Community Based Health Care and AIDS Relief Project

 

This project was initiated in 1996 in Bomu Parish.

 

 

Initially there were 12 volunteers from Small Christian Communities “Jumuiya Ndogo Ndogo”.  In 1998 the project was initiated in a second parish, Mikindani.  In 1999 the project expanded to Changamwe Parish.  In 2000 we began in Chaani and also joined our project to an identical project in Voi directed by the Sisters of St. Joseph with Sr. Genovefa as Project Director.  In November 2001, we began in Miritini parish. In November 2002 we began in Mtopanga Parish. In June 2005 we began in Kongowea Parish. In 2007 we began in Mbungoni Parish. In September 2008 we began in Kiembeni Parish.

 

The CHW volunteers called “Wahudumu wa Afya” receive basic training on very basic aspects of Healthcare, diseases and medicine.  They are encouraged to befriend and visit the sick in their respective “Jumuiyas” (Jumuiya Ndogo Ndogo or small Christian communities). Once a week they are accompanied by a nurse who decides on treatment, referrals or counseling.  They visit the sick irrespective of creed or ethnicity. Some of the services provided include: visitation of people living with HIV/AIDS by volunteers, nurses and others, treatment of opportunistic infections, Antiretroviral therapy for qualified clients, counseling services, VCT, social services for very poor, and medical referrals for complicated cases to  local government hospitals.

 

The project is supported by funds from the Maryknoll Society, Caritas Germany, pediatric AIDS Canada and Catholic Relief Service (CRS) . This year the program will begin in a tenth and eleventh parish and it is hoped other parishes can be served in the future. Long ago the AMECEA Bishops made the development of the Small Christian Communities as a pastoral priority in the region. The current service of the Wahuduma wa Afya highlights the wisdom of this decision.

 

PROJECT OBJECTIVES

 

• To mobilize and empower Catholics and their neighbors to serve their sick, especially those infected and affected with HIV/AIDS, through visits and care in their homes, irregardless of creed, ethnicity, nationality, gender, etc..
• To provide appropriate Antiretroviral Therapy to People Living With Hiv/Aids (PLWHA), and to add more to this treatment over time.
• To provide free medical treatment to poor sick non-HIV infected persons.
• To assist the community to promote good health and prevent ill health.
• To promote openness and free discussions on STI and HIV/AIDS.
• To guide and counsel people with AIDS and give them moral support.
• To teach on God’s Love and His power of forgiveness and mercy.

 

 

THE PROJECT FOUNDER

 

The project was started by Maryknoll Brother John Mullen. He has been privileged to serve as a Maryknoll Brother in Kenya since 1990. A Registered Nurse by training, his work now is to help Kenyans respond to the crisis of the AIDS epidemic which is ravaging our country. Small Christian Communities (SCCs) are the backbone of parishes in Kenya. Utilizing this existing Church structure the Project (the Archdiocese of Mombasa Community Based Health Care and AIDS Relief  Project trains volunteers from each SCC to visit the sick in their respective areas. The HIV prevalence rate being greater than 10%, invariably many people sick and dying from AIDS are found. 

The local health care system has been overwhelmed by the numbers of people with AIDS. The Project uses simple medicines to treat opportunistic infections which ease sometimes terrible suffering. More importantly, the care and concern of the volunteers are an important Christian witness that helps ease the pain of despair and stigmatization that afflicts many people with AIDS. The work can be difficult at times. He must struggle to stay close to Jesus in prayer. The Maryknoll community is a great source of support for him. He is grateful for his vocation to be a Brother and feels very privileged to serve God's people in Kenya.

 

 

 

THE MANAGEMENT

 

• The Programme Co-ordinator 
• Community lead Nurse
• Comprehensive Care Clinic nurse In-charge

 

Clinic and community workers include:

 

• 1 Part time Doctor.
• 1 Medical Officer
• 2 Clinical Officers.
• 19 Nurses.
• 2 Pharmacists.
• 2 Laboratory technologists.
• 3 Counselors.
• 2 Social Workers.
• 1 Trainer.
• 1 Accountant.
• 1 Secretary
• 2 Data entry staff.
• 1 Nutritionist.

