Archive for the ‘Project update’ Category

Rachel has been working at the hospital for the past three years and was central to setting up the new Rose Project funded Bwaila Maternity Hospital.

I must admit having felt rather apprehensive during the last few days in UK after my yearly Christmas break but I was ready to return to Malawi. I felt strong and enthusiastic, but leaving the comfort and security of family to return to the huge challenges of living and working in one of the poorest countries in the world left me feeling somewhat fearful. So I returned to Bwaila. Having played such a substantial role in the setting up of the new Bwaila Maternity Unit it felt like going home as I walked through the doors of labour ward, that first day after nearly 6 weeks away, to be receive a great welcome from my midwife colleagues.

It had been a difficult December. The unit had been without regular medical cover leaving the midwives and clinical officers (a cadre of healthcare worker specific to Malawi. Clinical Officers undertake a four year training) to take full responsibility for the everyday running of what is probably the busiest maternity unit in Southern Africa.

Despite predictions that the work load at Bwaila Maternity would decrease substantially after the opening of the new tertiary care wing at the Lilongwe central  hospital ( Ethel Mutharika Maternity Wing) this has not proved to be the case and we continue to attend more than 1,000 births a month.

The high-risk mothers are now being transferred to the tertiary hospital. In addition the health centres  are sending their difficult cases directly to EMMW. However, we continue to have extremely sick women and emergencies to attend. I can honestly say that the past 6 weeks have been some of the busiest I have experienced since I arrived in Malawi 3 years ago.

January sees the start of the clinical placements for our midwifery students. This year with an increase in students being trained it also means an increase in the number of students needing close supervision and clinical teaching in the ward situation. We have also had a new set of interns and clinical officer students on the unit all of whom require supervision and teaching.

I decided on my return that I should make my priority during this time the teaching and supervision of students of all cadres. It has been a pleasure to work with the interns, most of whom are highly motivated and enthusiastic learners. They are quick to learn and quickly become essential to the safe medical coverage of the unit.

The student midwives are of varying levels of enthusiasm and competence. They have little input from the college staff due to shortage of tutors which means that their practical skills need to be taught by our own permanent midwifery staff. There is still some reluctance on the part of some of these to undertake this role, given their overstretched work situation.

Others truly do not have the necessary skills to pass on their knowledge to students. I have spent most of my time this past month dedicated to this. I enjoy this part of my work tremendously and find that my own enthusiasm plays a key part in effectively creating  greater  interest and understanding thus leading to better and more adequate care.

As well as teaching, very often I am the most experienced obstetric professional on the unit. This means that my expertise is being constantly sought to aid in difficult and emergency situations.  I was very pleased to welcome a new Nigerian registrar onto the unit. We have already worked together in the past. We refer to each other constantly which gives strength to the medical and midwifery cover. I truly feel that together the possibilities to effectuate change are more than ever present.

 

Addressing maternal mortality…..

The Rose Project had hoped to open the new district maternity hospital (Bwaila) this month but as time progresses I realise that it will be another 6-8 weeks before the equipment is fully installed. The hospital itself looks wonderful and there is excitement in the air at the prospect of  improved maternity facilities in the capital city Lilongwe.

This hospital will be run by the District Health Department and will be home to approximately 9,000 annual births. The existing hospital  which resembles a shed, was built in 1939 to accommodate 4,000 annual births, There are now 12,000. there is only one obstetrician and three fully qualified midwives.

Some of the women deliver their infants onto stone floors and in some cases unassisted due to the shortage of healthcare workers.

It is important to note, that Malawi has one of the highest maternal mortality rates in the world with 100 maternal deaths per 100,000 births. Much of this is attributed to the acute shortage of healthcare workers, poor working conditions, low pay, the high number of women in poor health due to HIV infection and traditional practises. In the case of the latter, many women like to deliver in the rural areas attended by traditional birth attendants, unfortunately, many of these attendants do not have access to adequate training and  are slow to refer women into hospital, when complications arise.

The majority of the  meetings on this trip, were related to looking at ways to address this situation.

Caring for the carers

Clinical officers are a cadre of healthcare worker that was established many years ago in Malawi to deal with the shortage of medical doctors. These individuals carry out a four year training programme and in many medical institutions in Malawi they do the work of doctors. This cadre of healthcare worker is indispensable in Malawi but are inadequately supported within the healthcare system.

In Malawi there is one doctor per 100,000 people and 56 nurses per 100,000 people.

