Group photo of Friends Women’s Association members after their annual general assembly held at Kibimba on August 15, 2017
The Friends Women’s Association in Burundi has just issued a report on their work in 2017 which can be found at the following link: http://www.fwaburundi.com/friends-womens-association-newsletter-001/. Their work at the Ntaseka Clinic in Kamenge, Bujumbura includes the following:
- Women receiving contraceptives = 2190
- Children vaccinated in campaign = 7213
- Patients seen by part-time doctor = 186
- Patients seen by nurse = 2482
- Laboratory tests (excluding HIV/AIDS testing) = 1927
- People tested for HIV/AIDS = 2100
- Total HIV+ = 142 (108 women and 34 men)
- Percentage testing positive = 7% (this is extremely high for Burundi)
- HIV+ patients under ARV treatment = 190 (150 women and 40 men)
In addition the clinic sponsored the following programs:
- Rape Survivors Project with 6 trauma healing workshops and 5 self-help groups.
- READY program which gave information to youth on sexual and reproductive health.
- Caring for HIV Positive People with home visits, nutritional support, discussion groups and self-help groups.
- Improving Women’s Reproductive Health that promoted birth control information and HIV testing.
- Gender Based Violence with 7 workshops to sensitize 175 community and religious leaders on gender based violence issues.
This is fantastic amount of work for a small, out-of-the-way free clinic in a slum with a staff of only eleven people.
I well remember in 2002 when Cassilde Ntamamiro, a Burundian Quaker nurse, who had cared for her sister, brother-in-law, and two children as they died from AIDS when there was still no medical treatment available in Burundi, proposed starting the Friends Women’s Association and its Ntaseka Clinic. At this beginning two important decisions were made that led to the development and success of the clinic.
First, it was decided that the organization would be organized and led by women. In 2002, the Quaker Church in Burundi was led completely by men who were opposed to any involvement with HIV/AIDS because in order to do so one had to discuss sex. At that time none of the 9,000 members of the Friends Church would admit to being HIV+ because it meant that someone in the family had to have had sex outside marriage. I remember in 2005 when the first Quaker, Felicite Niyonzima, was willing to stand up in church in front of hundreds of people and admit that she was HIV+. As soon as she did this, women quickly came up to her and told her that they were also HIV+. The Friends Women’s Association has been properly run for these last 16 years with an annual meeting of the membership, quarterly executive committee meetings, and proper financial and narrative reporting that has led to the continued rise of the organization and its effectiveness.
The second issue was that, since HIV/AIDS had such stigma in Burundi, no one would come to a clinic that was only for HIV+ people. So the decision was to make it a normal health clinic with an HIV/AIDS section. This general orientation has actually helped the work against HIV/AIDS because part of family planning, for instance, is to teach people how to keep from becoming HIV+ and part of maternal/child health includes information on stopping mother to child transmission of HIV/AIDS.
As coordinator of the African Great Lakes Initiative, I was closely involved and supported the development of the Friends Women’s Association and its clinic. It began in an inadequate rental property. The first step was to buy a plot to build the clinic. When this was accomplished, it is remarkable that the clinic building was constructed by work camps of up to six Burundian and six international work campers. The international work campers were required to raise $1200 or more for the materials for the building that they were going to construct. I remember one year when about 1st September I sent Cassilde the funds to buy and put on the corrugated iron sheets on the roof and by 15th September, when I visited the site, the roof was already on.
In 2014 the Board of the Friends Women’s Association decided to add the position of Coordinator to the clinic to supervise its administration and development. Pastor Parfaite Ntahuba filled this position and her dedication to the clinic and the people of Kamenge has been essential for the development of the clinic.
Yet there were potholes on the road to success. For example, in order to test patients for HIV/AIDS the clinic needed a counselor and a counselling room. The clinic had to add on a small counseling room at the side of the building and then hire a counselor. A bigger challenge was getting a CD4 machine which would determine the blood count of those being tested to see if they needed antiretroviral (ARV) medicines. Another challenge was the great need of the Complete Blood Count (CBC) machine, which establishes whether the body can handle the side effects from the ARV drugs. Without these two machines, the staff had to take the tests to other facilitates which cost funds in travel and time wasted. Finally in 2015 after great effort, the CBC machine was purchased. Today, with the new recommendations “Test and treat”, the CD4 test is no longer a great requirement.
In order to dispense ARVs, the clinic had to have ten patients who needed the drugs. The clinic now has more than 200 such people and the number is increasing each month.
