Statement by Michel Sidibe Ex Director of UNAIDS, on occasion of the International Day for the Elimination of Violence against Women 25 November 2009.

‘UNAIDS is fully committed to stop violence against women and girls. The response to HIV provides an opportunity to reduce intimate partner and sexual violence and develop comprehensive responses to gender-based violence and HIV prevention within and beyond the health sector.

There is strong evidence of the links between gender-based violence and HIV. According to a 2006 report by United Nations Secretary-General, one out of every three women around the world has been beaten, coerced into sex, or otherwise abused in her lifetime, usually by someone known to her.

“We need to scale up effective programmes which promote gender equality at country level and invest more in building-up the evidence base,” said Michel Sidibé, Executive Director of UNAIDS. “Policies and programmes addressing gender inequality and gender-based violence will help achieve our universal targets for prevention, treatment and care. Investment in responses is an essential part of HIV programming.”

The Rose Project would like to sincerely thank Caroline and Philip Wiehe for hosting a coffee morning on the 20th November. We would also like to thank their daughter Stephanie for the hard work she put into making this a success. Stephanie has been a supporter of The Rose Project since the beginning and is responsible for bringing aid to many people in East Africa.  In excess of €2,000 was raised and will fund the training of a midwife for the new maternity hospital.

Mary

3rd October
My journey began in Cape Town, where I attended the Royal College of Obstetricians and Gynaecologists one day workshop on Millennium Development Goals 4&5. These goals address infant and maternal mortality respectively. I was somewhat disappointed with the conference, as after each presentation no time was allocated for questions. This was particularly regrettable in relation to the presentation on Malawi, as there was a senior obstetrician presently working in Lilongwe, who could have contributed substantially to the presentation.

5th October
I arrived in Lilongwe, with board member Father Enda Mc Donagh who I had met up with in Johannesburg. Fr Mc Donagh has been an advisor to The Rose Project from the beginning and brings a wealth of experience and knowledge, given his time as advisor with Caritas International HIV section.

6th October
We began the morning with a visit to the old hospital. For anyone not familiar with this facility, it is difficult to take on board the appalling conditions, with many women lying on the floor and giving birth also on the stone floor. From here we went straight to the new hospital-what a contrast. Then we met with the clinical staff at the Lighthouse clinic which is next door. This HIV and AIDS clinic which was funded by The Rose Project, opened its doors December 1st World AIDS Day 2006. Since its opening, it has placed 8,000 patients on treatment, many of them expectant mothers.
We then headed to the new Wellness Centre, a healthcare facility funded by The Rose Project for healthcare workers, many of whom themselves are sick and need support and treatment. Holistic care will also be available to their families. Wellness Centres are the brainchild of the Swaziland Nurses Association and are now in operation in Zambia, Lesotho, Malawi and Uganda. They have been successful in supporting healthcare workers and in turn reducing the attrition rate from these countries. We met Dorothy Ngoma the Director of the Wellness Centre in Malawi and discussed the plans for the official opening.
We then headed to the rural HIV and AIDS programme in Likuni, this programmes which The Rose Project and CAFOD (sister agency of Trocaire) co-fund is experiencing difficulties due to cuts in funding. Whilst the patients receiving treatment are doing well and Home Based Care is not as much in demand, other critical issues are coming to the foreground, such as child abuse and domestic violence. These are areas which The Rose Project and CAFOD will seek to address in the coming months
In the afternoon, three members of the board arrived and joined me at the Irish Embassy for a reception at 7pm. The Irish ambassador, Mary Robinson and the vice President attended the reception. It was a good opportunity to meet other individuals and organisations working in the area of healthcare in Lilongwe.
Following the reception Mary Robinson joined me and the other board members for dinner.

7th October
Opening of the new 146 bed Bewail maternity hospital.

