Mission Statement for the Children’s Crisis Care Center (4Cs) is to meet the needs of each child in crisis who are in reach of the V40RC programs.
This need has emerged as adult mortality due to AIDS makes it increasingly difficult to find family members to care for orphans. The crisis center will also be a safe haven where children who are caring for sick parents come to learn and where they can always come to get advice, moral and emotional support.
One important problem raised by continuing stigma is that of informing children about their parents’ sero status. Community health workers have been trying to persuade HIV-positive parents to share this knowledge with their children, but so far with little success. Very often, the children know, or at least suspect and the workers strongly feel that if the truth of the situation could be discussed openly within families, it would be easier for the children. However, confidentiality forbids this without the parents’ consent.
Child-headed households are becoming more common. Even when a very small child is sent to grand parents, the eldest child usually remains in the family home with the responsibility of caring for the other children. This program also targets children of sick parents who are healthy themselves, but who in future will become orphaned.
They will be invited to join the centre in order to prepare for life without parents. They will learn to care for sick parents and also how to bring up their young brothers and sisters when their parents pass away. While learning, they share a great deal together, and also form supportive groups that, it is hoped, will help them in the future.
Expected Accomplishment of the 4Cs Project
With the project mission as to meet the needs of each child in crisis who are in reach of the 4 Cs project, our overall goal is to establish a functional Children’s CrisisCareCenter in Kamwenge District;
- to sustain and establish unique holistic, multidisciplinary, multifaceted “one stop crisis and trauma centers” offering counseling, social services and support groups;
- to facilitate the healing and restoration of targeted communities, empowering those that are suffering to become well adjusted members of society, restored mentally, emotionally, physically, psychologically and spiritually;
- to alleviate the fears and anxiety of dealing with trauma;
- to address the effects and affects of children that are suffering due to HIV/AIDS;
- To work towards the empowerment of disadvantaged communities by means of skills developed and poverty alleviation programmes.
The aim of 4Cs project is therefore to;
- Restore hope and healing to children who have suffered as a result of crisis and trauma;
- Serve the children and children families of Kamwenge district and well beyond its boundaries regardless of race, religion, social standing and cultural differences;
- Provide and sustain an advice desk, trauma and counseling centre, HIV/AIDS clinic as well as a shelter for at-risk children and at-risk mothers.
- Offer training and upliftment programmes to work towards the empowerment of children families in need.
The 4 Cs objectives are to,
- Provide direct services to children not served by government programs,
- Provide support services designed to enhance the efficiency of the government program,
- Facilitate guardianship services,
- Advocate for Kamwenge children and families in crisis
The 4C’s Project seeks to:
- Provide early comprehensive child and family evaluations to identify needed services;
- Help children in crisis (at-risk) move quickly toward the goal of a safe and promising future;
- Identify gaps in services to HIV/AIDS affected, abused, abandoned and neglected (at-risk) children in the community.
- Assist in more effective use of community resources;
To this end 4Cs will offer;
- Free, short-term child care for kids age 6 weeks through 12 years whose families are in crisis
- Free care for children whose families are in stressful situations. 4Cs’s free care will be offered Monday-Friday, year-round
- Opportunities for donors, service groups and corporations to partner with 4Cs in a variety of ways to keep children safe. Free Pizzazz parenting education classes
- Community Resource Referrals
- In addition to providing safe haven for children, 4Cs will strengthen families by providing a variety of support services. No emergency cases shall ever be denied care at 4Cs!
Expected measurable outcomes of this project, quantitative and qualitative measures
The establishment of the 4Cs will include a 20 roomed house for temporary shelter provision to children in crisis. It includes an HIV/AIDS clinic to serve over 400 children living with HIV/AIDS, a play therapy room for traumatized children expected to serve about 1200 children per year, a 200 capacity training hall for children in crisis, care givers and community servicer providers, administration and office space for the centre , 10 counseling rooms and 2 staff houses .
