Another success story

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http://www.cafod.org.uk/News/Emergencies-news/Getting-through-difficult-times 

When Monica fell pregnant, she was worried the child would be HIV positive. But thanks to the help of CAFOD's partner in Zimbabwe, her daughter was born healthy

Monica and her husband Morrison are both HIV positive. They live in Zimbabwe with their four children – three of which are HIV positive too.

Their son Leroy died in 2007. But their youngest – named Tadiwanshe which means “We have been loved by God” - is not infected.

I would like to thank CAFOD and Seke Rural for helping my family to survive at a difficult time. I hope the next harvest will be bountiful

Monica

“I went to get tested in 2000 when I became very ill,” says Monica, holding Tadiwanshe on her lap. “I found out I was positive – so my husband Morrison decided to get tested too”.

“When I got pregnant again, we decided to seek advice about what we could do”.

Living with HIV

CAFOD is supporting local organisation Seke Rural Home Based Care who have been helping families like Monica’s to live with HIV.

The couple received training in how to prevent the virus being transmitted to their unborn child.

“I carried the neverapin drug with me wherever I went for the last two months of my pregnancy” explains Monica. “When I was giving birth, I asked the staff at the health clinic to give me the drug”.

When their youngest daughter was tested, she was HIV negative. “We were so happy” Monica says.

In recent months, CAFOD had used emergency funds from its Harvest Appeal to distribute food to families struggling to survive in Zimbabwe.

Monica receives an emergency food parcel from Seke Rural including maize meal, pulses and cooking oil. They have also received support in growing their own food.

“We have learned how to look after our crops” said Monica, proudly, tending to her vegetable garden. “We know how to apply fertiliser and ant hill soil, and mulch grass and stalks”.

Monica also received two goats from Seke Rural – one of which was sold to buy chickens and guinea fowls, who lay eggs for the family to eat.

“I would like to thank CAFOD and Seke Rural for helping my family to survive at a difficult time. I hope the next harvest will be bountiful”.

Peanut butter project

Article from

http://huairou.org/sites/default/files/hbca-newsletter-special-edition-2011.pdf

Seke Rural Home Based Care, Zimbabwe

http://www.oxfam.ca/our-work/our-approach/hiv-aids-awareness/meet-our-collaborators-and-partners

Veronica Ngwerume is Director and a founder of Seke Rural Home-Based Care, providing home-based care for clients with HIV and AIDS in rural Zimbabwe since 2001. Seke Rural Health incorporates a sustainable livelihoods approach to their work. They also actively participate in communication, advocacy and policy development for improvements in home-based HIV and AIDS access, treatment and care.

Seke successfully implemented a series of ground-breaking 'Community Culture Dialogues exploring challenges to gender and HIV and AIDS and fighting unprogressive cultural practices that fuel the spread of the disease.

Seke has also recently mobilized a community-based paralegal project in partnership with the Zimbabwe Women Lawyer's Association. In an attempt to protect women and children from disinheritance following the death of a spouse from HIV and AIDS, Seke has trained local women as paralegals. They work within the community to disseminate information on women's property and land rights and further develop cases when these rights have been taken away.

Orphans and Vulnerable children

Article from http://www.childrenfirst.worlded.org/Partners/partners.htm

Seke Rural Home Based Care

Seke Rural Home Based Care supports community efforts to reduce the proportion of children facing psychosocial challenges as a result of HIV and AIDS. In collaboration with Children First, Seke supports over 1,400 orphan and vulnerable children in greater Harare (Seke and Manyame) with pediatric palliative care, training of caregivers, counseling, bereavement support, educational assistance and material support such as sanitary ware.

Areas served: Chitungwiza and Seke (Greater Harare, peri-urban settlements).
OVC Services Provided: Psychosocial support, medical support, educational support.


http://www.fao.org/3/a-ai499e/
http://www.fao.org/3/a-ai499e/

Vulnerable Children and Orphans (OVCs)
Vulnerable children are usually considered to be any children who lack family support, are poor, are disabled, are in prison, or who experience frequent changes in residence because of homelessness or refugee status. In the context of the HIV/AIDS pandemic, children are also made vulnerable by having a chronically ill parent or by living in a household where at least one adult has died in the last year. Orphans, who are a special category of vulnerable children, are considered to be any children who lack one or both parents. The literature refers to single orphans who have lost one parent as opposed to double orphans who have lost both parents. It also refers to paternal orphans who have lost their father as opposed to maternal orphans who have lost their mother. Moreover, the literature refers to several types of orphans according to the following factors: cause of orphaning, such as war orphans and AIDS orphans; support systems, such as foster-care orphans; and place of residence, such as street orphans. Some development specialists argue against using the term orphan, especially the term AIDS orphan, in order to avoid stigmatizing the child. In addition, some specialists argue against using the term AIDS orphan because it fosters confusion about whether a child was orphaned by AIDS or is suffering from AIDS himself/herself. 

Children's Property Inheritance in the Context of HIV and AIDS in Zimbabwe

By Laurel L. Rose, Ph.D. 

http://www.fao.org/3/a-ai499e/


2 Research in Seke District

Several orphans and their grandmothers were interviewed at Seke Rural Home-based Care (SRHBC), a CBO based in Seke (ca 30 km south of Harare). The organization has assisted people with will-writing (see Izumi, 2006b: 37). The interviews emphasized property disputes (i.e. property grabbing).

9.2.1 Case Summaries
Case 1
A 19-year-old male double orphan was staying with his maternal uncle because his paternal uncle (father's younger brother) had taken over his father's house and land after he had died of AIDS in 2004. Apparently, his paternal uncle did not have his own house or land. Although his paternal uncle told him that he could remain in the house, the uncle subsequently burned his special religious clothing and denied him food, thus compelling him to flee to his maternal uncle's house. The orphan complained about his paternal uncle's actions to the police, but they refused to intervene, saying that they could not assist in a “home affair”. The paternal uncle was also holding onto the orphan's father's death certificate, thereby preventing the orphan from claiming his father's property. According to the orphan, his greatest problem was that he lacked a birth certificate; he knew that without his birth certificate, he could not claim his parents' land and property, even though his father had written a will with the assistance of someone at the organization SRHBC. The orphan believed that his birth certificate would also be of use to him in getting social assistance and a better job. 