5am
This was a stressful morning, as my computer crashed and I lost part of my speech, however thankfully Julie my daughter managed successfully against a ticking clock, to sort out the problem out.  In addition, The Rose Project members had not anticipated was that all traffic would be stopped to allow the President’s car to move freely as the opening was a state occasion with full honours!
This produced complete chaos, with road blockages within miles of the hospital. As a result we had we considerable difficulty in reaching the hospital on time.
Thankfully, Billy our taxi driver put on his hazard lights and overtook all the cars until we were stopped by the police, at the round about before the hospital. Billy assured the police that we were VIP’s attending the opening and we got through. However the car behind had a little more difficulty in persuading the policeman and it was not until Julie produced my speech to him, which began by addressing the Honourable Vice President Joyce Banda ,that he allowed them through!

The event was absolutely wonderful and it was clear great effort had gone into the organisation. There was singing, dancing and theatre all carrying themes with an emphasis on the human rights aspect of maternal mortality. Malawi has one of the highest rates of maternal mortality in the world and this is for the most part due to the lack of healthcare available to women in pregnancy. Shortage of healthcare workers and infrastructure are the principal obstacles.
There were a large number of humanitarian organisations at the event, many interested in building on the work of The Rose Project in Lilongwe-both at a rural and district level.
After a wonderful morning we headed to a restaurant for lunch and entertained Rachel our representative in Lilongwe, who has worked around the clock to get the hospital ready on time for the opening. Dr Ndovie the district Health Officer also joined us.

8th October
The Vice President joined Dorothy Ngoma and other members of the Malawian Association of Nurses and Midwives to open the new Rose Project funded Wellness Centre. Dorothy is the Director.
This centre will focus on holistic care for healthcare professionals and their families. Due to the level of illness created by the HIV pandemic, healthcare workers in many African countries suffer from stress. In addition many are themselves unwell and require medical care in a confidential environment. Wellness Centres is an initiative of the Swaziland Nurses Association and are operational in Lesotho Zambia and Uganda where they have been successful in addressing poor healthcare amongst workers. In addition these centres have been successful in addressing the attrition rate. There will be a satellite Wellness Centre at the new maternity hospital.
The medical sub committee of The Rose Project met with the clinical staff of Lighthouse, to examine the results of the first year of the HIV counselling and testing in the rural health centres, this programme has a strong emphasis on Prevention of Mother to Chi8ld HIV Transmission. Possibilities were discussed on how the programme could be further enhanced. With 90,000 people having been tested in the first year of the three year programme and 4,000 referred for treatment, it was agreed that the first year has been a success.
The Lighthouse staff explained that each test carried out is of huge importance whether positive or negative. In a country where HIV prevalence is so high, each person who tests negative is given a pack with all the important information on how to remain negative. Of course those who test positive receive extensive counselling for both themselves and their families.

9th October
The Rose Project group headed started out early to visit one of the district health care centres in Lilongwe. Here we saw at first hand the HIV counselling and testing in Rural Areas programme which The Rose Project is funding with Irish Aid. This programme presently runs from 28 centres and is in its second year. We hope to expand to the remaining 13 centre this year. We have provided Lighthouse who is running the programme with extra motor bikes and this will make things easier to organise.
To date 90,000people have been tested, those who have tested negative are counselled on how to remain negative- in a country with had a HIV infection rate of 15% and in some areas higher, this is very important. Additionally this is the first entry into the medical system for many people who are in need to medical care.
For those who test positive a counselling treatment and care programme is commenced. 4,000 have tested positive many of whom are young expectant mothers. If these mothers are placed on treatment at 26 weeks firstly they will be cared for, in addition the chance of transmitting the virus to their infant is almost eliminated.

10th October
I had a meeting with Dr Address Malatta, Principal of Nursing at the University of Malawi, about the plans for The Rose Project and Haukeland University Hospital to fund the training of additional midwives through the University. This programme will start in December 2010 and when the training is complete these midwives will work at the new maternity hospital for a minimum of two years.

