Sun 29 Apr 2012 In: Health and HIV View at Wayback View at NDHA
When Sean Robinson arrived to helm the NZ AIDS Foundation in early 2011 a major Ministry of Health-commissioned report into the delivery of services for people with HIV, the first in 25 years, had suggested that support organisations should be independently funded from the Government coffers. It also highlighted the tense and fractious relationships between the Foundation and peer support groups, and suggested that provision of new HIV testing technology was not nationally consistent. There was a sense that the NZAF had been trying to corner the market in all things HIV and that this wasn't necessarily a good idea. That it should not be trying to dominate all it surveyed. "One of the first things the Miller Report led to was that Body Positive and Positive Women and INA were funded and that immediately changed the landscape," says Roibinson. "I would have wanted to develop relationships there anyway but proper funding made them much stronger organisations so the relationships could be on a more equal footing than perhaps they had been in the past." His impression of the Miller Report "when I read it and when I met David Miller early on" was that it was "quite nice to be coming into a sector where so many things had been done right. It wasn't a huge criticism of the support for people living with HIV. Certainly there were some areas that we could make significant progress in. "The approach I took is that part of the AIDS Foundation's contract with the Ministry is to run the HIV Forum which brings together the clinicians and all the other NGOs such as the positive people's groups, Prostitutes Collective, the Needle Exchange, sexual health services, infectious diseases, the Ministry - basically all the key interest groups. That's been running since the early 2000s and was set up to monitor and help implement the HIV strategy that the government of the time had. Now, that strategy was well out of date and the Forum had kind of run out of steam. So the Miller Report's recommendations became an obvious thing to focus on. SPREADING FAST TESTING Robinson says the Ministry of Health "actually rose to the challenge" and started to enact some of the Report's other recommendations only a year after the report came out. "That is a phenomenal speed in Government terms. For instance, in the last few weeks we've just had come through a process of a national conversation on testing." Reticent about revealing too much about what are, at this stage, only draft recommendations, he admits to liking the direction which is being sketched out. "The key thing I'm interested in is that fast testing, which is a technology that we pioneered through our own health service and which is much more responsive to people's needs than the standard HIV test, that's had a real push. Essentially the recommendations are all about getting fast testing into more of the health service including sexual health clinics and even GPs, which is exactly what we wanted. We will never be the health service for all gay and bisexual men or all people at risk of getting HIV. But we can be the health service for a big chunk of that community but equally important we have to be the catalysts to other parts of the health system being more responsive." HIV tests are only a few blocks, or a quick car or bus ride, away in the main centres. But what about a gay man in, say, Alexandra. "We have a network of sub-contractors and the aim is that you are never more than an hour's drive from an NZAF contractor who can provide the testing and the counseling," says Robinson. "But if we are successful in pushing through these recommendations on testing then that gay man in Alexandra will be able to get a fast test immediately from his GP, rather than have to go and get a lab-based test where he has to wait days if not weeks for the result." The NZAF already provides that fast test service in its own clinics "but we only test the minority of gay men that test in New Zealand. It's far more important that the gay man who goes to his local GP gets a responsive service using the best technology available." VOLUNTEERS AND MEMBERSHIP LEVELS One of the ways we tend to judge whether the NZAF is connected into its community and the level of buy-in from our community is the level and activity of the base membership of the Foundation and the number of volunteers. We rarely get a clear view from the outside of how that's going but only about 50 members voted on matters such as governing board membership at the last AGM. And this despite the ease and accessibility with which people can vote through an online form. "I think this is a perennial problem for NGOs and not just an issue for the AIDS Foundation," Robinson reflects. "There are real plusses and minuses to membership organisations. I guess the original idea was that members were people who were heavily committed and heavily involved in the organisation. We're 27 years old now and some of the people who might have been members in the first phase of the epidemic may well have lost energy to continue