TRANSITIONS IN THE SACBC AIDS PROGRAMMES
The SACBC AIDS Office reports on its activities over the past 6 months noting the transitions that have taken place with the ending of part of the PEPFAR ART programme. Treatment services, support of orphaned and vulnerable children, TB screening, home based care services and the provision of simple housing for orphaned children and their caregivers are some of the services that are being rendered in South Africa, Swaziland and Botswana..
SACBC AIDS OFFICE REPORT JULY 2013
- Patients in the treatment programme have largely been transferred to Department of Health Clinics, and some sites wound up operations by the end of May 2013. A no cost extension has been approved by PEPFAR enabling six treatment sites to continue for a further period of one year. (Dioceses of Rustenburg, Johannesburg, Tzaneen, Bloemfontein, Dundee, Eshowe). At the end of May 2014, these sites will need to transfer remaining patients to Department of Health Clinics or be supported from other sources than PEPFAR.
- The Global Fund and PEPFAR are supporting orphans and vulnerable children in many dioceses, with PEPFAR funding extended for another year. New funding is being sought to continue the work of supporting children affected by AIDS in all three countries. It is hoped that Phase 2 of the Global Fund Programme will be confirmed for the period beginning September 2013.
- The Department of Health (in priority districts), the Global Fund (in priority districts in inland provinces) and DFID /the British Government are currently supporting home based care and TB screening in areas of high HIV/TB prevalence. TB screening is an important inroad into HIV care.
- The orphan housing project, supported mainly by Dutch and German donors, has completed nearly 250 houses in several dioceses, despite a number of challenges in rural areas related to access, transport, human capacity and the weather. Homeplan is likely to sign new agreements for additional houses in 2013 and 2014.
- Retreats for caregivers and AIDS project staff, and events marking World TB Day were conducted across the region. Many of the latter were inter-faith events, and involved local Department of Health clinics.
- The partnership with CRS around the PEPFAR grant officially ended on the 31 May. The CRS Monitoring and Evaluation team, working in the SACBC/PEPFAR programme have been employed in the SACBC AIDS Office for one year. Some AIDS Office staff have accepted other employment opportunities.
- A new proposal to USAID (PEPFAR) is being submitted at the beginning of August. It is hoped that funding for TB screening, HIV testing and counselling will be made available for continued support to many SACBC projects. A new proposal has been submitted to CRS to support several OVC projects. Several other new funding proposals have been submitted to potential donors.
- The findings of the OIG audit have been released. The overall finding was that the SACBC AIDS Office managed US Government funds well. The report of an assessment conducted by Khulisa of the systems of the SACBC AIDS Office is currently in draft form; a number of recommendations have been suggested to strengthen overall controls and project management in the AIDS Office.
- The AIDS Office assisted St Joseph’s Theological Institute with a theological conference in January this year. Two editions of the Journal Grace and Truth, one already in circulation, the second due in November have covered the conference papers. One paper of the AIDS Office covers the history of the Church’s response over the past 30 years, the second examines the question of HIV testing for seminarians and candidates for religious life. It is expected that all the papers may also be published in a book.
- A shorter version of the history of the Church’s response to AIDS over the past thirty years forms one chapter of the book “A story worth telling. Essays in honour of Cardinal Napier.” Published August 2013 by the SACBC.
A. ARV TREATMENT PROGRAMME Theresa Bossert
- The objective of SACBC AIDS Office is for the treatment sites which have over the last 6 months been reduced to only 6 sites to ensure that 14,000 patients (now decreased to 8,900) receive optimum quality ART care, and to provide persons not qualifying for ARV treatment the necessary care and support.
- The project in the past year was run in 8 dioceses (Rustenburg, Tzaneen, Bloemfontein, Johannesburg, Eshowe, Dundee, UMzimkhulu and Pretoria), now reduced to 6 dioceses (Rustenburg, Tzaneen, Bloemfontein, Johannesburg, Eshowe and Dundee).
- The final year of the SACBC AIDS Office ART project funded by PEPFAR ended 31 May 2013, and a successful request for a No-Cost Extension means the services will continue at 6 sites till May 2014.
