Annual Report RCZ Community Based AIDS Program January – December 2009
RCZ CBAP C/O Morgenster Mission Hospital Morgenster Mission Masvingo Zimbabwe
Cell +263 11 875252 or +263 39 253849 E-mail [email protected] Contact person: Samuel Mhungu (Program Coordinator)
1 TABLE OF CONTENTS
Annual Report...... 1 INTRODUCTION...... 4 Acknowledgements...... 5 Background...... 6 Organogram...... 6 ACTIVITIES...... 7 Table of Activities...... 7 Brief Comments on Activities which were not done...... 10 i) Baseline research in the wards...... 11 ii) Workshops for volunteers...... 11 Workshop for Area Supervisors...... 12 OI and ART – Training for Area Supervisors...... 14 Workshop for church leaders...... 14 RCZ SPIRITUAL WORKERS AND THEIR SPOUSES HIV/AIDS WORKSHOP...16 Workshops with Headmasters...... 17 Workshop for Teachers...... 17 Home Based care...... 18 ARV Roll out...... 18 Support groups...... 19 Internal savings and Lending Scheme...... 19 Orphan Care and relief...... 19 Psycho Social Support Camp...... 20 Topics covered...... 20 ACTIVITIES IN RCZ...... 21 Women’s League...... 21 The RCZ National Youth Conference...... 21 The ZCC T O T...... 22 AIDS Awareness...... 22 Mid Term Evaluation...... 22 Highlights of the baseline research...... 22 Highlights of the Annual Participatory Review meeting...... 20 Cooperation with others...... 24 The 2009 Prisma ‘Result Appointments...... 24 STAFF...... 25 Appendix...... 27 Statistics...... 27 Donations...... 27
2 1. List of Acronyms AIDS ACQUIRED IMMUNO DEFICIENCY SYNDROME
ART ANTI-RETROVIRAL THERAPY
CABSA CHRISTIAN AIDS BUREAU FOR SOUTHERN AFRICA CBAP COMMUNITY BASED AIDS PROGRAM CADEC CATHOLIC DEVELOPMENT COMMISSION
CAT CHRISTIAN AIDS TASKFORCE DACHICARE DANANAI CHILDREN’S CARE
FI FAMILY IMPACT. EUR EURO HBC HOME BASED CARE HIV HUMAN IMMUNO DEFICIENCY VIRUS HOSPAZ HOSPICE ASSOCIATION OF ZIMBABWE IGP INCOME GENERATING PROJECT MMH MORGENSTER MISSION HOSPITAL NAC NATIONAL AIDS COUNCIL
OI OPPORTUNISTIC INFECTION PLWA PEOPLE LIVING WITH HIV AND AIDS PMD PROVINCIAL MEDICAL DIRECTOR PSS PSYCHO SOCIAL SUPPORT OVC ORPHANS AND VULNERABLE CHILDREN RCZ REFORMED CHURCH IN ZIMBABWE
SDC SCHOOL DEVELOPMENT COMMITTEE SU SCRIPTURE UNION
RML RELIGION MISSION LEAGUE RUDO RURAL UNITY FOR DEVELOPMENT ORGANISATION ZAN ZIMBABWE AIDS NETWORK ZCC ZIMBABWE COUNCIL OF CHURCHES ZWD ZIMBABWE DOLLAR
3 INTRODUCTION
General Review of this period
During this period the RCZ CBAP carried out its activities with the unwavering support from its Netherlands strategic partners, which include Oikonomos Foundation, the Netherlands, the congregation of Oud-Beijerland, Prisma, RML and the town of Bleiswijk.
The CBAP team carried out the day to day activities of the Organisation with the assistance of an office volunteer, Tivaone Matambo.
The Program’s focus was mainly on its three thematic areas namely; OVC, HBC and HIV and AIDS awareness. During the period under review an External Financial Audit, The Mid Term External Evaluation and the Prisma External evaluation on the Capacity Building Program were carried out. There was also the Prisma Capacity Building Programme where all staff members were equipped with knowledge in Performance Management, Governance issues, Training in Data Base Management, Research Methods, Records Management and Report Writing skills.
The ARV roll out programme commenced during the reporting period. This was received with great joy in the communities, considering that it was costly to travel to Morgenster Mission Hospital monthly to access the ARVs.
The Advisory Board members continued to offer technical support the organization. Area Supervisors contributed greatly towards monitoring and evaluation of the CBAP activities. The services of the volunteers are commended for the achievements realized by the programme in this period. There were no volunteer drop outs. Only additional volunteers were instated where there was need. The school patrons and matrons also contributed immensely to the Orphans and Vulnerable Children through counseling and psychosocial support.
The introduction of the dollarisation and the stable political climate was conducive for programming. However, the Program experienced enormous challenges in the payment of school fees for the children under the programme in this period. The budget for fees was enough due to the abnormal hyperinflation obtaining during the 2007-8 period.
The need to raise funds for the programme in 2010 and beyond is high.
4 Acknowledgements
The CBAP would like to thank among others, the following organizations and individuals for their support to the CBAP during this period.