With its diverse services including the clinical program, permanency planning program, Family conferencing, Care for the care givers, Economic assistance, HIV/AIDS compassionate care, Abuse victim empowerment, Training, shelter and Home based care, the centre is expected to offer services to over 1200 children per year. This figure multiplied by a family unit shows our work directly and indirectly will impact on over 10000 people annually.
The most critical issues to the project’s success and how to accomplish the projects objectives
Most critical to the successful implementation of a Children’s crisis care centre project is the availability of committed and dedicated team of people to the management of the centre.
The program will employ a team of multi-disciplinary clinical staff at the Children’s CrisisCareCenter with experts in working with HIV/AIDS affected, abusive and neglectful families and maltreated children. This experience and expertise supports the Center’s philosophy that early assessment and intervention increases the likelihood of a healing future for the traumatized child.
All activities of the centre will be carried out by a team of professionals, social workers, HIV/AIDS educators and specially trained staff and counselors from our program circles.
AIDS Information and resource Centre (AIRC) 2040
In addition to responding to the needs of the traumatized and the victimized, the goal of the 4Cs is to be proactive in the community by lobbying appropriate authorities for better services provision, especially in Kamwenge district.
It is a challenge to every body whose HIV status is positive. Being HIV positive does not mean that it is the end of one’s life. At V40RC we encourage every one who is HIV+ to accept the fact and chose to adopt Positive Living mechanisms.
Positive living is the ability of an individual to live with, accept and cope with the infection. Such a person protects him/herself against re-infection and also protects other sexual partners as well.
We are not infected as individuals but other people are affected as well. Positive living is a state of the mind; it places the focus on living with HIV/AIDS rather than dying from it. This cannot happen without the active support of family members, friends, colleagues, health care providers and community in General.
Living positively requires a sustained effort, hope, patience and faith, longer, happier, more productive and satisfying life for the person with the disease and his or her family.
Positive living will develop the person living with HIV/AIDS. It is also a package of ideas and suggestions which will enhance the lives of any one regardless of HIV/AIDS status.
All of us must recognize AIDS as our problem. All of us must make it our priority. We can not deal with AIDS by making moral judgments or refusing to face unpleasant facts- and still less by stigmatizing those who are infected and making it out that it is their entire fault. We can only do it by speaking clearly and plainly about ways that people become infected and about what they can do to avoid infection.
We do not have any choice but to contemplate exceptional measures to contain the spread and devastation of HIV/AIDS. And those measures have to be comprehensive and total at all levels. Acting against AIDS first of all means speaking about it and breaking the conspiracy of silence. We then must overcome the taboos and prejudice surrounding the disease and its sufferers.
Associations of people living with HIV/AIDS are now making a decisive contribution to breaking the silence surrounding the epidemic. They are also helping to provide case management for people infected with and affected by HIV/AIDS. We have now passed beyond the stage of denial, and silence and are embarking on the stage of confrontation and practical actions against this deadly epidemic.
At the household level, HIV/AIDS increases the vulnerability of rural families and communities to food and livelihood insecurity and pushes any of them to impoverishment through:
- Loss of Parents/bread winners leading to increased number of widows/orphans
- Loss of energetic people leading to loss of labor work force and decline in production
- Decline in income (especially cash) leading to increased drop-out rate of school going children, poor health status, then early and unwanted pregnancy.
- Increased Expenditure as a result of medical bills, transport and funeral costs
- Erosion of household asset base through sale of land and other productive assets like livestock and crops.
- Increase in the household dependency ratio due to a higher number of dependants relying on a small number of productive family members
- Disruption of traditional social security mechanism. Almost 20% of all the families are looking after at least one child who is not their own biological child. There is evidence now that these families are unable to cope with this added burden.
- Increase of child headed families and this leads to involvement in unprotected sex for survival
Our Goal: To contribute to the reduction of new infections of HIV and reduction of the adverse effects of HIV/AIDS in Kamwenge District.
Our General HIV/AIDS Intervention Objectives
- To strengthen the institutional capacity of V40RC and the PLWHIV Networks to effectively support community HIV/AIDS interventions and development among the HIV/AIDS affected households
- To advocate for positive, nondiscriminatory, culturally relevant and rights-based approaches to service delivery. To mobilize Local and religious leaders in the HIV/AIDS affected communities to put their authority and faith into sustainable solutions to HIV/AIDS.