Case 2

A 16-year-old male double orphan was living with his maternal grandmother. His parents had died when he was very young, and his paternal relatives had taken his parents' land and property. His paternal relatives had no interest in seeing or assisting him and his three siblings. According to his maternal grandmother, his paternal relatives had taken his parents' property because they did not recognize their marriage.

Case 3
A 14-year-old female double orphan was living with her maternal grandmother who was caring for the nine orphans of four of her children who had died of AIDS. In addition, the grandmother was caring for another ailing daughter who was bedridden. Only one of the nine orphans was in school; his maternal aunt was paying for his school fees although her husband would not allow him to live with them. The parents of the female orphan had owned no land because her father had been foreign-born and had lived in another part of Zimbabwe. Because her father had not maintained contact with her and her siblings, they were experiencing problems acquiring their birth certificates and their father's death certificate.23

9.2.2 Case Analysis
Although the interview sample was small, the interviews substantiate information obtained from separate interviews with legal professionals in Zimbabwe. In effect, the cases reveal that children's property inheritance in Seke was being negatively affected by three present- day factors. The first factor concerned the lack of birth and death certificates for orphans. In Cases 1 and 3, the orphans lacked birth and death certificates that they needed for educational, social assistance, and employment purposes. In Case 1, however, the certificates were being withheld from an orphan, whereas in Case 3, the certificates were not easily obtainable due to the foreign nationality of the orphans' father.
The second factor concerned land scarcity. In Cases 1 and 2, the orphans' paternal relatives had confiscated the orphans' property and were not providing support to them. In Case 1, the younger brother of an orphan's father had taken over his land because he (the brother) had been unable to obtain land because of land scarcity in the region.
The third factor concerned the unwillingness of orphans' relatives to acknowledge them if their parents had not been married. In Case 2, the orphans' paternal relatives had taken over their parents' property because their parents had not had a formal marriage.

 http://www.fao.org/3/a-ai499e/

SEKE RURAL HOME BASED CARE partnership with Arkansas Hospice   

http://www.arkansashospice.org/foundation/documents/MainNewsletterSpring2009.pdf

  

Caring for Vulnerable Children

http://reliefweb.int/report/zimbabwe/zimbabwe-caring-vulnerable-children

REPORT

from US Agency for International Development

Published on 31 Mar 2010 —View Original

Success Story USAID helps provide training and resources for village-based caregivers

In Zimbabwe, a nine-year old boy living with HIV knew to take his antiretroviral treatment whenever he heard the country's national anthem on the radio. The anthem is played twice a day, at sunrise and sunset - and this schedule coincided with when Kudakwashe needed to take his pills. When the radio had batteries that worked, this system worked well. When there was no money for batteries, however, the boy ran the risk of either taking his pills at the wrong time or missing the dose entirely - which was harmful to his fragile health.

Kudakwashe was orphaned by AIDS and lives alone with his elevenyear- old brother, Brighton, in a rural village outside of Zimbabwe's capital city. Although their paternal grandmother is alive, she has turned both of the boys out of her home, in a situation that is not uncommon among children who have been orphaned by AIDS. Many extended family members don't have the fi nancial or emotional resources to care for these children - and this has caused the number of child-headed households in Zimbabwe to increase dramatically.

Seke Rural Home-Based Care (SRHBC) is a local organization supported by USAID that has put in place a program designed to provide care and assistance to families in communities hard hit by the AIDS virus. With USAID assistance, the organization provides training and resources to village-based caregivers, who are from the villages they serve. In Zimbabwe, social connections based on family are extremely important and communities appreciate having caregivers that they trust and know personally.

"People want to be looked after by one of their own," said Veronica Ngwerume-Kanyongo, Director of SRHBC.

Caregivers play a large role in the villages where they work - they provide respite for families caring for a family member living with AIDS, they remind people living with HIV or AIDS when to take their medication, and they provide special services to the orphaned and/or HIV-positive children in the community. Caregivers make sure the children take their medications on time, help ensure the children's school fees get paid, make sure children are going to and staying in school, and link children with extra services, such as summer camps.

Kudakwashe's warm relationship with his SRBHC-trained caregiver is obvious. He greets her with a smile and allows her to stand next to him with her arm around his shoulders. For a boy living with HIV who has lost both parents to AIDS and been abandoned by his grandmother, this level of trust in an adult is remarkable and encouraging. With his caregiver's daily support, Kudakwashe's health has stabilized and he is able to stay in school. Thankfully, he also no longer has to rely on a battery-powered radio to stay healthy.

A Cultural Approach to Addressing HIV and Women's Rights a SafAIDS article

http://www.safaids.net/content/seke-project-cultural-approach-addressing-hiv-and-women-rights-southern-african-communities

Seke Project: A Cultural Approach to Addressing HIV, and Women Rights in Southern African Communities

Country Projects

Project title: A cultural approach to addressing HIV, and women rights in southern African communities: community based training in safer sex

Project location: Seke District of Mashonaland East Province, Zimbabwe

Background

A project to reduce the vulnerability of women and girls to HIV in a rural setting by encouraging participation and dialogue among communities in the links between gender, HIV and culture was initiated by SAfAIDS in February 2007. This project direction was identified following research in the country, in Namibia and in Mozambique commissioned by SAfAIDS where it was identified that the patriarchal society which is evident in the entire southern Africa region is a contributory factor in the increase of risk of HIV for women and girls. Although policies and laws are in place to address domestic violence, the practice continues within a cultural context. Many issues of domestic violence are known to emanate from challenging a husband who demands unprotected sex where there is knowledge or evidence of extramarital affairs or sexually transmitted disease. It is within this background that the SAfAIDS in partnership with Seke Rural Home Based Care (SRHBC) a Community Based Organisation undertook this pilot project to test out an intervention to address the situation.

Project objectives

The Seke project sought to increase dialogue and discussion amongst communities, cultural and community leaders on the cultural practices and beliefs that impact on gender, human rights and HIV infection amongst women and girls. It also sought to increase behaviour change within the project site demonstrated by increased condom use and multiple partner reduction. Finally it sought to produce innovative materials that address culture, gender and HIV and AIDS issues.