ACHIEVEMENTS AND SUCCESSES
- This is a time of final transition of direct services by Church to Government. The transition looks different at different sites, but overall the transition steps are the transfer of patients to Department of Health facilities, transfer of assets and the possible absorption of programme staff by either Department of Health or Department of Health partners giving technical support going forward.
- SACBC AIDS Office has successfully transitioned 5 sites since June 2012 (Hope for Life, Inkanyezi HIV/AIDS Org, St Francis Care Centre, Holy Cross and Centocow Development Programmes. Two Parkhomes (at Inkanyezi and Hope for Life) and one vehicle (at Centocow), an X-ray machine (Hope for Life) and other clinical equipment were transferred for continued use by the Department of Health.
- Of the 6 remaining SACBC ART projects (Tapologo, Kurisanani, Siyathokoza, Nazareth House Yeoville, Blessed Gerard Care Centre and Newcastle ARV project), 1 site and 1 sub-site operate from Department of Health property, with the parkhomes to be transferred to DoH at the end of the program. Four of the remaining 6 sites are receiving ARV’s and Laboratory services from DoH. And 1 site’s staff salaries are covered by a District PEPFAR partner, Aurum Institute.
- Nazareth house has introduced a teen support group and this seems to help with teenagers’ adherence to ART.
- In February and March we had visits from CDC staff to track and document the transition process as it takes place. Our partner SCMS (Supply Chain Management Systems) which distributes our Anti-retroviral medication also visited the ART sites during February and March this year.
Across the board, collaboration at local level with the Department of Health has been very good, sites are attending meetings. In some provinces sites have attended trainings offered by DoH, HBC training and Data capturing workshops ( St Joseph’s in Sibasa, a satellite site of Kurisanani). A wonderful working relationship between DoH and Tapologo in Freedom Park (Rustenburg) is blooming, and the patients are benefiting tremendously.
|PATIENTS REMAINING AS AT MAY 2013|
|On ART||HIV Care|
B. EARLY DETECTION OF TB PROGRAMME Johan Viljoen
- The programme uses caregivers to do house-to-house TB screening. They visit every house in their area, and administer a questionnaire with five questions to each member of the household. If the respondent responds positively to any question, TB is suspected. The caregiver takes a sputum sample on the spot, and delivers it for testing to the local clinic. If it tests positive, the patient is initiated on TB treatment. The patient is monitored daily for compliance by the caregiver until the end of the treatment course. Most people with TB are co-infected with HIV. The caregiver also counsels household members for HIV, and tests them if they are willing. If they test positive, they are sent to their local clinic for a CD4 test, and are initiated on ART if they qualify.
- The programme began on 1 April 2012. It is currently operating in 11 places – Maria Ratschitz, Pomeroy and Zanethemba (Madadeni) in the Diocese of Dundee; Ntaba Maria in the Diocese of Queenstown; Care Ministry in the Diocese of Port Elizabeth; Kroonstad, Viljoenskroon and Virginia in the Diocese of Kroonstad; Masabelane and Joe Qwabi in the Diocese of Aliwal North; and Keimoes in the Diocese of Keimoes/Upington.
ACHIEVEMENTS AND SUCCESSES
- South Africa has one of the highest TB infection rates and one of the highest TB mortality rates in the world. There are various reasons for this. Firstly, patients are not diagnosed until they are nearly on their death beds. By then it is too late to commence with treatment. Secondly, those who initiate treatment do not complete the six month course, but stop with the treatment when they begin to feel better. The only way to reverse the situation is by detecting patients in the early stages of the disease, and monitoring their adherence to medication until the end of the treatment course. This programme has been remarkably successful in doing this. One of the implementation sites (Noyi Bazi Clinic, Pomeroy) reports a four-fold increase in the number of patients initiated on TB treatment since this program began.
- The statistics speak for themselves. In the first year of the program (1 April 2012 – 31 March 2013) a total of 44 090 people were screened for TB. A total of 16 722 were identified as TB suspects, and had sputum tests done. And a total of 5 403 were initiated on TB treatment.