- To strengthen collaboration and networking with public and private actors to accelerate delivery and access of services that are most critical to HIV/AIDS prevention, treatment and mitigation.
- To implement research strategies, monitor and evaluate the people-based HIV/AIDS programs, maintain a database for HIV/AIDS programs and provide HIV/AIDS consultancy services in the district.
Our Value base:
We consider UVRC to be a good match in HIV/AIDS intervention because our work aligns closely with the six key outcomes that form the value and culture basis for our existence.
- Ensuring PLHIV have a voice
- Demonstrating respect for PLHIV
- Recognizing the physical and psychological well-being of PLHIV is paramount
- Giving PLHIV equality of opportunity through recognizing and valuing diversity
- Providing PLHIV safe, non violent and stigma free environment
- Supporting PLHIV in improving their life chances
- Social and health education
- Free, accessible and sustainable care and treatment
- Food and nutrition
- Education for children
- Prevention of further spread of HIV infection
- Household income
Our Strategic options:
- Institutional capacity building
- Advocacy and networking
- Information, Documentation and Information Sharing
- HIV/AIDS treatment, care and support
AIDS Information and Resource Center Project (AIRC) is designed to serve as a hub for HIV/AIDS, sexually transmitted infections (STIs) and Tuberculosis (TB) information for health providers, government departments, journalists, researchers, universities and HIV/AIDS organizations and programmes.
AIRC will encourage networking and coordination of all HIV/AIDS players. This will in part be accomplished through the development of a database of all HIV/AIDS organizations and projects in the district.
It is well revealed that quality, culturally appropriate HIV/AIDS information is limited in Kamwenge and Uganda as a country. The little information that exists is frequently out of date and often out of print. Generally, access to any HIV/AIDS information in Kamwenge district is severely limited, especially for the smaller, rural AIDS projects. In addition, there is a need for better coordination of HIV/AIDS IEC and programme activities to prevent duplication of resources.
To respond to this need, the AIDS Information and Resource Center (AIRC) in Kamwenge will be established through a multi-dimensional public/private partnership including the Local governments, Religious teams, Families, Business institutions, Development Partners Networks of People Living with HIV/AIDS and schools.
In 2004, Kamwenge district participated in the Lot Quality Assurance and Sampling Methodology for regular HIV/AIDS surveys, done by Uganda AIDS Commission and World Bank. A team of 13 researchers was trained from Kamwenge local communities. This was done in building capacity for the district to do its own assessments and generate information that would inform decision making in HIV/AIDS programming. However, since then, the team has remained idle with all skills and expertise that would otherwise be a great resource to the district. This is a strength and opportunity for AIRC to build on.
The AIRC will employ about 10 staff and volunteers who will not only provide HIV/AIDS information in Kamwenge, but who also will develop and produce high-quality messages and materials, conduct trainings, work with journalists to improve their reporting skills, run a district HIV/AIDS hotline, and provide high-tech IT support services.
Kamwenge District Health department points out that in Kamwenge, the demand for HIV testing is growing and with that, a demand for HIV/AIDS information. Not only do the VCT sites require support materials for providers and clients, but VCT is inextricably linked to all aspects of HIV/AIDS and therefore creates a demand for information on issues such as treatment, care and support, TB, STIs, and mother-to-child transmission (MTCT).
The AIRC will provide regular updates on the HIV/AIDS and partner activities to prevent and mitigate HIV/AIDS across the District.
In order to ensure sustained information generation and sharing, AIRC will Identify sub county network information contact persons- people with specific competences will be facilitated to document information and best practices at the community level and forward it to the information officer at AIRC for publishing. Sub county information contact persons will be equipped with HIV/AIDS specific documentation skills and mobilize resources and materials for their sustainability. At AIRC all staff will be trained in web browsing and downloading to enable regular downloading internet materials and for repackaging and dissemination.