 

Subordinates staff includes:

• 1 driver
• 2 cleaners

 

 

DECENTRALISATION LOCATIONS AND MODELS

 

Our aim as ART providers is to reach as many people as possible by making our services accessible while giving hope for a better life to (especially) those living with the virus.  In view of this most of our decentralized/satellite clinics are situated in slums and semi-urban areas which boast of high population density with lack of proper basic needs including food, safe drinking water & affordable health care. In 2008 the cost of living in Kenya more than doubled!

 

In such areas the rates of malnutrition among children and even adults is high due to the poverty levels. Such situations of poverty are proven to lead to increased infections especially in this era of HIV/AIDS. 

 

Therefore once such area is identified, we approach the local parish priest, engage him in our activities and obtain an office within the church compound.  From here the community nurses, social worker & counselor will involve the local Chiefs and elders in the project. Thereafter the CHW (Volunteers) mobilize clients and enroll them for continued follow up and  home visits by nurses.  With each visit client needs’ are assessed and they are  encouraged to know their HIV status. In some instances we take DTC (blood testing in the homes) services to them.

 

Seropositive clients are then referred to the core clinic (Mikindani) for ART services. 

Follow up is continued weekly until the client is stable and is then referred back to the clinic for monthly ARV refills.

With the help of the community health workers we distribute Septrin (cotrimoxazole prophylaxis) to the clients.

This is normally encouraged as it makes tracking easy in case of default or missed appointments. 

 

CCC MODEL (of HIV/AIDS Care)

 

• Enrollment criteria
• Must be HIV Positive
• Must be in our catchments area
• Must accept community follow ups
• Must disclose to closest people especially relatives
• Must have a treatment buddy

 

COMMUNITY SUPPORT MODEL

 

 

LABORATORY

 

FUMEHOOD CHAMBER.

• Currently we have a high tech fumehood chamber where we process sputum slide smears and observe slide microscopically to look for Acid fast bacilli (cause of tuberculosis)

 

• The fume hood chamber has helped us in diagnosis and managing the HIV positive patients with tuberculosis.

 

CD4 MACHINE

• We had a problem in starting treatment for WHO stage 1 patients as they are Asymptomatic and due to the breakdown of the point care CD4 machine we could not do CD4 counts (necessary diagnostic tool to begin ART).
• Currently we have a facscount machine which is efficient and gives a CD4 count for both Adults and pediatrics.
• The point care machine gives CD4 percentage for pediatrics plus full haemogram for all patients.

 

 

 

SUSTAINABILITY OF THE PROGRAMME

We have community health workers who have volunteered doing client follow up in enhancing Home Based Counseling program.  Every satellite we have at least 30 volunteer community health workers.

The Catholic Archdiocese has given us free occupancy of most of the offices we are using in our satellites clinics.
Clients support for transport fare is getting weaned off to encourage them to be independent and be able to support themselves.  More decentralization for clients to the nearest satellite clinic for easy and affordable access of services.

Only bedridden clients are given food by prescription and are weaned off as soon as they get better. They are encouraged to start income generating activities e.g. SILC

Clients have formed support groups where health education is taught. They have formed income generating activities that have resulted in strong organizations e.g. Soap making, SILC (Saving Internal Lending Community)

Working closely with stakeholders for linkages e.g. DASCO/MOH

Accessing more  donors and maintaining good relationship with donors to ensure fund continuity.

 

HEALTH SERVANTS:
“WAHUDUMU WA AFYA”

This are volunteers who are chosen from their respective small Christian communities.  They are trained for 6 months on basic aspects of healthcare, diseases and medicine.  On completion of the training they are examined and graduate in a ceremony within their parish community, usually during Mass. They identify and accompany nurses to the sick thus making it easier for the nurses to reach the patients.  They must be willing, able and known to be able to respect confidentiality.

 

 

Awards and Recognition Recieved by CBHC