Doing More with Less

INTERNATIONAL AIDS DAY - Getting To Zero

Zero new infections, zero discrimination and zero Aids related deaths
(this year's theme)

There is good news from a recent UNAIDS report released for World AIDS Day (1 Dec). www.unaids.org/en/resources/unaidspublication/2011/  New HIV infections and AIDS-related deaths continue to fall, and the number of people on treatment in the less developed world is almost 50 percent of those eligible. This has happened in spite of a decrease in finances.

Especially encouraging for us in Zambia is that access to HIV treatment has improved greatly in Sub-Saharan Africa (SSA), the region which has long been worst hit by the AIDS epidemic, making up some 68 percent or 22.9 million of all HIV-infected people.

Access to antiretroviral drugs (ARVs) has increased in SSA by 1/5 between 2009 and 2010 though 1.2m people still died of AIDS-related causes last year. Zambia has reported coverage levels of between 70 and 80 percent; nearing universal access (considered 80%).

The overall world statistics are encouraging too; while 2.7 million people contracted HIV in 2010. This represents a fall of over 1/5 since 1997.

6.6 million people are now accessing ARVs , an increase of 1.35 million in less than two years. With improved access to treatment, new HIV infections are also declining sharply.

It seems that ARVs play a role in reducing transmission of the virus to partners. Infection rates are 1/3 to ½ fewer than would have been the case without ARVs. This amounts to 2.5m people alive today who would not have otherwise been.

Changes in behaviour such as abstinence, condom-use and male circumcision are also contributing. Prevention of mother-to-child transmission is another success, where 400 000 new infections have been prevented.
To continue to do more with less, the UNAIDS Report suggests a 4- Goal Investment Framework to use funding more efficiently and effectively.

1.Maximise benefits of HIV Response

2.Use national epidemiology to ensure best allocation of resources

3.Implement programmes based on local context

4. Increase efficiency in prevention treatment care and support

This new approach in funding could prevent some 12.2 million new infections - including 1.9 million children, and 7.4 million AIDS-related deaths between now and 2020 says the report.

For universal access to HIV prevention, treatment, care and support by 2015, an estimated US$22-$24 billion annually is required.

In the past two years donor funding has been cut by 10 percent from $7.6 billion in 2009 to $6.9 billion in 2010.

Without stable funding, opportunities to prevent new infections will be missed and there is a risk that the progress gained in the fight against HIV could be lost.

Our Aids Relief Programme at the Mission Hospital here in Mwandi continues with its static clinic based here at the hospital and the 6 mobile outreach clinics. The outreach is now undertaken weekly. There are 1478 people on ART, 164 of whom are children.

We are grateful to many people for being able to look after our clients in many different ways. Starting at the top we have PEPFAR and AIDS Relief with the funding and other structural and logistical support. On the ground here we have a number of Church Partners who help such as IPC with reagents, Aiken and Goldsboro and other individuals for their contribution to the Formula Programme. There are over 250 children alive today who benefited from this programme that uses WHO guide-lines. The Church of Scotland Guild ’s Food Support programme that brings nutritional support to the Hospital and Home-based Care programmes. There are numerous churches and visitors who by buying bags and craft items made by the Mothers’ Support Group give this group a small but steady income throughout the year.

This year in Mwandi the Community will meet as usual on AIDS Day Eve for a candle-lit service in memory of those who are no longer with us and who have been lost to HIV/AIDS. At the service we will have a large number or Orphans and Vulnerable Children, a visible legacy and testimony to the destruction caused to ordinary families by this appalling pandemic. It is a sad and moving occasion but also one of joy and hope in the presence of these children.
The next day, AIDS Day, there will be a march through the village, an all-age gathering for some speeches, songs and drama; a Fun-Run and Football Match are the sporting events planned.

Dedication of the new church at Mabumbu

We were invited this Sunday to attend and take part in the Dedication Service for the new church at Mabumbu. I suppose we should be careful in using the word ‘new’. Mabumbu Congregation is a long-established church from Paris Mission times. Infact, Mabumbu meaning ‘the groves’, is named after an older Mabumbu to be found nearer Mongu.

