C-SAFE Malawi is comprised of CARE, World Vision, Catholic Relief Services, Save the Children US, Save the Children UK, Salvation Army, Emmanuel International, Africare and Malawi Red Cross. C-SAFE Malawi is scaling down its "developmental relief" program from twenty-three districts, where it has worked since mid-2003, to eight districts that will fall under a new long-term Development Assistance Program. The DAP will promote long-term food and livelihood security in the country's most vulnerable communities.
With C-SAFE interventions, such as targeted food distributions and Food For Asset activities in full-swing, a number of C-SAFE members began discussing, designing and implementing exit strategies. Communal and backyard gardens, and income generation activities were deemed to be the most appropriate and viable strategies given the short time period before the program exit. The goal of the activities, managed in close coordination with beneficiary communities, is to ensure that sustainable mechanisms are in place to support the community's food and nutritional needs beyond the program.
Below are a number of stories from the field. Each captures some of the exit strategies employed by C-SAFE members and their impact on vulnerable households and communities targeted under the C-SAFE program.
EI Exit Plan Emulated: In preparation for the October phase-out of the C-SAFE Malawi program, Emmanuel International has implemented a number of practical exit strategies that are being emulated by other Consortium members.
Three Households Living with Chronic Illness: Three households with renewed hope through the C-SAFE program - how has the program prepared them for C-SAFE's exit?
Salvation Army Phases Out of C-SAFE to Development Assistance Program: The small, remote village of Chimbalanga is typical of any chronically food insecure area in Malawi. The low rainfall, infertile soil and inadequate harvest that plague this community are being addressed through a C-SAFE food security program which is preparing to transition to a long-term Development Assistance Program.
Promoting Sustainability in World Vision's Bvumbwe Project Area: in this semi-urban locale of 66,000 people, stories of hope and progress are emerging, owing partly to the timely intervention of USAID funded C-SAFE interventions, but more importantly, to the dedication and commitment of the entire community to map a sustainable future for themselves.
EI Exit Plan Emulated
In preparation for the October phase-out of the C-SAFE Malawi program, Emmanuel International has implemented a number of practical exit strategies that are being emulated by other Consortium members. Care, Catholic Relief Services and Salvation Army are among those agencies to have visited Emmanuel's projects to share in the lessons learned on these simple but sustainable measures, and to help inform the design of their own community/household-driven exit strategy.
Emmanuel International's Helen Jones explains how the beneficiary community were empowered by C-SAFE to begin the exit strategy process. "The C-SAFE program, which initially supported the immediate food security needs of vulnerable households with targeted food assistance, provided an opportunity for the entire community to learn and determine how they could help advance and protect their food basket and livelihoods. These ideas have been incorporated into a variety of exit strategies - from gardens to livestock assets, that are now being proudly coordinated by the community." In Chiloumba Village, Balaka, an input of seeds from Emmanuel International allowed the creation of a communal vegetable garden. The garden, developed by the village committee, is ripe with 12 plots of nutrient rich tomato, amaranthus and turnips, available at an affordable price to the village's 390 households.
Village Committee Chairman Fred Sitima is enthusiastic about the sustainable income generation activity that is providing nutritional support to the whole community, but of particular benefit to the most vulnerable. "We save the profits from our vegetable sales and have funds available to assist our chronically ill and orphans."
The communal garden also functions as a demonstration plot that has precipitated the establishment of close to 100 household vegetable gardens in the community.
Nineteen year-old Lucia and her husband are maize farmers with a young baby. Lucia began a household garden three months ago and is growing a variety of vegetables to boost her family's nutritional status and household food security. "Before the garden, we ate only small fish, maize and cabbage. Now I am growing turnips, pumpkin leaves, beans, tomato and okra. I can feed my own family, plus others in the village who are in need." Thus, those most in need - including the village's 15 chronically ill individuals (a proxy for HIV/AIDS) and 60 orphans, are also being supported by the village committee, which is in turn fostering a spirit of community care and concern for the vulnerable. "We visit these households regularly to provide food, medicine and home maintenance. C-SAFE is also training two people from the committee on Home Based Care work so they educate and support households caring for the chronically ill. We try to set an example for others and provide hope and encouragement," says Fred with a smile.
