Ululations, drums, singing and then dancing. One would think this gathering of men and women at Jali in Zomba, is a celebration of some sort, but no, it is not. These are people living with HIV (PLWHIV) about to start their meetings.
Singing their songs before their meeting, the PLWHIV group expresses hope against the virus that has seen some being stigmatised against, at least according to the lyrics of their songs.
Listening to Simati Chinomba, the chairperson of Jali support group in Traditional Authority (T/A) Mwambo telling their story, it is obvious that the activities, which started through Impact—a Catholic Relief Services (CRS) project which started in 2010 and helped form this group—have been impressive.
Chinomba, who tested HIV positive in 2003, claims to be healthy, and says their support group started with seven villages and 25 people, but now has 41 members from 25 villages. He says this is due to benefits attached to the group which include economic empowerment and health living.
“I would like to encourage people that have not gone for HIV testing to do so and if found positive to join our group,” said Chinomba in an interview, while decrying that there are few men in the group against 35 women.
According to Impact technical quality coordinator Alinafe Chibwana, the four-year $13 million United States Agency for International development (USAID) and United States President’s Emergency Plan for Aids Relief (Pepfar) programme was designed to enhance access to treatment and care for PLWHIV.
According to Chibwana, CRS and its alliance partners matched the funding with cash and in-kind resources to provide wraparound services for PLWHIV.
Impact also worked closely with the government to strengthen community systems that serve PLWHIV in support of Malawi’s national HIV response.
But Impact is not only about PLWHIV support groups, fighting the spread HIV, combating TB, and introducing good dietary and cooking practices. Impact also trained expert clients— HIV-positive volunteers that ensure that patients are encouraged not to default on the ARV treatment.
During a visit to some of the areas where CRS has been implementing the project, it was noted that children especially orphans and the vulnerable are also benefitting from the programme.
According to CRS, Impact OVC technical quality coordinator Antonio Kasote in an interview during the tour of some beneficiaries at Jali, the programme uses picture-based learning to help children take charge of their lives and become responsible. It also teaches them how HIV is spread so they become aware of its dangers and act responsibly.
“We also introduced education drop-in centres where children get assisted in homework from volunteers and also learn handcraft, and cookery. So far we have reached about 70 000 children,” said Kasote.
As a result, Kasote noted that the children love going to school and get empowered to avoid abuse.
But how sustainable are the activities since the project is coming to an end this year?
Based on available statistics from health officers the models under Impact have been effective.
For instance in the district, Likangala Health Centre in-charge Hezekiah Mwale specifically lauded the expert client model, pointing out that since its introduction there has been an increased uptake of HIV Testing and Counselling (HTC) services and a decline in default rates.
“Our team was overwhelmed, but since the introduction of these volunteers there has been a tremendous relief of the burden. We did not have enough time to teach about HTC and people doubted our officers. However, because the expert clients are part of the community, they are trusted and uptake of some services has greatly improved,” said Mwale.
According to Mwale, ARV default rates at the health centre has dropped from 10 percent to about 2.8 percent, while people that come for VCT services has jumped from two per day to about 50 per day.
Commenting on the benefits of the project that covered nine districts including Lilongwe, Ntcheu, Balaka, Machinga, Zomba, Chiradzulu, Mulanje, Thyolo and Chikwawa, Mwale fears that because the project is coming to an end the activities may suffer.
But Chibwana believes that other organisations will take it up from where Impact has left.
She highlighted that because the project has improved a number of indicators including default rates, it is important to continue with the structures that are already on the ground including support groups, village banks and drop-ins.