Following a baseline survey to assess the situation on the ground (link to base line survey report) programme implementation was planned following four main areas of focus. These were -:

• Community dialogues series
• Community behaviour change intervention
• Material development
• Community Gala

Achievements,

Dialogues were held with the women's groups and another set with the men's groups separately at it was difficult for women to discuss issues of sex and sexuality amongst the men initially. Women sited their lack of skills to negotiate for safer sex as a major problem. The men's group were worried about the various laws that made women challenge men such as the legal age of majority now at 18 years from 21 years, and the domestic violence law. Couples meeting were then facilitated by SAfAIDS and SRHBC with the view of improving communication skills and increase the couples' knowledge of their HIV risk, prevention methods, care, support and guidance in the community. Condom training was also conducted for couples to know when and how to use condoms correctly and consistently if so required. The need for voluntary testing and counselling was also highlighted through the trainings. Change committees made up of older people, the custodians of culture were set up to continue the dialogue and mentoring process in the communities within and outside the project life.

A community gala was held on 14^th November 2007 with over 500 Seke community members assembling at their district offices to celebrate the project and recap on the issues discuss during the dialogue series and the condom training sessions. The information was now cascaded to the rest of the community by the women and men who attended the trainings and dialogue series and through drama. The gala was full of funfair with a march led by a brass band and drum majorettes with a key address by the Minster of Health and Child Welfare who acknowledged the role culture plays in shaping society with both positives which should be upheld and negatives which should be discouraged. A detailed report for the Gala is available.

Way forward

The Seke project has been a pilot project that is now documented as a good practice and is being replicated in the rest of the country through a national project to ‘ Address the interlinkages between culture, gender-based violence HIV and AIDS and women's rights.' The Seke community itself continues to benefit from a further series of trainings that are on going and work on the ground from the change committees. They are also being considered for documentation as a best practice in a country programme assessing projects that work with women culture, GBV and women's' rights.

Bantwana Article on Seke Rural Home Based Care

http://bantwana.org/helping-health-workers-go-the-extra-mile/

Helping Health Workers Go the Extra Mile

By early 2000, an estimated 160,000 children were living with HIV in Zimbabwe and only 1-in-16 had access to life-prolonging antiretroviral drugs. In order to provide better access to health interventions in rural areas, organizations like Seke Rural Home Based Care (Seke) were established. Initially, home-based care programs only focused on adults, and children were left out of HIV and AIDS interventions. It was a challenging time for field workers like Stella Paraziva, who was one of Seke’s first staff members.

A child receives an HIV test from a Bantwana-trained community home-based caregiver.

Over the next decade, Stella conducted home visits to patients with HIV and AIDS. Due to limited resources, she traveled to patients’ homes on foot, walking up to fifteen miles a day with a bag of medicine on her back, and only two rolls of bread to sustain her throughout the day. By the time she reached the village, Stella had precious little time to treat those that were suffering, and even less time and resources available to help children who needed HIV and AIDS care and support.

In response, Bantwana’s Children First program began working with field workers like Stella, nurses, and local clinics to provide treatment to children who were excluded from critical health care services. Together, they established the Integrated Management Pediatric AIDS Care and Treatment (IMPACT) program.

With the help of a Bantwana-provided motorbike, this caregiver can now travel many miles to reach children in need of critical HIV care and support.

Under the IMPACT model, Bantwana and Seke trained community home-based caregivers to identify HIV-positive children and encourage them to go for HIV testing, CD4 counts, antiretroviral therapy, and psychosocial support. These caregivers are trained volunteers who live in the communities and provide routine visits to patients, relieving field workers of some of their workload. To better serve children in remote communities, Bantwana also donated motorbikes to Seke, which enable caregivers and field workers like Stella to travel up to 100 miles a day, thus reaching more children with critical HIV and AIDS services.

“Many of these children did not have anyone to talk to, to comfort them and offer them security,” Stella explains. “Now, even if they have enlarged lymph nodes or a skin disease, they won’t feel inferior. They will know that there is someone who cares, someone who asks if they are adhering to their medication, someone who checks up on them.”

Bantwana’s IMPACT program has succeeded in refocusing health care on the children who were left out of home-based HIV and AIDS services. Thanks to IMPACT, Seke now has more than 400 caregivers who support field workers like Stella Paraziva in placing over 170 children on life-saving antiretroviral therapy, in addition to offering psychosocial support to hundreds of others. With the provision of the motorbikes and the additional trained community home-based caregivers, Seke can now effectively collect CD4 counts and better reach patients for counseling and ART adherence monitoring, thus improving the lives of orphans and vulnerable children in rural Zimbabwe.

“Our children are our future, our tomorrow,” says Stella. “We cannot replace their parents, but we can continue to help and protect them until they grow up.”

Back to Success Stories

Article from USAID

One  of our success stories.

http://www.usaid.gov/sites/default/files/success/files/fp_zm_homebased_care.pdf

http://www.usaid.gov/sites/default/files/success/files/fp_zm_homebased_care.pdf

A Staunch Defender of Rural Children Living with HIV

USAID-supported field officer works tirelessly to provide home-based care to Zimbabwe’s young
Mai Paraziva works with the Seke Rural Home-Based Care program to increase access to health care for rural children/ Credit: Children First
“This work needs more than money, more than desire for a salary — it’s a sacrifice,” Mai Paraziva says.

