RWANDA: Locals taking AIDS orphans, widows under their wing

By, IRIN PlusNews, November 23, 2006

KIGALI - The continued poverty and suffering in Rwanda, 12 years after the genocide, is spurring local people to take responsibility for orphans rather than wait for handouts.

"I survived the genocide but my parents did not. After looking after my brothers and sisters I looked around and saw many more children who needed support, like I received from friends and neighbours when I was a child," said Emmanuel Ngabire, who founded of the Rebero Orphans Centre with Leonce Mpenzi.

The centre, in the suburb of Gikondo, in the capital, Kigali, cares for 70 orphans and 18 widows who contracted the HI virus through sexual violence during the genocide.

An estimated 270,000 Rwandan children have lost one or both parents to AIDS-related illnesses, while 800,000 people are thought to have died in the genocide, leaving the country with the highest number of child-headed households in Africa. Rape was deliberately used to intimidate members of the minority Tutsi community and moderate Hutus.

The Rebero centre, where the children come to play after school each day, is supported largely by a group of Rwandan professionals, who donate an average of US$230 per month to feed the children and widows, and also chip in for medical expenses and other emergencies.

Jacqui Sebageni, one of the centre's benefactors, commented, "When we first met these two young men in April, I was struck by the fact that even though they were themselves on a survival level, they reached out to help people in the same situation."

NGOs and the government provide support in their respective capacities, but orphans also need the guidance and support that people with intact families often take for granted. "Because of our country's history, most Rwandan families that have some means are supporting four or five other families," Sebageni said.

Mpenzi met many of the centre's patrons while working as a waiter at Kigali's Intercontinental Hotel. When he had enough pledges of support, he left his job and became a full-time volunteer at the centre.

Twenty-three of the children are HIV-positive, including Jean-Pierre, 6, (not his real name), a shy football enthusiast. "Both his parents are infected," Mpenzi said. "The whole family is on antiretrovirals and his parents are too poor to pay the small fees ... when he starts primary school next year."

Jean-Pierre's family, like the families of other orphans and widows supported by the centre, receives seven kilos of beans and six kilos of flour every month.

Another beneficiary is Venancia Nyirabuzara, 53, whose husband and much of her extended family were killed during the genocide, leaving her with three children. She contracted HIV after surviving a brutal sexual attack when she was three months pregnant and transmitted it to her son, now 12 years old.

"I wanted to die after the genocide; even when I started falling ill and had a serious skin infection I refused to seek medical treatment," Nyirabuzara said. "I hated everyone around me and my children suffered; we had little food and no money because I didn't work."

Ngabire visited her five months ago and encouraged her to join a support group for women who were HIV-positive as a result of suffering sexual violence during the genocide. He also started bringing her weekly rations of flour and beans, and urged her to be tested and seek treatment.

"He took me to meet these women who showed me that I was not the only one with the same problem. I can be free and talk to them about my illness and my experience," Nyirabuzara said. "My children are also happier now that I am more active and not so depressed; I realised that when I was suffering, they were as well."

Since she began a course of life-prolonging antiretroviral medication five months ago, her CD-4 count [which measures the strength of the immune system] has risen from 210 to 320, but she has not yet told her son that he is HIV-positive, or that she is, but hopes she will have the courage to do so soon.

Ngabire and Mpenzi are trying to build a home where they can focus on caring for underprivileged HIV-positive children. "God protected me during the genocide and I promised that I would protect others," said Mpenzi. "Our community must care for these orphans - if we care for each other we will never see the same kind of killings again."

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Home-Based Care Reduces HIV Prevalence Rate

By, Victoria Muringayi, Zimbabwe Independent (Harare), November 10, 2006

THE National Aids Council (NAC) has attributed the decline in the Aids prevalence rate to various projects such as the home-based care system which deals with people living with the HIV/Aids virus.

NAC board chairman, Reverend Murombedzi Kuchera, said the awareness campaigns being carried out by various stakeholders nationwide were helping reduce the prevalence rate.

The prevalence rate for the HIV virus is now down at 18,1% from the previous 20,1%, while projections point to a reduction to a single digit rate by 2010," he said.