Exit strategies have also been prioritised in Balaka's Nkuli Village. C-SAFE has assisted in the procurement of 19 goats and 12 chickens - living assets managed by the village committee that can be sold when the need arises.
According to Joseph Kambalame, Nkuli Committee Chairman, "We also plan to buy agricultural produce locally - rice, beans, groundnuts - and sell it in other markets. The profits will be set aside to buy medicine and supplies for the chronically ill and the ever-increasing number of orphans in our village. We have also started a community bank account with some of our savings."
Prior to the October phase-out, C-SAFE is also training committee members in a number of issues related to chronic illness. Themes include basic sanitation; education on health and medicine; patient care; and the promotion of vegetable gardens . Joseph has high hopes for the community's support efforts. "By next year, each and every community member must be taking a role in caring for the chronically ill through home-based care. Orphans will be in school through encouragement and enlightenment as they will be better equipped to gain employment and support their families." According to Emmanuel's Helen Jones, "It was really important to us to develop viable exit strategies that benefit and empower the community, particularly in light of the complete phase-out of C-SAFE this year. We of course hope that this community will benefit from another program in the future, but we have to work on the assumption that they may not - hence the need to set up sustainable community-managed mechanisms. It has also been exciting to share some of these best practices with other C-SAFE members to prepare their villages for the program exit."
EI project areas in Balaka will not be included in the DAP.
C-SAFE Malawi, Chronic Illness and Exit Strategies
Three households living with chronic illness. Three households with renewed hope through the C-SAFE program. How are these households coping with the impending exit of C-SAFE?
Shaded by the flowers of a crimson bouganvillia tree, Nailuwa peasant farmers Moussa, 71 and Fellie, 61, speak softly of their orphaned granddaughter's battle with AIDS.
They tell of their anguish of knowing the 11 year-old currently lies in a Blantyre hospital bed after suffering repeated bouts of malaria, stomach upsets and other body aches and pains, instead of enjoying school and playing with her friends. "It pains me when she cries in distress and is so restless," says Fellie, a former mid-wife.
"She first tested positive to HIV in 2001, at age eight - but she was not told her status," says Moussa. "Her mother passed away in 1994, her father in 2000. It was then that we took her into our home to care for her." Moussa believes that the father's "drunken and irresponsible" behaviour led to his contraction of the virus, which was passed on to both the wife and the child she subsequently gave birth to. The household has been receiving C-SAFE food rations through Emmanuel International, which targets households supporting chronically ill individuals and orphans. Moussa and Fellie's household represents both of these target criteria. Emmanuel staff visit the family often and assist by personally delivering the rations to the house during the harder times.
In anticipation of C-SAFE's exit from the area, the household has made efforts to ensure that they can provide for themselves after October. Moussa and Fellie are growing their own maize, have two plentiful vegetable gardens of cabbages and tomatoes, plus a tall papaya tree.
"We encourage our granddaughter to live positively," says Fellie, "And to eat food that will make her strong, as well as good vegetables from our garden. She usually recovers well - I know that if she was at home, she would want to be in school."
Married for 43 years, Moussa and Fellie never expected to be in their current role - but in a country with a prevalence rate of 15% (the eighth highest in the world) and more than half a million AIDS orphans (UNAIDS), their predicament is not uncommon. However, their shared experience does not make it any easier to cope with.
"She still does not know her status," says Moussa, "We are fearful that she will be isolated at school, and we want to protect her from that. We have also not told her how her parents died. We will tell her when we think she can cope with these facts."
For now, the 11-year-old's education and medical fees are being covered by the proceeds from her father's will. The grandparent's faith in their daughter's recovery is strong, but they have seen how the virus can take the lives of once strong and active people. Moussa laments, "We know that one day she wants to become a teacher - but sadly, our hopes collide."
Seventy-something Eluby Kamoto is swathed in yellow cloth and flashes a smile just as bright. A popular member of Chiloumba village, Eluby has been living with chronic illness for four years.