The Rose Project in partnership with a number of other organisations including the University of Malawi, Department of Medicine and Realising Rights: The Ethical Globalisation  Initiative (New York) is looking at ways of addressing the situation through a number of initiatives.

Additionally, In partnership with the Norwegian  and Malawian Nurses Associations, The Rose Project has funded a new healthcare clinic for healthcare workers again in Lilongwe the capital city. Many doctors, clinical officers and nurses are themselves unwell, some have become infected with HIV in the workplace, others are wrestling with the effects of working in appalling conditions with little or no support. This new clinic called the Wellness Centre, will address the needs of these workers in a holistic manner and also their families.

Wellness Centres are in operation in both Lesotho and Swaziland and have proven to be most effective in addressing the attrition rate of healthcare workers from these countries.
This centre will provide support for the staff at the new maternity hospital.

Prevention of Mother to Child Transmission in pregnancy

Finally Lighthouse clinic,  a HIV facility which was funded in 2006 by The Rose Project, is doing wonderful work in the area of prevention of HIV Transmission in pregnancy. This clinic which is next door to the new maternity hospital will work closely with the hospital ensuring that all women who are HIV positive are cared for and that their infants and other family members.

In 2008, The Rose Project in partnership with Irish Aid, gave a grant of  €880.000 to Lighthouse Clinic.  The purpose of this grant is ensure that all expectant mothers attending the rural antenatal clinics, are tested for HIV and where  positive, are offered the appropriate treatment. The programme will run over a three year period. So far 600 expectant mothers have been diagnosed with HIV and are receiving treatment.

As you can see from the above we are making progress in the areas of  maternal mortality and HIV infection in pregnancy.

Current programmes:

Malawi

Prevention of mother to Child Transmission of AIDs programme - operated by The Lighthouse clinic

Wellness Centre - healthcare centre for doctors and nurses

Archdiocese of Lilongwe Community Programme

Uganda

Naggalama programme

Hospice Uganda

Kenya

KVOWRK

CAFOD programes - St Francis and Thika

Hospice Nairobi

KASO

Ethiopia

Addis Ababa community programme

Source of total funds:

Rose Project €4,876,276

Irish Aid €1,171,109

Irish Hospice €45,000;

Royal city of Dublin Trust fund €100,000

Programmes funded 2004-2008

2008

Malawi

New Maternity hospital, Lilongwe, Malawi

The Rose Project has given a grant of €3,000,000 to build and equip a new 100 bed maternity hospital in Malawi. This facility which will open in May 2009, will transform the standard of healthcare for attending patients.20% of the women giving birth at the largest maternity hospital in Lilongwe are HIV positive. Due to the acute shortage of staff, overcrowding and poor facilities, many patients aren’t tested for HIV and therefore go untreated, increasing the already high rates of mother to child transmission.

Funding over two years :                                                                                                            

Rose Project                €3,000,000

Prevention of Mother to Child transmission:

This new programme will be run by the Lighthouse clinic (funded by Rose Project 2006).  It will stretch out to the 40 rural healthcare clinics surrounding Lilongwe in an effort to reach 75,000 women with testing and treatment where necessary.

Funding over three years:

Rose Project                                     €282,136             

Irish Aid                                          €600,000 

Wellness Centre for healthcare workers

There is an acute shortage of healthcare workers in Malawi in particular doctors and nurses. Among other initiatives to address the situation, Rose Project in collaboration with the International council of Nurses in Geneva is co-funding the establishment of  this healthcare facility which will open Autumn 2009.

Funding over two years:

Rose Project                         €50,000

Archdiocese of Lilongwe

This programme provides treatment for opportunistic infections at community care centres by community health workers with support from community volunteers; home based care to the chronically ill in the communities. It also provides support to widows, OVCs and youth in life skills and basic sustainable livelihoods skills.

Funding over two years

Rose Project                         €15,500

2007

Malawi

NDIMOYO   Palliative Care Trust

NdiMoyo offers a daily care facility coupled with a palliative homecare programme which is offered within a 10km radius of the centre.  For this reason, The Rose Project felt the provision of an ambulance was crucial to the work being carried out.  The ambulance has enabled the organsiation to reach more people in need and those at a greater distance from the centre.  It has also allowed them to establish a schedule for taking patients to the local hospital.  The Rose Project also funded the construction of a roof on a hut for a seriously ill patient of NdiMoyo who was living in very basic conditions.