to be heavily involved. Now there's a new generation of gay and bisexual men, younger people who don't join things in the same way... it doesn't mean they don't support us but they don't tend to sign up as members. And I think on the volunteer side things are really healthy. We have a reasonable turnover of volunteers but we don't have a lot of problem recruiting volunteers." And yet, just three or four days before February's Big Gay Out there was an urgent call for volunteers. "The Big Gay Out and World AIDS Day street appeal are our biggest events and we got them... you can probably never have enough volunteers." How many volunteers does the Foundation have? "I think we generally have about 300 people involved in volunteer work at various stages and that includes over 100 people who are Get It On champions so they are out there in their social lives talking about condom use and Get It On. There are people who do condom packing, who help with fundraising and events like the Pacific Fono... there is still quite a lot of activity." Robinson returns to the low level of voting at the AGM. "New Zealanders aren't good voters at the moment. The General Election got only about 50% of people to vote. There are some difficult questions around membership and how do we motivate people and make it meaningful." But those 50 votes came off the back of the worst annual HIV diagnoses figures ever. If that isn't going to focus the mind and motivate members and people who might become members of the NZAF then what will? "These are issues that community organsiations all over the place are struggling with: what are the right ways to engage with their communities of interest, how do you have representation on boards. The whole issue of boards themselves is a bit vexed so we don't have all the answers to that. I think there's a mix of some people feeling disenchanted and others having moved on in their interests and no longer paying attention." THAT AWKWARD 'STRAIGHT' THING Michael Stevens is a gay HIV positive man whose record of commitment to the objectives of the NZAF is pretty impeccable. Hs is sometimes its staunchest defender and occasionally a perceptive critic as well. In a recent blog on GayNZ.com Stevens said he felt it was awkward to have Roboinson, a straight man, up on the Big Gay Out stage welcoming gay people to 'our' gay event. How did Robinson feel about that? "I noticed Michael's comments there and I can understand where he's coming from. Equally, on the day I had gay men who I'd never net before come up and congratulate me on what I'd said. I try to listen to the feedback and where I think it is valid I will definitely amend things. I've had conversations with Michael from time to time at which I've said: 'Thanks for that, I'll change the way I'll do things.' But I basically try to be sincere and deliver the goods and I hope that shines through. Occasionally I might get something wrong and I don't think I'll ever please all the people all the time. I think the gay community is the same as most communities in that you're never going to please all the people all the time." IS THE NZAF 'GAY' ENOUGH? There have been a number of functions held by the NZAF, such as welcomes and farewells for staff and dignitaries, at which there have been grumbles in the back rows that there is very little gay culture in the protocols of the AIDS Foundation. That there is a strong commitment to Maoritanga and much less to gayness, that the organisation could just as well be farewelling or welcoming someone at any faceless government ministry. That for some years the NZAF has felt less homosexual than it should. "The Foundation is an organisation that has its deep roots in the gay community and is heavily connected into the gay community. 85% of the staff here are gay men, 95% of the board. "When I came here I had a very strong perception that there is a very strong maoritanga here and it's been a very interesting view of coming to see what some of the issues for takataapui taane are. I think whether we are an organisation rooted in the gay men's community or not we are still part of Aotearoa/New Zealand and we need to be part of the overall cultural journey as a bi-cultural organisation. "At my powhiri, coming in as an outsider, I was very aware of this being a gay organisation. And some of the things that I perceived were the way that I was greeted - I was kissed and hugged and it was more touchy that you would get [elsewhere]. Overall I think there is some validity in that perception and some elements of gay culture, and that changes depending on which part of the gay community and the individuals and the ages of the individuals you are talking to... some of that has got a bit muted in some settings. But I can tell you for absolute certainty that on a day to day basis the culture here very much reflects the gay community. When I first came in here I had to decide how I was going to approach that. I could have just ignored it and been very serious about it as a straight man and been afraid to step on toes or embrace it and enjoy it.. But that's my style