“HOPE AND LIFE”

GROUP

PROJECT ON NETWORK OF PEOPLE

LIVING WITH HIV/AIDS WITHIN
MIGORI DISTRICT

P.O BOX 119- KARUNGU-40401

KENYA
TEL 008773-762057495
FAX 0087-762057496
www.karungu.net
NAME OF THE PROJECT:- HOPE AND LIFE

PROJECT TITLE:- NETWORK OF PEOPLE LIVING WITH

HIV/AIDS
ADDRESS:- P. O BOX 119 KARUNGU-40401

CONTACT PERSON:- FR. EMILIO BALLIANA

VILLAGE:- RABUOR

SUB-LOCATION:- GUNGA

LOCATION:- WEST KARUNGU

CONSTITUENCY:- NYATIKE

DISTRICT:- MIGORI

DURATION OF PROJECT:- 3 YEARS

PROJECT STARTING DATE:- MARCH 2003

DATE OF APPLICATION:- 15TH DECEMBER 2003

BUDGET REQUESTED KSH 1,200,000 (EURO 14,634.15)

PROJECT ACCOUNT:- HOPE AND LIFE PROJECT

BARCLAYS BANK OF KENYA
ACC. NO. 120379

PROJECT COMPLETION DATE:- 2006

ABBREVIATIONS.
AIDS―Acquired immune deficiency Symptoms

HIV―Human immuno deficiency virus

SCMH―St Camillus Mission Hospital

PMTCT―Prevention of Mother to Child Transmission of HIV/AIDS.

ARV―Antiretroviral

NGO―Non Governmental Organization

Project location:
The project is located in Karungu Division, Migori District, of Nyanza Province in
Kenya, where an estimate 5000 of the 20,000 population are HIV positive. Kenya
Ministry of health statistic for the year 2002 show the number of HIV infected people
has increased to 200,000 in Migori and Homa-bay district alone. The high incidence
of HIV/AIDS is causing havoc within the local community, resulting in severe
economic and social problems, including an estimate 4000 orphans living with over-
burdened relatives or fending for themselves, and the lost of tribal pride and
cohesiveness.

THE PURPOSE OF THE PROJECT:

The purpose of this project is to create a network of people living with HIV/AIDS
(PLWHA) in Migori District of Kenya. Shame, secrecy and fear of, or actual, social
isolation are commonly experienced by people infected by HIV/AIDS. Men become
sickly and unable to provide for their families. Women are often shunned by a
husband’s family and forced to return to their parents or supported by the mercy of
friends. A supportive group of similar PLWHA can provide a venue for openly
discussing their situation and, with the guidance of a trained facilitator, focusing their
efforts on improved self care and, hopefully, reaching out to others with a message of
HIV/AIDS prevention and control.

It is the rare PLWHA who becomes an HIV/AIDS activist. But there is security and
power in numbers. By promoting local support groups there may emerge a person or
persons to serve as positive examples of PLWHA for their communities. Their good
example may be only the benefits (weight gain, restored energy and ability to care for
children) of faithfully taking antiretroviral medications. Others may be moved to
speak either privately to individuals or publicly at a church or other HIV/AIDS
programs before groups of high-risk adolescents or young adults. Posters and
billboards can help to spread the message about HIV/AIDS, but nothing is so
powerful as a heartfelt message delivered by a PLWHA.