Organisation/Individual Nature of Support Oikonomos Foundation, The Financial, moral and technical support through the Netherlands invaluable advice from Evert-Jan Schuitmaker (Oikonomos Consultant) Blieswijk Financial support towards OVC educational support. PRISMA Effectively funding Staff Capacity Building Programmes Reformed Mission League Financial and technical support through Mr Arie van der Poel especially towards the funding of RCZ Spiritual Workers’ Workshops Congregation of Oud-Beijerland Providing funds for OVC support. CABSA Provision of important on-going educational material and information through the desk of their I T Officer, Lyn van Rooyen Dr IIsa Breugem (CBAP Continuously fundraising for the Program and Founding Coordinator) technical support as well as invaluable moral support CBAP Advisory Board Technical support, guidance and steadfast love and commitment to the Programme. Morgenster Mission Hospital Material and technical support and excellent Management Team and staff partnership and strong networks especially with the O I clinic PMD Masvingo Networking and guidance on health issues Masvingo Scripture Union Good networking relationships Ministry of Education Networking and guidance especially on issues relating to children in schools ZAN Facilitating strong networks with other AIDS Services Organisations NAC Organising training workshops for AIDS Service organizations as well as Monitoring and Evaluation of activities DAC Organising workshops and monitoring and evaluating Program activities Hospice Association of Zimbabwe Training on Palliative Care Standards and donation of HBC material. NANGO Regional Coordinator Facilitating networks with other organizations RCZ Central Office Unwavering technical support and guidance
The list is endless. My sincere apologies for those not mentioned – you are equally invaluable. The CBAP team strongly holdfast to the notion that the best of it is yet to be. May the Good Lord abundantly bless all our invaluable stakeholders and strategic partners for all their invaluable support to transform CBAP qualitatively.
Mhungu Samuel: Program Coordinator RCZ CBAP.
5 Background
Organisational Structure The CBAP is a department of the Reformed Church in Zimbabwe. The RCZ manages the program via the CBAP Advisory Board. During this period, the CBAP was managed on day to day basis by the Program Coordinator, Samuel Mhungu with the assistance of the Program Officer, Maria Kujinga and the Field Officer, Samuel Mafa. The financial administration was done by the Accounts Clerk, Gladmore Manemere. Tamari Zishamba was the typist for the Program. Muchuva Machando was the General Hand. Tivaone Matambo joined the organization in April 2009 as a volunteer staff member. Organogram RCZ Synodical Administrative Board
Board of Advisors
Program Coordinator
Program Officer
Accounts Clerk Field Officer
Area Community General Typist Supervisors Volunteers hand
6 ACTIVITIES
Table of Activities
OUTPUTS ACTIVITIES GOALS 2009 REACHED 2009 % TARGET 2010 REACHED 1. Improved 1.1 Sourcing and All leaflets/posters sourced by 819 pamphlets and 359 Not applicable As and when available knowledge, distributing HIV/AIDS CBAP are distributed booklets on HIV/AIDS attitudes and leaflets and posters for the distributed to behavior communities when they are stakeholders regarding available relationships 1.2 HIV/AIDS and Life 1. Scripture Union runs seminars in Not done 0% Dropped. To be reviewed and skills seminars in schools 23 primary schools for Grade 7 in the next strategic plan HIV/AIDS in for all groups of children pupils. 6 wards of 2. Scripture Union run seminars in 8 Masvingo high schools for form 3 pupil district by 1.3 Conducting HIV/AIDS 1. 40 church leaders at 2 x 1 day 1 x 1 day workshop = 1. 40 church leaders at 2 x 2010 Workshops in the workshops in each ward = 240 in 6 165 church leaders 50% 1 day workshops in each community for selected wards per year Attendance ward = 240 in 6 wards per stakeholders =68% year 1 x 4 day (at Morgenster) and 1 x 1 1 x 1 day workshop = 28 2 x 1 day workshops for day workshops per Head teachers in heads in the 6 wards 100% Head teachers in each ward each ward for a total of 31 head 1 x 3 day (at Morgenster for a total of 31 head teachers. = 29 heads in 6 wards Attendance teachers. attended =93% 3 x 1 day workshops per teacher in 2 x 1 day workshops per each ward for a total of 62 teachers Not done 0% teacher in each ward for a (2 teachers per school) total of 62 teachers (2 teachers per school) 1 x 5 day workshop for 20 teachers 20 selected teachers from 100% 1 x 5 day workshop for 20 from new ward (Walking with all the 6 wards attended selected teachers (Walking Wounded Children) the workshop. with Wounded Children) 2 x 1 day workshops for 1 x 1 day workshop or 50% 2 x 1 day workshops for Community leaders in each ward community leaders = Attendance Community leaders in each for a total of 300 219 =73% ward for a total of 300 2. Improved 2.1 Establishing Income 10 household gardens established in In place and are being 10 household gardens support to generating projects for ward 31. supported supported in ward 31.
