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The contribution of grassroots groups in HIV/AIDS Prevention and care in Kilimanjaro region, Tanzania, the case of KIWAK

The contribution of grassroots groups in HIV/AIDS Prevention and care in Kilimanjaro region, Tanzania, the case of KIWAKKUKI . By Dafrosa Kokulingilila Itemba, Executive Coordinator of KIWAKKUKI Tanzania. A paper presented in Bergen, 10 th January 2007. Happy 60th Birthday Gro Lie!.

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The contribution of grassroots groups in HIV/AIDS Prevention and care in Kilimanjaro region, Tanzania, the case of KIWAK

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  1. The contribution of grassroots groups in HIV/AIDS Prevention and care in Kilimanjaro region, Tanzania, the case of KIWAKKUKI By Dafrosa Kokulingilila Itemba, Executive Coordinator of KIWAKKUKI Tanzania. A paper presented in Bergen, 10th January 2007

  2. Happy 60th Birthday Gro Lie! This presentation is dedicated to Professor Gro Th Lie for her everlasting technicalSupport, Love and for her keeping the KIWAKKUKI Candle burning !

  3. Background of KIWAKKUKI • Women Against AIDS in Kilimanjaro alias “Kikundi cha Wanawake Kilimanjaro Kupambana na UKIMWI - KIWAKKUKI ) exists because of the cause the women decided to pursue 16 years ago, to reach out to more women and let them be worriers in the war against AIDS. There was and still there is a big need to prevent the further spread of HIV and also the demand for care and support of those marginalized by the epidemic.

  4. Who does KIWAKKUKI work for ? The main beneficiaries of KIWAKKUKI include the PLHIV who are open and those not open about their sero status and OVC. Both groups have been marginalized by the epidemic and also by the policies and systems which deprive them access to service, resources allocation locally ,nationally and internationally. Another disadvantaged group is that of youth, who are reported as highly vulnerable in the Tanzania’s National AIDS Control Programme Reports and elsewhere in Sub-Saharan Africa.

  5. KIWAKKUKI’s National Response After all these years of hard work and enormous challenges, KIWAKKUKI has emerged as a leading NGO in integrating the HIV/AIDS response in Tanzania by offering a comprehensive support through the strategies of HIV/AIDS Awareness Raising, Home Based Care, Voluntary Counselling and Testing and Orphans’ and Vulnerable Children Support.

  6. KIWAKKUKI’s National Response contd…. KIWAKKUKI does not work in isolation but operates as per the Multi sectoral priorities of the Tanzanian government. What we do is a contribution to the national efforts in HIV/AIDS prevention, support and care.

  7. KIWAKKUKI ADMINISTRATION AND OFFICE STRUCTURE ANNUAL GENERAL MEETING Over 5,214 members KIWAKKUKI COUNCIL 11 elected members with district representatives and 2 PLHAs BOARD OF TRUSTEES 5 Consultants EXECUTIVE COORDINATOR HOD OVC HOD HEALTH EDUCATION HOD FINANCE DISTRICT AGM HOD VCT HOD HBC ASSISTANT HOD ASSISTANT HOD ASSISTANT HOD KIWAKKUKI District Council ASST.HOD HBC ASST. HOD VCT MVCT LAB. TECHNOLOGIST SUPPORTING STAFF OUTREACH WORKERS Counselors Counselors ASSISTANT. Lab. IMP POFO SECRETARY DOCUMENTALIST DISTRICT COORDINATORS ASS. SECRETARY H.Ed Committee VCT Committee OVC Committee Research Committee HBC Committee Fundraising Committee DRIVERS OFFICE ATTENDANT Grassroots Volunteers Grassroots Volunteers Grassroots Volunteers Grassroots Volunteers Grassroots Volunteers Grassroots Volunteers HIRED SECURITY GUARDS

  8. The Partnership Begins Our partnership with Norway started with Professor Gro Lie’s training of our initial counselors in 1991 , These multiplied by training hundreds of more counsellors. then we were introduced to Kvinnefronten by Karen Maria and Chiku Ali in 1997, and then to FOKUS and NORAD, Bergen College in 1998, School For All in 2003, Lovisenberg Diakonale, Hoyskole and many friends.

  9. What are the KIWAKKUKI grassroots groups? • According to the Thesarus English Dictionary, the word grassroots means (waged people, proletariat, working class, workers etc) To KIWAKKUKI, it refers to the women in the communities who have formed groups of 20 or more and have dedicated themselves to work for those marginalized by HIV/AIDS by being infected or affected

  10. What are the KIWAKKUKI grassroots groups?Contd.. • KIWAKKUKI has 160 of such groups. Today the number of groups has risen from 42 at the fist Annual General Meeting in 1992 to more than 6,000 from virtually all corners of Kilimanjaro who also act as community volunteers. These have mobilised themselves in smaller teams as the main service providers and the backbone of KIWAKKUKI.