Individual and group counselling to promote HIV testing and the use of affordable
antiretroviral therapy (ART) is a secondary goal, as is the establishment of co-
operative links with other HIV/AIDS-related educational and support services, such as
programs for children orphaned by AIDS and the program to prevent mother to child
transmission (PMTCT) of HIV/AIDS just going on at St. Camillus Mission Hospital.
Target groups
People living with HIV/AIDS all around Migori District.
Background of HIV/AIDS in Karungu
The project to create a Network of People Living with HIV/AIDS (PLWHA) was
started by some members St. Camillus Mission Hospital (SCMH) in Karungu
division, in the Migori District.
The region is home to two African tribes. The most numerous are the Nilotes
composed mostly of Luos. A smaller group of Bantus, consisting of Subas, Luhyias
and Kurias are also present. The Luos, being numerically dominant, have gradually
influenced other tribes to adopt Luo cultural practices, such as inheritance of widows,
a practice, which contributes to the spread of HIV/AIDS.
Agriculture is both the main occupation and the source of food for families.
Unfortunately, the region does not receive reliable rainfall and has had meagre crop
yields in recent years. Coupled with the high-density population this makes Karungu
one of the poorest zones in Kenya, a designated hardship area. Irrigation could be
achieved, given the proximity to fresh water from lake Victoria, but the machinery is
too expensive for the farmers of this region. Because of repeated crop failures, it is
common for men to migrate to urban centres seeking jobs to support their families,
leaving many women and children without a male presence in the home.
Another common occupation is fishing. Even though fish are plentiful, international
fish processing companies control the amount paid for fish. Thus, despite being
hardworking, fishermen are paid poorly. Working throughout the night and living
apart from their families in fishing villages, they fall into a risk-taking lifestyle of
drinking and casual sex, exposing themselves to HIV/AIDS. Returning to their
families, they then infect their wives and other partners with HIV/AIDS and other
sexually transmitted diseases.
In secondary schools, male teachers are known to exploit schoolgirls sexually.
Vulnerable schoolgirls feel compelled to cooperate with teachers in order to pass their
exams. Because many may not be able to afford all the school fees or have pocket
money for basic needs, teachers can take advantage of them in return for money or
favours. Other financially destitute young women are lured into prostitution by older
men or turn to it in desperation, quickly becoming HIV/AIDS positive and infecting
others, in turn.
Policemen and soldiers are other male workers who often live apart from their
families and drift into risky activities regarding HIV/AIDS during their off hours.
Unfortunately, many men from Karungu who migrate to urban areas remain in
financial hardship, forcing them to live in slums. Seeking a social outlet, they, too,
gather in bars where they soon fall into irresponsible sexual behaviours, exposing
themselves and, ultimately, their wives to HIV/AIDS. For, although women may fear
sexually transmitted diseases, most are not able to influence their husband’s behaviour
regarding extramarital sex or the use of condoms.

Statistics from the Ministry of Health indicate that 2.5 million Kenyans are living with
HIV/AIDS and that ¾ of that population are found in rural areas. In 2001 the total
population of the five districts of the projected project was 2.2 million. Of this, an
estimated 200,000 were HIV-positive, including 25% or 5,000 out of a total
population of 20,000 in Karungu. Factors leading to the fast spread of the virus in this
area include poverty, ignorance and unquestioned adherence to certain cultural
practices such as polygamy and wife inheritance.

It has been reported that even the hospital (St Camillus) is not pared either. It is in our
records that 41 of their employees have been diagnosed for HIV and out of those, 25
have died and five are now receiving antiretroviral therapy.
Some have declined antiretroviral and some have now taken a public leadership role
in the fight against AIDS. Table 1 (below) shows the results of HIV/AIDS testing
among selected patients since the St Camillus hospital opened in July 1997.

YEAR TOTAL TESTED POSITIVE % POSITIVE

1997 88 68 77.27 %

1998 579 450 77.7 %

1999 639 472 73.9 %

2000 978 623 63.7 %

2001 871 656 75.3 %

2002 959 623 64.96 %

2003 4112 2892 70.3 %

Table 1.

Table 2 provides a sobering commentary on the HIV infection rate in Karungu. These
are the results of tests on blood donors. Because of the high prevalence of severe
anaemia related to malaria, many transfusions are needed each year. If blood donors
are representative of the general population, then approximately 29 % of adults are
HIV- positive.

YEAR TOTAL HIV TESTS HIV POSITIVE HIV NEGATIVE % POSITIVE

1997 147 34 113 23.12 %

1998 552 156 396 28.3 %

1999 1054 361 693 34.3 %

2000 967 286 676 29.6 %

2001 1047 244 803 23.3 %

2002 990 307 683 30.7 %

TOTAL 4757 1388 3364 29.2 %

Table 2.
In 2002 the official death rate in Kenya was 180,000 and 34,312 persons who died in
that year were from South Nyanza, representing 19% of Kenya’s death rate. In Kenya
AIDS kills an astounding 700 persons per day, most of them being the young adult
teachers, workers and parents necessary to bring Kenya into its next phase of
economic and social development. Among the factors promoting the spread of
HIV/AIDS are unprotected sex, poverty, ignorance, wife inheritance, polygamy, and
the compromised position of women.
St Camillus Mission Hospital has recorded a death toll of 1290 from July 1997 –
2001. Although most patients were not tested, the majority are undoubtedly related to
HIV/AIDS, having died from tuberculosis, Kaposi’s sarcoma and various other
opportunistic infections.
Table 3 shows Admissions and death rates since July 1997.

YEAR ADMISSION DEATH % RATE

1997 513 59 11.5 %

1998 2544 61 6.38 %

1999 2288 178 7.78 %

2000 2809 302 10.75 %

2001 3211 358 11.15 %

2002 3005 332 11.04 %

Table 3.