Mai Paraziva’s children can attest to the fact that she is not the typical mother and grandmother. For one thing, she spends most of her days riding a motorbike around rural Zimbabwe – rain or shine, fair weather or foul.
As a field officer for a local NGO, Seke Rural Home Based Care (SRHBC), Mai spends her days and nights tending to the needs of children sick with HIV/AIDS. For more than ten years, she has worked closely with nurses and local clinics to imple- ment a USAID-funded program that aims to increase access to health care for HIV positive children.
Mai serves as the link between clients and services in the rural areas where communication by phone is unreliable and unreal- istic. From the beginning, her work has been a labor of love. When she first started work in 2000, Mai conducted home visits on foot with a nurse. She carried a bag of medicines and blan- kets on her back, walking up to 25 km with only a drink and two bread rolls to sustain her for the day.
Since then, with USAID support, the organization has acquired motorbikes, which have allowed Mai to travel up to 160km through narrow and rough village footpaths. “At first, I was scared I wouldn’t have the stamina to push the bike. I can now ride with one hand, legs up, no problem,” she says.
Before USAID intervened, vulnerable and marginalized children were excluded from many basic social services, as well as from psychosocial support. Under the program, home-based care- givers are trained to identify sick children in their communities and encourage them to go for HIV testing.
SRHBC, in conjunction with local clinics and hospitals, provides a wide array of treatment, logistical, and other-care services to improve the lives of hundreds of orphans and vulnerable chil- dren in Seke District. Its focus on monitoring and psychosocial support has begun to fill in some of the gaps in social and emo- tional support for vulnerable children. “This is a serious issue,” Mai comments. “Our children are our future, our tomorrow. There is no way to fill in the gap of parents. We just have to keep continuing to help them until they grow up.”

Africa: In Zimbabwe, Change Like A River in Aids Fight

http://allafrica.com/stories/201112010001.html?viewall=1


Aids awareness rally, Seke village, Zimbabwe

By Julie Frederikse

Seke — When social worker Charakupa Ngwerume was named by the village chief to serve as a counselor on a customary court, his first priority was to campaign for the nomination of female counselors. He says that women bring more than 70 percent of cases before the court, including complaints of abuse, land grabs and child marriage.

Ngwerume's involvement in this cultural and legal body in rural Seke, outside Zimbabwe's capital, Harare, is part of an innovative response to HIV and gender-based violence from the Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS). Domestic abuse and HIV/Aids are seen as intertwined, given strong evidence that violent relationships increase the risk of women contracting HIV.

Called "Changing the River's Flow", this behavior change program developed by SAfAIDS sees traditional African culture as a river: while it may seem to be permanent, it actually adjusts over time to changing circumstances.

"As a social worker I've studied sociology and anthropology, so when we discuss cultural issues we are not advising confrontation, we are promoting dialogue," said the 62-year-old Ngwerume, who grew up in Seke.

"In the past there were reasons for cultural practices - some were put there to support the institution of the family - but in this era of HIV and Aids we are revisiting the good aspects of the culture and also finding those practices that are driving HIV in today's world."

The globe marked World Aids Day on Thursday as it does every year on December 1 as an opportunity for people to unite in the fight against HIV. An estimated 33.3 million people around the world have HIV - most of them in sub-Saharan Africa. More than 25 million people died from the virus between 1981 and 2007.

Zimbabwe is the only country in southern Africa, the region most affected by HIV worldwide, where HIV prevalence has substantially declined, according to a study by the United Nations Population fund and its HIV-Aids program, and experts say that is partly because of positive behavior change, such as that taught by Changing the River's Flow.



The UN estimates Zimbabwe’s HIV prevalence to have dropped from 29 percent in 1997 to 16 percent in 2007, while the country’s Ministry of Health announced earlier this year that HIV prevalence had declined to 13.7 percent. SAfAIDS attributes this to factors such as a reduction in multiple concurrent sexual relationships, the increase in condom use and HIV testing, and early diagnosis and treatment of sexually transmitted infections.

Fighting Back

African countries are using a number of approaches to stem the spread of HIV, including Changing the River's Flow. Cultural practices that can be detrimental to the HIV/Aids fight include a custom whereby a widow is "inherited" by her late husband's brother. Instead of condemning it, Ngwerume told Allafrica that he is encouraging open discussion about its relevance and potential dangers - with the help of a newly appointed female member of the traditional court.

Participants in a recent SAfAIDS summit held in Harare were taken on a field trip to assess the impact of Changing the River's Flow in Seke. There they met a woman who had refused to be part of the traditional inheritance practice after her husband died.

Memory Mawoyo told the visitors that because she didn't agree to become her brother-in-law's second wife, his family took all the property that she and her husband had worked for together. As a result, she and her children were forced to move back to her parents' home.

But the 39-year-old says things changed when SAfAIDS introduced Changing the River's Flow in Seke.


"I am now fighting back and claiming what rightfully belongs to me and my children," said Mawoyo, who says the program helped her understand and access Zimbabwe's Wills and Inheritance law.

Ngwerume said that if a man insists on taking the widow as a second wife, both are encouraged to test for HIV. Mawoyo revealed that she and her husband were both HIV-positive.

Traditional Persuasion

SAfAIDS Executive Director Lois Chingandu credits traditional leaders for their support of the Changing the River's Flow program. "We know they are the custodians of culture," she said, "and they command a lot of respect in the communities they lead."

The local chief, Tichafa Kunaka, known as Chief Seke, reports two important changes in his area: an increase in the reporting of gender-based violence to local police, and wider use of condoms.

"The women are now starting to come to me to ask what I can do as chief to persuade our men to use condoms," Chief Seke told AllAfrica through a Shona-English interpreter. "So I am now speaking to all the men in the village, teaching them the importance of using condoms."

Chief Seke has also helped challenge the cultural practice of "appeasing avenging spirits". Ngwerume sees this as one of the most encouraging developments in the 35 years he has been a social worker in his home area.

"In our culture there is a belief that if a relative is killed in another village, his spirit will go to that village and cause a lot of havoc," Ngwerume said. "The family would then visit a traditional healer and be told to make amends to the avenging spirit by making a payment of a virgin girl."

Chief Seke says that when he was growing up he saw this practice as "okay, spiritually" but his view has changed. "I now see it as child abuse."

Assessing Impact

Ngwerume says the idea is not to challenge the concept of paying compensation, but that the form of payment needs to be discussed.

"Instead of bringing a virgin girl," he said, noting that this is in violation of Zimbabwe's Domestic Violence Act, "it has been agreed to instead bring cattle or money."

This approach ties into a new initiative launched by the independent group of global leaders known as The Elders. The Global Partnership to End Child Marriage, also known as Girls Not Brides, aims to end this harmful traditional practice that affects some 10-million girls annually.

