‘Holding hands’ in the community


The work of Partners in Hope is supported by SIM Malawi project MW#96853 Medical Discipleship and Spiritual Ministry


In this the fourth, and final, article about the work of Partners in Hope Medical Centre we look at its community work through the Tigwirane Manja (Chichewa for Let us hold hands) Community Outreach Programme


How does a hospital, dealing with more than 14,000 HIV/AIDS registered patients monitor so many people, to make sure that the majority of them, for example, adhere to the regime needed to ensure their medicines have the best chance of success, or ensure that problems they face can be addressed? In the case of Partners in Hope Medical Centre (PIH) the answer was to establish a community-based programme to do just that … and a good deal more besides.

Set up in 2011, Tigwirane Manja (TM) has its own staff and a number of ‘Expert Clients’ (patients of PIH who have received training to help their fellow villagers in a range of aspects of living with HIV/AIDS), based in support groups around the catchment area which serves the centre. Today there are 20 such support groups, all offering assistance and advice to patients and also giving practical help to manage their condition as well as possible.

SupportMembers of the Tigwirane Manja Mbunda support group outside of Lilongwe

“Reaching into the community, as TM does, helps us to find the real problems which people are facing,” said  Luka Mdala, Senior Community Educator with TM and someone who has been with the programme since its inception.

“When they come to the clinic they may only stay for a few minutes to get their vital signs taken and to receive their ARVs. When we see them in the community, through the support groups, we can spend more time with them and find out if they have any other problems, whether they be medical, physical, financial or spiritual. Through the support groups we can then try to see if we can help overcome those problems.”

Education, as  Luka’s job title suggests, is an important part of the work of TM and the support groups, and this covers a wide range of subjects relating to HIV/AIDS, from overcoming stigma and discrimination, to basic nutritional guidance.

“The support groups offer people a chance to come together and to share real-life stories about how they have coped, or have struggled with their condition,” said Mwelura Harawa (right), Programme Co-ordinator for TM.

“Coming together like this can be vital for people, especially when they are first diagnosed with HIV/AIDS. This is particularly true for younger people and adolescents. Of our 20 or so support groups three are specifically for this younger age group.

“It is very easy, when first diagnosed, to feel as if you are completely alone in the world. Our support groups are there to show that there are others like you and that you can cope with life.”

But it is not just individuals who are being helped by TM support groups. Joseph  Jeke is Senior Group Village Headman, overseeing 58 villages in the Mbuna  Community. He explained the impact the groups have had on his district.

“We lost many people to HIV/AIDS before treatment was available to them. TM came into our villages to support our people and these people are now energetic and able to help in the development of the village.

“We see our relationship with TM and PIH continuing to develop in the future. I would hope that the people in Mbuna who have HIV/AIDS will be able to live good lives and will be able to make positive contributions to the life of our villages as a result of this partnership,” he said.

Well tended: One of the pigs being reared as part of the Mbuna Income-Generating Activity

Indeed, Mbuna is at the forefront of some new developments which are being piloted by TM. Income-Generating Activities (IGAs) are an important aspect for organisations working with people with HIV/AIDS. As their name suggests IGAs offer people a chance to generate income which will help them to make a scheme sustainable and will also give them some much needed income to improve their standard of living, especially to maintain good nutrition.

In Mbuna, alongside the usual ideas of growing tomatoes and maize, for example, TM has introduced a pilot scheme for rearing pigs.

“IGAs are important in our work because the income that is generated can have a significant effect on how someone copes with HIV/ AIDS,” said Mwelura Harawa.

“We felt it was important to introduce IGAs because we were seeing the support groups having more and more of a female face. The men in our communities tended to see the support groups as somewhere for people to come together just to sing and dance and so they were missing out on many of the benefits of being part of such a group.

“By introducing the IGAs we have started to see more and more men attending support group meetings and that has got to be good not only for the individuals but for the community as a whole as they take part in what is going on.

“The extra income may allow the person to buy food, have access to transport to get them to and from the clinic, even to pay for school fees for family members. It is all geared to making life more positive for the people we are working with.

“Pig rearing, such as we see in Mbuna, is a little different from the usual scope of IGAs. We are treating it as a pilot project at present and we will evaluate it and see if it is something we can introduce into the support groups.”

Gesiyati Gumbi is an Expert Client in the Mbuna support group and is heading up the pig-rearing project. He talked about the project and also a little of the role of an Expert Client.

“We were very pleased here in Mbuna to be selected to run this pig-rearing project,” he said.

Good stewards: Members of the Mbuna IGA who are responsible for rearing the pigs

“Our  three pigs we are rearing are growing well, and we hope that this project will be a success and help bring in extra income for the support group, so we can help more people.

“As an Expert Client, part of my work is to help deliver HIV education to support group members and also to help make sure everyone is adhering to taking their medications when they are supposed to. It can be difficult for people in our community to accept their positive status and so the support group is here to help people to accept that and also to live as positive a life as possible,” he said.

Looking ahead, Mwelura Harawa is certain that working with community leaders will be an important aspect of the work of TM, especially in the area of stigma and discrimination.

“There is a lot of stigma and discrimination attached to HIV and AIDS,” he said.

“People in the community suffer because of this if they have a positive status. I am looking forward to the day when this situation is much changed. TM works with community leaders to provide good, positive HIV/AIDS education and training so that they, too, can have a role to play in this.  Currently, we meet with all the community leaders quarterly, so we already have a well established forum to help this work.

“I am positive about the future for the support groups, even the possibility of developing more to add to the 20 or so that are already in place. But what we need to make sure is that these are not just places where people come to ‘sing and dance’ but that they have a positive impact in helping people come to terms with life with HIV/AIDS and helping them to make active contributions to their community through education and IGAs. It will take hard work but I am certain that we have good foundations on which to build, and the work of TM will continue and grow in the future,” he said.