Although the Kenyan government has begun to intervene in the fight against
HIV/AIDS by establishing Voluntary Counselling & Testing centres (VCT), most are
situated in urban areas. Co-operating non-governmental organisations like USAID
and WHO fund a variety of programs but, again, few have gone deeply into rural
areas. In Karungu, St Camillus M. Hospital has collaborated with Organisations like
the Catholic Relief Services (CRS), which assists 500 orphans educationally and
medically. In March 2003, the Catholic Medical Mission Board (CMMB)/SCMH
started a project to Prevent Mother to Child Transmission of the HIV virus (PMTCT);
this project teaches expectant women on how to prevent the infection to their newborn
babies. Because of the economic crisis affecting Kenya, the government is not in a
position to develop or maintain the variety of the programs required to effectively
reach those in rural areas. To efficiently manage to combat the HIV/AIDS pandemic
in the region, we started Prevention, Control and Networking projects in May 2003.
These sister projects were initiated due to the high population and high death rate
resulting from the HIV/AIDS infection. Hence, all groups concerned, both private and
public are invited to offer assistance in speeding up the training desperately needed in
this rural area.

Project Description:
(AIDS) in Migori District has spread through different risk groups during an initial
period, started by wife inheritance, prostitute girls, poverty, sex workers, and clients,
to housewives, women in fertility age and infants. The fast spread of this virus is
contributed mainly by adverse factors of the cultural way of life and belief, especially
a switch of economic and social structure in the country from agricultural based
production to industries and breaches, whish are concentrated in urban centres. This
change accelerates massive migration of rural labour into urban areas leaving their
families behind. This situation leads to disintegrations of family and community,
people become ever more individualistic and materialistic. All these factors contribute
to a fast spread of AIDS. Women have a high risk to infect the virus and spread it
further.
We will use information programs as a means of meeting and recruiting community
leaders to join in the network. By creating forums for open, facilitated discussion of
the dangers and depth of the HIV/AIDS crisis, we hope to create a climate wherein
people infected with or affected by HIV/AIDS will feel comfortable to contact one of
our speakers or counsellors about testing, advice, or support. Over time, we hope to
identify a significant number of PLHA who can embrace and profit by the support and
solidarity of participation with others in peer and support groups.
Ours is a real grassroots effort. It requires setting up and developing an effective
resource/information/networking centre. In addition to the project director and key
workers, it requires identifying leaders, elders and other people in target villages/areas
and training them to be effective outreach activists. With training and confidence
gained by speaking frequently about HIV/AIDS, some of them may help us to
establish HIV/AIDS information and networking centres in busy commercial or
religious centres.
There are no effective, comprehensive and ongoing services for PLHA outside of
major medical centres. By raising awareness of the benefits of consistent medical
attention, the use of prophylactic antibiotics, the value of antiretroviral drugs, and the
comfort to be realized by sharing experiences and feelings with similarly affected
people, we hope to create a desire for a wider network of PLHA.
Numerous religious and other NGOs have programs addressing the AIDS crisis.
None have reached effectively into this highly affected area. Thus, collaboration and
cooperation among agencies is a key starting point. Duplication of materials, efforts
and positions is wasteful and time-consuming. It will be our goal to identify and
contact all groups proposing to offer HIV/AIDS services in the target areas. We will
compare agendas and methods, evaluate outcomes achieved, and determine how to
pool resources and personnel most effectively.
Hope and Life has a valuable resource in its well-established HIV counselling
program. Several of our counsellors are accomplished teachers, group facilitators and
public speakers. We can “share” them with other agencies to build their counselling
capacity. They will also be used in individual and group counselling sessions and to
assist PLWHA in forming and facilitating support groups.
Obtaining and using affordable antiretroviral drugs is key to extending the lives of
young adult teachers, farmers and parents infected with HIV/AIDS. We know that,
when people learn of the availability of Antiretroviral drugs, they are more inclined to
be tested. Therefore, a major goal is to secure and make available affordable generic
Antiretroviral drugs, a process that is not yet achieved due to financial constrains.
World AIDS Day is a logical date for PLWHA and HIV/AIDS workers to gather to
acknowledge the reality of HIV/AIDS in Nyanza Province. We will plan an Annual
Assembly of PLWHA for that date, hopefully including at least one PLWHA speaker
who demonstrates living positively with HIV/AIDS.