SAfAIDS executive director Chingandu said a team will be visiting Namibia, Malawi, Swaziland, Zambia and Mozambique, as well as Zimbabwe, to assess the impact of the Changing the River's Flow program since its introduction in 2009. Chief Seke believes that the assessment will show that the program has helped lower the incidence of HIV and Aids in his area.

"Only five percent of Seke - mainly the old people - do not agree with these teachings," he told AllAfrica proudly. "And it is only five percent of my community that doesn't know and accept HIV prevention methods."

Example of a project proposal

Project title:
Legal name of organization: SEKE RURAL HOSPICE

Proposed project

Areas of support requested for

Equipment for patients
Palliative care for children and young people  
Palliative care medicines  
Capital improvement costs
Increasing access to palliative care in rural areas    
Training courses for palliative care service providers held in Africa
*if person responsible for the project is different from the institutional contact, then fill in the details of the institutional contact as well


Project aim:  In 1-2 sentences, please summarise what you expect this project to achieve. (Aim of the project).
The project aims to capacitate volunteer caregivers with knowledge on palliative care. This will help to improve palliative care services provided to the community.



Background Information on the Organisation: Please provide a brief description of the organisation, and what you do. Explain how this proposed project fits in with the overall aim of the organisation.  (2 paragraphs)

Seke Rural Home Based Care is a registered non-governmental organisation which was founded in January 2001 as a response to the HIV and AIDS pandemic.  It operates in all the 21 wards of Seke-Manyame Rural District and in 7 wards of Wedza Rural District, both of Mashonaland East Province.  SRHBC also operates in 10 wards of Makoni Rural District of Manicaland Province.
Since 2001 Seke Rural Home Based Care has been implementing home based care and palliative care interventions to improve the quality of life for people affected and infected by HIV. SRHBC relies heavily on volunteer caregivers who are the backbone of the organisation. There are a total of 1023 caregivers and all of them have been trained in Home Based Care but only 145 have been trained in palliative care due to limited resources. The caregivers assist in identification, referral and monitoring of HIV positive clients through adherence education and monitoring. They are also responsible for coordinating support groups at community level.

The organisation is also involved in OVC care through addressing education, Health and social protection needs of children. The Education component comprises of direct school fees payment and payment of fees through proceeds from School Development Committee income generating activities which were funded by SRHBC. The Health interventions include School Health Assessments, Adolescent Sexual Reproductive Health for in school youths and assistance for HIV positive children using the Integrated Management of Peadiatric HIV AIDS Care and Treatment (IMPACT) model. The IMPACT model was piloted in Seke District by Seke Rural HBC and was very successful. The model has been documented and handed over to the Ministry of Health at national level which is now cascading the model to other District of the country. Social protection interventions include psychosocial support groups, support for child protection committees and counselling for children and their families.  The organisation mainstreams livelihoods and gender in all its programming.



Project justification: Please explain the need that your project will help to address
There is still a gap when it comes to knowledge on palliative care by the volunteer caregivers. So far, their supervisors only have been trained and these are 145 out of a total of 1023. There is therefore need to capacitate some more volunteer caregivers so as to improve on the quality of services received by the community.

Project Summary: Please provide a brief summary of the project by answering the following questions
 What are the objectives of the project?
To train 120 secondary caregivers in palliative care (40 from each District)
To provide treatment for pain and opportunistic infections

Where will the project take place?
Mashonaland East Province .i.e. 21 wards of Seke-Manyame Rural District and 7 wards of Wedza Rural District,
 Manicaland Province 10 wards of Makoni Rural District.

What activities will you undertake?
-Training of volunteer caregivers in palliative care
- Purchase of drugs for pain relief and for treatment of opportunistic infections
- Home visits for treatment of Opportunistic infections and for adherence monitoring



What are the methods you will use for this method
Trainings - Lectures from facilitators
- Group discussions

Drugs - Purchase of drugs from pharmaceutical companies
- Home visits for treatment of opportunistic infections


Who will your project benefit:  list the number of people you will reach: how many men? How many women? How many children? Are they from urban or rural areas?
The project will benefit 300 chronically ill clients .i.e. 75 children, 165 women and 60 men. All of them will be from rural areas

Who will be involved in the project?



What are the results that you expect at the end of the project?
Improved palliative care services given to the community
Identify and assist 300 people in need of palliative care services


How will you know if your project was successful? To help you measure progress, please select which of the indicators below you can use to measure your project (you may choose as many as are relevant to your specific project)





Project implementation work plan



Project management: Who will manage the grant? Explain the skills of staff involved and their roles in the project (1 paragraph)
The grant will be managed by a finance department with two key personnel: Finance Officer (ACCA Affiliate) and Finance Assistant (Diploma in Entrepreneurship). The Finance Assistant is responsible for preparing payment vouchers, making payments as well as handling cash. The Finance Officer will be responsible for budget monitoring, reconciliations including bank, financial report writing and giving financial advice to programming team. All transactions by the department have to be authorised by the Director who coordinates the project. The treasurer of the board (Executive Masters in Business) is in charge of the finance department




Sustainability:  Please describe how this project will be sustained in the future (if the application is for an ongoing piece of work rather than equipment costs)

Training of volunteer caregivers will ensure sustainability since these caregivers are community based and act as the eyes, the legs and the link between the community and health centers. They were also identified by the community as approachable, honest and trustworthy members who can assist them while maintaining confidentiality. These volunteer caregivers are also motivated by the wealth of knowledge that is bestowed on them making them the focal persons in their villages. They also work in the community they live and some of the clients are their relatives and so culturally they are expected to help.

Sustainable Livelihoods Project

Initiative title: Sustainable Livelihoods Project

Reporting period: July 2012-September 2012

Type of report: First Quarter Project Report

Date of submission: 10 October 2012

Executive Summary

Please write a brief summary highlighting the major issues contained in this report. This should not be more than 1 page.

This project is being implemented by Seke Rural HBC to promote sustainable livelihoods for PLHIV, OVC and other vulnerable households in Seke-Manyame rural district. Seke Rural Home Based Care (SRHBC) is a registered Non Governmental Organization (NGO) that operates in Manyame, Wedza and Makoni districts. The organization was founded in 2001 with the mission of enhancing quality of life for those facing chronic and terminal illnesses and grief by surrounding them with love and embracing them with the best in physical, social, emotional and spiritual care.