7 PLWHA and PLWHA in selected 1 school garden established in ward In place and is being 1 school garden supported HBC patients communities 16 supported in ward 16 in 6 wards of 1 community garden supported in 1 community garden Masvingo ward 22 supported in ward 22 District by 1 community plot established in Not established 1 community plot 2010 ward 23 established in ward 23 Sewing project established in ward Sewing project started in Continued support of 23 April. Training of 15 Sewing project in ward 23 volunteers (6 from ward 23 and 2 each from other 5 wards) 2.2 Establishing Credit 2 centres with groups of 5 people In place. 39 volunteers 97.5% Monitor existing credit facility schemes in 6 wards each = 40 people in each of six were trained in credit schemes wards running credit facilities facilities. To date 32 groups formed. 2.3 Palliative Care training 1. 3 x 1 day workshop in each ward 1x 1 day workshop for 33%. 1.2 x 1 day workshop in for selected primary and per year for 250 primary 291 primary caregivers each ward per year for secondary caregivers caregivers of HBC and OVC Attendance = 300 primary caregivers of 116% HBC and OVC 2.1 x 2 day workshop on ARVs for Not done. Issue still 10 community nurses at pending with the 2.1 x 2 day workshop on Morgenster Hospital Ministry of Health ARVs for 10 community nurses at Morgenster Hospital
2.4 Routine HBC delivery 11 HBC kits delivered/replenished Done. Cotrimoxazole 11 HBC kits and replenishment of HBC quarterly at 11 centres was distributed to 5 100% delivered/replenished kits quarterly clinics for Opportunistic quarterly at 11 centres Infections clients 2.5 Establishment of 12 (2 per ward) nutrition gardens In place and are being 100% Ongoing support of community nutrition established supported nutrition gardens gardens for PLWHA 2.6 Formation of support 15 support groups to be formed 18 support groups were 120% Monitor existing groups groups for PLWHA formed 2.7 Provision of Training No of ARV beneficiaries trained Training not done. ARV Health Ongoing training for ARV and support for ARV and supported roll out commenced on 1 education is beneficiaries monthly. beneficiaries September 2009 at 4 done each time centres beneficiaries come to collect supplies 2.8 Distribution of ARVs 300 ARV beneficiaries receiving ARV were distributed to 300 ARV beneficiaries
8 ARVs each month 105 clients from CBAP receiving ARVs each wards and 27 from other month wards. Total = 132 3. Improved 3.1 Psychosocial support to Awareness sessions (6 hrs per Done by school patron Awareness sessions (6 hrs support to OVC term) in schools led by teachers and matron teachers. 100% per term) in schools led by OVC in 6 Each school to have an active Schools have dormant teachers wards of CBAP club CBAP clubs Each school to have an Masvingo active CBAP club District by 3.2 Psychosocial support 2010 camps in schools and PSS 2 x 3 day camps held for 60 1 x 5 day PSS camp held 50% PSS 2 x 3 day camps held communities for the pupils (registered orphans) in each 6 for 118 children from all for 300 registered orphans infected and affected wards – 120 per ward = 720 the six wards under the Attendance from all the wards children. children Programme =16%
3.3. Provision of Exercise books, ballpens, pencils Exercise books, ballpens 100% Exercise books, pens and educational support to OVC for each of the 1600 children. and pencils issued to pencils for all registered School fees in the form of school 1468 children. orphans. development projects for 1600 School fees were not 0% Examination fees to be paid children paid. for 80 registered OVC (‘O’ Provision of 120 uniforms and 100 Examination fees paid and ‘A’ levels) jerseys for 120 selected children per for 64 ‘O’ levels and ward 2 ‘A’ levels 31 school uniforms and 110 jerseys provided. 3.4 Provision of Food 5 kg maize seed distribution for 300 5kg seed maize 5kg seed maize distributed security services needy orphans in 6 wards per year distributed to 640 needy 213% to 700 needy orphans in 6 orphans in 6 wards. wards this year 4. Improved 4.1 Staff training As per staff development On going -Completion of current ability of staff studies and volunteer -Monitoring and Evaluation team to fulfill training the purpose of 4.2 Meetings with Area 14 Area Supervisors meet 5 times Area Supervisors met 5 14 Area Supervisors meet 4 CBAP in 6 Supervisors for training in per year at Morgenster for two full times at Morgenster for 100% times per year at wards of all relevant areas days two full days Morgenster for two full Masvingo days District by 4.3 Meetings with 1 bi-monthly one day workshop in 3 x 1 day workshop held 45% *1 bi-monthly one day 2010 volunteers for training in each ward for a total of 130 in each ward for a total workshop in each ward for relevant areas volunteers of 118 volunteers a total of 118 volunteers 4.4 Conduct workshops for 2 x 2 day workshops per year for 60 1 x 2 day workshop was 50% 2 x 2 day workshops per RCZ Church leaders pastors and their spouses done for 51 ministers,30 year for 60 pastors and spouses, 7 evangelists, 5 their spouses
9 youth counselors and 30 MTC students 4.5 Annual Participatory 1 x 2 day workshop for 30 people 1 x 1 day Annual 100% 1 x 1 day workshop for 30 Review meeting (staff and stakeholders) participatory done for 30 people (staff and stakeholders stakeholders)
Brief Comments on Activities which were not done Activity Planned Actual and percentage Comment 1.2 HIV/AIDS and Life Skills Scripture Union runs seminars in 21 Not done. 0% After consultations with Scripture Union it was agreed seminars in schools for all groups of primary schools for grade seven pupils that this would be reviewed in the next strategic plan. children and 7 high schools for form 3 pupils The main challenge was on the workplans. The times they needed to visit schools could not tally with ours as we would be doing different activities or not going to the schools for other activities as determined by our approved 2009 Work plan. 1.3 HIV/AIDS workshops in the a) 2 x 1 day workshops for church 1 x 1 day workshop for 165 The first month of the second half was characterized community for selected stakeholders leaders in each ward = 240 in all wards church leaders in each ward by the Prisma Capacity Building Programme which had = 50% deadlines to be met. Could not complete this activity due to limited time. b) 3 x 1 day workshops for a total of 62 Not done = 0% The workshop could not be done before the training on teachers (2 teachers per school) Walking with Wounded Children. It was seen best to train the teachers on how they would work with children before having refresher courses. The previous years had witnessed a lot of staff mobility in the education sector and disruptions in schools. c) 2 x 1 day workshops for community 1 x 1 day workshop for 219 The other workshop could not be done due to time leaders = total 300 community leaders = 50% constraints since there were the Prisma Capacity Building Program workshops as well as the Mid Term External Evaluation exercise. Usually November and December are planting seasons in the communities, hence gathering people for workshops would mean more absentees 2.3 Palliative Care training for a) 2 x 1 day workshop in each ward for a) 1 x 1 day workshop in Same as above selected primary and secondary primary caregivers = 300 each ward for 291primary caregivers caregivers = 50% b) 1 x 2 day workshop on ARVs for 10 b) Not done. 0% Issue is still pending with the Ministry of Health community nurses at Morgenster Hospital 2.7 Provision of training and support a)300 ARV beneficiaries receiving 105 clients have benefited There are health education sessions done for the for ARV beneficiaries ARVs each month from the ARV roll out beneficiaries each time they come to collect their