- Department of Health policy now determines that certified lay counsellors can also perform HIV rapid tests (in the past these could only be done by a nurse). The program had all 110 caregivers (ten from each implementation site) trained as counsellors, and trained to perform HIV rapid tests. This training had two benefits. Firstly, people do not go to their local clinic when referred, to do an HIV test. But they are quite willing to be tested on the spur of the moment in the privacy of their homes. This program has been remarkably successful in getting people tested for HIV. Secondly, the qualification obtained by caregivers is government accredited. It will enable them to be employed as community health workers after the end of this program. In the first year of the program, a total of 12 226 people were counselled for HIV. 5 625 of them agreed to be tested. 2 084 of them tested positive, and were referred for CD4 tests. 1 696 of them were initiated on ART.
- Interestingly, the implementation site where the most TB was detected is Virginia (Free State), where 1 414 patients were found to be TB positive, and initiated on TB treatment – 27% of the total initiated on TB treatment for the entire program. This could be due to the fact that Virginia is a gold mining town, with migrant populations. The site where the most cases of HIV were found is Pomeroy (KwaZulu/Natal), where 688 patients were initiated on ART – 41% of the total initiated on ART for the entire program.
- Across the board, collaboration at local level with the Department of Health has been very good. In its National Strategic Plan, the government has identified TB as its top priority. It envisages implementing this kind of program in the whole country (the Department calls it an “Accelerated Case Finding of TB” programme). But due to financial and human resources constraints, it has not been able to do so. It therefore welcomes collaboration with the Catholic Church. In some cases the Department has provided our sites with TB training. In other sites it has provided them with sputum bottles. In all sites the Department has been happy to test our sputum samples for TB, to perform CD4 tests on HIV positive patients, and to provide the patients with TB treatment and ART.
ANNUAL STATISTICS 1 April 2012 – 31 March 2013
Sterkspruit: Eastern Cape
Aliwal North: Eastern Cape
Queenstown: Eastern Cape
Port Elizabeth: Eastern Cape
Kroonstad: Free State
Virginia: Free State
Viljoenskroon: Free State
Keimoes: Northern Cape
|Caregivers trained in TB||Male||1||0||10||24||13||0||2||20||10||0||0||80|
|Community members trained in TB||Male||944||0||226||809||181||0||842||1389||1988||1530||0||7909|
|Clients screened for TB using question
|Clients identified as showing TB symptoms||Male||381||584||1599||315||264||320||560||1208||1505||1532||62||8330|
|Clients referred for sputum test/chest Xray||Male||376||637||1150||294||192||239||560||1164||1453||1505||0||7570|
|Clients referred for TB treatment||Male||285||280||132||61||30||7||68||614||658||419||16||2570|
|Clients on TB treatment followed up for adherence||Male||541||359||284||178||384||40||320||354||645||546||50||3701|
|Clients that completed TB treatment||Male||39||285||78||13||25||92||11||74||360||88||21||1086|
|Clients counseled for HIV||Male||955||676||1801||26||91||226||483||312||364||538||66||5538|
|Clients tested for HIV||Male||214||603||747||16||84||9||15||196||197||393||55||2529|
|Clients testing HIV + referred for CD4 tests||Male||108||404||57||14||10||0||8||67||117||131||32||948|
|Clients referred for ARV treatment||Male||73||313||39||14||22||0||10||82||116||78||24||771|
|Clients on ARV treatment followed up for adherence||Male||108||718||359||85||94||104||161||84||173||76||67||2029|
C. OVC PROGRAMME Nandi Sithole, Priscilla Rakhetsi
THE OVC PROGRAMME
- The OVC programme provides care and support to the Orphans and Vulnerable Children across nine provinces of South Africa. All this is made possible through the work of dedicated Care givers who do home visit on a daily basis to make sure that children receive the best care. The projects are encouraged not to work in isolation but to work very closely with the local schools and clinics for the purpose of referral processes so that the children’s needs are met holistically. Additionally, some of the Children’s activities such as the provision for home work assistance and HIV prevention Education done through peer education programme are executed in the local schools’ premises. Within the OVC programme there is a need to advocate for children who experience sexual abuse and when perpetrators are not held accountable for their wrong doing. The main focus of the OVC programme at the moment is to encourage the project to educate children about sexual abuse and teenage pregnancies because the rate of those incidents is escalating. The SACBC AIDS Office is advocating for care and support within the OVC projects to strengthen the response and incorporate family-centred and child-focused interventions for the betterment of our future’s children.