Mabumbu is about 30 minutes from Mwandi. The road is still easily passable, though sandy and dusty. The daytime temperatures are fierce, around 40C, at the moment, as we await the frontal rains from Congo. There have been the odd few spits and drops but that has been convectional. The trees have shot new green leaves in expectation of the coming rains and most people have prepared their fields for sowing. A few courageous individuals have even sown a ‘lima’ or two, gambling on the arrival of the rains in the next week or so. Mubita’s Aunt last week came to say good-bye to us as she was leaving the cattle and fishing camp at the river and returning home to Kakulwani to prepare her fields.

After leaving the tarred road the first major settlement is the village of Namango. It is a typical rural village with daub and wattle houses, thatched roofs and reed-fenced lapas and is situated in a sandy clearing, scattered with baobabs, local palms and other indigenous, deciduous trees that provide wild fruit and shade. Traditionally Namango was the village where our Senior Chief had his fields. At this time of year the Palace moved to Namango for the sowing and the fields were tended by his wife. In the middle of the village we passed the ‘lutaitai’ the special thatch shelter built for the Senior Chief to sit in on arrival and hear submissions from local people needing his help. The Chief stays in Namango at his Kwandu (residence) for a week during the sowing, but his wife will stay longer if required. At Namongo there is also a full Kuta (Court) with its own Indunas.

The party from Mwandi arrived at Mabumbu to a warm welcome from the excited congregation. A beautiful and well-built daub and wattle sanctuary and vestry had been constructed and roofed by 70 zinc corrugated sheets. It had been completed in September taking about 12 months to build; the rafters costing K1.6m and the roofing sheets K4.2m (around GBP800/US$1200). The PC(USA) Church in Albemarle helped with the purchase of the sheets, and were thanked and remembered in prayer. The former thatched Church is being retained as a Church Hall. Future plans include the purchase of a new Communion Table and more congregational benches.

The Convenor, Lewis Banda, is supported by an Eldership of 8 men and women drawn from 3 Alume (MCF) and 15 Anamoyo (WCF). This lively and growing 215 member congregation is divided into 4 Sections and all live within a 10km of the Church. The Church is a focal point of the community and has a Sunday School attendance of around 48 most weeks and its Jericho Choir a membership of 18+.

There was a certain familiarity to the Dedication Service as it followed the Scottish Common Order to a great extent with the Opening of the Doors and ‘Ye Gates’ from Psalm 24 to begin with, then the Offering of the Keys. The prayers and readings were shared out amongst the eldership and Consistory visitors including us.

After the Dedication of the Church and its furnishings we moved on to the Proclamation, Scripture Reading and the Sermon based on Matthew 21:12-17, concerning the cleansing of the Temple by Jesus. Rev Manda said while it was important to keep the Church building clean, sweeping out the dirt and re-arranging the furniture was not enough, God’s House is to be a House of Prayer for all, not a den of thieves, we were not in Church to be in business for ourselves. Our bodies as Temples of the Holy Spirit needed to be kept clean too, so that all who entered the new building would be blessed. In other words our business as a Church is outreach to others.

After the Restoration of a Backslider we moved into Holy Communion, served in the French way in a horse-shoe formation round the Table. This was followed by the closing hymn and Benediction.

The Congregation gathered on reed mats under the trees in the Church yard to cook a bring-and-share lunch. The Rev and Mrs Manda, other Consistory visitors, the Uniting Church of Australia visitors and ourselves were served in the vestry. We enjoyed fried chicken, fish, gravy and buhobe. Outside the congregation cooked in their sections mainly reconstituted dried fish stew and mangambwa (pumpkin leaves cooked as greens). At the moment there is little grazing available so there was no mabisi (thick sour milk), only a small amount of fresh milk was available. Maheu from a plastic bucket was the drink on offer. Commercially-produced maheu and mabisi can be bought now in town for those urban Lozis pining for the rural food of their childhood. Maheu is made from left-over porridge to which water and flour is added and left overnight to make a refreshingly tart drink. Sugar can be stirred into it for those with a sweeter tooth.