There will be development and use of data capture tools, directory and the data base. Standard tools will be developed to capture regular information on sub county PLWHIV networks and members, best practices and the data will always be sorted and disseminated according to the need.
Linking PLWHIV networks with national and international organizations through information sharing. AIRC will subscribe to national and international directories of AIDS organizations in Uganda and outside. Such organizations will also use AIRC as a key contact for accessing and initiating relationships with the local AIDS networks and groups in Kamwenge District.
Specific AIRC Objectives
- Provide Kamwenge people with up to date and accurate HIV/AIDS and related information by developing and maintaining materials on HIV/AIDS, VCT, STD and TB materials.
- Develop and maintain a materials and networking database and national links and email list-servers.
- Develop the High-quality print and audio-visual HIV/AIDS BCC materials that are useful to all program managers of HIV/AIDS interventions in Uganda.
- Establish and maintain an AIDS Hotline to ensure that Kamwenge People have an additional resource to access free and anonymous HIV/AIDS information, counseling and referrals. Hotlines have proved to be an effective means for people to access free and anonymous HIV/AIDS information and referrals.
- Establish 14 sub county AIDS Resource Center sites at SubCounty offices that will serve as information centers.
- Encourage networking and coordination of HIV/AIDS stakeholders in Kamwenge district.
- Provide technical assistance in BCC materials development and strategy formation.
- Implement a referral function for HIV/AIDS related services and support to the clients
Unique Features of AIRC
- The ARC will be the first and unique one-stop center for HIV/AIDS education.
- Incorporating a journalist training function into the broad implementation plan increases awareness of available AIRC resources among the community and the general public.
- In addition to offering an assortment of print resources, the AIRC will provide a high-speed access to Internet resources, enabling health professionals, students, and journalists to obtain a wealth of electronic HIV/AIDS research resources.
- Through the HIV/AIDS hotline, the AIRC will provide HIV/AIDS related information and counseling services to callers from anywhere in Uganda. Users will call the hotline number to get accurate information on VCT, PMTCT, HIV transmission, ART and other HIV related issues.
This will be a learning, study and comfort centre for a wide range of clients. The AIRC is expected to receive approximately 20 users per day. Most of the AIRC users will be persons living with HIV/AIDS, students, NGO staff, religious institutions, medical practitioners, researchers, Children of sick parents and AIDS Orphans, counselors and journalists.
Psychosocial Support to persons living with HIV/AIDS:
This activity will be coordinated by the center, targeting people who are living with HIV/AIDS. The goal is to provide opportunities for persons living with HIV/AIDS to share common experiences, hopes and fears, and to rebuild dignity, a sense of self-worth, hope and friendships and develop a vision for life. It strongly promotes responsible sexual behavior among the members. Personal stories and testimonies are so touching and can change many people’s perceptions and feelings about life and HIV/AIDS.
This will provide an opportunity for the PLWHIV Network Support Agents to identify members who may need person-to-person counseling and identifies need for home visits.
Sessions/presentations on important topics will be integrated in psychosocial therapy days. Such topics include; benefits of Voluntary Counseling and Testing, Food and Nutrition, positive living, making a will, food security, saving for the future, PMTCT, TB treatment, care, treatment and adherence.
Our statistics show that most HIV/AIDS affected persons have no access to finances –the fact means they cannot keep their job but must support their children. The causes are a myriad of issues, from insufficient emotional skills to lack of education caused by poverty and/ or generations of unhealthy role models. Alcohol and substance abuse exacerbates domestic violence.
The majority of our clients will be from semi-urban or rural areas where there are few or no facilities, no concept of their rights and no resources whatsoever to help themselves. These situations are more often than not complicated by very little opportunity for sexual choices and safety, poverty, unemployment and housing issues.
The clients with the AIRC services will be linked to the microcredit facility and other services to get supported.