Eluby explains that an accident a number of years ago left her almost crippled with swollen thighs and an aching back and hip. "I also suffer from malaria, constant headaches and high blood pressure," says Eluby. Using a stick to hoist herself around, this elderly woman is also caretaker to her 13 year-old grandchild. This is a role she has played for 11 years after the young girl's father died of cancer and mother from a stomach disease.
For the last year, Eluby and her orphaned granddaughter have being receiving a monthly ration of beans, cornmeal and vegetable oil from C-SAFE, but this assistance will cease by October when C-SAFE phases out of the district. "I will be very sad to see C-SAFE leave our area, but we have done a few small things to help with our food needs," says Eluby pointing to a neat garden adjacent to her small home.
The village committee helped to dig a backyard trench suitable for growing a wide range of vegetables and assisted with manure and a fence. Eluby is now growing a nutritious selection of turnip, amaranthus, pumpkin and beans. For household cereal requirements, the household has cultivated a small patch of maize which the granddaughter helps to maintain.
"It is difficult to look after a young girl when you are not well and you are alone. The C-SAFE food aid has helped us greatly this past year, and this new garden will help us a lot this next year. But I would not be in this position if it were not for the committee's help to get it started. The many vegetables have already been most helpful and we are both feeling healthier. I trust our village committee and I know they are going to assist me with fixing up my house and any emergency needs we might have in the future."
Jane is 46 and is living positively with HIV.
Jane's health began to deteriorate in 2001 at a time when she was the sole breadwinner for her household. With little or no food in the household at the time, Jane sought help from numerous traditional healers who prescribed various substances to ingest and bathe in, to no avail. Her village's home- based care (HBC) group, trained by World Vision through C-SAFE, implored her to visit a hospital for tests, where she was diagnosed with tuberculosis. Jane spent two weeks in hospital, while her three children withdrew from school to care for one another. The TB treatment made her feel weak, recalls Jane, as it was not accompanied by good, nutritious foods.
"Then the HBC group came to visit me to tell me that C-SAFE was going to provide food for my household, it was such a relief for my family," says Jane.
"Early this year I completed my TB treatment and began anti-retroviral treatment, which at first gave me headaches, toothaches and body aches, but combined with the C-SAFE food, I started to feel strong again - strong enough to make a good backyard garden for our household."
Jane's children are now back at school, and the family enjoys a nutritious diet of maize, sweet potatoes, sugarcane, cabbage, rape and papaya from the garden, which will sustain the family when C-SAFE phases out of the district this month.
C-SAFE staff have also advised Jane on other locally available foods and natural therapies. And in efforts to help her build her immunity and effectively absorb nutrients, staff are sensitising Jane and other chronically ill community members on the benefits of consuming fresh lemon juice, garlic and ginger.
"When I think about how sick I was, I can't believe how good I feel now - it makes me so happy. I can now do my housework, work in my garden, help my children and dance - I love to dance."
Salvation Army Phases Out of C-SAFE to Development Assistance Program
The small, remote village of Chimbalanga in Phalombe District is typical of any chronically food insecure area in Malawi. The low rainfall, infertile soil and inadequate harvest which plague this community are being addressed through a C-SAFE food security program which is preparing to transition to a long-term Development Assistance Program (DAP). The Salvation Army, one of C-SAFE's nine members, introduced the "developmental relief" program to the area mid last year with targeted food distributions and Food For Assets activities. The phase-out of the USAID Food For Peace funded C-SAFE program and phase-in of the DAP (also funded by FFP), planned for October 1st this year, prompted the drought-hit community to employ measures that would support their food security through the transition and well into the hungry season.
"Though the DAP will provide supplementary rations of corn-soya blend to our chronically ill and orphan community members, our village committee decided to establish a communal vegetable garden to meet basic dietary needs. Grown with seeds donated by the Salvation Army, the garden provides affordably priced vegetables to the whole community. The chronically ill and village orphans can buy at a discount price," says Dick Mataka, Assistant District Program Manager.
