Report by BHW Partnership Facilitator

The BHW South Africa Partnership Facilitator and his wife visited this partnership in early August 2017. They spent an afternoon talking through various aspects of the partnership and budget, and then visited a couple of beneficiaries.  

Recent Events

People are still dying in the community but because of the training more people are being tested. Until recently the testing was being left far too late for patients to be helped much at all. The government is now willing to test patients earlier and begin treatment. MHBC has been approved to do HIV testing at home rather than people having to come into public to be tested. This is especially difficult for TB and HIV patients. 

Three of their staff have been trained as counsellors and testers. They have less trained volunteers than a few years ago as they tend to go to other organizations where they can get better wages. The large NGO's and government take them. 

They have had a recent disappointment with a large donor church from the US pulling away. The biggest cause of the disappointment is that this church has set up in the community and taken key staff with them. They feel like they have been used. 

The monthly support groups are very useful tools for spreading the word and people are beginning to get the message. People are getting tested earlier and the number of new HIV infections is going down. A percentage of the BHW funding goes towards these groups. It is very helpful for young people and children who often do not understand the great importance of taking their medication every day. Government trainers are brought in to talk to the people and caregivers to deal with children who don’t understand the details of their illness. 

They have been appointed as a pickup point for stable HIV+ patients to pick up their regular medication. This reduces the time it takes to get their medication and the stigma associated with having to go and pick up their pills in public. One of the caregivers has been trained to dispense the medication. 

Home Based Care is still the core ministry of Masoyi. Transport is the largest issue they face, getting around the community. They often have to walk long distances to meet, find and care for people. Many families cannot cope with their family members who are unwell, especially when they are really unwell. They are often locked in a room and left alone most of the day. This affects their mental well-being as well. We met one dad who was very unwell and his 11 year old son who was soon to become an orphan. Their circumstances were very sad. The son has to care for his dad, change his nappies, clean and cook, and try to get to school. From time to time the team comes to help and encourage him and pray with them. 

The kits they purchase with BHW's financial support are very important for this. They provide the teams with basic things to help with clients and to leave with them. The houses are often very poorly kept, dirty and filthy so it’s a challenge to go visiting sometimes. 

Home Based Care still gives hope and encouragement to those who are infected and affected. 

Personal Stories

These profiles are of some of the key people working in Masoyi HBC. 

Emma Ncongwane

Emma is married with three children. Her husband is a self-employed electrician. Her father was a pastor. She left school eight years ago and joined Masoyi HBC. Her role is administration, helping with finances and HR. This involves compliance with regulations and the Department of Social Services and communicating with donors. She has done some training in business administration and bookkeeping.

Her love and passion for children is obvious. Some community kids get a plate of food after school. It hurts her when donors pull out and the big issues this creates to carry on with some of the programme. It is especially hard knowing some children won’t be able to get food. She is keen to see income generation developed. 

Ma Flo confirmed that Emma has a very big heart, is very committed and works hard. She is highly respected by everyone. 

Lorrecia Malisa

Lorrecia is married to Norman who works in a furniture shop and who is also a pastor. They have a 3-year-old child. Lorrecia leads Home Based Care and has been at Masoyi for 3 and half years. This role involves four days of visiting the sick and needy people in their homes in seven locations. Then she has one day in the office writing reports.

Before coming to Masoyi Lorrecia had trained as a nurse and also did some computer literacy training. She was brought up in a Christian family. She looked after her very sick aunt and saw her suffer. Through this sad situation she chose to do nursing so she could help other sick and suffering people.

She likes to listen and talk with the sick people and their families. This teaches her a lot about peoples’ struggles and helps her appreciate her life. The hardest part of her role is seeing people with no food or income and living in pathetic homes. It is also hard when patients can’t take their medication as they have no food. Some families don’t care for their sick family members and this is very hard to observe.

Ma Flo shared that Lorrecia has a genuine heart love and is committed to her role and caring for the sick people. Even when she doesn't receive her stipend as there aren’t any funds she still comes and doesn't complain.

Jabulila Themba

Jabulila is 48 years old, married with four children and four grandkids. Three children are still living at home. She was brought up in a Christian family and her faith is very important to her. Before Masoyi she trained for home based care and also got a certificate for child and youth care. She also did training for testing HIV and counselling.

Jabulila is a vivacious woman with a huge smile and lots of enthusiasm. She told us her role is Jack of all Trades. Her role is Operational Manager for six departments and she coordinates the programmes with 15 facilitators. Her favourite department is working with kids. There are 1,500 children under their care.

They see a lot of child-headed households. They see that children are the future of their society and so many get neglected and need family care. They hold workshops for kids who are 12-18 years old and invite social workers to teach about drugs and how to run child-headed homes.

They ask the kids to share their challenges and try to follow up where more input is needed. One of the big issues they try to get sorted is getting legal documentation sorted before young people turn 18 otherwise it’s too late. Getting information for Moslem kids is usually the most difficult, especially the girls. 

The hardest part of her job is planning something and it doesn't happen. Getting the balance is difficult and challenging.

