Hospital Management Team
Mua Catholic Hospital
P.O. Box 41 Mtakataka
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:
Print/copy a book about HIV/AIDS and a child on ART. This is a Dutch book (with also an English version) that we are translating in Chichewa and adjusting to the situation in Mua. If we get permission of the publisher we will translate the adjusted version back to Dutch for the children in IJburg to read. This book will assist in disclosure and explanation to children.
Have some toys available to make the clinic more child friendly and more fun to go to every month.
The ART are free of charge provided by the Malawian government (through Global Fund), but other drugs for opportunistic infections, side effects of the ART are not free of charge, for the hospital has to buy them. With the assistance of IJburg, Mua can offer free health care for those children on ART.
other activities, e.g. special sibling day, schoolaweness, follow-up
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,
PROPOSAL LINK MUA AND IJBURG
DATE: FEBRUARY 2007
TO: FOUNDATION LUKULU
1087 GD AMSTERDAM
FROM: MUA CATHOLIC HOSPITAL \
P..O. BOX 41
INTRODUCTION MUA HOSPITAL
Malawi is one of the poorest countries in the world. Malawi is located in Central ľAfrica, 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).
EVIDENCE ABOUT THE NEEDS IF THE INTERVENTION, OR NEEDS ASSESMENT
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 OR PURPOSE OF THE INTERVENTION
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.
create awareness among children in IJburg on living conditions in other cultures
create awareness on HIV/AIDS
improve the health status of children on ART
create child friendly ART services at 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.
create a book for children to explain HIV and the reason for ART
translate this book (back) in Dutch a sent it to IJburg to expose primary schoolchildren with other cultures and living conditions
sourcing toys to make the clinic more child friendly and more fun to go to every month
stimulating children in IJburg to donate some (of their) toys to Mua
reduce the morbidity and mortality in children on ART by creating more accessible health care (free of charge)
Organise a special sibling day to create awareness and understanding for sibling of children on ART
Identify one (or more) child(ren) on ART in Mua who can share his or her live experience with children in IJburg.
Visit primary schools around Mua to create awareness on HIV and ART
Start a special day at the HOPE clinic for children
Print 200 booklets
Sent one electronic and one hardcopy of the translated version to the Netherlands
Acquire over 20 toys
Provide free medical care for all children on ART
To organise a sibling day at the HOPE clinic and invite 50 siblings
Visit 30 primary schools
This proposal is to run for one year, with aim to prolong the relationship between Mua and IJburg.
ORGANIZATION AND MANAGEMENT
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.
EVALUATION AND IMPLEMENTATION, INCLUDIING THE BUDGET AND ACCOUNTING STRAGETIES
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.
HOW TO CREATE AN ACTIVE LINKWITH CHILDREN IN IJBURG
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.
|Specific objective||Intervention||Target||timeframe||Evaluation||Responsible person|
|Disclosure of HIVstatus to children on ART||Translate adjust and print a book about a child on ART||Have 200 books printed/copied||Within first halve a year||In review meetings of HOPE-clinic staff||Co-ordinator HOPE-clinic, MO|
|Motivating children in IJburg to be active
Making the HOPE-clinic more child friendly
|Children in IJburg donating toys or buying
of toys within Malawi
Creating a special day for children at the HOPE-clinic
|Acquire min of 20 toys
Having a special day a week for children at the HOPE-clinic
|Within first halve a year
To start as soon as possible, ongoing
|In quarterly report, repot about the amount of toys available||Co-ordinator HOPE-clinic
Assisted by MO and matron
|Reducing morbidity and mortality for children on ART by creating more accessible health care||Free treatment at Mua Hospital for children on ART||Having free treatment for all children on ART for one year||Ongoing as (long as funds allow)||Quarterly report with actual expenditure sent to donor||Accountant with MO|
|Creating awareness and understanding among sibling of children on ART||Organising a sibling day||Having one sibling day where all children on ART and their siblings are invited||Second half of the year||In the review meeting after the day, special report to donor||Co-ordinator of sibling day|
|Creating awareness on living conditions in other cultures by children in IJburg||Sending drawings, letters, pictures of the clinic, children on ART and their homes to IJburg||Every quarter have some material collected to be sent to IJburg||Quarterly||Feedback from the children in IJburg/ donor||Co-ordinator HOPE-clinic, assisted by MO and matron|
|Create awareness among primary school children around Mua on HIV/AIDS and ART||Lessons by health staff in the primary schools around Mua||One day visit of 50 primary schools around Mua||Second year||Special report||Co-ordinator of this awareness campaign (to be selected from HOPE-clinic staff), assisted by a group of health workers|
|ITEM||In Kwacha||In US$|
|Printing of booklet||K 56.000||$ 400|
|Toys||K 35.000||$ 250|
|Medical bill of children on ART ( K23.000/month)||K 280.000||$ 2000|
|Sibling Day||K 28.000||$ 200|
|Communication||K 14.000||$ 100|
|Accounting||K 7.000||$ 50|
|TOTAL||K 420.000||$ 3000|