Let’s Celebrate – Edzimkulu programs approach sustainability.

Thank you! When Edzimkulu was established eight years ago our goal was to move from aid and development to sustainability. We are standing on the threshold of realizing that goal. We are deeply grateful to the Friends of Edzimkulu who have participated in small and large ways on our journey.

As you know eight years ago we were driven to make a difference in Ndawana, South Africa. Our focus included health and education, with a sustainable health care initiative being our highest priority. Today Ndawana is home to a fully functional clinic facilitating over 1,200 patient visits per month. We are leaders in the United Nations Integrated Management of Childhood Illness (IMCI) initiative, having been recognized as the single best model in all of South Africa for early intervention with children under the age of two around HIV, TB, malnutrition, diarrhea and pneumonia through home based care. Ninety percent of mothers in our program who are HIV positive are now accessing treatment and their babies are being tested for HIV.

Sustainability has always been our goal and to that end we are in the final stages of making all our programs and services sustainable. It is our intention to transfer our health care programs and clinic operations to the KwaZulu-Natal Department of Health (DOH) and our training programs to TB/HIV Care, a South African NGO, on April 1, 2012.

We have already reached our goal of sustainability in the following areas: 

• The Department of Health and TB/HIV Care have absorbed 29 of our 31 employees;
• The health clinic is now an official government recognized South African clinic with a budget of R 2.1 million ($300,000 Canadian);
• Large scale gender justice and HIV education, counseling and treatment programs are in place, so positive attitudes and practices will continue to grow;
• Our preschool continues to provide early education and nutritious meals to local children. The South African government is now funding the teachers’ salaries and progress is being made toward long term funding.

Eight years ago we began the journey to assist the orphans of the HIV pandemic in Ndawana. Initially we were providing food packages including items like rice, powdered milk, oil and candles to over 200 orphans. We have now successfully obtained the appropriate government support for all but 62 of them. Sadly these are the children who have fallen through the government cracks with support being highly unlikely for reasons such as parents dying and no death certificate being issued. Without a death certificate it is impossible to prove that the children are actually orphaned. The estimated amount required to continue to provide basic food packages for these orphans until they finish high school is approximately $45,000 in today’s currency. We have not yet attained sustainability for this program but are working on a strategy for securing ongoing support either in South Africa or from Canadian sources.

As we draw nearer to our end date our hard work continues. This year’s projects include:

• Construction of a clinic waiting room that is designed to minimize the spread of infectious diseases, especially exposure to TB, which is a serious health threat to anyone with HIV;
• Addressing the crucial issue of housing for nurses with the construction of a nurse’s residence, which in turn assists in attracting nursing professionals to the community;
• Important new work in the area of gender equality as it relates to HIV prevention.

With these programs completed by spring 2012, we can transfer responsibility for our programs confident that the legacy of Edzimkulu will continue in the very capable hands of those entrusted to complete this work. Although Edzimkulu will officially wind down in the spring of 2012, our founders Jim and Chris Newton intend to continue a part-time presence in South Africa helping to ensure our sustainability goals.

While Edzimkulu is an amazing success story, the transfer to the Kwazulu-Natal Department of Health and TB /HIV Care on April 1, 2012 will be very emotional for all involved. Friends of Edzimkulu can feel very proud that we have accomplished what few NGO’s ever manage.

So again we say “Let’s celebrate!” You have been a part of a major success story in assisting the community of Ndawana and far beyond its boundaries to experience the caring and compassion of a community of friends half way around the world. Together we said, “we see you,” “we hear you” and “we care.”
Together we have Changed Lives.

With sincere thanks and gratitude,
The Board of Directors,
Edzimkulu A Society for Children of AIDS
Ngiyabonga – Thank you

 

New Waiting Room

Here are some photos of the almost finished new waiting room at the Ndawana clinic. It will be a great space and should be completed any day now!

A new waiting room was required because tuberculosis has become an increasingly serious problem globally but especially in countries most impacted by AIDS.  Up to 50% of HIV positive people are co-infected with TB.  Poor adherence and lack of support structures have resulted in many strains of TB are becoming resistant to front line drugs available for treatment.  While TB is relatively easy to treat once diagnosed, multi-drug-resistant (MDR) TB requires hospitalization and separation from other patients because it often kills. We now have MDR in Ndawana, and the likelihood of more MDR there is likely.

Our current waiting room was small and had little airflow because there was no cross-ventilation and there are only three windows.  Up to 60 patients sometimes wait in an area the size of an average bedroom.  Consequently, to protect patients (and staff and volunteers) from becoming infected with TB, the new waiting room with maximum possible cross-ventilation, because TB is airborne.