10 supplies. It is at these sessions that they are educated on adherence, side effects etc 3.2 Psychosocial support camps in PSS 2 x 3 day camps for 720 pupils in 6 1 x 5 day PSS camp for 118 It is not feasible to hold a PSS camp with 360 children schools and communities for the wards ie 120 per ward children. 16% at one given time. Experience has shown that it is best infected and affected children to have a manageable number of 150 children at each PSS camp = 300. The other PSS camp could not be done in April holiday due to lack of cohesion in schools caused by remuneration disagreements in the civil service. 3.3 Provision of educational support School fees in the form of school Not done. 0% The school fees budget proved to be too little given the development projects for 1600 children amounts charged by the schools which are too high. 4.3 Meetings with volunteers for 1 bi-monthly one day workshop in each 3 x 1 day workshops for a The other workshop could not be done due to time training in relevant areas ward for a total of 130 volunteers total of 118 volunteers constraints since there were the Prisma Capacity Building Program workshops as well as the Mid Term External Evaluation exercise. Usually November and December are planting seasons in the communities, hence gathering people for workshops would mean more absentees 4.4 RCZ Church Ministers meetings 2 x 2 day workshops per year for 60 1 x 2 day workshop for 51 The workshop was scheduled for 4 – 6 December 2009. Pastors and their spouses Ministers, 30 spouses, 7 It could not be held because the school examination evangelists, 5 youth calendar was extended to 18 December 2009, hence the counselors and 30 MTC venues were occupied. students
ACTIVITIES
i) Baseline research in the wards
A baseline quality survey was carried out in all wards under the program to assess the impact of the programme’s activities. Such a survey greatly contributes to the designing of relevant future interventions by the program and also presented opportunities for the programme to monitor and evaluate its activities.
ii) Workshops for volunteers Workshop 1.
11 a) A one day workshop for volunteers was carried out in all the six wards and was attended by 113 volunteers. The topic was on co- operation.
Objectives of the workshop: To identify root causes of conflicts, the feeling of people involved and effects of poor cooperation To identify reasons for divisions or conflicts; in the home, in the family, in the community and at work places. To list practical suggestions of how to improve co-operation in these four places
Comments From the discussions, it emerged that poor cooperation can have damaging effects on people’s lives and also affects our performance as a programme and as volunteers. b) Workshop 2
A one day workshop for the volunteers on ART was carried out in all the six wards. It was attended by 109 out the expected 118 volunteers.
Objectives of the workshop To know the basic facts about ART To explain the benefits and common side effects of ARV To outline the role of the secondary caregivers in an ART programme
Comment It was at this workshop that the volunteers were taught about adherence, follow up of clients, pill counting etc
Workshop 3
A one day workshop was done for volunteers in all the wards. The main objective of the workshop was to assess their knowledge level on what they were taught about HIV/AIDS and ART issues.
Comment: From the results of the written test, 80% of the volunteers still remembered what they were taught.
WORKSHOP FOR AREA SUPERVISORS
12 Five bi-monthly two day workshops with area supervisors were held at Morgenster as part of the programme’s on-going monitoring and evaluation exercise.
Objectives . To get updates of orphan and patients . To ensure ongoing monitoring and evaluation of volunteer activities in their wards or communities. . On going training on areas such as, gender awareness, OI and ART
Gender Awareness
Objectives Understand gender and sex characteristics and gender based roles from family unit and the broader community structure. Understand the socialization process as a learning process that develops the value systems, roles, status, power that results in oppression. Analyse gender based behaviour at family unit level and the broader community and transform their perceptions. Understand the dangers of gender imbalance, stereo-typing and how that impedes participation of women in development. Understand cause- effect of gender bias using the “Problem tree Model” and develop recommendations for gender mainstreaming. Understand Zimbabwe’s gender policy and examine its practical implementation by Government and non Governmental Organisations.
During the discussions, it was observed that; In Education, the girl child is segregated while the education of the boy child is a priority and schools administration is done by men In the Health sector, women dominate service delivery, and women tend to utilize health services more than men. Community projects are usually run by females but land ownership is dominated by males Agricultural production’s labour force is derived from females but males control the utilization of the produce. In Church, membership is largely dominated by women in terms of numerical visibility but power is vested in males In the political arena, males dominate despite the adoption of quarter systems and women’s league Formal employment is dominated by men.
Conclusion
13 The one day awareness workshop was an eye opener to most participants. Although the term gender was familiar, it was taken for granted but after the training, it induced a high level of self- awareness. The demand for further training and the opinion for the inclusion of their spouses in similar trainings strongly indicated passion and commitment to live a changed and gender sensitive life.
