Proposal for the AIDS Foundation 2002

WOZA MOYA PROJECT
HIV/AIDS COMMUNITY CARE AND SUPPORT PROGRAMME

1. Introduction

This proposal is to secure funding for a 12 month period, from April 2002 to March 2003. The Woza Moya project is presently being supported by donations from the Buddhist community in San Francisco, USA and the UK. This community care programme will focus on Home Based Care, Orphan intervention, Health Education and Poverty Alleviation.

The Woza Moya project is currently in the training / implelentation phase of the project. The recruitment and mobilisation of the volunteer team is complete. See list of Care Givers in Appendix 1. The training of the volunteer team is in process right now. The planning , preparation and production of a survey is also complete. See Appendix 4 for survey. The volunteer team began conducting the survey in the second week of October. This was completed in December. Once the initial phase of the training has been done, the focus will be on coordinating the smooth implementation and running of the Home Based Care programme, in the Chibini community.

Professor Linda Richter of the Human Sciences Research Council and Vuleka Productions have recently come - through the Woza Moya project - to work on their own project in the Chibini community. ( See appendix 5 ).

The Woza Moya project is operating from the Buddhist Retreat Centre which is well placed to make a difference in the HIV/AIDS struggle, in the Ndlovu region of KwaZulu - Natal. The Buddhist Retreat Centre has been in existence here since 1980 and has built up a good reputation amongst the local community.

2. Identification of the Need

The levels of unemployment are extremely high in the Chibini community. There are no telecommunications or electricity and the main source of water is still the river and bore holes. Most people live in traditional style homes made of mud and thatch, which often have problems, like walls collapsing during the rainy season. The area was badly affected by political violence from the late eighties through to the nineteen nineties. This resulted in considerable loss of life, displacement of people as they fled certain areas to avoid attack, the disintegration of families, orphan hood, the death of breadwinners and increased levels of poverty.

This situation made this community particularly vulnerable to HIV infection and the impact of the disease. At a time when people had to face a daily struggle to survive, they were not particularly concerned about a disease that might kill them in ten years time. Their immediate needs, such as food and shelter, were far more relevant. For these reasons early attempts at HIV/AIDS education were not very successful in this community.

Preliminary visits to various homes in the Chibini community have revealed many households that are struggling to cope with the impact of the disease. The most common problems encountered by families affected by the disease are:

• The lack of accessible and affordable treatment
• Caring and nursing the terminally ill
• Orphan hood
• The loss of a breadwinner and increased levels of poverty
• Psychosocial trauma, stigmatism and bereavement

3. Aim of the Programme

The aim of the programme is to strengthen support services within the community to enable them to care for the sick and dying and also to support those left behind in an effective and sustainable way.

Specific objectives:

• Mobilise and organise target community so that they are able to adequately respond to the issues of care and support.
• Training and equipping the volunteer team to deal with tasks such as:
  • Home based care
  • Bereavement counselling
  • Community fostering and care of orphans
  • The provision of skills training to affected households as a means of poverty alleviation.
  • Advocacy & Lobbying: Lobby government departments, health & welfare, around issues of treatment and care and social grants for orphaned children. Challenge pharmaceutical industry to make treatment affordable to those worst affected by the epidemic.

  4. Proposed Intervention : Specific Services

  Woza Moya is of the belief that if AIDS interventions in communities are to succeed and be sustainable they need to be rooted in the target community and run by local people from that community. This ensures that intervention will be low cost and will not be reliant on large supplies of outside resources. It also ensures that the nature of the service provided is in keeping with the local culture and norms of the community.

  For this reason Woza Moya does not see it self as the provider of services at local level within communities. Instead Woza Moya sees itself playing a facilitating role and providing technical assistance and support to the volunteer team in the Chibini community.

  4.1 Mobilisation & Organisation of Community

  The first step of the programme has been to mobilise the target community to respond in an organised way to the effects of the epidemic. Meetings were held with local parties such as: tribal and civic leaders, community groups such as women's clubs and church groups, teachers, the clinic, hospital and social welfare authorities and other NGO's and CBO's in the greater area.

  The purpose of these meetings was to assess what was currently being done by the various parties in response to the problem and to brief them on the Woza Moya project's AIDS care and support programme.

  Lessons learned from elsewhere in Africa suggest that concerned members of the community, usually volunteers, be organised into a team to respond to the problem. Woza Moya proposes to facilitate the process whereby volunteers will be organised into an AIDS action team working in home based care.

  4.2 Training and Building Capacity Within the Community

  Woza Moya will facilitate the training process and utilise the services of other NGOs and agencies that have built up expertise in the respective fields. Following the establishment of the community AIDS action team, the team is being trained in these areas listed below. This course focusses on the care and counselling aspects of the programme.
  • Understanding HIV/AIDS and the progression of the disease
  • Lay counselling skills, including deathbed and bereavement counselling
  • Basics of home based care - caring for the sick and terminally ill
  • Treatment of Opportunistic infections and symptom control
  • Orphan care
  • Networking and referrals
  • Approaches to poverty alleviation
  Jabu Molefe from the Health Department in Pietermaritzburg, ran a 3 day workshop on HIV/AIDS. Two Zulu speaking trainers from Community Development and Outreach Project, in Pietermaritzburg, have done a 3 day counselling course with the volunteer team. ( A more comprehensive counselling course will be offered at a later stage. ) Sister Mseleko, from the Ixopo clinic, has run a 5 day Home based Care programme with the volunteers.

