat does, so the more muscle you have the
more able you are to reduce your blood sugar.
Other strategies
Get enough rest. Stress uses up the nutrients stored in your body.
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Seek early diagnosis and treatment of all illnesses or unusual conditions. In this way
you will use up less of your stored nutrients in fighting these infections
Most importantly, simple nutritional strategies give people a positive sense of taking
action rather than of being passive – a feeling of being in control. Many of the healthy
habits for a positive lifestyle are not only helpful to people with HIV but to everyone.
A more comprehensive list of strategies for people with HIV can be found in the
publication Taste for Life.
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Taste for Life – an innovative resource exploring the relationship
between HIV and nutrition
A brief background - Eating with Hope
A few years ago, André Croucamp and Neil Napper developed Eating with Hope, a
comic book on managing HIV through food. This was developed together with
AIDSLink, for the Gauteng Department of Health. Almost 5 million copies of Eating
with Hope have gone out to clinics in Gauteng.
In the last few years there has been a lot of new research into the role of nutrition in
managing HIV. André and Neil felt that it was time to conceive of a new resource that
integrated the more up-to-date research findings. They also felt it was necessary
integrate information on traditional medicine to coincide with the Traditional Healers
Bill and to integrate information on antiretrovirals to coincide with the Government’s
rollout. They joined hands with the Medicinal and Edible Gardens Association
(MEGA) to produce Taste for Life.
Taste for Life is an easy-to read but comprehensive look at all the ways in which
people who are living with HIV can change the quality of their lives by changing what
they put into their bodies. Its content covers the relationship between HIV and
nutrition, antiretrovirals, supplements, traditional medicines, and substance use. It also
encourages food gardening.
The main purpose of the publication is to explore practical and accessible strategies
for positive living, primarily with regards to nutrition. These strategies are modelled
by a group of fictional characters who belong to a support group that has started their
own food garden. Celebrity-like interviews explore each character’s story with its
own particular challenges and insights.
Taste for Life promotes the idea that living positively should not be seen as living
blandly or chemically or in a boring routine or suffering endless prohibitions. Living
positively means developing a refined Taste for Life that has its own colourful, exotic,
sensual, self-indulgent, intelligent and fun possibilities.
The resource takes the form of a lifestyle magazine making its educational messages
more accessible to ordinary people. It is bold, colourful, photographic, slick and
entertaining – including magazine type interviews, beautifully styled photographs of
food, fashion-like photo shoots, gadget pages, recipes and additional information in
boxes that look like adverts.
By presenting information in this way, Taste for Life tries to move away from the
desperation and scarcity that is communicated by the below-the-line publications that
are so common in the sector. Taste for Life normalises “positive living” and
communicates the idea that adapting your lifestyle to deal with HIV is like adapting to
and living with any other chronic disease.
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Target group
The primary target groups for this resource are trainers, care givers, counsellors,
health care professionals, Traditional Health Practitioners, corporate well-being
programmes, organisations involved in AIDS education and the National Department
of Health.
Development process
Taste for Life is based on contemporary research into the relationship between HIV
and nutrition. Sources included:
- South African National Guidelines for People Living with HIV
- Neil Orr’s Positive Health
- WHO and FAO’s Living well with HIV/AIDS (which, incidentally references
Eating with Hope as one of its main source materials)
- FANTA guidelines (Food and nutrition Technical Assistance Programme,
www.fantaproject.org)
- ACRIA (AIDS Community Research Initiative of America, www.acria.org)
- NAPWA’s publication on nutrition
During its development phase a number of focus groups were held with traditional
health practitioners and other health professionals (at Chris Hani Baragwananth
Hospital).
Once the first draft was completed we did send it to the following reviewers who are
working in the field of HIV/AIDS:
- Dr Francois Venter (medical doctor),
- Dr Eftyhia Vardas (medical doctor),
- Dr Pierre Brouard (psychologist),
- Dr Rocco Joubert (naturopath),
- Dr Minette Coetzee (a nurse, researcher and consultant, with a lot of
experience with children and orphans),
- T.Dr Paul Barker (traditional doctor),
- T.Dr Sheila Mbele (traditional doctor),
- Kate Greenaway (HIV/AIDS Technical Advisor, C-SAFE),
- Joe Vanables (nutrition expert),
- Sean Lotriet (HIV/AIDS course design expert),
- Daleen Raubenheimer (World Vision),
- Gillian Gresak (Anglo Platinum),
- Jean-Francois Sobiecki (ethnobotanist),
- Dale Millard (permaculturist and self taught ethnobotanist),
- John Nzira (permaculturist).
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The loss of MEGA
While the Medicinal and Edible Gardens Association contributed a lot to the initial
research and was the original publisher, they experienced internal problems with
capacity and governance issues and signed out of the contract. It is most regrettable
that they are no longer part of the project. Further print runs will be undertaken by the
author’s company, Event Horizon Productions.
The rationale behind creating fictional characters
An important part of Taste for Life is the modelling of a functioning and highly
motivated support group. The development team has integrated a lot of different
information through Taste for Life’s characters – each one representing specific
educational messages. By ensuring that this complex group of characters all “know
one another” the developers were able to unravel a complex and stimulating narrative
about them all. A support group growing their own food was the perfect context. Each
character models different strategies and shares the ideas (educational messages) that
have motivated them.
Sister Joyce is an opportunity to talk about support groups and some of the challenges of
primary health care. She is also a practitioner of orthodox western medicine that has embraced
nutrition, which is usually considered as a practice of alternative medicine.