OI and ART – Training for Area Supervisors
The topic was covered during a workshop with area supervisors in preparation of the ARV rollout programme. They were empowered on how they would mobilize clients who are on ART to utilize the rollout programme. The move to take ARVs to the communities was a welcome development. This would be started at the beginning of September 2009. CBAP in partnership with Morgenster Hospital will kick start the programme at three strategic centers where CBAP is operating.
The ARV roll out programme was commenced on 1 September 2009. To date there are105 beneficiaries and there are four centers. All the wards covered by these four centers. Health education sessions are held at each visit and issues like adherence, counseling, reports of side effect are discussed. Area Supervisors and volunteers were trained on adherence, tracing and defaulter follow ups. Since the commencement of the ART programme, no defaulters have yet been recorded.
Workshop for church leaders
A one day workshop for Church leaders was held in all the six wards under the programme. A total of 165 participants attended the workshops
Objectives of the workshop To be able to share with different Churches on what they are practically doing to help OVC and people living with HIV and AIDS. To be able to facilitate a caring and compassionate response to the needs of people living with or affected by HIV and AIDS by explaining the counseling pastoral needs of HIV infected/ affected people in each phase of HIV infection To be able to share /positive messages from the Scriptures as guiding principles for their response to HIV and AIDS.
Impact assessment
From previous workshops, an impact assessment was performed to check weather Churches are practically assisting OVC’s and those infected and affected by HIV/AIDS.
14 The following were the responses from different Churches: Provision of food and clothing to orphans and patients Visitations and prayers Undertaking household chores Ploughing and weeding for the sick and orphans Encouraging responsible living Assist with hospital fees and in some cases with school fees Thatching houses
The Church leaders were encouraged to continue with the good work they were currently undertaking in their respective Churches.
Christian Guiding Principles
The following Guiding Principles were discussed basing on several Biblical references Our responsibility: To break the silence by speaking the truth in love Our attitude towards people: To accept as Christ accepted Our motivation: Compelled by the love of Christ Our service: Serving God in practical acts of love and compassion Our identity: We are the body of Christ Our search for answers and solutions: With wisdom m of the Holy Spirit Our task: To be Christ’s ambassadors Our hope: To believe is to have hope Our relationships: To uphold the dignity and worth of every human being
Spiritual Care and Counseling for a person with HIV and AIDS
The discussion centered mainly on the emotional experiences, human needs and Christian or spiritual counselling needed by a person infected by HIV/AIDS through the whole disease process, from diagnosis, asymptomatic phase, symptomatic phase, full blown AIDS (serious illness) terminal phase through to bereavement.
15 Comment The topics covered at this workshop were an eye opener to most of the participants given that they were delivered from a Christian perspective fulfilling one of CBAP’s co values
RCZ SPIRITUAL WORKERS AND THEIR SPOUSES HIV/AIDS WORKSHOP A two day workshop for RCZ Church Ministers and their spouses was held at Morgenster on the 11th and 12th February 2009. A total of 51 Ministers, 30 Ministers’ spouses, 7 evangelists, 5 youth counselors, 30 students from Morgenster Theological College and 7 facilitators.
Objectives of the Workshop 1. To appreciate the following about counseling: Goals, types, elements and benefits of counseling Components of a good counselor as well as the dos and don’ts in counseling Counseling techniques Pre-test, Post-test and Pre-Art Counseling Child Counseling Pastoral counseling 2. To understand the Church’s involvement in HIV/AIDS issues through the Christian Guiding Principles. 3. To understand what networking is and the benefits of networking in communities. 4. To have a better understanding of Lobby and Advocacy and then incorporate it in congregations. 5. To understand the importance of having an RCZ HIV/AIDS policy.
The workshop yielded some positive results given what was agreed upon at the end of the workshop. It was agreed that congregations would start forming support groups in their respective congregations. Congregations would continue networking with other stakeholders such as the health sector in order for them to get up to date information in as far as HIV/ AIDS issues are concerned. Participants were tasked to go and look at issues to do with the RCZ HIV/AIDS Policy and send the policy report and progress reports from the workshop at the end of May 2009.
Despite the fact that reports have not been submitted it is pleasing to note that some congregations in wards under CBAP have successfully formulated vibrant support groups with assistance from CBAP staff and local Health Centers.
16 Workshops with Headmasters a)Workshop 1
The workshop for headmasters was held in all wards. A total of 28 Headmasters attended the workshop. The Headmasters expressed their concern towards the delayed payment of fees, examination fees and stationary for the OVC under the programme.
The heads were also encouraged to also seek ways of assisting these OVC through engaging in dialogues with the communities so that they realize their responsibility to look after the needy and the vulnerable in their communities and not to rely only on donors.
The Programme managed to pay examination for 64 and 2 ‘O’ and ‘A’ level students respectively. This move was applauded by the heads, teachers and guardians, considering the examination fees had been pegged beyond the reach of many. b) Workshop 2 A three day workshop on Child counseling was held for all the Heads in the six wards at Morgenster. A total of 29 out of the 31 Heads attended the workshop.
Objectives of the Workshop
To demonstrate the understanding of the concept “healing”. To acquaint participants with information on “walking with wounded children” To discern what God purposed for human creation. To provide tools for children workers on how to assist children. To update and discuss on school fees issue.
The issue of non payment of school fees was also discussed at length in a bid to explore possible ways of assisting orphans and vulnerable children in schools. They promised to encourage the caregivers during their SDC meetings to pay the fees.
Workshop for Teachers
A five day workshop on Walking with Wounded Children was done for twenty selected teachers from all the six wards covered by CBAP. The workshop was carried out at Morgenster.
