YWAM-Mercy

"The Lord is gracious and compassionate; slow to anger and rich in love. The Lord is good to all and he has compassion on all he has made (Ps 145:8-9)."

Our God is full of mercy and compassion to all, including those who are living with HIV/AIDS. God has a message of hope, worth and dignity for all infected or affected by the disease. As a movement committed to following Jesus and His example, Youth With A Mission is called to love, accept and care for, without discrimination, all impacted by HIV/AIDS among our staff, students, volunteers and those with whom we work. We as YWAM acknowledge our responsibility and commit to serve and engage holistically with the HIV/AIDS pandemic in every country and in each area of culture and society until there is no longer need.

Foreword

This document presents organisational guidelines and practice within Youth With A Mission (YWAM). It applies to YWAM personnel (staff and students), as well as to YWAM volunteers. While the guidelines attempt to be as comprehensive as possible, some issues, particularly legal issues, are specific to each country. It is advised that YWAM leaders in each nation should consult country policies to determine the rights of employees and/or volunteers with HIV or AIDS.

What are HIV and AIDS?

Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system. The body is therefore less able to fight off infections. People who have HIV infection are HIV positive (HIV+). AIDS stands for Acquired Immune Deficiency Syndrome, which is a collection of signs and symptoms resulting from infection with HIV. HIV enters the body through contact with infected body fluids. The main routes of transmission are:

• Sexual intercourse
• Contaminated blood products
• Contaminated needles, syringes and cutting instruments such as razors
• Mother to child

Prevention

There is no vaccine that can prevent HIV. Therefore protection is by understanding the facts and following appropriate behaviour.

• YWAM should provide sufficient updated information to educate staff and students about protection from, and living with, HIV/AIDS.
• It is good practice to provide HIV/AIDS and Health and Safety training:
  

              1. on every DTS
              2. on briefing new staff, volunteers, students and outreach teams
              3. regular training, but at least once every year for staff

• In response to training, YWAM staff, volunteers and students should take precautions wherever possible to avoid placing themselves and others at risk from HIV exposure.
• YWAM believes that God has appointed sexual intercourse to be between husband and wife and therefore abstinence for single people. Abstinence outside of marriage and faithfulness within marriage are the only way to be sure that HIV is not sexually transmitted. YWAM seeks to multiply healthy family relationships that model and teach God's purposes for family as a way to address the AIDS crisis at its roots. This needs to be a priority in our prevention strategy.
• Health and safety guidelines and practice should be up to date and applied in every day life (Appendix 1)
• Post exposure prophylaxis(i): In the event of a situation where there has been potential exposure to HIV (such as needle-stick injury or rape), medical advice should be sought as soon as possible to assist in limiting transmission.

Non-discrimination

In keeping with the values of Youth with a Mission, YWAM staff, students, and volunteers will not be subject to discrimination on the basis of their HIV/AIDS status. For purposes of this document, this includes individuals having, perceived as having, living with, or otherwise affected by HIV/AIDS.

No program or service will be denied to any volunteer, staff member, or student based on their HIV/AIDS status. Staff, students, and volunteers affected by HIV/AIDS will be offered an equal opportunity to participate in any programs offered by the organization. Positive HIV status does not, in itself, reflect a lack of fitness to work. Furthermore, to the extent permitted by program requirements, YWAM will assist individuals affected by HIV/AIDS in order to fully participate in the organization's activities.

No current or prospective staff member, student, or volunteer will be asked or required to disclose their HIV/AIDS status to any employee, volunteer, director, or other individual involved with YWAM, except as required by law.

•  HIV is not spread through ordinary work or social contact. There is no medical reason for unwillingness to work with others who are HIV positive. YWAM staff, volunteers, or students who are HIV positive may live on base, using the same facilities such as bathrooms, just like any other person.
• Good information and training helps to prevent discrimination and prejudice.

HIV Testing and Confidentiality

YWAM aims to provide a loving environment in which people feel free to share personal information and receive pastoral care and support.

• Subject to national law, testing for HIV is not compulsory within YWAM. Applicants are not obliged to declare their HIV status, nor whether they have been tested for HIV.
• Testing is strongly recommended in some circumstances - e.g. if an individual has been at risk, wants to marry, or become pregnant. Professional advice and counselling should always accompany HIV testing.
• Confidentiality will be maintained with respect to a person's HIV and test status. Only the person tested has the right to release information regarding his/her status.
• Confidentiality may be broken only if an HIV positive person is putting other lives at risk. In such cases, reference should be made to national legal policy on disclosure.

Care

There is no cure for HIV/AIDS. Drug treatment, where available, can delay progression of the disease. This disease affects mainly the young productive members of society, leaving families and communities without caretakers and providers and people able to work.