so I prefer to just laugh and enjoy the campness, the double-entendres, the highly sexualised language at times... and also I guess the sincerity of people's stories and experiences. "One of the aspects of this organisation being staffed by people who have a personal connection and stake in the gay community is that so many of our staff have experienced the highs and lows of what it means to be a gay man living in New Zealand. And that adds to the passion. People bring their wounds as well as their strengths into the organisation and I think that's part of the culture as well." THE AUCKLAND-HAWKES BAY COMMUTE Robinson came to the NZAF from health work in the Hawkes Bay reigon. His family is still there and so he is running a weekly commute. "It works really well," he says. "I'm really enjoying Auckland and this year my partner is coming up more often to Auckland so we can enjoy the city together. At times it is tiring and there are times when I'm sure everybody would prefer it if I was in the Hawkes Bay more often. My family is by no means a standard nuclear family anyway. My partner and I are both divorced from previous partners whoiwe had our children with so our children go to their other parents for periods of time. I call it a concertina family because it expands and contracts over a two-week cycle. We adapt and it means that I can work really hard while I'm here and can work an eleven-hour day without having to phone home and say I'm going to be home late and have to negotiate everything. And I can be a bit flexible at the weekends and get good solid time with my family. It works pretty well... and I enjoy the difference between big city Auckland and the much more rural Hawkes Bay. LOOKING BACK It's sixteen months or so since Shaun Robinson sat down and wrote down an application or this job. Is he able to remember how it felt stepping into the job? "I was excited. I had a strong expectation that it was going to be quite a lot different from what I'd done before and that that was going to be stimulating and exciting. And that certainly hasn't been disappointing. There's always stuff that you don't know and some of the problems that the organisation was facing I didn't really know about until I came on board, although I'd been given a bit of a heads up by the board before I arrived so none of it bowled me over. Perhaps that comes from being 50 and having been in similar types of roles before." Any surprises in his first year or so? "If there's opne thing that has surprised me it is that we have achieved so much in such a short space of time. Because I do believe that the organisation has gone streets ahead in the past fourteen months and what I've done really is to take some of the barriers out of the way to help people get on and do the job that they want to do... once you line those kind of things up they tend to take care of themselves, especially when you've got good people." What's the hardest thing Robinson has had to do since stepping into the job? His answer will surprise no one who keeps a close eye on the NZAF. "The hardest thing was the working through the departure of the three senior managers last year. Wayne Otter was quite unwell and that was quite a difficult process. All of them had contributed an enormous amount. Wayne had been here for a really long time, Eammon had been here for eight years a contributed a lot and Simon had been here for less time but had made an equally big contribution. It was a mix of sadness and opportunity and it all happened so quickly when they all left within six weeks... it was not planned by any manner of means. It was just a sequence of events. But it opened up a lot of space which has allowed things to go forward faster and better, but it was also quite destabilising in some respects and I had to cover quite a lot of bases. "I had to make sure that the staff weren't totally freaked out with all the change. When anybody leaves who's been in a role for a long time there are things that have to be rebuilt and there can be things that they perhaps didn't pay as much attention to... everything has to change when vacancies like that happen and the staff have to go through a range of emotions. The board, I think, were freaked out by that happening so quickly and so I was settling down staff and reassuring the board, trying to decide what the shape of things was going to look like next... that six weeks leading up to Christmas was pretty damn intense I have to say." And the most rewarding aspect of the job so far? "Seeing how the staff have embraced the idea of working better together, and seeing stuff really work. Seeing our testing increase by 14%, seeing Get It On become really popular in the community and really energise the community. And I'd have to say that the new epidemiology results," which saw the number of HIV diagnoses plunge from their all-time high of two years ago, "have just been the icing on the cake." [Editor's note: This final part of our three-part feature was originally scheduled to appear last weekend but was delayed due to staff illness.] Jay Bennie - 29th April 2012