The Growth of KIWAKKUKI

Background to KIWAKKUKI:
KIWAKKUKI is a Kiswahili acronym (Kikundi cha Wanawake Kilimanjaro Kupambana na UKIMWI)Funded in 1990 and around the theme of Women and AIDS; formally registered as an NGO in1995.Fundamental goal is to accelerate Women’s access to Information on HIV and empower them with skills needed to fight HIV/AIDS in their Community. After empowerment, these women have made a big difference in the war against HIV/AIDS in Kilimanjaro region Tanzania. KIWAKKUKI was conceived as a result of the December 1990 World AIDS Day Theme of “Women and AIDS.” This theme inspired women from all walks of life in Moshi town who saw the need to join hands to engage in the campaign against HIV and AIDS in Kilimanjaro in order to mitigate the impact AIDS was bringing in the community. Women and girl children as traditional managers of domestic unpaid labour were the most impacted. “Let’s give women the awareness to become drivers of their own lives their own protection and that of their children. Many women see the need for giving assistance and support to those families impacted by AIDS. They have to bear pressure on those whose lifestyles endanger other families and that of their children. Women are educators of family and community life. They are potentially powerful leaders for change” wrote the late Juliet Howlet.

KIWAKKUKI works in all 6 Districts of Kilimanjaro, where it now considered the leading HIV/AIDS service organization Work started in Moshi town and gradually spiraled out to the grassroots approach whereby 20 sensitized women or more built synergies through group formation to extend services in their areas. Currently there are >150 such groups. These women have since then become brigades for service provision and indicators of KIWAKKUKI’s visibility.
Today the number has risen from 44 at the fist Annual General Meeting on 25th February 1992 to more than 6,000 from virtually all corners of Kilimanjaro region. Formal registration was in July 1995. After the initial meetings held at the Cooperative College, by then and the YMCA the venue moved to the Catholic Bishop’s Chancery with Sr Mary Lauda, then to the ELCT Women’s Department under Veronica Swai and later to the Primary health Department under Dr Janet Lefroy. In 1994 KIWAKKUKI offices were moved to the 1st Floor Rooms 109 + 110 of the THB building.
3.1 Vision:

A community taking appropriate measures to eradicate HIV while contributing efforts to mitigate the impact of AIDS.

3.2. Mission:

To integrate programs that focus on HIV/AIDS information and to increase community participation in providing services to those infected and affected by HIV/AIDS.

3.3. Core Purpose:

To unite women and help them harness the skills and talents needed in order to face challenges and restore dignity, self - respect and purpose to lives on individual and their families mainly AIDS patients and children.

3.4. Core Values:

Voluntarism, Unity, respect, sharing recognition of talents, love, transparency, Accountability to each other, Collaborating and Team culture.

The major commitments of KIWAKKUKI are in harmony with those of the Tanzanian government and also address some of the Millennium Development Goals and so cover 16 out of 18 Strategies streamlined by (TACAIDS) which is a significant contribution to the National Efforts and also touches on 7 out of 8 MDG, a contribution to the UN Efforts.
1995 was a turning point:
2-1- 1995 – The late Ms. Juliet Hardy Howlet the leading Founder died in the UK. May the Almighty God rest her soul in eternal peace.

30-1 – 1995 Annual General Meeting at Kahawa House Membership stood at 371

3 – 7- 1995 Obtained a Certificate of Registration No. SO 8488.

20- 9 – 1995 Moved from THB to Manking 'a Street, Mawenzi Ward

29 - 11 -1995 PLHA's meeting centre moved from Rainbow Centre to KIWAKKUKI and established as "Centre of Hope".

1996-1997: Two External Evaluations Conducted.

2000 was a celebrating year for 10 years of KIWAKKUKI whereby several events were organized for fundraising, PLHIV’s, Roundtable discussion, grassroots groups display for their work and the climax was the World AIDS Day at the YMCA where the World AIDS Day Event focusing “Women and AIDS was held in 1990.

2001 -2002: Conducted Organizational Development Intervention with EASUN, Qualitative Evaluation with FOKUS and ECD Evaluation with BvLF.

2002 purchased a plot of land for constructing an orphans’ Vocational Training Centre.

2003: A VCT Facility and research opened at the centre with the support of Duke University

2004, 2006 and 2008 KIWAKKUKI’s Best Practices presented at the International and National AIDS Conferences International.

2005: 1st Strategic Business Plan launched along Lindi Street for erecting an office building.