GENERAL OBJECTIVES
1. To develop a central information centre of Hope and Life located at St
Camillus Mission Hospital for people living with HIV/aids within Migori
District
2. To develop satellite HIV/AIDS information and networking centres in towns
and villages around the area.
3. To create and sustain a network of people living with HIV/AIDS
4. To carry out public education and training programs to promote and
disseminate knowledge on HIV/AIDS, its infection, communication skills, and
develop positive attitude on care and support towards AIDS patients.
5. To help reduce pain and impacts of poor and abandoned AIDS patients by
providing medical treatment and care to the selected needy people in within
Migori District.
6. To do outreach and provide counselling service to safeguard the human rights
of HIV/AIDS patients, provide community support, and building up network
of HIV/AIDS people, and cooperate with NGOs in the District and in Kenya.

APPROACH.
From the experience in working with the risk groups and people living with
HIV/AIDS, Hope and Life has realised that the most effective way of prevention is an
integrated approach of the work on AIDS. This means that its work incorporates
prevention training, forming peer groups, exposure for visitors, caring of adults and
orphans/children affected by AIDS, networking people living with HIV, home visit,
counselling and co-ordination with Nation agencies and NGOs both local and
national, in a holistic manner. In all its activities, it will promote active participation
of all stakeholders.

GOAL
To reduce morbidity and mortality rate within Migori District

PURPOSE
To support and empower the affected and infected people to live positively with
HIV/AIDS and not to be infectious to others.
ACTIVITIES:
1.1― Meeting of network committee
1.2 ―Visit to local associations of people with HIV/AIDS in Migori District
1.3―Coordination with other regional and national network
1.4―Annual assembly for people with HIV/AIDS within the district to coincide
with the world AIDS Day
1.5―Training of network members on counseling(on HIV/AIDS prevention, care
and support
1.6―Training of network members on home visit.
1.7―Training of network leaders to be TOTs (trainers of trainees)
1.8―Promote income generating activities
1.9―Advocate for the cheaper ARVs availability and use.
1. 10―Care and support to the infected/affected people
1. 11―Monitoring and evaluation
1. 12―Staff development and capacity building
Description of activities
1.1 Meeting of network members
In order to effectively coordinate the network, the network committee of
Karungu/Migori District region is formed. This committee meets once a month to
follow up progress of all network members and support activities of these member
associations. This committee meeting will take place not only at St Camillus Hospital,
but also in local associations in rotation depending on common agreement with all
committee members. The committee meeting also reviews information on human
rights of people with HIV, current situation of AIDS infection. The committee also
initiates the common activities of the network.
1.2 Visit to local associations of people with HIV/AIDS in other locations
Staff members of the network will pay two visits every month to local associations of
people with HIV/AIDS in Migori District. The visit aims at strengthening local groups
and associations giving advice, disseminating latest information, supporting mutual
aid among the members and so on.
1.3 Coordination with other regional and national networks, NGOs and other
agencies
It is very important and necessary to work closely with other agencies and
organizations. Only through this concerted effort that effective prevention will be
possible. The network will therefore work with other regional and national networks
of the people with HIV/AIDS to foster broader mutual aid among their members. This
coordination will as well as empowering them to negotiate with the government to
seek its support on resources and medicines, including its protection of human rights
of the people with HIV/AIDS. Coordination with other NGOs is also important in
sharing experience, drawing lesions and sharing of information.
1.4 Annual assembly of people with HIV/AIDS
The network will organize an annual assembly of people living with HIV/AIDS who
are members of Hope and Life and from other network associations within Migori
District. This annual assembly will be a platform for these people to share their
experience in their encounter with the deadly disease, relationship with their family
members, relatives, friends and community and to share information on scientific
development of HIV/AIDS medicines and or alternative caring. It also serves as a
platform for these people to deepen their solidarity with one another
1.5 Training of network members on counseling
Members of local associations, especially those who are new members of the Hope
and Life network, need counseling knowledge and skills to help their fellows who
share the same fate and their family members and relatives to cope up with this
reality. This skill will encourage the people with HIV/AIDS to stay home and in their
communities and live their last days with dignity. The network will invite
knowledgeable and experienced resource persons to lead the training.
1.6 Training of network members on Home visits
Hope and Life network realizes that it is important for people living with HIV/AIDS
to stay with their families at home because this is the best place for the ill fated people
to gain affection from their beloved ones. In this regard, it is necessary to promote
home visit and give counseling, mutual aid and support to these people to help them
live happily in their families and community. In the face of this need, the network will
organize training for members of local associations to develop their capacity and
skills on home visit. These home visits training will be organized once a year for
leaders and members of local association of people living with HIV/AIDS. The
training session will provide technique on how to deal with HIV/AIDS people living
at home and their family members and relatives, counseling and caring techniques and
so on.
1.7 Training of network leaders
This activity aims at developing network leaders to gain relevant capacity to operate
network. It will develop leaders with capacity in planning, project writing and report
monitoring, home visit, counseling and caring. These leaders will be the significant
human resources of Migori District network to carry on the work with people living
with HIV/AIDS.
1.8 Buyers club (Income generating activities)
At the moment, people living with HIV/AIDS become sick often and later remain
poor. We find that it is very important for the people living with HIV/AIDS to have
access to food and even to cheap medicines for opportunistic infection treatment, so
the income generating activity can be used to help in these problems.
1.9 Project management, monitoring and evaluation
To ensure continuation of experience in the operation and management, the
network will encourage a collective management system in which all
concerned members will be encouraged and supported to take part in planning,
making decision, evaluation, sharing of experience and so on. The network
will seek assistance from a monitoring coordinator of NACC to help
coordinate and monitor the work of all programs, so that it will be able to
provide effective and efficient services, small group discussions will also be
promoted to regularly monitor its work. The annual evaluation will also help
to review its operation in the past year as well as planning for the following
year. The results of these evaluation meeting will be used for improvement of
the work in the following year with new planning. In the evaluation, the
network may invite resource persons from outside to help look at its work.
1.10 Staff development and capacity building
Network members, i.e. full times volunteers and leaders play a very significant
role in the success or failure of the work. Whether target groups will benefit
from the programs offered by the networks depends totally on the network
members. Therefore, they need ongoing development to cope up with new
issues and situations to build their capacities for the work so that their
activities will effectively and fruitfully benefit its target groups and society as
a whole. This is particularly true for other staff members who are people with
HIV. This group of network members has the high rate of turnover. Therefore
it is necessary to provide staff training to equip them with knowledge, skill
and capacity needed for their work.
The network will organise in service training three times a year. The subject
will include techniques and skills needed for their work, such as project
proposals and reporting preparation, documentation, research coordination and
cooperation, network building, monitoring and evaluation, training techniques
and so on
INSTITUTIONAL CAPACITY