11th October

Trip to the rural clinic
This morning, Julie my daughter and Fr Enda accompanied me once again to the rural HIV and Aids programme in Likuni district. Massiye and Margaret the programme co-ordinators introduced us to a support group and we spoke with many of the members. Years ago all these people would have been in very poor health as there were no AIDS drugs available to economically poor people.  However with the advent of drugs to Malawi in 2004, the situation has dramatically improved.
The principal issue for the female members was domestic abuse and it was very difficult to hear their individual accounts of this violence. There were also men attending the group with their equally pressing issues.
However there was certain hesitancy among some of the women to speak in front of men for fear of further difficulties.  Malawi is remarkable patriarchal, in terms of governance and social organisation.
Some of the women in the group were expecting a child and are on The Rose Project funded prevention of mother to child HIV transmission programme.

This afternoon we visited the Wildlife Sanctuary and saw many beautiful animals that have been injured in some way. The area of captivity is huge and a beautiful sylvan setting. It was coming up to sundown and light in the sanctuary was spectacular.

A fitting end to a successful trip

Mary

We have received wonderful news from Rachel in the new hospital in Bwaila- the first baby was born in the new hospital yesterday morning, 20th October!!  This wonderful new facilility can now provide state of the art facilities to mothers and their babies.

Please check in later on to see photographs of the first newborns!!!

Deirdre

Mary has just been in touch to let us know that the opening went very well this morning. Thanks to the generous donations of so many Irish people and the efforts of the Malawian people and with the gracious assistance today of the Vice president Joyce Banda and Dr. Mary Robinson, this new hospital will have a fantastic beneficial impact on the lives of so many Malawians.  To hear more about the opening, tune into Newstalk at 1.35 to hear Mary Donohoe, Founder of The Rose project, interviewed by Ger Gilroy.

Deirdre

The Rose project is delighted that the Vice -President of Malawi Hon. Joyce Banda will officailly open the Rose project-funded Wellness centre on Thursday 8th october. To find out more about the Wellness Centre, take a closer look at our website!

Deirdre

25th September 2009

I met with Dr. Dermot Mc Donald, an ex master of the National Maternity Hospital in Dublin. The resident obstetrician in Lilongwe, Dr. Meguid, has expressed a interest in senior obstetricians visiting the maternity hospital in Lilongwe, to carry out clinical teaching and mentoring programmes. This is the second obstetrician who has expressed an interest in assisting the new maternity hospital, the other being the current master of the Coombe, Dr. Chris Fitzpatrick. I will keep you posted as to progress.

Mary

15th September 2009

Rachel our representative in Lilongwe, along with Matron Ruth Mwale organised for all the senior nursing staff to visit Queen Elizabeth’s hospital in Blantyre, as this is the largest public maternity hospital in Malawi. A follow up workshop was carried out on return to Lilongwe and all found the experience of the full day on the wards in this teaching hospital a very useful experience with staff at both hospitals sharing their different experiences and expertise.

Sept 8th Lilongwe 2009

All is progressing well towards the opening of the new hospital with great excitement in the air I t is a real honour for the Rose Project to welcome former President of Ireland and UN High Comminissioner for Human Rights, to officially opening the hospital along with the Vice President of Malawi.  Dr Robinson  President of Realizing rights is championing the issue of maternal mortality

Whilst the building is ready the greatest challenge is the acute shortage of healthcare workers. The Rose Project along with a number of International partners including UNICEF is working to address the situation in particular the shortage of doctors and nurses. With the generous support of UNICEF we have employed a full time very experienced midwife Rachel Macleod, to work alongside her Malawian counterparts. Rachel’s made aim is to assist the senior nursing staff at the hospital, with up schilling of midwives and overseeing the smooth transition from old to  new maternity hospitals.