ACHIEVEMENTS AND SUCCESSES
- NACCW Graduation Ceremony. On May 22nd 2013, the National Association of Child Care Workers (NACCW) hosted the graduation of two hundred and sixty one graduates from Gauteng, North West and Mpumalanga, among those thirteen Child and Youth care workers were from SACBC AIDS Office funded projects who performed exceptionally well to obtain the Child and Youth Care Worker qualification. The event was held at Sandton Convention Centre in Johannesburg and sponsored by USAID. The event was attended by different stakeholders including Department of Social Development, Pact South Africa, and HWSETA, Don Mattera (a well known South African Poet and Community activist and also the patron of the NACCW).
- The National Action Plan M&E Workshop. The SACBC AIDS Office funded projects in Mpumalanga and KwaZulu Natal attended the National Action Plan M&E workshop. The workshop was organized by the Department of Social Development. The main purpose of the workshop was to empower NACCA partners with skills and knowledge on how to analyse, interpret and utilise data for programming decisions and also to understand the importance of data quality. There were three projects that took part in the Mpumalanga workshop and it was conducted from the 4th to 8th March 2013 where a total of six delegates benefited from the workshop. In KwaZulu Natal a total of six projects took part in the M&E workshop that was conducted from the 11th to 15th March 2013 and ten delegates benefited from the workshop.
- National OVC Conference. Two SACBC AIDS Office Project Managers for the OVC programme attended the South African National Conference on Orphans, Children and Youth made vulnerable by HIV and AIDS which was held in Durban at the ICC fron 27th to 30th May 2013. The main purpose of the conference was to evaluate the progress made with respect to recommendations made in the 2006 OVC conference, highlight models of protection, care and support plans that are appropriate in addressing the challenges faced by orphans, vulnerable children and youth, share the gaps and challenges that still exist in our country and also to look at the contribution made by the National Action Plan for orphans and other children made vulnerable by HIV and AIDS in addressing those gaps. The conference was hosted by the Department of Social Development and USAID.
- Nutrition Assessment, Counselling and Support. A total of six care givers from three SACBC AIDS funded projects attended a Nutrition Assessment Counselling and support workshop that took place in Durban from 11th to 13th June 2013. This workshop was for PEPFAR partners in KZN and was organized by the USAID in collaboration with Family Health International 360 and the Department of Health. The main objectives of the workshop was to update PEPFAR implementing partners on the current nutrition situation in South Africa, to provide guidance on how to align work plans to support Department of Health nutrition priorities as well as USAID PEPFAR food and nutrition guidance and how to improve coordination and collaboration among Department of Health and other departments with PEPFAR partners.
- World TB Day. During the world TB day in March 2013, all the SACBC AIDS Office-funded projects had an opportunity to celebrate this day by means of hosting TB campaigns at their sites. The projects collaborated with Department of Health at the district level which assisted with TB screening and education and different stake holders in order to make it a success. The focus of the world TB day was to educate people about TB infection, modes of transmission, signs and symptoms and how can it be treated.
- School Uniforms. The SACBC AIDS Office rolled out once-off funding to cover the school uniforms of all the children under the care and support of the SACBC AIDS Office OVC funded projects. This activity started in December 2012 and ended in January 2013. A total of 7003 children benefited.
- Retreats. In March 2013 all the OVC projects had an opportunity to organise a retreat for all the Care givers. The main idea of the retreats was to give the care givers a chance to share with each other their experiences of working with children. This enabled the care givers to voice their challenges on working with children and also to reflect on their personal lives.
- Winter Project. In view of the cold winter a total of 12718 children within the OVC programme received blankets, tracksuits and towels, socks and shoes. These were bought from PEP Store. It was a huge collaboration between the sites, SACBC staff members and PEP Stores personnel, to ensure that this was successful.