Objectives of the Workshop
17 To equip teachers with counselling skills To discern what God purposed for human creation To provide assessment tools in order to assist traumatized children.
The workshop was an eye opener to most of the teachers who had no training in counseling before. With the knowledge and skills they acquired, they promised to work with children better. Previously, they were not able to handle some cases of abuse as they had no knowledge and skills of dealing with such cases.
Home Based care
Home based care kits were replenished on each quarter. These boxes are kept at clinics and strategic schools (in cases where the clinic is too far away) where volunteers can easily access them. Stocks were adequate throughout the period under review
The programme’s main funding partner, Oikonomos Foundation, the Netherlands, assisted in the procurement of drugs through Morgenster Mission Hospital. The stocks were beefed up by 40 HBC kits. This greatly relieved patients since drugs and other necessities were beyond reach of many in terms of availability and affordability. The HBC kits were used effectively and efficiently to the benefit of the patients under the programme’s HBC as well as prevention of cross infection since the kits also have protective items like gloves. Co-trimoxazole was also distributed to clinics only where they could be distributed by the nurses to clients with opportunistic infections.
ARV ROLL OUT The ARV roll out which commenced on 1 September 2009 has been one of the Programme’s outstanding objectives. It resulted in the increased co-operation between Morgenster Mission hospital’s Opportunistic Infections clinic and CBAP. The accessibility of the ARV in the four centres has resulted in the reduction of defaulters and HBC clients. ARVs are initiated at the Morgenster Mission Hospital where clients are admitted at the ART and TB ward for 2 weeks. If they do not develop side effects they are then discharged and given clinic review dates. Clients who develop side effects which cannot be managed by clinics will come back to Morgenster Mission Hospital.
Review of clients discharged is done on a monthly basis by CBAP and sometimes together with nurses from the OI clinic in the four centres now in operation. Health education sessions on each visit are done and they cover issues such as adherence, possible side effects. These sessions are also covered during the pre ART counselling sessions done at the hospital. There has been a gradual increase of clients since the ARV roll started in September. A mechanism to trace and follow up defaulters is already in place.
18 Volunteers have been trained on ART are responsible for making follow ups. It is heartening to note that since the roll out started, no defaulters registered.
Support groups The Anti-Retroviral Treatment has resulted in the decrease of stigma and discrimination among the infected and the affected. There has been an increase of people going for Voluntary Counselling and Testing at the centers where CBAP is distributing ARV drugs. Most HBC patients are no longer bed or housebound. To date there are 18 support groups which have been formed which include the affected and the infected. In these groups people are free to express their feelings and share personal experiences in their fight against HIV/AIDS. In ward 24, members from the support groups managed to help each other to plough and weed in members’ fields and this helped on group cohesion and support.
One pastor, Rev Chikuku in ward 25, managed to mobilize people in his area and formed support groups after attending the RCZ Pastors workshop facilitated by CBAP.
Internal savings and Lending Scheme Soon after the credit scheme facilities training in June, the 39 volunteers who were trained cascaded the knowledge in the communities and they formed groups. So far there are 32 groups. The volunteers were empowered through this scheme and some groups have success stories to tell. They managed to buy household goods for each other such as blankets and cooking pots, something they could not have done as individuals.
Orphan Care and relief During this period children in schools under the programme did not receive educational support in the form of school fees and stationery during the first and second terms as had been the case in the past years. This was due to the shortage of funds which came about as a result of the dollarisation system.
There is an imminent increase in school drop outs by OVC’s due to shortage of funds. However, the communities are being empowered and encouraged to assist the orphans as much as they can.
A total number of 270 needy orphans received a 10kg maize meal each from Oud Beijerland. The children and their caregivers appreciated this kind gesture, given that maize meal was in short supply during the period under review. They commended the programme for giving them the mealie- meal to boost their morale and nutritional status.
A total of 110 children received jerseys while 31 children benefited from the sewing project and got uniforms.
19 A total of 640 needy orphans received a 5kg bag of maize seed each as part of food security. The maize seed came through Morgenster Mission Hospital from GZB
Psycho Social Support Camp A five day psychosocial support camp was held in ward 16 at Zivezano Secondary School. 118 children from all the six wards under the Programme attended the camp. The main objective of psychosocial support camps was to equip children with life-skills so that they are able to cope with the various life challenges they could encounter in their life journeys.
TOPICS COVERED Life is a Journey Stress Management Team Building Children and ART Self Image Family & Communication/Friendship Formation Tree of Life Personal Hygienic Approaching Adulthood/Sex: Delight or Disaster
At this camp, an officer from Scripture Union facilitated on some of the topics. The presentations were quite relevant to the children’s life experiences and challenges. The camp created a good opportunity for the children to learn, while at the same time, showcase their talents in poetry, drama and music.
Highlights of the Annual Participatory Review meeting A one day Annual Participatory Review meeting was held at Muchibwa school. It was attended by 30 stakeholders who included community members, caregivers, People Living with HIV/AIDS, teachers, orphans, headmasters and church leaders. The participants commended that CBAP was doing a sterling job in the communities and the quality of life of orphans and vulnerable children as well as patients has improved. They also indicated that the ART roll out programme has also seen those Home based care patients
20 improving and managing to carry out community activities. The participants were not happy with the non payment of school fees by the programme and the volunteers felt that they had few workshops.
Recommendations from the participants included the following: That volunteers be given bicycles since some travel long distances to see clients Payment of school fees in the following year More volunteer workshops Transport for patient traveling to and from Morgenster hospital The topic on ART to be included at church leaders workshops since some churches forbid HIV patients to take ARVs as some claim to have powers to cure the virus.