Funding:

The Rose Project                 €40,000

UNC Project 

More than 80% of deaths due to Malaria in Africa occur in pregnant women and children under the age of five. The Rose Project provided funds to the UNC(University of North Carolina Project) with the aim of preventing incidences of Malaria in HIV positive women and reducing morbidity and mortality rates among childbearing age, by supplying Malaria Nets to those most at risk.  The provision of these nets has been approved to take place over five years. In this period, 17,500 nets will have been provided.

Funding:

Rose Project                                     €21,000

Kenya

Participatory Development Initiatives-Widow & Orphan Support Programme (PDI-WOSP)

PDI is a community based organisation operating in the Nairobi Slum.  The group is involved in socio-economic and community based development programmes and activities are geared toward the struggle of widows and orphans affected by or living with HIV.  The goal of the organisation is to address the profound challenges of the vulnerable people living in the slums, and reach out to the marginalized in the community.

Funding over one year:

Rose Project                         €14,000

Kenya Widows & Orphans Support Programme (KWOSP)

KWOSP, with the help of The Rose Project has been able to improve the welfare of widows and orphans affected by or living with HIV, through focusing on their psychosocial needs, hence in an effort to  mitigate the impact of the virus.  KWOSP has been successful in putting forward various strategies aimed at addressing the impact of HIV. Nutrition programmes, training in psychosocial support, home based care and income generating activities amongst some offered.

Funding over one year

Rose Project             €17,200

Nairobi Hospice

Nairobi Hospice is an outreach facility which has been in existence for more than 16 years.  It was the first Hospice to open in Kenya and provides palliative care for both cancer and AIDS patients.  Until 2006, Nairobi Hospice had one doctor to take care of the needs of all the patients - current trends show that an average of 450 patients are on the Hospice’s programme at any one time.  The Rose Project began partial funding the position of a second doctor and made this commitment

Funding over three years

Rose Project             €6,800

The Rose Project co-funds a number of HIV programmes with their UK partners: Catholic Agency for Overseas Development (CAFOD)

St Francis

St Francis community is a group of indigenous Kenyan women founded by the Franciscan Sisters who run four main HIV & AIDS projects to help reduce transmission and to promote positive living amongst youths, people living with HIV & AIDS, and the wider community.  The Rose Project with CAFOD, have provided funds to allow the St Francis sisters establish two new voluntary counselling and HIV testing centres, which serve approximately 330,000 people.  These centres encourage and achieve early diagnosis and appropriate action and it is anticipated that due to these their establishment, infection levels will rapidly decline.

Funding over two years

Rose Project                    €63,676     

CAFOD                        €34,000

Thika

This project is run by the Assumption Sisters and aims to prevent the transmission of HIV through the provision of quality care. The aim of this programme, is to improve the quality of life of those living with the virus and to increase life expectancy.  Again, The Rose Project partnered with CAFOD, providing funds to allow the organisation to provide a new voluntary counseling and HIV testing centre giving access to 2,500 members of the community.  This centre will contribute to empowerment and education of over 2,000 youths and 5,000 community members, enabling informed choices on sexual behaviour.  Those already infected with the virus will be able to regain quality of life and to live positively through holistic care.  The centre will also provide economic and social support to orphaned and vulnerable children.

Funding over two years

Rose Project               €53,345      

CAFOD                       €34,000

Denge Community Outreach Programme (DECOP)  

Decop was initially started in support of men and women who had lost their partners to AIDS.  Since then, the organisation has expanded greatly in the area of Home Based Care, thus improving the lives of not only those infected by the virus, but those affected also.  Decop helps by providing basic human needs such as food, water, shelter and clothing.  They exist as a community support group to empower the community with broad based strategies that promote socio-economic growth, thereby widening peoples choices and involving them in the expansion of their capabilities.  The Rose Project fund the provision of home based kits, home & hospital care visits, the provision of group therapy sessions and nutritional food supplements.

Funding over two years

Rose Project              €10,000      

ESB                            €10,000

Kisumu Urban Apostolate Programmes (KUAP)

In partnership with Aidlink, The Rose Project is assisting KUAP in the provision of basic human needs such as water, sanitation and nutrition.  Other Programmes such as HIV prevention training, Mother to child transmission projects, clinical services and child counselling are also catered for.  Communities in the Kisumu region are currently overburdened with the responsibility of caring for orphans and some communities lack the ability to protect and nurture the children.  This programme seeks to address the health and welfare of such children and the prevention of further spread of the virus.

