Zimbabwe + 2 more

C-SAFE: HIV/AIDS and Nutrition Newsletter - Issue 6, Aug 2004



Best Practices Identified in C-SAFE Programming. Reports from two recent consultancies on Targeted Food Assistance and Food For Assets in the Context of HIV/AIDS will be released by the end of August. A launch of our findings and dissemination workshops will be held regionally and in each C-SAFE country in September. The Partnership Exchange to study Chronically Ill Programming (held in Zambia in May) has completed a report of its findings and recommendations. This document is currently being formatted for publication and will be available in early August. Stay tuned!

Zimbabwe holds First Annual National Conference on HIV/AIDS. Attended by several C-SAFE partner staff, this event focused on current achievements and failures in Prevention, Treatment and Care. Among recommendations arising from the conference, delegates agreed that: stigma and discrimination are still a significant constraints that must be tackled at every level with vigor and creativity; greater political, financial and technical support should be provided for improving dietary quality and increasing dietary intake to recommended levels. Evidence-based nutrition interventions should be part of all national AIDS control and treatment programmes; comprehensive and sustainable home based care projects should be prioritized and supported; and there is an urgent need for comprehensive workplace policies. (submitted by Maria Tokwani and Loveness Makones, CARE Zimbabwe)

Puzzle winners: Bothwell Mhashu and Abel Whande (CARE Chirumnazu, Zimbabwe), Cathleen Sosopi (CRS Zambia) and Takondwe Kabambe (C-SAFE Malawi). Several other correct entries were received from non-C-SAFE staff - congratulations to everyone who learned enough to fill in the puzzle!

From a Beneficiary's Perspective: One Small Victory in Zambia

The wind that carpets western Zambia with sand swept from the Namib Desert creaks through the reed walls of Namakando Liyala's two-room house. It blows now in the dry winter months - a seasonal variation that in some ways mirrors the changes with which Liyala struggles since becoming infected with HIV.

"The past years I would feel better, then I would get sick," Liyala explains. "When I feel better I try to work, then I would start to go down again." Testing positive for HIV after the death of her husband in 1999, Liyala, 50, now breaks down much of her daily life into the tasks that she can or cannot accomplish that particular day. Though she used to work in the local market, her frequent illness now keeps her from working steadily, and the subsequent loss of income in a country where the vast majority of the population lives on less than $1 a day has made life hard. "I used to sell items at the market until two years ago when I got too sick," Liyala says. "These days I am just struggling."

I met Liyala in Mongu, Zambia - a dry, dirt-street town in western Zambia. Learning of her plight, community care workers of the Mongu Diocese first visited with Liyala in 1999, soon after the death of her husband. After counseling her, they encouraged her to be tested for HIV - the first step towards getting help through the Community Based Care program run by the diocese. In 2002, Liyala was able to begin receiving monthly food rations through C-SAFE - the Consortium for Southern Africa Food Security Emergency. Through C-SAFE - a unique consortium made up of the relief agencies CARE, Catholic Relief Services and World Vision - Liyala receives beans, sorghum and wheat each month, rations without which she would be entirely dependant on the help of strangers for her food each day.

WV in Bulawayo makes learning a priority! Thabani Maphosa has developed a method of making sure his colleagues make time for learning. The C-SAFE HIV Newsletter is circulated to all staff on a roster that prompts everyone to make time to read it, comment on their learning and pass it on. This demonstrated commitment to professional development is a great boost to staff morale and is intended (over time) to have a positive impact on programming. Well done, Thabani!

July 23, 2004: Zimbabwe Members of Parliament Tested for HIV.

In a bold step to encourage people to learn their HIV status and to reduce the stigma attached to HIV/AIDS, nine members of Zimbabwe's parliament were tested for HIV at a Population Services International (PSI) New Start Voluntary counseling and testing center. With support from USAID and DFID, New Start centers have spread throughout Zimbabwe to become the second largest voluntary counseling and testing network on the continent. www.psi.org/news/


May 5, 2004: DHL to provide no-profit delivery for Merck drugs to Africa (AIDSMap). The international courier DHL is the latest multinational company to join the ranks of those providing services at no profit to assist in the roll-out of antiretroviral therapy with the announcement that it is to provide non-profit courier services to deliver Merck & Co anti-retrovirals to treatment and distribution centers in Africa.

July 5, 2004: Multivitamins help keep AIDS at bay (PLUSNEWS). The recently released findings of a study in Tanzania have revealed that daily doses of multivitamins may slow the HI virus. The study, which began in 1995, analyzed 267 women that were given multivitamins or a dummy pill. Only 7% of 271 women who took multivitamins developed AIDS, compared with 12% who took the dummy pill. The high-dose multivitamin containing vitamins B, C and E used in the study cost about US $15 for a years supply.

July 13, 2004: Global Fund approves US $211 million over the next five years for Zambia's fight against HIV/AIDS. (PLUSNEWS). The Fund's executive director, Richard Feachem, described the country as a "star performer" in the administration of Global Fund resources for tackling AIDS, tuberculosis and malaria.

July 14, 2004: Long-term stress Suppresses Immune System (AIDSMap). Long-term stress suppresses the ability of the immune system to fight viral as well as bacterial and parasitic infections, according to a meta-analysis of almost 300 studies published in the July edition of the Psychological Bulletin. The investigators also found that the immune systems of individuals who are older or already suppressed due to illness are more prone to stress-related change. For more: http://www.aidsmap.com/en/news/C274077B-6298-4D5D-8889-EC09D08EB874.asp

July 20, 2004: Blair Launches Britain's New $2.4B Strategy for Fighting Global AIDS. British Prime Minister Tony Blair launched the three-year strategy to fight global HIV/AIDS (Reuters, 7/20). The new plan will include about $278 million for AIDS orphans as well as doubling its contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Blair has said that he will put the fight against AIDS at the forefront of his agenda over the next year when Britain holds the six-month rotating presidency of the European Union and chairs the Group of Eight summit (Associated Press, 7/20).