Activities in RCZ
Women’s League The Programme Officer was invited to give presentations at women’s meeting in Masvingo congregation. The CABSA’s Churches Channels of Hope Manual was used to prepare the presentations. The presentations mainly aimed at: Positively changing the attitude of church members towards PLWHA. Fighting stigma in the church. Formation of support groups. HIV/AIDS transmission and prevention A support group was formed in Masvingo RCZ congregation after the presentation.
The RCZ National Youth Conference The Program Coordinator was one of the speakers at the RCZ National Youth Conference held at Zimuto Mission on HIV/AIDS on 23 -27 December 2009. The youths who attended were over 1000. The presentation showed that the youths need more facts and information on HIV and AIDS as stigma and discrimination are still rife amongst church members. The Coordinator emphasized that the church has to be inclusive, compassionate and embrace the one body mentality as reflected on 1 Corinthians 12 verses 12 - 31. Youths were challenged to take pride in knowing their status so that they live positively and responsibly. It was also reiterated that HIV and AIDS were in our church and even among them as youths hence our collective responsibility to make churches channels of hope. It was really touching when the Moderator Rev Dr Chomutiri gave his testimony on testing. He told the youths that he got tested despite his age at one time when he got sick in South Africa when commenting on the presentation by the Coordinator. It was fascinating to note that talk of HIV and AIDS on church gathering is no longer taboo in the RCZ church.
21 AIDS Awareness The topic on AIDS awareness was included in every HIV/AIDS workshop of CBAP.
Monitoring and Evaluation The following strategies contributed towards effective and efficient monitoring of the programme activities: Baseline surveys. Meetings with area supervisors. The spot visits or checks at schools and in the communities. Stakeholders’ evaluation of the programme at the end each workshop OVC and HBC register updates.
A motor-cycle was purchased to assist the monitoring and evaluation process. It is highly anticipated that the motor cycle would add value to the work of CBAP.
Mid Term Evaluation A Mid-Term evaluation was carried out in all the six wards operated by CBAP. It showed that the programme is relevant, efficient and effective as proved by the External evaluation report. The final report made various recommendations some of which would be implemented this year. The actions plans on the recommendations are part of the workplan for 2010.
Highlights of the baseline research The research overally reflected that there was improvement on the attitude of the community members towards orphans and HBC patients. The patients and orphans reported improved care and support from the caregivers and community members.
Community members
Most of the respondents were between18 and 50 years. Most of the respondents were married females. This is usually due to the fact that females would be at home whilst most males would be at work in urban areas or the neighboring countries such as South Africa and Botswana. Majority of the respondents rely on farming as their sole means of survival The majority of the respondents attained primary education.
22 10 to 35% of the respondents are caring for HBC patients, an increase of 16% from the last analysis However, 80% to 90% of the respondents are willing to care for HBC patients. There has been an increase of 2% which shows that more people are willing to look after HBC patients
Patients In June 2009, research results reflect that most respondents are either married or windowed with very few either single or separated. In ward 16, 42% are married whilst 45% are widowed, 40% widowed in ward 22 and 52% married. Wards 23 have 40% married and widowed, ward 25 has 32% married and widowed. 40% to 70% of patients in June relied on others for assistance. However, ward 23 has 70% who rely on farming because there is an irrigation scheme in ward 23. 60% to 90% of the patients are being cared for by relatives 20 % of the patients are not well cared for. There has been an increase of 11% from the previous analysis. As a result of the dollarisation, most families are now very poor such that caring for a patient would be another burden.
Orphans The three main caregivers are grandparents, aunts/uncles and brothers/sisters. Between 5 and 25 % are getting some assistance from the church there has been an in crease of 10% from 2008 analysis. This has been a remarkable achievement for the Programme whose continued emphasis on orphan care has realized an improvement as compared to 2008 when only 2% to 15% reported that they are well cared for. 79-83% of the respondents reported a positive attitude from the community. The attitude of the community is improving as compared to the previous research analysis. This has been as a result of CBAP Programmes in the communities.
Churches The Church’s perception of HIV and AIDS is that it is just like any other disease. 60% to 100% regard it as any other disease and only 20% to 40% regard it as punishment from God. These responses were from ward 31 and 25 respectively. The Church continues to support HBC and OVC. There are some activities taking place on HIV/AIDS prevention and support of HBC and OVC. However, there are more of prayers and Biblical teaching than practical support to HBC patients.
Secondary school Children; Sexual behaviour The majority of pupils reported that they abstain from sex. 20% to 35 % of those who are sexually active use condoms to prevent themselves from contracting HIV/AIDS, STI’s and pregnancy.
23 However, it was noted with concern that HBC patients faced problems which included food shortages, lack of transport to major hospitals, drug shortages. OVC are also facing problems which include shortage of school fees and stationary due to the fact that the programme could not afford as a result of the dollarisation system which was adopted by Zimbabwe at the beginning of 2009.
Cooperation with others During this period, the CBAP experienced splendid and beneficial cooperation with local regional and international organizations. CBAP regularly networked with other organizations in the field such as Care international, RUDO, Scripture Union, NAC, DAC, Hospaz, ZAN, Diocese of Mutare Community Care Propgramme St Peters Community Care Programme, CAT, FI and many other regional and international organizations during workshops training and exchange visits This has greatly added value to the Programme’s experience, expertise and knowledge base.