• YWAM will treat all people living with HIV as any other staff member, volunteer, or student. They will be encouraged to continue to work as long as they are medically able. Depending on their medical condition, flexible working hours and time off for counselling and medical appointments, transfer to lighter duties, part-time work, extended sick leave, and return to work arrangements will be explored.
• Care for those who are HIV positive should be holistic: physical, emotional, social and spiritual to strengthen self-esteem. It is recommended that support is also sought from family, church, counsellors and community groups to enable Godly living with the virus.
• YWAM will offer referral for supportive counselling as available.
• Maintaining health, balanced diet and exercise assists general well being, including for those who are HIV positive. People living with HIV have lowered immunity and greater vulnerability to sickness. Therefore, it is important that all YWAM personnel receive prompt medical attention for illnesses so they do not put others at risk.
• Medical expenses are the responsibility of each individual YWAM staff, student, or volunteer.
• YWAM is not liable to cover costs of health care, funerals nor dependants.
• YWAM recommends that all staff, students, and volunteers have adequate medical insurance for appropriate medical care and emergencies.
• YWAM does not have staff nor facilities to provide hospice care. Each situation needs to be dealt with sensitively, involving the person's family, friends and home church wherever possible. Offering additional support to the family and/or friends of those who are infected may also enable them to cope with the impact of HIV on their lives; however this should not compromise confidentiality. 

YWAM responsibility

• Protection from HIV is the responsibility of each individual.
• YWAM leaders at each location are responsible for:
           1. Knowledge of YWAM HIV/AIDS guidelines
           2. Knowledge of national laws and policies related to HIV/AIDS and employment rights
           3. Briefing new staff, volunteers, and students about the policies
           4. Inclusion of HIV/AIDS guidelines in DTS and staff training 

Management of staff, teams and departments to minimise problems related to HIV/AIDS

         1. Information on local centres for voluntary HIV testing, counselling and health care. If available, emergency telephone numbers should be made known to staff and volunteers in case of accidents, assaults, rape, etc
         2. Promotion of a safe, healthy, caring, non-discriminatory environment

At every YWAM base, specific staff should be trained in health and safety, and encouraged to give advice:

         1. to leadership on best practice in difficult or sensitive situations
         2. on where to obtain voluntary counselling for pre and post-HIV testing
         3. on prevention of mother to child transmission
         4. on post-exposure prophylaxis(i) in case of emergency
         5. on local access to affordable anti-retroviral treatment, with counselling
         6. to update with current knowledge, prevalence (percentage of people infected) and practice in HIV/AIDS issues

Appendix 1

Health and Safety measures:

• Precautionary measures should be taken to reduce risk of HIV transmission.
• Good hygiene should be kept on each YWAM base, such as in food preparation.
• Universal Precautions should be followed when dealing with body fluids (see section on health care settings below).
• Appropriate disinfectants and cleaning materials should be available, not only to prevent the risk of possible transmission, but also to protect those who are HIV+ from possible sickness
• First aid kits should be available on all bases, YWAM vehicles and at all outreach locations, containing items such as plasters, disposable gloves and oral resuscitation mouthpieces. Items such as disposable syringes and needles should be carried by YWAM staff, volunteers, and students in places where there is no guarantee of the proper sterilization of such materials.
• In some nations where screening of donated blood may not be guaranteed, staff, volunteers, and students should be aware of safe sources. It is advisable that YWAM teams are aware of each other's blood type before going on outreach to a country where screening of donated blood can not be guaranteed. If, in an event of an accident, the need occurs for blood to be given to a staff member, volunteer, or student, other team members can make themselves available as a blood donor. Blood typing and HIV testing should be done before blood is given (never assume a person is HIV negative).
• YWAM should take action to reduce the possibility of accidents which present a risk for HIV infection in places where safe blood supplies are uncertain. In particular, transport guidelines should include:
            o Vehicle maintenance and insurance
            o Use of seat belts
            o Qualified drivers
            o Use of helmets for motor-bike riders
• Building maintenance guidelines should require the use of protective head gear and clothing.
• All equipment should be checked regularly and withdrawn from use if damaged.

Health care settings:

All YWAM staff involved in giving health care should understand and use Universal Precautions with all patients, at all times, in all settings, regardless of the diagnosis. Universal Precautions include:

• Careful handling and disposal of “sharps”
• Hand washing with soap and water before and after all procedures; use of protective barriers such as gloves, gowns, aprons, and goggles for direct contact with blood and other body fluids
• Safe disposal of waste contaminated wi th blood or body fluids
• Proper disinfection of instruments and other contaminated equipment
• Proper handling of soiled linen For full details please see: the World Health Organisation's HIV/AIDS fact-sheet for health service delivery and the World Health Organisation's HIV fact-sheet for nurses 

Appendix 2

    References:

• Bible (New International Version)
• Youth With A Mission (YWAM) General Policy on Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) in the workplace (March 1996)
• AIDS and HIV Infection, UNAIDS, (2003
• Beautiful Gate HIV and AIDS Policy (May 2004)
• HIV & the Law. The AIDS Law project: University of Witwatersrand, South Africa
• Center for Disease Control
• Skadden, Arps, Slate, Meagher & Flom LLP

Appendix 3

(i) Prophylaxis is prevention. If a person is exposed to possible risk they may be able to receive medication which will prevent the virus from being able to replicate within the body. This is currently available if acknowledged within 72 hours of this exposure.

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