Bongi, a young traditional healer, is an opportunity to talk about traditional medicine and the
role that culture plays in determining our choices.
Hannes relates to Bongi through his boere remedies and also introduces readers to the skill of
planting their own food.
Ruth is a coloured mother who is unemployed. She is an opportunity to talk about HIV
positive children and about accessing good nutrition when you do not have a lot of money. We
have also made her a great cook which gives us the opportunity to introduce Ruth’s recipes.
Moeketsi, the ex-boyfriend of Bongi, is an advertising executive and is an opportunity to give
critical insights into the way advertising messages are created. He is also an opportunity to
talk about the use of supplements and the use of substances (which is not uncommon in that
industry).
Nonhlanhla is an activist with a politicised “struggle” message as well as someone who is
already on ART.
Thaba, the journalist is a reflective voice that pulls everything together in his own story of
trying to learn more about the treatment and lifestyle options for people with HIV after the
death of his friend.
Ordering copies of Taste for Life
To order copies of Taste for Life contact André Croucamp of Event Horizon
Productions on 0836603024 or [email protected].
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Some background information on André Croucamp
André Croucamp has a degree in Theology from Rhodes University and a MA in
Palaeoarchaeology from the University of the Witwatersrand. For more than 15 years
he has worked as a researcher, writer, and developer of educational media. He has
produced comics, games, posters, documentaries, textbooks, installations, seminars
and participative group experiences. His media has covered fields as diverse as
science, health, entrepreneurship, sustainable agriculture, the arts, and heritage.
Here follows some information on the media he has produced in the field of HIV and
nutrition.
His relationship with AIDS education began with the AIDS Centre of the South
African Institute of Medical Research. He was invited to write handouts for the first
AIDS conference in South Africa. Soon after this he was offered a job by the SAIMR
where he did psycho social research and developed training material. With the
encouragement of Prof. Ron Ballard he wrote the first education material linking HIV
education to STD education. In 1993 he co-facilitated the design of the Oranjemund
Health Education Programme, which integrated the skills, needed to deal with HIV
and other STDs into a primary health skills programme. This programme was the only
one in a Southern African mine (in the early 1990s) to actually reduce the rates of
HIV and STDs. He was asked to present the methods and success of this programme
at the 1996 World Bank Conference on AIDS in Southern African Mines, at Victoria
Falls. The offer to do similar interventions in South Africa were turned down by major
mining houses on the grounds that they “could not afford to empower mine workers and
expose sensitive environmental issues.”
In 1993 he was asked to act as a consultant on the Open Talk comic project (with
Storyteller Group and Old Mutual). He facilitated the workshops that brainstormed the
content. In 1995 the government rated Open Talk as the top AIDS education resource,
together with Roxy Comic, and he was asked to develop Open Talk's Facilitator's
Guide and Open Talk's User's Guide.
1996. The Heart to Heart's facilitator's guide – for Storyteller Group’s innovative life
skills comic, Heart to Heart.
1996. The Choice Game (with the Department of Education, Storyteller Group and the
Planned Parenthood Association) – a board game, accompanying the Heart to Heart
comic, exploring the possible consequences of life choices in a realistic but nonmoralistic way.
1997. Eating with Hope (also with Gauteng Department of Health and AIDSLink) – a
comic promoting ways of controlling HIV infection through nutrition.
1999. Sustainable Urban Greening Strategies (with Trees for Africa and the Youth
and Urban Development Programme of the Royal Netherlands Embassy) – a book on
Urban greening strategies for local government and their partners
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2000. Children First (with the Early Childhood Development programme of the
Gauteng Department of Education and the Storyteller Group) – a comic book to help
parents in squatter camps provide the stimulus that their babies and toddlers need in
the early years of development.
2001. Finding the Way (with the Medical Research Council and SA HIVAC) – a 36
page comic book, promoting ethical and community owned processes of participation
in HIV vaccine trials.
2002. Break the Silence – educational supplement for the Break the Silence
exhibition on HIV/AIDS, by Artists for Human Rights, at the Sandton Civic gallery.
2004. Test of Courage (with the Centre for the Study of AIDS) – a documentarydrama that complements the Finding the Way comic and explores some of the
challenges of participating in a HIV vaccine trial.
2005. Taste for Life (with StoryWorks, AIDSLink and MEGA) – a resource on the
relationship between HIV and nutrition, designed to mimic a popular lifestyle
magazine.
2005. Helping Nature Help You (with Food and Trees for Africa and Woolworths) –
a 13 part DVD series on sustainable agriculture in schools.
2005. Food and Medicinal Gardens – Permaculture for Primary Health Care (with
MEGA, Ukuvuna, Afristar, and sponsorship from Hewlett Packard) – a resource for
the least developed villages in Limpopo, providing an introduction to working with 32
safe-to-use and easy-to-grow medicinal plants.
2006. Are Your Rights Respected?(with the Gay and Lesbian Archives’ Deaf Oral
History Project and Outreach Programme; StoryWorks; Foundation for Human Rights
and the European Union) a sexual health comic for Deaf youth, covering the topics of
HIV, sexual abuse and sexual orientation.
2006. Eyes Wide Open (with the Gay and Lesbian Archives; StoryWorks; Conference
Workshop Cultural Initiative Fund and the European Union) – a sexual health comic
for Gays and Lesbians living in outside South Africa’s big cities
André has also produced a variety of educational materials in the fields of
environmental management, entrepreneurship, thinking skills, heritage, as well as arts
and culture.
André Croucamp
0836603024
0114864685
[email protected]
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