2007: 2nd Strategic Business Plan (2007-2011) launched.

December 2007: Construction started with a strong back up or Action Medeor Pharmaceutical Organisation based in Germany and a few other donors.

31st of August 2008 – Moved into our own Office Building along Lindi Street, Korongoni Ward.

1st October: Foundation Stone placed at building by the leader of the Uhuru Torch

7th October: Official Launching of the building and celebrations.


3.6. KIWAKKUKI major HIV/AIDS Strategies:

· HIV/AIDS Prevention through Awareness Raising for community behaviour change.
· Home Based Care and Post test Clubs as an aspect of the Continuum of Support, Care and positive prevention.
· VCT, an Entry point to Treatment, Support, Care and Positive living
· Orphans’ Support as an aspect of the Continuum of Support and Care.
· Impact Mitigation through Community Development Projects and Micro credit.

. KIWAKKUKI in a Nutshell Strategies Approach programmes

KIWAKKUKI’s work is centered on addressing AIDS as a development Challenge by Lobbying and Advocating for Access to basic rights for the beneficiaries as follows:
The right to Accurate Information on HIV and AIDS: Means of transmission, non transmission, Prevention, Behaviour change strategies leading to making informed choices, life skills. This also addresses cultural taboos such as talking about sex in the families between parents themselves and also between parents and children as well as between teachers or instructors and pupils or students in order to sustain family lives and promote an AIDS free generation. Coverage include women members, school children, out of school children, men and the community at large. These are reached in either KIWAKKUKI organized forums or in most cases in community or institutional organized forums. The KIWAKKUKI peer educators reach > 10.000 community members with HIV and AIDS awareness and behavior change messages every year. This has promoted openness and free discussion on HIV and AIDS in the community.


A. Awareness Raising
Activities
· Information centre-daily education
· School health programmes
i. Parents/break the silence
ii. Income Generating Activities under school health clubs
· Work place education programme
· Outreaches (in risk area, church places, mosque, WDC etc.)
Approaches:
· Community theatre in high risk
· Youth Talk to Youth In school & out school youth
o Songs, Role plays,
· The Fleet of Hope (focuses on behaviour change)
· Sensitizing Community Forum
Using Research as a Strategic Approach to inform Service:
• Identifying service provision gaps in HIV/AIDS Policy on Prevention, Support & Care..
• Generating data on prevailing HIV risk factors among people presenting for VCT, school children, common OI’s and clinical characteristics of patients in the HBC, KAP
• Presenting scientific findings.
KAP STUDY RESULTS
• Results to 4 primary schools in Moshi Municipal: Fe:116 and Male: 117
• School children already engaged in sexual matters were- F: 62 and M:41
• Community’s views on persistent cultural misconception habits which lead to spread of HIV & AIDS were Widows’ inheritance, Female Genital Mutilation and Witch craft/Superstition
Conclusion: More girls start sexual debut earlier than boys.

4.2 .HOME BASED CARE
The right to access basic needs and care by women donating their time, energy and small resources to conduct home based care and support on the African neighbourly basis. The





KIWAKKUKI volunteers follow up > 3,000 patients every year in their homes and they have revived hope to several of them and reduced stigma in the families and community at large. Some of the patients are referred by the grassroots women and the KIWAKKUKI medical staff for further examination, CD4 count, treatment and legal aid and other social support. > 500 referrals are made per year.

Activities:
· Home visits-Normal Visits & Special Needs Team.
· Referrals –External (KCMC & Mawenzi)
· Providing Treatment for Treatment of opportunistic Infections (OI)
· Follow up on adherence for who are on ARV.
· Research along side HBC (THIRST & ISAAC.)
· Income Generating Activities to PLHAs.
· School Health Club

4.3. Voluntary counseling and testing (VCT)

The right to health care and early access to treatment. The grassroots women have mobilized and escorted several individuals and families from their villages to access VCT services at KIWAKKUKI and other centres. >11,000 clients have been reached since 2003. Consequently, those who have been found HIV positive have accesses early treatment and care. Normally they get referrals from the VCT centres.
Activities:
· Free same day results VCT services
· Internal referrals
· External referrals
· Quarterly VCT committee meeting
· Quarterly PLHAs meeting in their respective Districts/Wards
· Mobile VCT (MVCT)