Ma Flo is very thankful for Jabulila and her passionate and caring heart for people. She is also able to calm Ma Flo down when she is stressed.

There have been other job opportunities with a regular salary offered to Jabulila. However, she has refused because she is committed to the community she is working in and to MHBC. 

Partnership's Influence within the Community

They get a lot of people coming to them for information and help; the government, churches and NGO's want them to help but they do not have the resources or the time. They are frustrated that people want help, people who often have funding from donors but they have nothing going on the ground and they want to use MHBC because of their reputation and effective programmes. Many people are referred to them without any funding even though those groups have the resources. And then these organizations take or attempt to lure their people away. They have trained nurses but others don’t.

Clients love and appreciate MHBC compared to other organizations. They develop relationships with the whole family. They are part of the community so are driven by other motives. The government clinics ask them to look out for people who are not coming to the clinics for treatment. There is a lot of confusion as some people are logged into multiple clinics so it’s hard to keep track of them all. 

Future Thinking

The key for the future here is more home based care. They see this is their niche and where they need to remain, even though there are now few organizations operating in this sector. HIV is still an issue but there are many other issues to deal with in the community. 

The people need treatment and information, not either/or. They seek to provide care, encouragement, motivation, information, support and prayer, and treatment literacy. To do this it requires people on the ground with time to listen to the challenges and concerns of the family members and the clients and to deal with the feelings and attitudes of those involved in this. 

They will actually be doing more in the future as there is an increase of TB and cancer as well as HIV/AIDS. Those on ARV's are also more susceptible to secondary infections and diseases. At the clinics the people on ARV's are often told that the virus is undetectable in their test and they think they are healed and stop taking the medication. 

Poverty causes people to disengage with information and they often do not hear what is going on around them. For a long time female condoms have been available at the clinics but no one has been teaching people how to use them. 

They do a lot of community dialogue and are being asked to do more because they are so good at it. One of the next ones will be with the sangomas, traditional healers. They have all sorts of strange ideas and give very dangerous advice but they are trusted by many in the community and need to become part of the solution to the issues of the community. They do not listen to the government or understand the jargon and propaganda. They are a major part of the problem in the community with weird solutions and multiple wives so Masoyi are trying to bring them into the loop which of course generates many interesting spiritual conversations.

The team gets to hear all the problems of the community; police abuse, water problems, road issues, crime, which they can do little about. 

Current Issues and Challenges

Current trends in the NGO and government sectors see the programmes shifting away from care to training and prevention. Many of the donors attend the same seminars and are shifting in the same direction. Few if any are in the community caring for people. This is where the real needs are and many organizations have shifted away because it is much easier to run training than to care for people. Time frames can be managed in training but not when caring for people. That just goes on and on. One can understand the need for sustainability, however who will care for those who are in poverty and who need care. Most of the donors are not aware of the needs on the ground. They are responding to international policies and hardly ever get to talk to or relate to those who are working in the communities. 

There seems to be an unwillingness or an inability to get the balance right between prevention / training and sensitization and the care and support for those infected. Agencies seem unable to get the balance, it’s either one strategy or the other. 

There is a lot of inaccuracy in the figures that come from the clinics. Much policy is formed on the basis of false information. 

The impact of HIV/AIDS is slowly diminishing, however, there has been a huge upsurge in cancer in the community. It may be a result the ARV's that are given to those who are HIV+. These people need care as well and often do not appear in the statistics. There is still a need to deal with those who are infected and affected. 

The team members get to hear many terrible things and have to deal with it. Family violence and all forms of abuse are common. The women are often not able to tell anyone about their circumstances and if they did would be ostracized by the community. They are pawns in a vicious, violent situation. 

Prayer and Praise Points

1) The ongoing impact of their ministry.
2) The trust that exists between them and the community and the opportunities this creates to genuinely love people and encourage them.
3) They have to deal with a lot of personal information and stories of trauma which is not easy to deal with. They are constantly being debriefed and supported.
4) They are struggling financially with the loss of two donors. This causes them to be discouraged as they want to grow and they see other groups with a lot of money but who are not delivering real care in the most appropriate ways.
5) They are a strong team and there is a lot of mutual support and regular Christian input.
6) There are many challenges concerning world-view especially those that are being encouraged by the sangomas (traditional healers) and urban legend.  

Comments

This is a very influential group of people in this community. They are passionate about their role and ministry. They are committed and do so at personal cost to themselves. Most of them could be earning regular salaries from NGOs or government agencies but they choose to stay so they can stay in their niche area, home based care. 

They are under increased pressure as they have lost two significant donors. They have had to reduce programmes but attempt to stay engaged with those who once attended these programmes. They would love to do more. 

They have realized their financial vulnerability but really don’t have people in their close network to help them. However, they are beginning to talk about this and make some plans. Despite this, they are passionate and effective so I consider them to be making a very valuable contribution to their community. 

There is a sense that this is a mercy ministry and to add income generation without the right people would distract them from core business. 

There is a lovely spirit in the team. They burst forth into song at the slightest provocation and genuinely love those who come into their centre and out in their homes. I am inspired when I go there.