The Prisma CBP also yielded very encouraging positive results with regards to networking which include among others, the formation of a Coalition of Prisma Associate and Anchor partners in Zimbabwe working on Child Advocacy. These organisations are: Scripture Union, Christian Aids Task Force, Family Impact, ZOE and the Reformed Church in Zimbabwe Community Based Aids Program. Also involved in consortium (but not a partner member of PRISMA) is, the Christian Legal Society. These organisations await responses for their proposal to potential funding partners for financial support on Child Rights issues.
It is also worth mentioning that the Program Coordinator was requested to facilitate on a workshop for parents by Scripture Union officials in Masvingo Civic centre as part of the close networks established over the years. The topic was on handling a wayward child. The participants were fascinated to note that some of the children who are regarded as wayward are in actual fact traumatized and need support from the systems or people surrounding them instead of blames and labels only.
Exchange Visits Two exchange visits were made to St Peter’s Community Care Programme in Checheche in Chipinge and Murambinda Hospital. The exchange visits provided a platform for learning and sharing experiences from each other.
The 2009 Prisma ‘Result Appointments The 2009 Prisma 'result appointments' are as follows:
Output: 15 Support Groups formed in all the 6 wards under CBAP. Outcome: 80% of the Support Group members do not feel stigmatized.
Output: CBAP offers good support to orphans.
24 Outcome: 90% of the orphans under the Programme well cared for.
Output: CBAP staff has a final workplace policy in 2009. Outcome: All CBAP staff members infected by HIV are covered by the workplace policy.
Output: CBAP offers good care for the target group. Outcome: The percentage of HBC patients well cared for is at least 95%.
Output: The ARV program is started. Outcome: At the end of 2009 a number of 150 beneficiaries in CBAP working area are provided with ARV’s. At least 45% of the beneficiaries are women. Achievements and Explanations on the Outputs in this period.
Output 1 18 support groups formed in all the 6 wards under CBAP. Stigmatization is now reduced.
Output 2 CBAP offers good support to orphans 50% to 70% of orphans are well cared for. However CBAP has not been able to pay school fees for the OVC under the programme. However examination fees were paid for O and A level students.
Output 3 CBAP staff has a final workplace policy All CBAP staff are encouraged to know their HIV status.
Output 4 CBAP offers good care for the target group. 78% to 100%of patients reported that they are well cared for. Output 5 The ARV roll out program in partnership with Morgenster Mission Hospital commenced on 1 September 2009. This was well received in the communities.
By December 2009 105 clients are receiving ART in the four centres under CBAP.
STAFF
Staff Development Programmes
25 Name and Designation Staff Development Programme Attained or Attended. Program Coordinator Completed successfully all the subjects for the Master of Business Administration with the MANCOSA (Samuel Mhungu) and now working on a Research Project focusing mainly on Business and Professinonal Ethics. Attended an insightful Prisma Capacity Building Programme Conference in Johannesburg (South Africa). Attended a Prisma Project Proposal and Report Writing workshop in Bulawayo (Zimbabwe). Attended an HIV and AIDS Training of Trainers Workshop for Church Workers by the ZCC. Programme Officer Has successfully passed her practical and theoretical examinations in Ststemic Counselling with (Maria Kujinga) CONNECT. Currently working on her final chapters of the Project. Attended a Prisma Conference in Johannesburg (South Africa) Attended a Prisma Project Proposal and Report writing workshop in Bulawayo (Zimbabwe) Attended the Child Advocacy Stakeholders Consultation workshop in Bulawayo Attended the CABSA Refresher meeting in Bulawayo
Field Officer Attended an educative Hospaz training of trainers on Palliative Care Standards (Samuel Mafa) Has successfully passed his practical and theoretical examinations in Ststemic Counselling with CONNECT. Currently working on her final chapters of the Project. Currently working on his final chapters of the Project. Attended the CABSA Refresher meeting in Bulawayo Attended the Advocacy meeting for Children’s ART
Accounts Clerk (Gladmore Manemere) Wrote her final examinations for the first year National Diploma in Accounting at Masvingo Polytechnic College where she attends evening classes on part-time basis. Now she is in her final year. Attended a one week training on Excel in Mutare (Zimbabwe).. Typist Is working on her final chapter of her Systemic Counseling project in partial fulfillment of the (Tamari Zishamba) CONNECT requirements. Attended a Records Management and Typing Skills training General Hand Benefited all the Prisma CBAP which involved all the CBAP staff. (Muchuva Machando) Office Volunteer Benefited from most of the Prisma CBAP since he joined the programme in April 2009. (Tivaone Matambo)
26 NB. It is important to also to note that other than the above mentioned staff development programmes, there were other training and staff capacity building programmes funded by Prisma which have been alluded to in this report.
Appendix
Statistics Ward 16 Ward 22 Ward 23 Ward 24 Ward 25 Ward 31 Total No of OVC Females 222 193 92 60 76 74 717 Males 225 173 115 62 112 112 777 Total 447 366 207 122 188 188 1494
No of dropouts Females 8 16 5 2 11 3 45 Males 21 11 8 9 18 8 75 Total 29 27 13 11 29 11 120
No of Volunteers Females 20 17 14 9 10 13 83 Males 2 6 6 9 8 4 35 Total 22 23 20 18 18 17 118
No of HBC patients Females 31 75 20 16 35 16 193 Males 12 52 13 14 25 10 126 Total 43 127 33 30 60 26 319
* It is with regret that one of the volunteers died during the reporting period.
Donations See attached detailed Financial Report for the year 2009.
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