The organization targets People Living with HIV and AIDS (PLHIV), cancer patients, the terminally and chronically ill, orphaned and vulnerable children (OVC), widows and other vulnerable households. The aforementioned groups are targeted under a Home Based Care model that mainstreams sustainable livelihoods into all its interventions. The sustainable livelihoods project comprising of communal nutrition gardens, rearing of small livestock (under the “Pass on the gift”

project was incorporated to enhance drug adherence. SRHBC works with PLHIV support groups where most of the members take ARVs. It is very difficult to adhere to these antiretroviral therapy drugs without sufficient food. The communal nutrition gardens initiative was brought in as part of a solution to this nutrition challenge.  

During the period under review the following major activities took place.

Monitoring of “Pass on the Gift Project”

Support Group Visits

Construction of a Strong Room

Construction of an Ablution block

Drilling of a Borehole at the organizational premises

Permaculture Training Workshop

Basic Food Processing and Packaging

Programme context

Please indicate any changes that may have happened in the context of the programme during the reporting period and the implications thereof on programme design.

Internal Changes

Impact on the Initiative

Detail changes made to programme design

1. Governance

• The Third Quarter Board meeting was held on the 29th of September. 

The Board members were given an update of the activities carried out during the quarter. A financial report was read and copies were given to all present board members.

The board now sits regularly as expected.

2. Programme

• Monitoring visits were done to the “Pass On the Gift” project. Chickens are being continuously    passed on to identified beneficiaries.    

• Drilling of a Borehole at the organizational premises –Borehole was drilled and fitted with a submissible pump. The borehole has brought life to the organization as a whole in the following:

a) Availability of clean drinking water for staff and clients.

b) Flushing of systems in the toilets/ablution block. This will enhance hygiene as people can wash hands after visiting the toilets.

c) The green house has come to life. Seedlings for income generation are now being produced.

• Construction of a Strong Room-One of the storerooms was converted to a storeroom. The strong room will be used as a safe keeping place for all confidential information of the organization as well as to archive all other files and important asserts of the organization.

• Construction of an ablution block and connecting pipes.-An ablution block is under construction. The block will consist of 2 flash toilets and 1 shower for women and   2 toilets, Urinary and 1 shower for men. The availability of the ablution block will accommodate the large numbers of people attending workshops and various activities and will increase hygiene.

• Report on Stolen Tanks in the communal gardens- 2 by 5 000 litre tanks were noticed missing in Zhakata ward 5 and Tariro support group member’s communal garden during garden monitoring visits in August. The matter was reported to the police and follow up is being done.                             

As a protective measure and for sustainability there are plans to place people who are permanently stationed in the gardens as guards. The guards will be resident in the gardens and will not pay rentals 
but will also have a potion to manage and utilize for their own benefits in the garden.

Training Workshops

• A permaculture Training workshop was facilitated to garden beneficiaries. The workshop comprised of both theory and practicals. Representatives from all the communal garden were trained in basic permaculture. The workshop covered among other topics, various types of bed designs, soil and  water  conservation. A practical session on compost making was facilitated by the Agritex officer with all members participating, where compost was erected in the organizations demonstration garden.

Initially there was an intention to connect pipes to already existing indoor toilet facilities but it was ideal to construct a block of toilets outside which would cater for more people and are more hygienic than the indoor toilet available. Long term plans are that the organization will connect water and sanitation to the office block.

3. Human Resource

The organization is short staffed. However, the availability of development studies students from various national Universities is helping to alleviate the work load and smooth running of organizational activities.

4. Finance

Updates of expenditure on activity budget lines helps the smooth running and implementation of the programme

External Changes

The project is not affected as the economic situation is stable because of the dollarization.

1. Economic

Most gardens at the moment are under land preparation as there is little production taking place. The   beneficiaries can still afford bus fares to Chitungwiza for regular checkups and collection of their   Antiretroviral Drugs from the savings they did from their last sales. Most of the beneficiaries have  engaged themselves in ISALs where they are kept busy in income generation activities. This has  boosted the economic background of the whole community.

2. Politics

The organization is not affected by politics as the current political environment is conducive for the implementation of programmes.

3. Health/`HIV and AIDS

• Support group meetings are taking place.

• Very little gardening activities are taking place and the gardens are being used as platforms for meetings and sharing of experiences by beneficiaries.

• Social workers, nurses and caregivers continue to carry out home visits.

• Home visits to PLWHIV who are members of the garden and beneficiaries of the pass- on the gift project are regularly visited and assisted with counseling and basic home based care kits where the need arises.

• Monitoring of PMTCT clients are ongoing as a measure to prevent the “Lost to follow up” which results from mothers defaulting to bring babies for periodic checkups to their health centre’s.

4. Implementing of the pass -on the gift

Follow up to the 67 second phase beneficiaries that received chickens under the “Pass On the gift” Project. The beneficiaries signed contracts and agreed to pass on to the 3rd phase of beneficiaries. 
Replacements were made by the few initial beneficiaries that had lost their chickens so as to enable the passing on of the chickens. The community is benefiting on nutrition by consuming chicken meat and eggs from the surplus.

5. Maintenance of central Database

Data entry is still ongoing and staff members are now able to generate statistical reports from the data base. However there is still a challenge of data entry as data obtained when the project started still needs to be updated.

Part One: Activity Summary

Please list your project activities as they appear in your working agreement with COGENHA and provide a brief summary of progress made in these areas during the last six months.  Please detail the number of women/girls and men/boys reached through each activity, as appropriate.  If you have not undertaken a particular activity during the period, please indicate why and what steps you will take to address this under the variance analysis column:

Objective 1: ​To increase household food production and nutritional support for 137 households benefiting under the homestead and communal garden schemes in Ngome, Mandedza and Zhakata wards and existing 87 beneficiaries by June 2011.

Planned Activities

Actual Activities conducted

Outcomes / Impact

Men, women, boys and girls.

1. Harvesting and replanting

Most of the beneficiaries in communal gardens harvested their plots and currently beneficiaries are preparing their plots for the rainy season.

The gardens are currently being used as meeting areas for support group members.