- Income generating project at Rorisang. Three years ago, Rorisang Men and Youth Development project in Klerksdorp diocese sent two care givers to the Micro finance training in Durban that was organised by the SACBC AIDS Office. Out of that training the site started a group saving scheme project in April 2011 that involves the management and Care givers only. The main idea was to extend and encourage guardians and Child headed families to replicate the mode of savings. In March 2012 the project expanded to where it involved 38 households of child headed families and foster parents who make a contribution of R100 per child on a monthly basis taken from the social and foster care grant. The amount of contribution made from January 2013 to June 2013 was R37 000. They have some policies that assist with the regulation of the group saving scheme and these monies are shared between the households during December to assist the families to buy food and clothes for children during Christmas time.
- HIV/AIDS Disclosure programme at Kopano Lerato (Mercy OVC). In April 2012, SACBC AIDS Office organised an adherence workshop in Durban which was conducted by an organisation called Zoe Life. Kopano Lerato OVC project had an opportunity to take part in this training since they had experienced a lot of challenges around children defaulting from ARV treatment. The training was on how to assist children to adhere to ARV treatment since it is a challenge to our society. Kopano Lerato OVC project saw a need to start the Disclosure program so that they can tackle this big challenge of children defaulting from ARV treatment. From July 2012 to June 2013, a total of twenty children between the ages of 9 to 18 years who are on ARV treatment became aware of their HIV status and now understand the importance of adhering to the treatment. It was not an easy process for making the children aware of their condition but through the skills and knowledge acquired during the training, determination and cooperation between the Care givers and parents managed to overcome this obstacle.
- Kroonstad Career Exhibition. During March 2013 school holidays, Kroonstad OVC programme organized Career exhibition for grade 10 and 11. A total of 87 children across Lejweleputswa benefited from this exhibition. It was a one-day exhibition aiming at exposing learners to various opportunities post-matric and to prepare them to make informed decisions concerning their career choice. Different exhibitors such as Thabiso Centre skills development, Central University of Technology (Welkom campus), South African Police service and UNISA had an opportunity to showcase different opportunities offered by their institution to the Children.
GOVERNMENT AND OTHER COLLABORATION
- The OVC programme at SACBC AIDS Office and its funded projects have a good relationship with the Department of Social Development, Department of Health and other NGOs such as Zoe life, Realeboga Bakubung, NACCW. Some of the SACBC AIDS office funded projects are receiving funding and care givers stipend from the Department of Social Development and also participate in the trainings organised by the Department of Health and Department of Social Development. The OVC programme activities offered to children are aligned to Department of Social development and Department of Health guidelines. 17,071 children received blankets, tracksuits pillows and towels during the Winter months.
- 560 homes were renovated, which benefitted 1,532 OVC within the programme.
D. SMALL GRANTS, HBC and OVC Kabelo Huma, Nondumiso Jwara
- The SACBC AIDS Office supports small projects in South Africa, Swaziland and Botswana which provide care and support to people infected and affected by HIV and AIDS through Home Based Care as well as Child Care activities, which include nutritional, social, psycho-social, material and educational support.
ACHIEVEMENTS AND SUCCESSES THIS YEAR
- During the first half of this year, once off funding was made available to small projects to organise and hold World TB day events, healing retreats for caregivers, provide School Uniforms and winter hampers for OVC as well as host sports tournaments.
- Home Based Care Kits. The following sites were given once-off funding to purchase medical supplies such as gloves, linen savers, diapers, nutritional supplements and antiseptic liquid: Asiphile eSt James (Durban); Ikhaya Community Development; Siyabathanda and KwaKristo Umsindisi.
- Gardening Project. St Joseph’s Sodality gardening project at Christ the King parish in Hlatikulu, Swaziland was given once-off funding for irrigation equipment.
- TB DAY Events. Once-off funding of less that R5000.00 was made available to sites to conduct awareness programs as well as conduct TB screening and HIV counselling and testing to mark World TB day. 582 Adults and 259 children were reached. 72 people were screened for TB and 158 were counselled and tested for HIV at Lulisandla (Durban); Asiphile eSt James(Durban); Ithembalethu Outreach Project (Durban); Thandanani Community Organisation (Durban); Sinothando Project(Durban); Matikwe clinic (Durban) and Sizumndeni Centre (Mariannhill).