Research along side VCT on:
· Social demographic characteristics
· Risk sexual behaviour
· Reasons for Testing
· Health Status
· Effects of consequences of Testing
· Coping Health AIDS in Tanzania(CHAT)
Effects of consequences of Testing
We have been able to see that those HIV Negative clients who have come to KIWAKKUKI for repeat testing has largely been able to retain their sero negative Status. VCT has been a tool for their behaviour change.1st Time Testers were 12,082 (85.43%) and 2nd Time Testers were 2,448 (17.31%).In 2003/2004:We Tested 5,269 (prevalence rate:16.6%) while in 2005:We Tested 2,778 (479+ve prevalence rate:17.24%).In 2006:We Tested 2,610 (prevalence rate: 13%) while in 2007: 11% and 2008: 9%
Conclusion: Not all clients turn up for 2nd test
• Prevalence rate is high but going down.
• Male Tested were 213 (5+Ve and 208-Ve)
• Female Tested were 214 (16+Ve and 198-Ve)
• Prevalence rate at the community during Mobile VCT is 4.9%
Conclusion: HIV prevalence is lower with MVCT but still higher for women than men


4.4: ORPHANS’ SUPPORT: OVC who have access to education, skills training, shelter, recreation, good nutrition health and succession plans through memory work

The right to education and equal opportunities for education. The grassroots women do identify needy orphaned girls and boys for school sponsorship and facilitate their placement into various levels of education. Some of these have made it to University level and many to diploma level and many others have acquired vocational skills. Some of these children are heading families and have assumed roles of parenting by supporting their siblings. >12,000 orphans have been supported since 1998. In 2008 sponsored children: Primary school: 1,182, Secondary school: 716Vocational Skills: 43 which make total to be 1,941


These women have also organized the provision of the right to shelter for the child headed homesteads and other very desperate households. The grassroots women have linked these households with the head office for the construction of shelter. The women have worked with the community leaders to contribute towards the construction of such houses which legally belong to the children. >than 35 houses have been constructed up to December 2007.

The right to social wellbeing (of the beneficiaries): The grassroots women are also supervisors of another form of informal micro enterprise conducted by PLHIV and OVC surviving parents and caregivers. These get a loan of an equivalent of 95 USD each to run Income Generation Activities (IGA’s), the profit of which is used to support children to access their rights of education, health, food and nutrition as well as psychosocial support. AIDS has made surviving parents and caregivers more destitute as grandparents have to be parents again!
The right to identity and protection: KIWAKKUKI has discovered that many orphans have no birth certificates. They have been linked with the human rights organization, KWIECO which facilitates access to this basic right. Moreover, the children’s protection has been enhanced through the Memory Project which facilitates the surviving parents to disclose their sero status to their children. This has lead to joint planning of the children’s care and family property as a future protection for the children. 180 wills have been written as added value towards protection of the children and widows and 288 birth certificates are in process.


The right to social wellbeing (of the care providers): The grassroots women have also been sensitized to seek economic livelihood and be able to shift from ill being to well being. This helps to minimize their dependence on men and controls the spread of HIV. In groups of 3 up to 5, women have formed a mutual support system whereby they inject money as a saving and take loans after a minimum of 6 months. The team is its own collateral and they get new funding every time they complete a cycle of loan fund. The members are obliged to run small businesses and use the profit to increase their income and provide material support to the orphans and PLHIV.
KIWAKKUKI STRATEGIC APPROACH OF BUILDING PARTNERSHIPS

KIWAKKUKI works in partnership with other HIV/AIDS partners in Kilimanjaro as follows:
• Clinical Referrals at KCMC Hospital. HAART Clinic, Dermatology, Paediatric and Majengo Health Centre for Sexually Transmitted Infections Clinic, PMTCT.
• Kibong’oto hospital for TB chest clinic, Mawenzi hospital provides Exemptions and free medicine, Early management of opportunistic infections and free ART.The Government: Good collaboration with the Reg. Commissioner’s office, The RMO’s, The Social Welfare Office , The 5 Distr. Comm.’ offices, The 6 Distr. Exec. directors’ Offices, the 6 DMO’s Offices, ward and village offices. - Collaborators: KWIECO a Human Rights support org. Others: Amani Str. Children Centre, Mkombozi Str. Children Centre, TACAIDS, Mildmay International. Network membership: TAF,TANGO.KIGEN
Training and Research Partnerships
• The University of Dar es Salaam- ICDP
• Tumaini University – Patients based Researches
• Moshi University of Cooperative and Business Studies – KAP Studies
• Duke University- Patients & Children Researches.
• Oslo Deaconic Nursing College -Nursing
• Bergen University- Social Work