Hospital Management Team

Mua Catholic Hospital

P.O. Box 41 Mtakataka

Malawi

Africa

Albertine Baauw

The Netherlands

Dear Albertine Baauw,

Thank you very much for the suggestion of link Mua with IJburg. In our opinion it is a very good suggestion and we have discussed in which way it might work best.

We would like to suggest to focus mainly on those children who are affected with HIV/AIDS. Since July 2005 Mua Hospital provides ART to adults and since June 2006 we are also allowed to provide children with ART.

The number of children is growing and they require special attention, different from the one for adults. Issues that arise when children start ART (like how and when to disclose to the child his/her status, what to do when the child refuses to take the drug) are very important, but also involvement of the child in the clinic. Now the ART-clinic (at Mua called HOPE-clinic) runs on Tuesdays (for starters) and on Thursdays (for refill). We are considering starting a special day for children and their guardians.

With assistance from the link with IJburg we propose the following activities:

We have tried to put these suggestions in a proposal including the required topics. See attached proposal. Any extra suggestions or corrections are welcome.

On behave of Mua Management team,

Yours sincerely,

Erdi Huizenga

DATE: FEBRUARY 2007

TO: FOUNDATION LUKULU

ALBERTINE BAAUW

ZWANENBLOEMLAAN 206

1087 GD AMSTERDAM

FROM: MUA CATHOLIC HOSPITAL \

P..O. BOX 41

MTAKATAKA

MALAWI

C-AFRICA

Malawi is one of the poorest countries in the world. Malawi is located in Central –Africa, in between Tanzania, Zambia and Mozambique. Just like many other African countries Malawi is severely affected by HIV/AIDS (national prevalence is between 11-15%).

Mua Hospital belongs to the Diocese of Dedza of the Roman Catholic Church. Dedza Distric is in the central region of Malawi. Mua is situated in the eastern side of Dedza District .

Mua Catholic Hospital serves a catchment area with a population of about 130,000 people. The hospital is a referral hospital for eight health centres and has about 140 beds.

One of the departments in the hospital is the HOPE-clinic, for counselling and providing ART (anti retroviral therapy, AIDS-inhibitors) to HIV/AIDS patients. It started in June 2005, by February 2007 278 people are alive and receiving ART at Mua Hospital.

The ART is provided by Global Fund through Malawi government free of charge, following a national protocol.

Most of those who have started ART are improving a lot: less illnesses and gaining weight and strength. Many of them start doing their daily jobs again (as farmer, housewife or student).

Since the start of allowing children to receive ART at Mua in June 2006 the number has slowly grown. At the end of February 25 children have started ART at Mua HOPE-clinic. In the coming year 2007 we expect that number to rise to 50.

The ART itself, the stationary (master cards) and the trainings for providers are provided though the government of Malawi. The clients are assisted free of charge, so there is no any income from this clinic for the hospital, but there are some costs (building, maintenance, extra human resource, some other items like weighing scale, thermometer, pens, etc). Since this is a very important part of health care in Malawi and also prevention of many diseases, the hospital is very willing to put these extra recourses in the HOPE-clinic. But this makes it difficult to do extra activities that might be necessary.

Most of the clients at the HOPE clinic do not have the financial arm to pay for their medical bill. They are more often sick and therefore have high medical bills, but due to their illness are less capable of creating an income. This counts even more for the children: their parents often are also infected with HIV or have passed away leaving the child with a relative.

The overall goal of this proposal is to connect children in IJburg with a group of children on ART (age 0-14 years) in Mua.

The plan is to start a long term relationship between children in Mua and children in IJburg. The children in Mua will benefit by donation towards the healthcare for them, and the children in IJburg will learn trough the contacts more about living conditions in other cultures.

This proposal is to run for one year, with aim to prolong the relationship between Mua and IJburg.

The organisation will be done by the co-ordinator of the HOPE/clinic (one of the clinical officers), assisted by the MO (medical officer) and the matron. In the different activities all staff working in the HOPE-clinic will assist (clinicians, nurses, counsellors and clerks).

The overall responsibility is with the hospital management (Principal Hospital Administrator, Principal Medical Officer, Medical Officer, Accountant, Matron)

Since the HOPE clinic is running already and more and more children are coming. The child friendliness that will be started will be handed over to each new staff member that start assisting in the HOPE-clinic. By involving the whole team of the hope-clinic this will not end if one person leaves Mua.

Because members of the hospital management team are participating in the running of the HOPE-clinic, the management team will easily assist in the communication with IJburg.

In the future the child health care might become free of charge for all children if/when included in service agreement with the government.

As soon as the number of staff at Mua allows, a special day for children will be introduced at the HOPE-clinic.

All the activities (also these new activities) at the HOPE-clinic are evaluated by the whole team that works at the HOPE-clinic, in their quarterly meetings. Minutes of these meeting will be sent with progress reports to the donor. Special events (like the sibling day) will be separate reported.

The medical bills paid by the project will be accounted for by the receipts per patient. As for the budget of these medical bills we can only make an estimate, as we can only estimate how many children will start ART, how many of them will fall sick and will come to Mua to get assisted. To solve this problem quarterly reports with actual expenditure will be sent to the donor.

For the other activities receipts will be used to account for the way money is spent.

Mua Hospital will sent an, adjusted for the situation in Mua, book that explains HIV and ART for children to IJburg.

The children in IJburg will be requested to donate some of their toys, which can be sent by container to Mua.

Mua Hospital will sent the Newsletter of Mua Hospital to IJburg.

Where possible Mua will sent drawings, letters and (digital)pictures to the children in IJburg of living situation/clinic/activities.