Awareness Campaign in Mbinda Village

On the 5th of July NAYO held a campaign at Mbinda village to spread awareness of HIV and AIDS, including the importance of getting tested and knowing your status. The campaign was a huge success, attracting a large crowd with at least 85 people getting tested during the course of the campaign.

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Performances were given by the Judges Cultural Group, the children of Nancholi Youth Organisation music and drama groups and the Bristol Volunteers for Development Abroad (BVDA).DSC_0125

Prior to the start of the programme, chlorine was distributed to households around the village for water purification as part of the Hygiene and Sanitation project being carried out by the Bristol Volunteers. Mosquito nets were also handed out during the course of the campaign.

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Future awareness campaigns are currently being planned for further villages and we hope to build on the success of this first campaign.

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Community Irrigation Scheme

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Pictures of our community irrigation scheme. The maize harvested here is sold to be cooked whole on a coal grill or boiled – in March or April after the rainy season maize is harvested to be made into maize flour for Malawi’s staple food Nsima.

The money made from the project goes back into the community working the fields, towards buying food for those HIV clients who most need it, as well as buying more seeds. The simple irrigation channel is much needed in the dry hot season of September to November. It dramatically cuts down on the labour hours – otherwise the farmers would be watering their crops by hand with buckets.

At the moment the irrigation channel is very basic, just a hand dug 3 foot ditch which is plugged by plastic bin liners and using big rocks as sluice gates. In the future NAYO would like to construct a more permanent structure using cement – currently the channel is rebuilt every year after the rains have washed it away.

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The tragic story of Enifa

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Enifa Chirombo is a recent NAYO client who we have mentioned in a previous blog post, we have since learnt more of her story. She is 19 years old and extremely sick both physically and mentally. Her life has been a series of tragic events of which she has been a helpless victim, this is a space to voice her sad story.

She was orphaned at the age of one and was taken into the care of her aunt, Chrissy. As a three year old toddler Enifa was often found outside her house during the night. Her aunt believed, according to folklore, that witches were taking Enifa in the night to initiate her in witchcraft and therefore Enifa had become a witch. What Enifa did receive at the age of four from these nocturnal outings was cerebral malaria. She started convulsing twice daily and nightly. Chrissy took Enifa to a ‘herbalist’ or witch doctor and the convulsions stopped for one year but returned after that. She had epilepsy.

At the age of ten she fell in the cooking fire and severely burnt her upper arm. There is a huge scar there now from her shoulder to 10 cm above her elbow. From then on she stopped going to school. She was befuddled, confused and probably psychologically disturbed.  At seventeen years old she became pregnant from sexual abuse by men taking advantage of her mental illness. The baby was born prematurely and died at four days old. Enifa had contracted HIV and genital ulcers. She is now on ART treatment but has abdominal pains, diarrhea, is anemic and malnourished. She is often found in other people’s houses.

This is a serious case of constant neglect from the guardian. Her aunt Chrissy, who is a widow with her own children and surviving on earnings from piece work, sees Enifa as a burden with the stigma of being a witch and HIV positive. Chrissy refuses to take her to the hospital and is expecting NAYO to provide all the money to support Enifa for food, medicine and transport costs.

Enifa is completely vulnerable, with no strength and in constant pain. She also has no voice – with little schooling and has retreated mentally inside herself- most likely due to psychological trauma form her experiences. She can only voice her basic needs of escaping from pain, water, food and warmth. NAYO’s nurse has entered Enifa onto the palliative care programme to monitor her many illnesses.

Ultimately what Enifa desperately needs besides her basic human rights, is love and care. There is no easy answer, Malawi is without the infrastructure to protect the most vulnerable and silent apart from individual NGO’s with limited resources like NAYO.

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Enifa

Changing perceptions on AIDS

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The backbone of NAYO is the group of field workers who each visit up to 30 clients suffering from HIV or AIDS normally twice a month. They are essentially social workers; each designated a catchment area of normally 2 villages to supervise. This is done with the help of local volunteers who are their ears on the ground, they report to the field worker if something is wrong with a client or if there are any other HIV sufferers that need to be enrolled as clients. It’s an impressive structure which encourages community responsibility and acts as a safety net for those that are really helpless.

One of the biggest challenges NAYO field workers face is the stigma of AIDS and HIV among people in the village where it can be linked to witchcraft. There is a pervading tradition that men with HIV should sleep with young virgins to cure themselves of the disease. People are often fearful to get tested for HIV as they don’t want to face the discrimination that comes with it from their neighbours.

One such victim of this stigma is Enifa a girl of nineteen years old with HIV whose mother died when she was little. She lives with an aunt and her family who do not look after he well and refuse to take her to the hospital when she needs to go. Enifa came to NAYO’s nutrition support handout but was too weak to carry the 50kg bag of maize back to her house. NAYO called her aunt to help who laughed at Enifa’s weakness. On visiting this girl at her home it is easy to see she is not being cared for properly. She is emaciated and shivering in the hot mid-morning sun, without a blanket she uses her chitenge for warmth, as she tries to eat a cold, congealed bowl of porridge. NAYO’s nurse and field workers are working on an intervention to educate the aunt on HIV and encourage her to care for her better.