Communicating Management of HIV/AIDS in the Community, 8-28 August 2004, Mazabuka, Zambia . The Salvation Army Chikankata Health Services, Chikankata, Zambia, in collaboration with the Regional AIDS Training Network (RATN) offers a course in Management of AIDS in the Community. This course will examine strategies to improve the quality of life to people infected/ affected by HIV/AIDS; to increase the community capacity to cope with HIV/AIDS; to prevent further transmission of HIV through behavior change; and to increase the ability of participants to build a broad institutional capacity to respond to HIV/AIDS. Contact: http://www.ratn.org/course1.htm

2005 AIDS Impact Conference will be held in Cape Town, South Africa April 4-7, 2005, co-organized by AIDS Impact, the Human Sciences Research Council, South Africa and the Nelson Mandela Foundation. The Conference invites people with HIV/AIDS, people from resource poor settings and community workers to join academics, health workers, social care providers and policy makers in bringing together multiple perspectives on current HIV/AIDS issues. The Call for Abstract and Early Registration deadline is October 1st. For more information email enichols@iavi.org or organiser@aidsimpact.net.

Kenya's National Nutrition Congress, 21st to 23rd February 2005, Nairobi Kenya. The program is designed to help participants advocate for nutrition as a key development issue; lobby for allocation of adequate resources; develop strategic partnerships; provide a forum for information-sharing among members with interest in nutrition; provide technical expertise in policy formulation, research and programming in nutrition. You can now register and submit your abstracts online. For more information, visit our website: www.k-can.or.ke

2nd Food Safe International Conference and Exhibition: Promoting the Health of the African Nation, 25-28 October 2004, Gaborone, Botswana. The Conference will address all the relevant issues related to promoting good health, safe food, good nutrition and a healthy environment for the developing nations. Please Contact the Conference Organizer Nina Hamid on Tel/Fax: + 267 3959504, Cell: + 267 72107166, Email: nhamid.fsi@it.bw

'Youth-Net and Counseling' Conference on Youth, Children and HIV/AIDS, Malawi. 'Youth Net and Counseling' (YONECO), a NGO dealing in issues of youth, children and women in Malawi is coordinating and will host this conference from 24 to 27 August 2004 at the Sun and Sand Holiday Resort, Lake Malawi, with support from the Humanist Institute for Cooperation with Developing Countries (HIVOS). The conference was originally intended for partners, but has been extended to other organizations to encourage networking and coordination. The conference fee of US $600; registration is due on 1 August 2004.

For information, contact:

Mac Bain Mkandawire, Tel.: +265-9-953-542, email: mhjmkandawire@sdnp.org.mw
Howard Chitekwe, Tel.: +265-9-290 035, email: yoneco@sdnp.org.mw
James Kalimbuka, Tel.: +265-9-301 892, email: kalimbuka@yahoo.com

Synergy's HIV/AIDS Program Planning Course in Accra, Ghana, October 25-30, 2004. Funded by USAID, the course is designed to build capacity at the country level to manage expanded resources. Participants will learn how to integrate a five-stage programming cycle of assessment, strategic planning, program design, implementation monitoring, and evaluation of HIV/AIDS prevention, care, and treatment interventions in the context of scaling up programs to meet targets set by the U.S. President's Emergency Plan for AIDS Relief and other global initiatives. The application deadline is July 30. http://www.synergyaids.com/tc_devEss04.htm


Criteria for admission/entry/discharge/exit? Graduation strategies, exit strategies... what do all these terms mean?

The admission criteria for atargeted food assistance describes the specific vulnerable groups and the basis on which to select and prioritize individuals or households for enrollment into the program. Can be used interchangeably with 'entry'.

The discharge criteria identifies at what point households should no longer receive food aid, due to improvements in nutritional status or household food security status, successful completion of medical treatment in the case of tuberculosis (TB) patients, or meeting additional criteria. Can be used interchangeably with 'exit' in the context of criteria for beneficiary selection.

The graduation strategy of the targeted food assistance program refers to activities, whether training or additional programming, which prepare beneficiaries (individuals or households) for the end of a specific food intervention. These activities will help to sustain and build on the improvements to the individual's (or household's) food security status made during the initial intervention.

The exit strategy is the process of preparing to end targeted food assistance in a given community. Exit strategies are those which strengthen community-based structures/processes for supporting vulnerable households to the extent that external support is no longer required. 'Exit strategy' (which applies to a program) should not be confused with the 'exit (or discharge) criteria' (which applies to beneficiaries). Exit strategies can also include 'new' external support (i.e. a Development Assistance Program, as C-SAFE Malawi is moving toward) where communities are not yet positioned to take over.

'Treatment optimism' - this refers to a belief that treatment is a cure (even though it clearly is NOT), that the effects of HIV infection are no longer as serious as they once were, and that safer sex is 'optional' because treatment is available.

Underweight, Stunted, Wasted -- are you clear on the difference?

How measured
What does it mean?
What does it look like?
Wasting Weight for Height Recent weight loss/recent dietary/insufficiency Thin child*
Stunting Height for Age Failure to grow over time / longer term dietary insufficiency Short child
Underweight Weight for Age Combination of wasting and stunting Thin short child*

* Either of these categories can be accompanied by swelling (oedema) which can mask thinness. Swelling generally occurs in the face, feet and hands so remember to look at the ribcage, neck, arms and legs... This is a VERY serious sign!

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