  Jabu Malinga, the social worker in Ixopo, for the Chibini area and Bonginkosi Magoso from the Social Securities in Ixopo, introduced the volunteer team to the Social Welfare Department and gave an overview of all the pension schemes. Jabu's input also touched on orphan care and community fostering. Jabu expressed strong interest and support for the project and offered to do regular and various workshops with the volunteers. Sue Hedden ( project coordinator ) and Jane Nxasana ( senior care giver ) attended a 3 day training workshop on orphan care and fostering, with Thandanani.

  The final stage of the training will focus on poverty alleviation. Woza Moya will arrange for selected people from the AIDS action team to be trained in the development of food gardens. The trained members will then serve as advisors to affected families wishing to establish food gardens. This part of the training will be facilitated by the Valley Trust and and will run for a period of 3 days.

  4.3 Deployment of Volunteers

  Once the volunteers have been trained they will be deployed in the community. The volunteers have already organised themselves into working pairs, each being responsible for about 15 - 20 families; together for 40 homesteads. See Appendix 3 for Family Allocations. The volunteers are presently doing prelimimary visits with their assigned families. Each care giver will be supplied with a home based care kit and will also receive technical support from the coordinator of Woza Moya.

  The only form of payment to the volunteers will be for out of pocket expenses, such as taxi fare. The services of this local AIDS action team will be advertised through the local clinic, hospital, welfare department, churches and community structures, thereby ensuring that the community know how to access the services of the AIDS action team.

  The volunteers will serve as community care workers and will be tasked with the following responsibilities:

  • Home visits to the sick and terminal AIDS patients: care workers will be supplied with basic care kits and will advise and assist family members to care for sick AIDS patients. The care workers will not be expected to provide daily care for patients. This is the responsibility of family members. The volunteers will act in a supportive role, advising and teaching family members how to care for the terminally ill. Care workers will also liase with the local clinic to source nursing supplies and medication for the patients. In certain instances cases will be referred to Christ the King Hospital for symptom control, pain relief and respite care.

  • Counselling: Care workers will also be tasked with providing deathbed counselling to terminal patients and bereavement counselling to family members.

  • Identification of orphans and other vulnerable children: Home visits to attend to sick and terminal patients will provide the care workers with an opportunity to identify children soon to be orphaned. Care workers will be expected to discuss the future of the children with family members, so to ensure plans are put in place to care for children before the parent dies. Care workers are also expected to come across children whose parent/s have already died. Care workers will be required to refer all these cases to the local welfare authority. It is recommended that a local child care committee be established in the area to assist the welfare authorities in identifying orphans and other vulnerable children, recruiting foster potential parents and ensuring such children are not abused or neglected once placed in foster care. The formal foster care placements and grant applications will be handled by the welfare authorities as this is a statutory requirement.

  • Poverty alleviation: Care workers will identify families experiencing poverty and will refer such cases to those volunteers trained in the development of food gardens. Affected families will in turn be given advice and guidance on how to develop food gardens. In certain cases immediate relief will be sought from NGOs and CBOs providing such assistance.

  • Coordination and feedback: Care workers will meet as a team every two weeks to report back on work undertaken, progress made and problems encountered. The coordinator of Woza Moya will be responsible for collating data received from the care workers and will take up any problematic issues with the relevant parties.

  4.4 Advocacy and Lobbying

  Experiences from elsewhere in Africa and South Africa highlight that while community based care and community fostering are regarded as best practices in dealing with the problems of caring for the terminally ill and orphaned, these approaches are not with out their problems.

  It will be the responsibility of Woza Moya to take up these problems on behalf of the target community and the AIDS action team. Woza Moya will have to lobby and work closely with the relevant authorities and stakeholders in respect of the following:

  • Nursing supplies and basic medications to treat opportunistic infections and for symptom control: work closely with clinic and hospital to ensure patients and care givers are able to access such supplies.

  • Legal documents: work closely with Home Affairs to ensure that persons affected are able to obtain copies of relevant documents such as birth certificates, identity documents and death certificates for the purposes of applying for social welfare grants.

  • Orphan care: work closely with Department of Social Welfare to ensure that grant application process is made user friendly and that social workers process foster care efficiently and timeously.

  • Department of Education: work closely with the Department of Education to ensure that orphans or children whose parent/s are ill with AIDS are not denied admission to school because of their inability to pay school fees.

  • Treatment Action Campaign: work closely with this NGO in an effort to make treatment more affordable and accessible to people living with HIV/AIDS.

  • AIDS Law Project & Lawyers for Human Rights: work closely with these NGOs to ensure the rights of people living with HIV/AIDS and their families are not violated.

  5. MONITORING & EVALUATION

  Woza Moya will be responsible for monitoring and evaluating the programme. Community care workers will be required to keep log sheets of all visits undertaken and cases handled. This data will be gathered every two weeks and collated by the coordinator of Woza Moya.

  Community care workers will be required to commit themselves to set number of hours per week - this will be decided in consultation with the volunteers.

  The coordinator of Woza Moya will do occasional random visits to homes of those visited, to discuss the quality of home visits made by the care workers. These visits will assist with the evaluation of the efficacy of the home visits.

  Records will also be kept of orphan cases handled and progress made in processing of social grants and admissions to schools.

  Data will also be kept in respect of poverty relief interventions.