One of 45 communal gardens established in the district, this flourishing 14m x 10m garden was constructed in July with the assistance of C-SAFE Salvation Army staff. The committee was trained in garden construction and cultivation, and how the income generation activity could sustain vulnerable households. "The profits from the vegetable sales are used to purchase soap, clothing and medicine for households supporting chronically ill individuals and orphans. The garden represents a community owned and run initiative that can be utilised by the most vulnerable members of Chimbalanga," Dick states.
Using the communal garden as a model, a number of household gardens have been established, providing nutritional vegetable supplements to the often poor diet of household members. Even cereal staples are scarce in this area as the lack of fertiliser and more seriously, the lack of rains, hampers maize cultivation.
In an effort to encourage diet diversification, C-SAFE Salvation Army staff has conducted preparation and cooking demonstrations of locally available foods such as rice, cassava and sweet potato. The staff has also sensitised the village on HIV prevention and AIDS care, with special emphasis on the nutritional needs of HIV positive and chronically ill individuals.
In addition to food aid to chronically ill and orphans, the Development Assistance Program will provide the community with bean and soya seeds, plus promote small-scale businesses and their linkages to local markets.
With the C-SAFE program drawing to a close, Salvation Army has taken time to explore with the community how village assets such as roads will be maintained, the benefit of each household establishing a backyard vegetable garden, as well as plans to involve the Malawi Ministry of Health in community growth monitoring and nutrition education.
Dick Mataka affirms, "C-SAFE has promoted food security and progress for this community and educated them in methods to support themselves beyond the program. We look forward to participating in the development intervention that will begin in October and the sustainable methods we will learn and implement in the years to come."
Promoting Sustainability in World Vision's Bvumbwe Project Area
Lush green tea plantations blanket the undulating hills and valleys of southern Malawi's Thyolo District, providing a bounty of produce and profit for their foreign owners. Hidden in the shadow of these vast estates is the Traditional Authority of "Bvumbwe", where communities are locked in a battle against poverty, hunger and HIV/AIDS.
But in this semi-urban locale of 66,000 people, stories of hope and progress are emerging, owing to the timely intervention of USAID funded C-SAFE, but more importantly, to the dedication and commitment of the entire community to map a sustainable future for themselves with the knowledge that the C-SAFE Malawi program will phase out by October.
"This area is income and asset poor and has a high prevalence of HIV, which has affected development at both the household and community level. In 2003, C-SAFE member World Vision delivered a program of targeted food distributions to households affected by chronic illness and orphans, and Food For Assets work, which included road rehabilitation, small-scale irrigation and water harvesting. When we learned that C-SAFE was phasing out of the area, we looked at how best we could capitalise on what had already been implemented, and what role the community could play to ensure their own food and livelihood security beyond the program's close," says Chimwemwe Ngalauka, Thyolo C-SAFE District Coordinator.
C-SAFE's intervention, while addressing the immediate food security needs of the area, allowed the community to identify gaps, build on the program and plan for the future using their own skills, knowledge and awareness.
Home Based Care (HBC) groups comprised of 20 volunteer community members per village have been pivotal in the success of C-SAFE's intervention, as well as complementary initiatives that will continue after C-SAFE exits.
With the impending phase-out of C-SAFE targeted food assistance, HBC groups went about creating communal gardens. They recently harvested twelve 50kg bags of maize, which they sold to pay for school fees, food and medicine for orphans and the chronically ill. These gardens, which also provide a model for backyard gardens, will continue to be cultivated, consumed and sold.
The Home Based Care groups have also responded to the high prevalence of HIV/AIDS in the area, undertaking community sensitisation on stigma, discrimination and principles of Positive Living. The HBC members counsel community members to get tested for HIV, facilitate hospital visits, and if they are found to be HIV positive, HBC members will identify the household for food distributions if chronic illness is present, educate the household on the importance of a balanced and nutritious diet and building physical strength, as well as offer spiritual support. 1,200 individuals who are "Living Positively" with HIV/AIDS, assist HBC groups in community sensitisation to impart their own experiences and be models of hope for others. Some HBC members also use their own money to buy clothes and supplies for households affected by chronic illness.