In addition the Royal college of Obstetricians and Gynaecologists (RCOG UK) is assisting The Rose Project to source medical staff from outside the country as a temporary measure,  with 12,000 annual births at the hospital  and only one full time resident obstetrician, all the assistance possible is needed. The good news is that the Malawian government is funding the College of Medicine to train more doctors however it will be a long time before there is a sufficient number. In addition it will be vital to ensure that the working conditions for these individuals is attractive otherwise when training is complete they will leave the country. There is an additional cadre of healthcare worker in Malawi, which does not exist n Europe. Clinical Officers carry out a four year training programme at the college of Health Sciences and deliver the bulk of medical care. These are very competent, though under acknowledged within the healthcare system. The Rose Project along with a number of national and international organisations  looking at ways to address this situation

Sept 9th 2009

A number of Irish donors including Denis O Brien visited the new hospital. They also visited the HIV clinic which is beside the new hospital. This clinic was funded by the Rose Project in 2006.The focus of care at the clinic is on Prevention of Mother to Child HIV transmission during pregnancy. Since the clinic opened 6,000 people have been placed on AIDS This clinic will work closely with the new maternity hospital in the area of mother to child HIV transmission

Sept 10th 2009

The meeting with the District medical Officer was focused on the need for the District to rise to the challenges the new hospital is presenting. This is very difficult due to the shortage of personnel. In a hugely under resoursed healthcare system, a new hospital is bound to present many difficulties, however Dr Ndovie is one of the most enthusiastic people I have worked with and so we are   fortunate. In the afternoon I visited the ministry of health and spoke with the chief district nursing officer who assured me that midwives finishing their training in both September and December will be joining the existing midwives at the new hospital. A total of 8 midwives will be allocated to the hospital but we need 40. To address the shortage the Rose Project is funding the sponsorship of additional nurses to train in midwifery at the university of Malawi. This programme will commence in December and will bring an additional 16 midwives to the force. Hopefully within the next two years the administration of the hospital will in a position to have a  three shift rota in place, each  shift for 8 hours. Presently there are only enough nurses to work a two shift rota, this leads to total exhaustion among the staff and  inevitable mistakes.

10th September 2009

Today, we organised a Chinese meal for all the senior nursing staff and it went off very well. Due to the staff shortages, we had the meal in the library next to the hospital rather in the Chinese restaurant.  It went very well and it was agreed by all to have been a good team building exercise .

11th Sept 2009

I visited the visited the College of Nursing.

The Rose Project is working with the department of nursing (Kamuzu College of Nursing) at the University of Malawi, on a midwife sponsorship programme.  We will fund extra midwives to be trained and in return the midwives will commit two years to the maternity hospital. This sponsorship programme will commence at the university in December 09 and the first group of midwives will join the staff at the maternity hospital, in December 2010

Sept 12th 2009

This morning I visited the  new Wellness Centre which is complete and the staff are fully installed. This is a new healthcare centre which the Rose Project has funded; it will be operated by The Malawian Association of Nurses and Midwives  with additional funding from the Norwegian Nurses Association. Healthcare workers in Malawi are severely overstretched and require support at many levels. The HIV pandemic has seriously overstretched an already challenged healthcare service. Many of the nurses  and midwives work 16 hour shifts due to the shortage of personnel. In addition many healthcare workers have become infected  through injuries in the work place such as needle stick.

In addition to providing holistic healthcare to the healthcare workers, this centre will also provide care to their families. The concept of a Wellness Centre is the brain child of the Swaziland Nurses Association where it has been in operation for five years and has proven to be most successful. Lesotho and Zambia followed suit and both these countries are experiencing a positive impact on the health force.

Sept 13th 2009

Finally this morning I finalised plans for the opening of the maternity hospital with Rachel our representative in Malawi, and ensured that all the invites had been delivered.

Mary

The Rose Project is delighted to announce that Dr. Mary Robinson will be officially opening the new maternity Hospital at Bwaila, Malawi on 7th October 2009.  We are very grateful for Dr. Robinson’s continued support for The Rose Project.