  11. What are the KIWAKKUKI grassroots groups?Contd.. • These women have worked faithfully without payment before the onset of AIDS and have continued so for the historical cause of reaching out to the needy. This traditional ‘shadow’ work is quite vivid today in the community because it has been visualised by the AIDS pandemic.

  12. Map of Kilimanjaro MAP OF KILIMANJARO SHOWING KIWAKKUKI GRASSROOTS GROUPS 2006 KEY =40grassroots Districts

  13. A network of CBOs /volunteers in Kilimanjaro as per district District No of Groups Total membership No. of Wards in Total No of wards where KIWAKKUKI Operates Moshi Municipal 13 426 15 12 Moshi Rural West 22 1507 31 12 Moshi Rural East 25 13 Hai 36 1106 14 11 Rombo 16 427 20 12 Mwanga 19 634 16 7 Same 28 964 24 24 Total 159 5,064 120 91 (75.4%)

  14. KIWAKKUKI’s GrassrootsStrategic Issues • Social Advocacy: Grassroots capacity has been strengthened through skills building in the areas of HIV/ and AIDS prevention, care and support. The bottom line is for these groups to own and participate in HIV/AIDS prevention, policy implementation and open dialogues on existing policies. KIWAKKUKI grassroots also have been networking and building coalitions with other key players like Faith based Organisations, the private sector and the government.

  15. KIWAKKUKI’s Grassroots Strategic Issues contd.. • Policy Development: Grassroots groups are also empowered to facilitate the achievement of important health and social development goals including advocacy for policies that are pro poor like the cost effective free VCT food and offering income security, nutrition and soft loans to PLHA’s. KIWAKKUKI’s major policy undertaking is to increase access to appropriate HIV/AIDS knowledge, greater involvement of PLHA’s and access to care and treatment and promotion of human rights in the HIV/AIDS era.

  16. KIWAKKUKI’s Grassroots Strategic Issues contd.. • Mainstreaming of HIV/AIDS and Gender in KIWAKKUKI programming: Making deliberate efforts not to do business as usual but to include gender sensitivity and address HIV/AIDS at the workplace in planning, implementation, monitoring and evaluation. At the grassroots level, women are empowered to be assertive and try out some negotiation skills to make their position felt and their community work appreciated by men.

  17. KIWAKKUKI’s Grassroots Strategic Issues contd.. • Programme Monitoring and Evaluation: Women in the grassroots have learnt to follow up and evaluate the work they do in the community. They never did this before. They follow up the wellbeing of the orphans, , the micro credit projects, the bed ridden patients and they also follow up significant changes in the areas they conduct outreach education. They have learnt to keep records and present the results both orally and in writing at the monthly meetings.

  18. A Section of members’ Monthly Meeting

  19. Objectives met by the KIWAKKUKI grassroots groups: • To raise community awareness about HIV/AIDS, particularly targeting women and young people. The teaching team of grassroots volunteers use community Theatre, School Without Walls and general campaigns to influence existing forums in the community, like in churches, mosques, market places, schools, public meetings, local, national and international events. Lets imagine we are a public meeting here now…..

  20. COMMUNITY DRAMA

  21. Grassroots groups distributing food form WFP to beneficiaries (These are orphans and people living with HIV/AIDS).

  22. Objectives met by the KIWAKKUKI grassroots groups contd.. • To help restore dignity, self respect and purpose to the lives of the individuals and families affected by HIV. KIWAKKUKI grassroots members mobilize communities to go for counselling at KIWAKKUKI or other nearby centres. They promote post test clubs of self help groups in which PLHIV share their fears and emotions and some join teams of grassroots volunteers as they overcome their stigma.

  23. Objectives met by the KIWAKKUKI grassroots groups contd.. • To help develop a sense of responsibility within communities for HIV prevention. Grassroots women supervise fund raising events. Women volunteer to sell Tshirts, wrap rounds (khangas) distribute IEC materials and sensitise communities on the importance of everyone’s participation in the AIDS war.

  24. Objectives met by the KIWAKKUKI grassroots groups contd.. • To identify the physical and psychological needs of HIV infected people in their families and coordinate support for those in need. The home based care and OVC teams offer home based care to patients, OVC, distribute school materials, medication, food and nutrition, offer supportive counseling and refer cases for further management: Health, Human Rights etc.