"Home-based care is one of the very important strategies in national efforts to address challenges faced by Aids victims at home."

Zimbabwe has over 300 000 people who require anti-retroviral drugs, but only 42 000 of them are receiving treatment. The remainder have to be catered for through home-based care initiatives.

The NAC said it was receiving US$250 000 for anti-retroviral drugs every month from the central bank to cater for those who cannot survive without the drugs.

"We have anti-retroviral drugs that can cater for 42 000 people who are on treatment and need the drugs constantly," Kuchera said.

"We are currently mobilising our resources so that we can source funds for patients on anti-retrovirals so that everyone infected with the virus receives the drugs."

Kuchera was speaking at a community home-based care certificate award ceremony held in Harare last Friday by a non-governmental organisation Jekesa Pfungwa/Vulingqondo.

Jekesa Pfungwa funnelled at least US$30 000 that it received from Irish Aid through Zimbabwe Aids Network to offer community home-based care to 20 monitors and 10 field officers throughout the country.

The money was used to buy bicycles, home-based care kits for the monitors and the field officers to improve efficiency in the programme.

Jekesa Pfungwa deputy director Mabel Moyo said the community home-based care course is the third that they have offered to the community and the 20 monitor's role is to educate and give information to primary care givers, who are family members taking care for the terminally ill.

"The home-based care monitors and field officers have undergone a refresher training course which is a special programme, that was done according to the national standards as required by the Ministry of Health," said Moyo.


Source: http://allafrica.com/stories/200611100363.html

MALAWI: Home based care eases pressure on public health sector

By, IRIN Africa PlusNews reports, August 5, 2006

MZUZU - Faced with the devastating impact of an HIV/AIDS epidemic compounded by abject poverty, Malawians have eased the pressure on state hospitals by caring for chronically ill family and neighbours at home.

A home based care (HBC) project in Northern Malawi has assembled 225 young volunteers in the region's nine districts to provide community based support to homes and guardians looking after people living with AIDS (PWAs). The aim is to ease their suffering and prolong their lives.

Levi Soko, the acting project coordinator for HBC told PlusNews that the project was also looking after 4,000 orphans - providing them with school fees, school uniforms, learning materials and, where necessary, bedding.

"We are supporting 860 affected families who are hosting chronically ill patients. By the end of the project [our target is] 3,000 guardian families. The goal of the project is to create awareness of HIV and AIDS prevention and transmission messages, and also to support guardians that are looking after the [PWAs]," Soko said

It is hoped that the project, which began in 1996, will be able to support 5,000 orphaned children by 2005.

The HBC concept, which gets village committees to organise volunteers to help families care for people laid low by AIDS, is becoming increasingly popular throughout Malawi. The country's 22 district hospitals, including four referral hospitals, are struggling to cope with the overwhelming number of sick people.

HBC minimises the number of times a person would have to be hospitalised.

In Malawi, AIDS kills 70,000 people every year. It is estimated that between 850,000 and one million people now carry the HI virus that causes AIDS. An indicator of this is that 75 percent of Malawi's recorded 27,000 tuberculosis cases in 2001 were HIV positive, according to hospital sources. It is also estimated that 38 percent of the people who have HIV/AIDS are in the most productive age group.

Jennie Mueller, head of Development Aid from People to People (DAPP), a project that helps communities implement programmes to cope with AIDS, said HBC also helped to educate families about HIV/AIDS.

"It helps families understand the illness and people can die with dignity at home. It provides hope and a way to cope and it helps the grieving process because the community would already be reaching out to that family over the period of illness," she said.

Soko said, when possible, the HBC project also offered vocational training such as embroidery, mat making, welding and carpentry to orphans.

"If one community member has a workshop, we request them to offer internship. We do not have a formal structure to accommodate all of them [orphans]. We're using community resources that are on the ground," he explained.

The HBC project is supported by the Catholic Development Commission of Mzuzu Diocese with funding from Catholic Relief Services and a British-based catholic organisation, CAFOD. Soko said the project also worked with other organisations with related projects such as the District Social Welfare and District AIDS Coordinating Committees.

"They really assist us in implementing our activities. We also interact with all the other churches. As of now, we have nine home based care providers, also known as parish coordinators, and two field officers who monitor the care providers," Soko said.