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Land preparations are underway and no harvesting is taking place in gardens.

Objective 2: To strengthen nutritional support to 137 households under the communal garden scheme in wards 2, 3 and 5 by June 2011

Planned Activities

Actual Activities conducted 

Variance Analysis (Explain the difference, if any, between planned and actual activities carried out)

Output Indicators (Include Figures: i.e. number of beneficiaries reached)

Outcomes / Impact

Men

Women

Boys

Girls

Planting of Crops in the demonstration garde

Tomatoes have been planted in the green house. Cabbages are covering the rest of the open field.

A green house was constructed in the demo garden

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The demo garden is now supplying affordable seedlings to the garden beneficiaries and the local community.

The green house is now a source of unrestricted funds for the organization through the selling of seedlings

1) Monitoring of all garden activities

Garden monitoring visits have been taking place.

No farming activities are taking place since it is a dry period of the year and water levels are low.

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Seeds have been transplanted from the demo into the in Mandedza ward 2 nutritional garden.

Ngome and Zhakata communal gardens are still under land preparation prior to the oncoming rainy season.

Planned Activities

Actual Activities conducted

Variance Analysis (Explain the difference, if any, between planned and actual activities carried out)

Output Indicators (Include Figures: i.e. number of beneficiaries reached)

Outcomes / Impact

Men

Women

Boys

Girls

Objective 3: To improve income levels of 137 households through enhancing market gardening and markets linkages by 2011

Planned Activities

Actual Activities conducted

Variance Analysis (Explain the difference, if any, between planned and actual activities carried out)

Output Indicators (Include Figures: i.e. number of beneficiaries reached)

Outcomes / Impact

Men

Women

Boys

Girls

Basic permaculture training

A workshop on Basic Permaculture Training was conducted

Refresher courses on market linkages were also conducted

Refresher courses on conservation farming were conducted and it was seen that traditional farming methods are a better climate change adaptation strategy in Seke.

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The training was conducted by an Agritex officer and the participants were taught on the advantages and disadvantages of various types of composts.

Two refresher workshops on conservation farming and market linkages were held.

Demo compost was erected in the demo garden

Objective 4: To reduce the number of OVCs being assisted with school fees by 10%

Planned Activities

Actual Activities conducted

Variance Analysis (Explain the difference, if any, between planned and actual activities carried out)

Output Indicators (Include Figures: i.e. number of beneficiaries reached)

Outcomes / Impact

Men

Women

Boys

Girls

1) Pass- On Gift Poultry

A total of 174 (67 initial beneficiaries and 67 second lot received pass on) granny headed families have benefited from the pass on the gift project.

174

Monitoring visits were conducted to the initial 67 beneficiaries to ascertain the  

Part Two: Lessons Learned – Successes and Challenges

Please choose two or more of the activities listed above that you feel went well and provide more detailed information about them.  Focus on describing why you think the activity went well, examples of the feedback received about the activity from your target group/community members, how you might build on these successes in the future and include any other information that you think might be appropriate. Do the same for the challenges as well.

Activity

Why Was It Successful – What Lessons Have You Learned?

Feedback Received

Future Steps

Construction of a Borehole at the organizational premises.

The borehole is supplying water for staff members and clients that visit the organizational premises. Water has since been connected to various outlets. Soon the organization will have flashing toilet systems that are more hygienic.

The Demonstration garden is now fully operational as it has water supply throughout.

The borehole will enable the watering of  the crops in the demonstration garden.

Seedling production will be increased as the greenhouse now has constant supply of water from the borehole.

Programme Challenges

Challenges / Constraints

​

Impact on Your Project /Organisation

Steps Taken to Limit Impact

Future Steps

The wells dug in the gardens dry up and do not sustain the garden activities throughout the year.

Due to the unavailability of water from September to mid November, production in the gardens was low.

Maximum effort was put towards support group meetings, where the gardens are used as meeting places and a lot of essential topics are shared amongst the members.

Non farming activities are taking being implemented in the communal gardens as it was during the dry season.

Part Three: Technical Support Received

Please tell us about any technical support you have received during the period that has been provided with financial assistance from COGENHA.  Please indicate who provided the support, describe the purpose of the support, how the support was provided (eg did you attend a workshop, one-to-one training, mentoring?), your assessment of whether the support was useful or not, and the new skills that your organisation has acquired as a result.

Technical Support Provider

Purpose of Technical Support

How Was Support Provided?

(Workshop/Mentoring/Training)

Was the Support Useful?

(Why / Why Not?)

Financial Management Workshop For Oxfam Canada Partner Organizations

Improve partners understanding of the link between proposed activities, budgets and reports.

Partner representatives were trained in financial management and how finance relates to programme and vice versa.

The training was essential as it integrated finance and programme staff .Programme staff were also  oriented on accepted accounting practices particularly around cash and risk management

Part Four: Future Technical Support Needs

Does your organization have any specific technical support needs that you would like COGENHA to provide financial assistance for during the next six month period?  If so, please describe them, indicate the name of a Consultant or organisation that you would prefer to receive this support from (if known), how you think this might strengthen the work of your organisation and the estimated cost of this technical support (if known).

Technical Support

Provider

(If Known)

Purpose of Technical Support

Preferred Method

(Workshop/Mentoring/Training)

Estimated Cost

(If Known)

1. Refresher Training on finance for non finance staff

Training

2. Training on seed and seedling nurseries management

Part Five: Linking and Learning

Please tell us about any COGENHA-organized linking and learning activities (eg workshops orexchange visits) that your organisation has been involved in during the past six months.  Please list other organisations that were involved, indicate the purpose of the linking/learning activity, why you found the activity useful or not useful, and what future plans you have made to follow up with the organisation(s) involved.

Type of Linking/Learning Activity & Organizations Involved

Purpose or Theme of Linking/Learning Activity

Was the Linking/Learning Activity Useful?

(Why / Why Not?)

Follow-up Plans

Part Six: Documenting and Sharing

Are there any particular areas of the work you have undertaken, or lessons you have learned over the past six months that you would like to share with other organisations doing similar work?  If so, how would you like to share this information (eg by facilitating a workshop, preparing and distributing a case study or report, presenting a paper at a conference, etc)?  Indicate what, if any, support you would like to receive from COGENHA or another organisation to help you share this information.