The room will be five times as large as the current waiting room and will have a total of 39 opening windows, on all four sides.  The waiting room will be connected to the other two clinic buildings, so that patients and staff will no longer have to go out in the cold or rain to move from one building to another. 

We are looking forward to this new space!

Gender Justice Training Expands to the Sisonke District

Gender inequality is an important factor in the spread of HIV. In Ndawana we have taken on this issue by training selected people in the principles of gender equality, then as facilitators, and then conducting a program called Stepping Stones with all Edzimkulu employees. Following that, we conducted the same program with Ndawana teachers.  The response from both groups was overwhelmingly positive.  The Stepping Stones program has been used in a number of countries, and we are using a version written especially for South Africa. The program is used to educate and train people in gender, HIV, communication and relationship skills through dialogue. It is essentially a life skills program that teaches participants why we behave in the ways we do, how gender, attitudes and beliefs influence this, and ways in which we can change our behaviour, if we want to.

Now we have been asked to expand this program into the entire Sisonke District (500,000 population).  That program will begin in late November, with training of facilitators from an organization called TB/HIV Care and from the Department of Health, then conducting Stepping Stones, first with 100 TB/HIV Care employees, then with all the clinics in Sisonke, about 1000 people, and eventually with community members throughout the District.  

Meanwhile, we want to create a tipping point in Ndawana.  We now have started a Stepping Stones program for the HIV Support group and will then target students and mothers. We want to work deeply in Ndawana, where the population is 4,000, to make HIV prevention and gender justice a recognized part of the community culture.

These strategies will go a long way toward a sustained understanding of what is necessary to foster gender equality and change the attitudes and beliefs which keep the HIV pandemic going.

Photos from Gender Justice Training

These photos are from the Gender Justice Training described in this post. The photos are a great metaphor. The people are playing a game, which is part of the very difficult and emotional nature of the material. They need a break during the session to energize and get them out of the hard stuff for a few minutes. The metaphor is how they are becoming more connected and bonded through doing this program. Some of them are facilitating and leading for the first time in their lives, others are participating enthusiastically, and they are becoming a much more energized and connected community.

Groundbreaking trial results confirm HIV treatment prevents transmission of HIV

WHO and UNAIDS hail results from the HPTN 052 trial that show antiretroviral therapy to be 96% effective in reducing HIV transmission in couples where one partner has HIV – Read more here.

Gender and HIV

For thirty years in South Africa, people have been putting up billboards, handing out leaflets, giving speeches, telling people to get smart and stop getting infected with HIV.  And for thirty years the infection rate has continued to rise.  Since 2004 the government has been supplying ARV medication for treating HIV, and there has been a lot of testing and treating.  And still the infection rate has gone up, or at least stayed level.

A few months ago at Ndawana, we trained people in gender justice, then as facilitators, and we started a different kind of programming to talk about the realities of the behaviours that get people infected, and how we can think about and change our attitudes and beliefs so that our behaviours become more  consistent with our knowledge.    All our employees, including the driver, maintenance workers, and all the healthcare people are coming and participating and learning and having fun together, and bonding in new ways.  There is a new buzz in the village, and no one misses these sessions.  Even the nurses say they are learning new things and changing their attitudes.  When Chris asked one of our people how it’s going, she replied “We’re having too much fun.”

On Thursday we showed our End Stigma DVD to the teachers in Ndawana, then invited them to form a group like the one we are running with our people.  They seem eager to start, and our facilitators will begin to work with that group in about ten days.  We left that meeting thrilled, because there is so much stigma in the teachers, and they seem almost relieved to have a new way to think about and deal with that.  And, they have agreed to work with us to better support all the children on treatment attending school – almost 50 of them.

Then on Friday we met with about 25 TB/HIV Care community health facilitators and managers in Ixopo, where I proposed a five year program, with them being trained in gender justice, then as facilitators, and running this program all over Sisonke District (500,00 population), first with their employees, then with other groups like teachers, or churches, or young people.  Thabi and Busi spoke about how  the program has had a major impact on them.  Chris spoke about the changes she sees in our people.   Some people in the audience were moved to tears as Thabi spoke from her own experience.

Before we left TB/HIV Care managers voted unanimously both to undertake and to pay for the programs we proposed, which we believe could have a huge effect on HIV infection rates.  I will train facilitators and mentor the trainers in the programs.

I thought I was ready to retire (again).  I guess not.

Jim

Stephen Lewis on George Stroumboulopoulos Tonight

Check out the Stephen Lewis interview from George Stroumboulopoulos Tonight on CBC. He talks about the HIV/AIDS crisis and about the link between malnutrtion and AIDS in developing countries – http://www.cbc.ca/strombo/videos.html?ID=1845024600