The volunteers had mobilised their communities who donated items such as used clothes, maize flour and sugar while the HBC project provided other sundries, such as basic drugs and vitamins. With the assistance of the volunteer network, the project aims to enable guardians to better manage and care for HIV/AIDS patients.

"We provide foodstuff and Likuni Phala [a porridge] to boost the patients' nutrition. Sometimes the volunteers provide bedding, depending on the needs of the family. But most of all, counseling is emphasised so that the guardians should not lose hope," Soko explained.

However, Soko noted that the project was being undermined by various factors. Chief among these was that communities still discriminated against PWAs.

"This makes it difficult for people to declare their sero [HIV] status," he said.

Another was that in some instances community members demanded to be paid allowances for attending project meetings. "The problem is escalating and the resources ... are becoming too little," Soko said.

Despite these challenges, he said the project's volunteers were very dedicated.

"What it means is that they are serving their neighbours, they're serving their brothers and relatives," Soko said.


Source: http://www.irinnews.org/AIDSreport.asp?ReportID=1400

Congo-Kinshasa: Solidarity Against Aids

By, UN Integrated Regional Information Networks, October 10, 2006

The NGO ACS/Amocongo provides care and support to thousands of people living with HIV.

After losing her sister to HIV/AIDS two years ago, Kimya, an HIV-positive mother of four, felt she had no choice but to take in her sister's children, saying it was "the obvious thing to do - it is solidarity".

"At first the two children were placed elsewhere [with other family members], but it didn't work out," she said in her single-roomed shack in Lubumbashi, capital of the southeastern province of Katanga in Democratic Republic of Congo (DRC).

Despite her poor health and bleak financial position, Kimya, 55, (not her real name) decided that the best place for her nieces was with her. "I was really obliged to do this. My family had abandoned us - they don't even visit us any more," she said as she cradled her crying three-year-old on her lap.

Kimya discovered she was HIV positive in 2002, just after her husband died. "My husband's family came to see me to suggest that I be tested for HIV. I was tested and the result was positive," she said. "I was very unhappy - I had heard people talking about AIDS at the church and I thought I was going to die immediately."

Community Action Association Against AIDS/A Better Future for Orphans (ACS/Amocongo), a local nongovernmental organisation (NGO) founded in 1993, runs voluntary testing centres in nine of the country's 11 provinces, and provides schooling, feeding and psychological counselling to about 8,000 AIDS orphans. Kimya was tested at a centre near her home.

In 1997 ACS/Amocongo decided to expand its assistance to include the families and caregivers of AIDS orphans, on condition that the orphans were not abandoned.

"We want to prioritise African solidarity by telling these enlarged families to give these children affection and a roof over their heads, and we will do the rest," said Dr Jo Bakualufu Ntumba, in charge of follow-up and evaluation in ACS/Amocongo programmes in Kinshasa, the DRC capital.

The United Nations Children's Fund (UNICEF) estimates that after almost ten years of conflict, the DRC has 120,000 HIV-positive children, and 800,000 have lost one or both parents to the pandemic.

Last year, in an initiative financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria, ACS/Amocongo started providing free antiretroviral (ARV) treatment to 2,100 people living with HIV/AIDS. The NGO has a total of 6,600 HIV-positive people on its books in 20 treatment centres throughout the country.

Kimya is one of the patients whose health has improved since she started treatment, but she is worried about her youngest child, who has become HIV positive - the only one of the six she looks after to be infected. ACS/Amocongo has been providing antibiotics to limit opportunistic infections.

Paediatric ARVs are not available in Lubumbashi but, with the help of the Global Fund, ACS/Amocongo is hoping to receive the first batch before the end of the year.

According to Dr Lucien Kalenga, who heads the programme in Katanga Province, 300 of the 1,500 orphans ACS/Amocongo looks after in the province would be eligible for this life-prolonging treatment. "It is difficult to give ARVs to the mother and not to the child," he said.

While they wait, Kimya's priority is to find a way to feed her family. "They are sad because they are hungry. They haven't eaten today," she said wearily.


Source: http://allafrica.com/stories/200610110007.html