- School Uniforms Project: Small grants were made available for school uniforms for OVC in schools under the Catholic Institute of Education in various places including PE diocese, Archdiocese of Durban, Diocese of Marianhill and Umzimkulu diocese. In addition, OVC attending schools in the catchment areas of Christ the King, Good Shepherd, St Constantine, St Phillips, Sacred Heart parishes and Regina Mundi parishes in Swaziland were provided with school uniforms.
- Caregivers/Staff Retreats. Small grants of less than R7500.00 were made available to sites to afford their staff an opportunity to attend retreats. This was also extended to CATHCA as well as Education For Life projects. Siyabathanda CBO(Durban), Ikhaya Community Development(Durban), Asiphile eSt James (Durban), Ithembalethu Outreach Project(Durban), Diocesan AIDS Ministry(Keimoes), Francis Shannon Hospice(Kimberly), Nazareth Haven Hospice(through CATHCA), Inkanyezi HIV AIDS Organization(through CATHCA), SACBC Education for Life, Youth Alive Kokstad, Education for Life Cape Town, Education for Life Durban, Education for Life Witbank, Education For Life St Nivard’s, and CATHCA.
GOVERNMENT AND OTHER COLLABORATION
- The AIDS Office has collaborated with CIE to reach learners in rural schools in need of school uniforms. CATHCA and Education For Life also collaborated with the AIDS Office in providing retreats to caregivers as well as raising TB awareness and conducting TB screening. Local clinics and district health offices at some sites were very involved in the TB screening and awareness campaigns.
E. SACBC PEPFAR ART & OVC MAIN SITES
HIV Care & ART
|Eastern Cape||Amathole||King William’s Town PE AIDS Committee||Yes||No|
|Eastern Cape||Umkhahlamba||Aliwal North Diocese of Aliwal AIDS Commission||Yes||No|
|Free State||Fezile Dabi||Kroonstad AIDS Management Committee||Yes||No|
|Free State||Thabo Mofutsanyane||Qwa Qwa Batho ba Lerato||Yes||No|
|Free State||Thabo Mofutsanyane||Witsieshoek St. Kizito||Yes||No|
|Free State||Thabo Mofutsanyane||Reitz St. Elizabeth Children’s Programme||Yes||No|
|Free State||Motheo||Botshabelo Siyathokoza||Yes||Yes|
|Gauteng||City of JHB Metro||Nazareth House||No||Yes|
|Gauteng||City of JHB Metro||Orange Farm Inkanyezi HIV/AIDS Org||Yes||Yes|
|Gauteng||City of Tshwane Metro||Winterveldt Hope for Life||No||Yes|
|Gauteng||City of Tshwane Metro||Winterveldt Kopano Lerato||Yes||No|
|Gauteng||City of Tshwane Metro||Pretoria Holy Cross Home||No||Yes|
|Gauteng||Ekurhuleni||Boksburg St. Francis Care Centre||No||Yes|
|Gauteng||Ekurhuleni||Brakpan, Tsakane Sithand’izingane||Yes||No|
|Gauteng||Metsweding||Bronkhortspruit Kidz Care and Support Trust||Yes||No|
|KZN||Amajuba||Wasbank Diocese of Dundee AIDS Commission||Yes||No|
|KZN||Amajuba||Blaauwbosch Newcastle ARV Project||No||Yes|
|KZN||Ilembe||Mandeni Blessed Gerard Care Centre||No||Yes|
|KZN||Sisonke||Centocow Mission Centocow Development Programme||Yes||Yes|
|KZN||Sisonke||Creighton Thembalethu Development Programme||Yes||No|
|KZN||Ugu||Port Shepstone Sicelimpilo||Yes||No|
|KZN||Uthungulu||Nkandla Sizanani Outreach Program||Yes||No|
|Limpopo||Capricorn||Mashashane St. Joseph Community Care||Yes||No|
|Limpopo||Sekhukhune||Schoonoord Ngwana Swara Atla Saka||Yes||No|
|North West||Bojanala Platinum||Boshoek Tapologo Outreach Program||Yes||Yes|
|North West||Dr. Kenneth Kaunda||Stilfontein Rorisang Youth and Men Program||Yes||No|
|North West||Ngaka Modiri Molema||Mafikeng Tsibogang Christian group||Yes||No|