  25. HBC Worker dressing wounds of the client

  26. Objectives met by the KIWAKKUKI grassroots groups contd.. • To raise the status of women on family and community life so as to reduce the rate of HIV infection. By conducting all these activities the women are apparently promoting community life and the state of women in general. Many women and girl children in Africa are the beasts of burden and have been blamed for bringing AIDS in the family and elsewhere. A lot is done through peer support and assertiveness training so that they negotiate when, how and whether to have sex and to say no to sex where they think there is a risk..

  27. Objectives met by the KIWAKKUKI grassroots groups contd.. • To promote networking between Civil Society organizations and between government and CSO’s at a local level and to cooperate with other groups and organizations dealing with HIV/AIDS, including the sharing of information and resources. With the advent of AIDS, there has been a lot of interventions in the community where the grassroots women live and work. Collaboration is being used to reduce duplication and competition. The government also supports this by promoting networks .

  28. Achievements • KIWAKKUKI has been increasingly accepted and recognized as a leading NGO in Kilimanjaro for HIV/AIDS service provision through grassroots. • There has been a multiplier effect on the target population due to the growing number of members who join KIWAKKUKI in order to support the needy. • Many women are assertive enough and are giving testimonies on how they are fighting oppressive cultures based on gender discrimination and many now participate in seeking their democratic and civic rights.

  29. Achievements contd… • There has been a stimulation of free and open talk in the community on HIV/AIDS. • Grassroots women have volunteered to supervise poverty reduction activities among the beneficiaries in the spirit of impact mitigation and therefore have strengthened the ability of caregivers and youth to earn livelihood. • Grassroots women have supervised construction of 28 OVC’s houses by involving men as partners in development. • Grassroots women have helped to reduce stigma and discrimination in the community.

  30. Achievements contd… • They have supported the social and emotional as well as material needs of children. • They have strengthened the capacity of families and communities to care for children and AIDS patients. • Men are now admitting that it is possible for women to make a difference and some leaders have plans of starting a men’s group. • Improved status of grassroots women in general.

  31. Challenges of Grassroots Women in Kilimanjaro: • Volunteer fatigue and burn out due to the growing demand for support and care and the overstretched communities. Prof Gro Th Lie and Ellen A Lothe conducted a qualitative external evaluation and observed this. • Lack of incentives to keep the volunteers motivated. • Deep rooted culture of oppressing women in Africa through oppressive Customary Laws makes the volunteers work more difficult since their clients have difficulties to access basic rights especially inheritance and land ownership rights.

  32. Way Forward • Establish strategies for motivating the grassroots volunteers and also for allowing some rest as strongly recommended by Gro Lie in the External Evaluation of KIWAKKUKI, 2002 • Sensitize men’s involvement in care for AIDS marginalized groups. • Sensitize children on gender roles , equality and human rights so that they grow up without being challenged by the current misconceptions based on traditional beliefs.

  33. AcknowledgementsKIWAKKUKI’s shining star owes a lot to • Professor Gro Th Lie and Ellen A. Lothe for conducting a qualitative Evaluation for KIWAKKUKI in 2001 the follow up of which is going on well. Happy Birthday Mama Gro!!! • Women’s Front of Norway for supporting KIWAKKUKI since 1998.. Also opening the doors of Bergen and Oslo. Thanks to Karen Maria Moland, Agnete Strom, sister Chiku Ali, Malfrid and many others.. • FOKUS- Oslo for supporting us through Kvinnerfronten. Thanks to Ann, Mette and others. • Thanks to NORAD too, the father of us all.

  34. AcknowledgementsKIWAKKUKI’s shining star owes a lot to • Bergen University’s Social Work School for bringing social work students every Fall at KIWAKKUKI. Thanks to Gunnlaug, Linn and Bente Lindbek, the Dean and many others. • School for All for sponsoring several marginalized orphans. Thanks to Jon Dahl, Mai Bente, Eva Maria, Grete, Solveig Ullaland and many others. • Lovisenberggt Diakonale Hoyskole for bringing nursing students to Kilimanjaro. Thanks to Ellen. • Friends of KIWAKKUKI young and old mobilized by Malfrid and family. Thanks Malfrid. • And many others………..

  35. Conclusion/lessons learnt • All that grassroots women need is empowerment then they are on their marks… • When united, women can change the world through traditional safety nets since they are sustainable. • We have been made to believe that men and women live in different worlds especially when it comes to grassroots work and if we are not careful men will be left behind! • So we need solidarity with men for total scaling up of grassroots work. Solidarity forever…..

  36. AND …….. IF GRASSROOTS HAVE MANAGED TO GIVE AIDS A HUMAN FACE WHAT ABOUT OTHERS?

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