Funding over one year

Rose Project                €20,000      

Aidlink Dublin             €20,000

Uganda

Naggalama Hospital programme, Mukono, Uganda

Naggalama Hospital is located in Mukono, an area of Africa most affected by the AIDs virus.  The Rose Project became involved to help to scale up the HIV & AIDS department of the hospital in a effort to increase the number of people accessing comprehensive HIV care and antiretroviral treatment.  The main services include counselling and testing for early diagnosis and care of pregnant mothers and outpatients.  The long term goal of the hospital is to improve the quality of life for people living with HIV & AIDS. In addition the aim is to provide support in terms of human resources, training counsellors and health sensitization on HIV issues.

Funding Rose Project                    €136,955          

Irish Aid                                  €411,109

2006

Malawi

Lighthouse Clinic, Lilongwe, Malawi 

The Rose Project supported the Lighthouse Trust in building a new care acute care HIV clinic in Lilongwe. The clinic opened in December 2006 and now provides counselling and HIV testing to more than 1,000 people per month.  It clinic now provides Anti Retroviral Treatment to 5000 people, including expectant mothers, per year.  In addition a new ambulance has been funded, to bring patients to and from the rural.

Funding over two years

Rose Project                         €229,000

Kenya:

Women Fighting AIDS in Kenya (WOFAK)

WOFAK are providing essential nutrition and medical support to more than 150 children living with HIV each month. The importance of adequate nutrition in HIV is well documented. The Rose Project has continued its support of WOFAK in the delivery of nutritional support by directly assessing and providing nutritional support to children, and in providing counselling and education to parents and guardians in order to ensure the continued well being of these children.  At present more than 100 women and children are receiving counselling and support from the centre.

Funding over three years

Rose Project                         €98,700

Riara Health Project

This project is based in Kibera slums, the second largest slum in Africa. They are providing food aid for almost 100 orphans in six schools. The project uses local grown produce hence supporting local businesses. By providing food aid children tend to remain in school longer and achieving higher grades. The project also employees a counsellor partially paid by TRP who provides support for orphans enrolled in the programme. 

Funding over two years

Rose Project                          €16,634

POKOT

This programme addresses issues relating  to basic needs of medical care and education. The programme addresses such issues as Female Genital Mutilation (FGM) and education regarding HIV and AIDS. This area is prone to drought and famine and the project aims to provide education and adequate health care to combat the effects of HIV

Funding over two years

Rose Project                         €22,000

Lodwar 

The Rose Project has provided funding for a 4×4 jeep to the Diocese of Lodwar, which is used in delivering care to people living with HIV and AIDS.  Lodwar is a remote part of north east Kenya where HIV prevalence is 13% compared to 7% in the rest of Kenya. The vehicle provides the only method of transport to remote health units and delivering indispensable care and treatment.

Funding over one year

The Rose Project                 €25,000

Soweto Urban Development Association (SUDA)

Financial support was provided to match local funds for a small community centre. The centre was built by the local HIV support group.

Funding over one year

Rose Project                         €4,032

St Vincent de Paul Health Centre, Muhoroni Parish, Kisumu, Kenya

This centre was started by the Sisters of Mercy in late 2003 to provide care and assistance to people living with HIV in Muhoroni, an area with a population of over fifty thousand people, most of whom are squatters or low income sugar cane workers.  Due to the success of the centre, it soon began to expand and The Rose Project became involved when funds for a new Maternity wing were requested to complement services at the new centre.  A pharmacy, labour ward, sterilising room, antenatal ward and a ward for premature babies will be provided.  This new wing will provide privacy to women both during labour and child birth. Prior to this patients had to pass through out-patients and other wards where the risk of opportunistic infections to infants was substantial.

Funding over one year

Rose Project                         €28,000

The Association of People with Aids in Kenya (TAPWAK)

Tapwak is a membership organisation and currently serves more than 5,000 people who are living with HIV.  It has contributed significantly to creating awareness and the provision of counselling, home based care, and other support activities.  Other contributions have been toward the promotion of responsible sexual behaviours and creating awareness on the rights of people living with HIV.  The Rose Project’s support has enabled Tapwak to continue this work through three drop-in centres, whilst also funding hospital and home based care.  Training in palliative care has been provided to 75 new members of staff.  This programme also assesses the needs of children by running an orphans’ project to treat their needs and problems and provide them with necessities such as food, clothing and blankets.