Information to be Documented and Shared

Means of Documenting and Sharing

How Can COGENHA or Other Organisations Help?

1) Stories of change

     

Photos are taken and the stories are written

COGENHA has already approved the budget for the collection of the stories of change.

2)Profile of the organization and more stories of change to be told digitally

Digital story telling

Purchase of laptop with the capacity to carry the software suitable for digital story telling

Part Seven: Financial Information

So that we can put COGENHA’s partnership with your organisation into a broader context, please tell us about financial or technical support you have received from other organisations during the past six months.  For funding support, please indicate the amount received, the duration of their support and the activities undertaken with this support (include contributions to administration/overhead costs as well as project activities).  

Name of Financial Supporter/ Donor

Activities Supported

Amount of

Financial Support

Duration of Financial Support

Young people we care-youth HIV/AIDS awareness and participation

17 759

Sept 2011-Dec 2011

Part Eight: Monitoring and Evaluation

a) Monitoring: Indicate outputs under each objective and the indicators used to monitor them. Please comment on how these were done. Identify key monitoring indicators

Objective 1

Outputs

M&E Indicators

Comments

To enhance nutritional support for the        

Existing 187 PLHIV households.

Reduction of opportunistic infections

Reduction in malnutrition cases and improved diet.

Improved drug adherence

Improved quality of life

Drug adherence has improved.

Quality of life of community members has improved due to the availability of disposable income.

Objective 2: To increase food security to the community.

Improved agricultural methods i.e. conservation farming

Food preservation and processing for the off season period

83 members of communal gardens attended a conservation training workshop 

80 beneficiaries from communal and household gardens attended a food processing and packaging workshop.

Objective 3: To improve income levels of 187 PLHIV

Availability of disposable incomes

Increased productive and non productive assets

65 out of the 67 grandmothers receive income from sales of excess chickens received through the “Pass on the gift” project.

Objective 4: To provide psychosocial support to PLHIV and their families

Reduction of emotional ,social and spiritual pain

Reduction of HIV stigma and discrimination

Resilience among the vulnerable groups

3 different support group meetings are held in the communal gardens weekly.

The communal gardens present a platform for the members to meet and share various experiences and knowledge on day to day matters that affect them.

Objective 5: To offer security to organizational property and assets

Elimination of trespassers

Reduction of theft and burglaries

Files kept under secure environment

Materials for fencing the organizational premises have been purchased.

Fencing of the organizational premises is underway.

Objective 6: To provide a viable source of water and sanitation needs

Clean drinking water available

Constant and reliable water supply

Improved Hygiene and sanitation

Reliable water supply now available from the borehole drilled.

Objective 7 : To empower women and man to exercise their socio economic rights that are gender sensitive.

A gender sensitive community

Gender sensitization workshop carried out.

57 members from various support groups within the communal gardens attended and participated during the workshop.

Objective 8: Documentation and sharing of best practices

Replication of best practices

Objective 9: To enhance organizational development

Effective and capacitated staff

Please provide a story from a lived experience of one of your beneficiaries to explain the impact of your service and work in the lives of individuals or communities.

Story of Most Significant Change-

Good Nutrition is a necessity in the life of people living positive. Maideyi  a 40 year old woman had the challenge of losing weight and constantly being affected by various opportunistic infections including diarrhea. Maideyi  tested HIV positive and was commenced on ARVs (Stalanev) in 2007 at Marondera Hospital. In late 2007 Maideyi started working as a house helper in Seke were she was encouraged to join one of the psychosocial support groups. In the support groups she got 
encouragement and information on adherence which helped her to improve her condition.

In 2008 Maideyi remarried, with the help of Seke Rural Home Based Care palliative care nurses she was capacitated with  information on Prevention of Mother To Child Transmission (PMTCT).The 
couple was referred to Kunaka hospital for the programme which she adhered to quite well. In 2008 the couple was blessed with a baby girl who they exclusively breast fed for 4 months then weaned her off to solids. The baby had a DNA PCR test done 3 months after cessation of breast milk and was found to be HIV negative. The mother had her tested again at 18months and she tested negative. The baby is now 3years and very healthy.

Maideyi had another pregnancy in 2011.She delivered twin boys. With the support from SRHBC staff, she went through the PMTCT process again. She breast fed the twins for 6 months exclusively. The children had a DNA PCR test 3 months after cessation of breast milk and they were also found to be HIV negative.

Right now Maideyi and her husband are a healthy couple with three vibrant children. She continues to take her ARVs and practices positive living.

Maideyi credits her successful PMTCT initiative to the support group meetings that they hold every week in the communal gardens. The   support group meetings often have teaching sessions from palliative care nurses and social workers .The social workers also carryout home visits to individuals were counseling and psychosocial support is offered. Since Maideyi is a beneficiary and has a plot in the Tariro Support group communal garden, she has benefited a lot from the programme as she has a variety of nutritional vegetables from the garden. Weaning off her babies was not a challenge as she  got supplements from the garden that were healthy and of nutritional value to her children. Maideyi also affords doctors review and bus fare to Marondera to collect her ARVs from the surplus she gets from sales of her garden produce.  

Nature of Evaluation

Process used (and how beneficiaries/communities were involved)

Role of COGENHA

Major finding from the Evaluation

End of programme Evaluation

Focus Group Discussions and personal interviews.

Site visits

Funded the evaluation

There is need to introduce and train community members on small grains to increase yield and reduce hunger.

There is need to strengthen non agricultural practices during the dry season.

New Funding Opportunities

Have you approached any other organisations for financial support over the past six months?  Yes     No.

If so, please tell us the name of the organisation(s) and how you have approached them (e.g. meeting, developing/submitting a proposal) and what, if any, success you have had.  

Potential funding partner

Approaches used (e.g. Proposal?  Meeting?)

Amount Requested

Expected Outcome

Proposals to seek more funding are under way.

Proposal

-

There are expectations that the children first project will have a second phase focusing on  Orphans’ and vulnerable children

If you have not approached any other organizations in the past six months, please tell us the plans you have to do this in the future.………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………