Project management, monitoring and evaluation.

To ensure continuation of experience in the operation and management, the network

will encourage a collective management system in whish all concerned members will
be encouraged and supported to take part in planning, decision making, evaluation,
sharing of experience and so on. The network will seek assistance from a monitoring
coordinator of NACC to help coordinate and monitor all programs, so that it will be
able to provide efficient and effective services, small group discussions will also be
promoted to regularly monitor its work. The annual evaluation will also help to
review its operation in the past period as well as planning for the following period .
The result of this evaluation meeting will be used for improvement of the work in the
following period with new planning. In the evaluation, the network may invite
resource persons from outside to help look at its work.

HUMAN RESOURCE CAPACITY

The group has a well established office with all the necessities, like running water,
electricity, a full library with necessary reference materials,
New furniture: 1. Combined desks
2. Visitors chairs (3)
3. Office chairs (3)
4. File cabinets half covered (2)
5. File cabinet (1)
6. Computer with printer (1)

Resource persons

1. Co-ordinator __ Teresa Atieno is a trained counsellor with a practical

experience For many years and in addition has attended other community
based program courses.

2. Ass-Coordinator―Peter Oluoch is a trained counsellor with a practical

experience for Many years and has attended other community based program
Courses.

3. Secretary ― Meresa Atieno is a trained Community AIDS educator,

has a computer certificate and she is responsible for report writing and
any other related duties.
ACCOUNTING CAPACITY

Hope and life has an account with Barclays bank of Kenya at kisii branch for safe
custody of the organization money . our records are also legible for any inspection e.g.
book keeping, balancing e.t.c

EXPECTED RESULTS

Community members trained in Home based care more sensitisation to be done, IEC
(Information Education Communication), materials distributed to about 70% of the
population lasting positive behaviour change to a reasonable level. Hence HIV/AIDS
infection rate reduced PLWHA taken well care of stigma and discrimination reduced.
The spread of HIV/AIDS significantly reduced.
 ORGANISATIONAL STRUCTURE

DIRECTOR
Fr. Emilio Balliana

CO-ORDINATOR
Teresa Atieno

ASST.CO-ORDINATOR
Peter Oluoch

SECRETARY
Meresa Atieno

HIV DOCTOR CLEANER COUNSELLORS

Dr. Bertha Emma 1. Polycap
2. Charles
3. Barnabas
4. Dorothy
NURSE 5. Girphas
6. Caroline
Victorine