Other critical HIV/AIDS services at the AIRC
Our HIV/AIDS outreach programme shall be provided under the supervision of a professional Health or social worker supported by a professional nurse assisted by an HIV/AIDS educator and several counselors offering the following services:
- Voluntary counseling and testing;
- Pre and post test counseling, dietary advice, behavioral change, family support;
- Sexually transmitted diseases treatment;
- Home based care;
- On site VCT, prevalence testing;
- CD4 Counts, viral load, pregnancy and drug testing;
- Support groups for HIV/AIDS positive women and men;
- Awareness and education workshops;
- Peer education
Statistics clearly show that issues surrounding HIV/AIDS and family problems (marital relationships, parent-child relationships, the effects of unemployment and poverty) are the most significant of the identified crisis triggers. Consequently, these define where the need is greatest.
With respect to HIV/AIDS, the V35RC’s goals for prevention are:
- to promote safe and healthy sexual behavior;
- improve the management and control of STD’s;
- provide appropriate post exposure services;
- provide access to voluntary HIV/AIDS counseling and testing, prevalence testing and KAP surveys;
- provide information, awareness talks and workshops on HIV/AIDS;
- Carry out wellness days to include health assessment covering all aspects of wellbeing to encourage maximum participation by management and employees.
Youth center support and training
In this regard, the aim of the AIRC project is to create awareness and educate youth and learners on a vast number of topics through workshops within a safe environment.
Our training courses shall cater for men, women and peers who wish to address HIV/AIDS issues, social issues in their communities, schools and workplace. Training will be carried out by a team of professionals, social workers, HIV/AIDS educators and specially trained staff and counselors from our centre.
AIRC Home visit services:
Home visits will be made by volunteers and medical professionals when there is need such as incapacitating illness and to counsel the bedridden parents and the children. Our team at AIRC as much as possible will try to visit the clients’ homes (with permission of the family head) even if the client is not bedridden. This visit helps the Team know the home, cross check information, look at the general environment and assess need for other services.
Any AIRC member will do the following on a home visit:
- Give the client and family information about the availability of the compassionate care service.
- Seek permission of the client and family for the routine compassionate care.
- Make an appointment with the client and family for the compassionate care visit and plan the visit.
- Plan to be introduced to the relatives of the client if it is the first visit.
- Assess the need for providing counseling to the relatives and provide it appropriately or provide information or skills on hygiene, nursing, physical and emotional care and nutrition of the patient.
- If there is a client who has any prescribed drugs checks on use and adherence.
- Provide information on other sources of support within the community such as Health facilities, NGOs and support the client to contact them as appropriate.
Core activities of the AIRC staff and volunteers in regard to persons living with HIV
Staff and volunteers at AIRC will spend some time with clients and these issues are emphasized.
- Help the positive person accept the diagnosis and consider a way forward.
- Encourage the positive person to develop early health care-seeking behavior.
- Inform the positive person about antiretroviral therapy, treatment and prophylaxis of opportunistic infections and alternative remedies such as aromatherapy reflexology and herbal medicines.
- Give continued emotional and psychological support to help the positive person cope positively with challenges that arise.
- Encourage the positive person to confide in people who are directly affected by their Sero status and any significant persons who can provide support.
- Empower the positive person to embrace positive living to improve the quality of life. (Medical and general self care) and encourage fellowship through club activities such as Bible studies, music, dance and drama for those who can participate.
- Explain the importance of family planning with HIV infection and AIDS, and inform the client how to prevent mother –to-child infection for other HIV Positive family members.
- Educate the client about use of condoms to prevent re-infection and infection of sexual partner (spouse).
- Discuss gender issues in relation to positive living such as negotiation skills, condom use, pregnancy and partner testing.
- Inform the client of social support and refer to other support systems like the Mild May and Bailer Services.
- Inform the clients of income generating activities like tailoring and crafts work, piggery and poultry.
- Encourage clients to seek spiritual support.
- Provide information on the importance of proper nutrition.
- Encourage the practice of general hygiene
- Avoiding overindulgence in substances such as alcohol and cigarettes.
- Provide counseling to the affected family, based on the member’s consent.
- Encourage a positive outlook on life, including planning for the future for self and family
- In all Network activities, non-discriminative methods are used to avoid causing stigma.