Burundi has one of the highest birth rates in the world with each woman having an average of six children by the end of their childbearing years. The country is very small, over-populated at 11 million people with its soils becoming infertile with over-cultivation. Burundi is predominately Catholic country and many of the hospitals and clinics are run by Catholics who are against modern birth control methods. Consequently the Ntaseka Clinic’s birth control program using modern methods is of great significant. The fact that more than 2000 women came to the clinic in 2017 for birth control is an important accomplishment.
An outreach meeting where the clinic staff are discussing family planning with a large audience.
It wasn’t always this way – when the clinic began few women came for family planning. This was due to the mis-information that many Burundians had about family planning and the various methods of birth control. To counter this bias against family planning, the clinic staff frequently holds meetings in various parts of the community to respond to people’s concerns about family planning and to explain the various modern methods of birth control. Of time this has meant a large increase in the number of women coming for family planning.
Orga, the first woman under anti-retrovial treatment at NTASEKA Clinic with her daughter. “I was almost dead, but God has used FWA to give me back life.”
I have discussed the challenges that the Ntaseka Clinic had in meeting the requirements to adequately test and counsel people taking the HIV tests. This was just the beginning. Burundi’s HIV+ rate is about 2% so Kamenge’s rate of 7% is well above average for the country. Since Kamenge is a poor slum with lots of destitute women this is not at all surprising.
Like the issue with family planning, because of the tremendous stigma against the HIV/AIDS people were reluctant to come to the clinic to be tested – people were in denial and preferred not to know their status. To counter this, the clinic conducted as many outreach sessions in the community as possible. For example, in their family planning public gatherings the staff would also include encouraging attendees to go for HIV/AIDS testing. When the clinic did workshops on healthy living/reproductive health with youth, HIV/AIDS testing was part of the message. The success of this outreach is indicated by the substantial increase in people attending the clinic to be tested.
Members of one self-help group meeting at FWA with Grace HORANIMANA (in white chair), FWA social worker.
There are additional steps needed. When a person is diagnosed as HIV+, she/he is usually quite distraught. This is where the role of the counselor is important. Sometimes the counselor has to seek out the HIV+ person in her or his home. Being HIV+ is no longer a death sentence as it used to be, but great care needs to be taken to live a healthy lifestyle. This includes proper nutrition. The ARV drugs are not beneficial if the person does not eat properly. Since the beginning of the clinic, there has been a program of nutritional support to the HIV+ women. Unfortunately this is quite expensive so the clinic provides as much as it can. Note that 75% of the people who test positive for HIV/AIDS are women. This is not unusual in Africa where women tend to have a much higher rate of being HIV+ than men.
This still is not the end as the clinic wants to have the HIV+ women in support groups. These begin with the three-day Healing and Rebuilding Our Communities workshop. The women are then formed into self-help groups. Now there are ten such groups with around twenty women in each group.
Parallel to this work, the clinic also holds workshops for rape survivors and women who have been abused including sex workers.
During the 16 days campaign of activism against gender-based violence (GBV), FWA organized a peaceful walk against Gender Based Violence on December 8, 2017.
Since prevention is better than cure, the clinic also attacks one of the major root causes of HIV/AIDS – Gender-Based Violence (GBV). As can be seen in the picture above in December the clinic held a public demonstration in the community. In addition for the last two years the clinic has conducted workshops with community and religious leaders (mostly men) to sensitize them on GBV and train them on how to intervene in cases of GBV.
Wow, this is a lot! And it is done with a staff of only eleven.
Heads-Up – Crowdfunding through Global Giving:
From March 12 to 30, the Friends Women’s Association will be participating in crowdfunding for the Ntaseka Clinic through Global Giving. The goal is to have at least 40 donors contribute at least $5,000. If successful, FWA will then be able to post various projects on Global Giving’s webpage which can attract new donors. My next Friday’s Report from Kenya will explain this campaign and ask you to participate by making a contribution.
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From 1998 to 2016, David Zarembka was the Coordinator of the African Great Lakes Initiative of the Friends Peace Teams. He continues his peacemaking work in East Africa with Transforming Community for Social Change (TCSC) and Friends Church Peace Team (FCPT). He has been involved with East and Central Africa since 1964 when he taught Rwandan refugees in Tanzania. David is married to Gladys Kamonya and lives in western Kenya. David is the author of A Peace of Africa: Reflections on Life in the Great Lakes Region. He is an analyst on eastern Africa issues for TVC News in Lagos, Nigeria.
Transforming Community for Social Change (TCSC)
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Reports from Kenya: www.davidzarembka.com/