The youth of TA Bvumbwe are enthusiastically involved in activities initiated under C-SAFE that will continue and expand beyond the program. According to Sophex Chimponda, C-SAFE HIV/AIDS Facilitator, "The work has been challenging, but the main objective has been to mobilise youth for behaviour change through a number of interventions. Youth drama and traditional dance performances are designed to sensitise the community on HIV and sexually transmitted diseases. They also urge young people to become worthy role models for others." These activities have been carried out at C-SAFE food distributions in order to share these important messages with the maximum number of people. The group of over 500 youth is also trained in counselling fellow youth on safe sexual practices and HIV prevention.
"Through TA Bvumbwe's community-based interventions," says Sophex, "11,000 people have disclosed their status. Now, most people go to get tested, they know ways to prevent virus contraction and stigma has reduced. It does remain a challenge, however, to get certain people to open up and talk about sex."
In addition to providing targeted food assistance to vulnerable households, C-SAFE also initiated Food For Assets activities in Bvumbwe. As a means of increasing the productive assets of the community and securing food for the most vulnerable, 250 people from households affected by chronic illness, those caring for orphans, or who were landless, constructed and rehabilitated 12 kilometres of road, over a six-month period. The new road has created a valuable asset of which there is a strong sense of community ownership, and has brought hope and opportunity to a neighbouring village of Kapyepye that once existed in isolation.
Prior to the road's construction, Kapyepye had no access to health services, education or local markets. To sustain their livelihoods, villagers would log the abundant forest around them, burning charcoal which they would haul long, rugged distances to sell at the city market. The new road has prompted the village to grow alternative sources of income, such as cassava, beans and bananas, which they now sell at Bvumbwe main village, accessible by the new road. The localised environmental degradation is evident to the villagers and they have taken steps to reclaim the forest forming "Forest Committees" to ensure that deforestation is brought to a halt.
The community is also benefiting from C-SAFE initiatives in Bvumbwe main village, through exposure to HIV/AIDS awareness messages and opportunities for sustainable development. The road has paved the way for other NGOs to plan and implement new education, health and sanitation interventions in this once secluded community.
In the nearby village of Chinthebe, where C-SAFE has already phased-out, FFA water harvesting was been conducted, which is now sustaining the small community. The two water harvesting structures were built with C-SAFE's technical expertise, tools and training. Maintained by ten households affected by chronic illness and orphans, the structures are being utilised to harvest Chambo fish for both consumption and profit.
The fish provide an excellent source of protein for the community, and the sale of fish to both local markets and organisations is raising funds to care for orphans and the chronically ill. The water from these structures is also being used to irrigate a number of community gardens ripe with cabbage tomatoes, onions, rape and turnip - the seeds of which were bought by the community. The community is learning about gardening techniques from Bvumbwe main village and are planning more water structures and gardens.
C-SAFE's Chimwemwe Ngalauka also notes the additional importance of program integration and relationship building in TA Bvumbwe during the C-SAFE program. "World Vision Taiwan has supported the community with the donation of treadle pumps, which have provided clean and accessible water. A donation of goats has provided productive assets for the community, and as the herd grows in number, the goats are donated to other HBCs in neighbouring villages. World Vision Taiwan has donated maize, vegetable seeds and conducted community capacity-building activities. The TA is also working hand in hand with the Ministry of Agriculture and the local hospital to establish clear guidelines on roles and responsibilities post C-SAFE."
And with weeks left before C-SAFE completely exits TA Bvumbwe, Chimwemwe assures that the community is prepared. "Staff have always endeavoured to raise awareness about the program's time span and consistently remind beneficiaries of the program's exit during monthly food distributions."
Beneficiary Musuzgu speaks for her community, smiling as she gazes towards the vista of distant tea plantations, "We are so thankful for C-SAFE - the food for our helpless ones, the opportunity for new roads and income, and learning how we can protect ourselves from AIDS and care for one another better. We here in Bvumbwe are all working hard together as a community, and though we don't know what our future will be, we now have the means and know the ways that we can help ourselves."
Stories and photos by Kristy Allen-Shirley, C-SAFE Communications Coordinator
This document was made possible by USAID's Office of Food For Peace. The opinions expressed herein are those of the author and do not necessarily reflect the views of USAID.