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Enifa

At a different village, field worker Crispin visits another young woman suffering with HIV whose husband refused to accept this. He refuses to use contraception even though she is not well enough to have any more children. She looks about 18 years old and is already a mother of 3 year old twins and a newborn baby, more children would most probably kill her. His thinking is ‘you are my wife, why should I use contraception?’ He had only recently consented to have an HIV test himself, which was fortunately negative.

When we arrived the husband was out at work. We sat on stools in the house, the baby lying on a blanket on the floor and the toddler curled up protectively over his mother’s lap as she leaned helplessly against the wall. She was very thin and looked weak.

Crispin asked her questions to understand the full story. At one point the mother breast fed her baby, her breast was small, shriveled and lifeless. Crispin held his head in his hands, saying, “Look she can’t even feed her baby milk. She hasn’t enough food. This is so pathetic.” And it was heartbreaking to see this young mother not able to eat enough food herself yet alone nourish her three children, and yet she was being forced to be this baby-making machine.

Crispin set up another meeting where the husband could be present so he could counsel them together on family planning. He planned to also talk to the husband separately to try and instill the seriousness of his wife’s health. There is not much question of the wife leaving the husband. Divorce is rare and a taboo in rural life, especially a female instigated divorce. Most of the time, the woman and children are so dependent on the husband that it would just be inconceivable to leave him.

NAYO’s social work is simple, with little funding but effective at giving those most vulnerable people in the community – women, children, those with HIV-fundamental support and care. The field workers reliable presence, hard work and compassion among for with HIV or AIDS also help to break down the stigma attached to the disease.

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Nutrition Support

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On Saturday NAYO had their monthly nutrition support for those 105 clients suffering from HIV – 96 of these clients were able to come, the other 9 had too far to walk but the food is still at NAYO for them to collect when they can. NAYO’s field workers distributed 2kg sugar, 2 litres of cooking oil, 2kg dried Nyemba beans (kidney beans), 50kg maize, 2kg ground nuts (peanuts) per person. This amount of food will not be able to last them for a whole month as they will be feeding their families too but it will help. NAYO provides nutrition support alongside antiretroviral drugs as, due to their strength, they need to be taken with food.

NAYO is committed to giving their community support to help them become self sufficient. However with the flood crisis at the beginning of 2015 causing mass crop damage now resulting in rising food prices, many in Nancholi are now even more dependent on aid, particularly the vulnerable living with HIV. NAYO’s nutrition support is not a long term answer but it can at least give those with HIV the drugs and limited food to get healthy and stronger. If you would like to donate please contact nancholiyouthorganisation@gmail.com (we are currently setting up a Virgin Money Giving page to ensure an easy and quick way to donate, this will be ready soon.)

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Everyone sits patiently while the food is divided up.

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Peter and Joshua measure out the oil

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Ground nuts are an important source of fat and protein. They are ground and used with vegetables to make a relish

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Chisomo hands out the food packages

The New Nurse

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Meet Dorothy Mtenje, NAYO’s new, full-time nurse who will be setting up the palliative care clinic for those living with HIV and AIDS. The clinic should be ready to receive patients by November.

“I left my previous job to join NAYO as I was being underutilized and I wanted to be somewhere I can really help. I felt pity on the Nancholi area as it is far away from a hospital. The clinic was built but they didn’t have a nurse.”

Dorothy began working as a nurse in December 1992 – so that is 23 years of experience! She trained as a nurse and midwife at Trinity in Nsanje. She has worked at a variety of organizations: mission hospitals, district hospitals, a United Nation ‘Millennium Village’ project and a University of North Carolina research centre.

It took NAYO 6 months to find the right nurse as we wanted someone with experience – and Dorothy is the perfect fit!

What is palliative care?

Palliative care is an essential component of caring for people living with HIV/AIDS because of the variety of symptoms they can experience. It focuses on providing patients with relief from the symptoms and stress of this serious illness. The goal is to improve quality of life for both the patient and the family. Lack of palliative care results in untreated symptoms that hamper an individual’s ability to continue his or her activities of daily life.

The Village Bank

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Seventeen women sit in a circle on green plastic chairs under the shade of a mango tree at the top of the hill outside NAYO’s office. Most of them wear the same wrap around skirt, called ‘chitenje’ in Chichewe, a brown background patterned with red and yellow droplets. This is worn like a uniform and sign that they are from the same village.

The women are listening to the roll call of names and numbers from the two women with notepads, who are NAYO volunteers. With each name called, money is passed around the circle to two other women who collect it. They are giving their savings of the week into ‘the bank’.  The bank are two other volunteers who are entrusted to keep the money safe. This project was established by NAYO but is now self-sufficient.

They meet every Tuesday morning. They each give between 50 to 1000 Kwacha (5p to £1.20) each handover is recorded by the two NAYO volunteers with the notebooks – numbers are spoken in English in Chichewa, which makes shopping a lot easier. They hand in their savings each week until December when the dry season is over and the rains are beginning, so the soil is ready for planting. Then they can add up the books and withdraw those savings in order to buy seeds and fertilizer but also to prepare for Christmas.

When the women need a loan during the year they can ask for it from the bank. They must repay it within 6 months with a 15% interest. This interest is used by the women to support those in their village that are sick. This system not only gives the women some control over their finances and their lives, where normally they would be reliant on the men as the only, or main, bread winners and also the money spenders. But it also keeps the money within the community by spending the interest on the community rather than it being sucked up by a banking cooperation, ‘many of whom charge exorbitant interest rates that sometimes reach up to 200% per annum’ (The Guardian).

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