Funding over one year

Rose Project                         €19,200

Kenya Voluntary Women Rehabilitation Centre (KVWORK)

With The Rose Project, KVWORK is continuing to helping empower women and female child sex workers to reduce their vulnerability to HIV and to assist AIDS Orphans.  Women over the age of eighteen involved in the sex trade are offered community mobilization, health and business education, and are also educated on their human rights, offering paralegal training and thereafter giving economic empowerment.  Female child sex workers under the age of eighteen years are given health education and human rights training and thereafter undergo vocational skills training.  Included also is home based care for women with AIDS.

Funding over four years

Rose Project                         €210,000

Uganda

Hospice Africa Uganda

At present this clinic is run from an education building with just two rooms, where everything from seeing and assessing patients, to holding meetings and storing records takes place.  The overflow of these patients are seen in a tent outside.  The Rose Project provided funding for the initial excavation of a new site. In addition, funding was provided for training 10 nurses in the area of palliative care. The nurses came from countries surrounding Uganda. From 2008-2010 a senior clinician’s salary will be funded.

Funding over five years

Rose Project                       €29,700    

Irish Hospice Foundation    €45,000

Makondo

The Rose Project is funding a new housing scheme for families who are experiencing extreme poverty as a result of AIDS.  These small dwellings will be built by and within the existing community.  This is a rural programme, hence The Rose Project has funded an ambulance to assist transporting patients to the nearest hospital, which is some distance away.

Funding over two years

Rose Project                 €45,284    

Irish Aid                      €60,000

Zambia

St Mary’s Hospice Lusaka  

The Rose Project matched funding given by local staff for a generator at this medical facility which provides medical care and support services for the terminally ill.

Funding

Rose Project                         €6,735.30

2005

Malawi

Kanengo AIDS Support Organisation (KASO) (€20,600)

The Rose Project is assisting KASO in its Community Home Based Care and orphan programme. KASO provides vital care and support to vulnerable people by carrying out weekly home visits and distributing food aid essential for Anti Retroviral drug efficacy. The programme also provides nutrition programme for orphans and vulnerable children.

Funding over four years

Rose Project             €39,300

Ethiopia

Addis Ababa: HIV & AIDS Programme

There are a total of 43 people enrolled in this programme, which provides essential support to those most in need. The programme provides a monthly allowance to help poor families with food and where necessary medicine and school fees. The programme also assists clients with small Income Generating Activities to encourage sustainability independence. Training has also taken place in Home Based Care activities. 

Funding over three years

Rose Project             €33,600

Tanzania

Medical Missionaries of Mary, Singida

The project in Singida provides care and support for over 450 people affected by HIV. The programme operates on many strands; facilitation of voluntary counselling and testing, care and support including Home Based Care, prevention and awareness programmes. The project also supports orphans and vulnerable children with school fees and health care.

Funding over one year

Rose Project                                     €92,240

2004

Love and Hope programme, Nakuru, Kenya

This community-based programme was the inspiration for The Rose Project. Over the past five years, The Rose Project has funded nutrition drugs salaries transport (an ambulance) and a new community healthcare centre which opened in 2007

Funding over five years:

Rose Project                                                      €134,713     

Irish Aid                                                            €100,000    

Royal City of Dublin Hospital Trust Fund              €100,000

Recent news from the Love and Hope programme, Nakuru Kenya - where Rose’s family continue to live. The Love and Hope programme was set up ten years ago by Patricia  Speight and Kenyan woman Genevieve  Ololo, a committed  humanitarian. In 2007 GOAL provided the team with a disused 40ft container and in 2007 a new community healthcare centre was funded by The Rose Project.

There are now 12 Kenyans providing the programme with Patricia. The centre has continued to expand its services over the past 10  years, reaching many people living with or affected by HIV or AIDS.

The Rose Project has also provided funding for food, drugs,  salaries and an ambulance – to try to reach patients in  the rural areas. The new Love and Hope Community healthcare centre has added to the programme. Due to the additional space, the centre has been able to expand its services and has started adding new programmes for  adolescents who have experienced sexual violence.

In the words of its Founder, Franciscan Missionary Sister for Africa, Patricia Speight:

The centre is working to capacity and at the moment is using the garage for additional space! Patricia also remarks on how it is so wonderful that patients can come to  the centre and be seen in privacy assuring their dignity.

In the recent ethnic violence in Nakuru the new centre provided sanctuary to more than 100 people - in some  cases, saving lives. In addition, many of the patients had their homes burnt down and fled Nakuru. For the patients this is very serious, as many are on active AIDS treatment and to discontinue or to have a break in  treatment puts the patients at risk. The team are working to ensure  those on treatment have access to it.