The Archdiocese of Mombasa AIDS Relief and CBHC Project began as a pilot project in 1996. Located in one parish, the Mombasa AIDS Relief Pilot Project (MARPP) was funded by the Maryknoll Society. The pilot project was initiated to help the local church respond to the crisis of the burgeoning AIDS epidemic. Based on the success of MARPP, Caritas Germany agreed to fund an additional parish for 2 years (1999-2000). In mid 1999 the project was initiated in a third parish and Caritas agreed to the merging of funding sources in order to administer the growing program more efficiently. In July 2000 the project was expanded again to include a fourth parish. The current long term goal of the Archdiocese of Mombasa AIDS Relief and CBHC Project is slow, gradual expansion of one parish per year to assist the local church in its response to the AIDS pandemic.

The project is dependent on volunteers as the essential component to the evolving system of services. Each Parish is subdivided into Small Christian Communities (SCCs). Catholics living within the areas covered by the SCCs meet regularly to pray together. The SCCs choose the volunteers who are trained and begin to visit the sick in their respective areas. Nurses with access to essential medicines accompany the volunteers once a week. The rate of HIV infection being around 20%, invariably People with Aids (PWAs) are found and then regularly visited. Many other medical and social problems are encountered. Advice and counseling as well as many referrals to the local health care system are common.

Currently more than 2500 clients are being served by the project. Effort is made to improve the quality of life of those afflicted with HIV/AIDS. Food, medicine and more importantly care and acceptance are offered to those suffering from many hardships as they approach death. At present there are more than 130 volunteers in the project. Salaried staff include 7 nurses, 3 counselors, 1 social worker and 1 secretary. The program is being coordinated by Sister Augustina Masway, SSJ, and Brother John Mullen, MM. For the year 2000 the project's funding is dependent of the generosity of Caritas Germany and the Maryknoll Society.

PROBLEM STATEMENT

HIV/AIDS is a reality in Mombasa Kenya. Some estimate the prevalence rate in Mombasa to be greater than 20% of the adult population. Kenyan government statistics show HIV prevalence to be increasing in Mombasa from 10% of pregnant women in 1990 to 17% in 1997. National prevalence for Urban Adults in Kenya was 18.1% in 1998. (NASCOP Report 1999) Those suffering from this disease are in need of assistance. The Archdiocese of Mombasa AIDS Relief and CBHC Project has shown that concerned Christians can respond with compassionate care to give hope and comfort to those individuals suffering and dying from AIDS. The motivation of the volunteers and staff is service to the sick poor responding to Jesus' request to Love God by loving their neighbors. There is an emphasis on spiritual care in the project.

OBJECTIVES

The four parishes being served are located in the Western Deanery of the Archdiocese of Mombasa. Approximate population of this catchment area is 200-250,000 people. Given HIV prevalence of 20%, 20-25,000 people are potential clients. In the initial parish over 1,300 clients are being followed after 4 years of visitations with well over 200 deaths.

The objective of the project is not to replace the existing health care system. Rather it seeks to mobilize Catholic Christians to serve their neighbors during a time of crisis within society. The project complements the existing health care system which has been overwhelmed by the epidemic.

The objective of assisting as many people as possible suffering from HIV/AIDS is being addressed and met. The project aims to increase services within the Archdiocese at the rate of one parish per year. The project is ongoing and dependent on the generosity of donor funding and the goodwill of the Kenyan people. Results are difficult to measure in a project of this kind.

Methods

During the second half of 2001 the project will begin to serve a fifth parish. Following the pattern established by beginning services in the first 4 parishes, the pastor is contacted and a meeting with the leaders of the SSCs is called. A team of nurses and volunteers from the project present the plans and aims of the project. Questions are encouraged and answered. The leaders are instructed to return to their SCCs and facilitate the choosing by the members of the SCC 2 volunteers to undergo training. These chosen volunteers must be available (i.e. not working fulltime and thus able to visit with the nurse) and willing. Training of the new volunteers then starts and visitation of the sick in the parish begins. An office is rented, medicines are stored there, and a nurse begins to accompany the community health volunteers. Given the high incidence of HIV and the abject socio-economic circumstances, a clientele of the sick poor rapidly accumulates.

Currently there are 7 nurses, 3 counselors and 1 social worker employed by the project. 2 of the nurses are experienced Religious Sisters while the other 5 nurses are relatively inexperienced new graduates. The inexperience of the new nurses is a positive factor for the program as they have not developed bad professional habits, are generally eager to learn and serve, and start at the bottom of the government salary scale. The counselors have been trained at the only CPE (Clinical Pastoral Education) Training Program in East Africa (Bugando Medical Center, Mwanza, Tanzania). There is a need for more counselors. Finally the social worker is qualified with over 12 years work experience.

The Eastern Deanery AIDS Relief Program (EDARP) in Nairobi is a larger and similarly successful project in Nairobi based on the same SCC model. There is liaison between the 2 projects and the EDARP program has assisted in the start-up of the Mombasa project with training support.

SUMMARY

The Archdiocese of Mombasa AIDS Relief and CBHC Project is responding to the many needs of a locale being ravaged by the AIDS pandemic. It is a community and Church based response dependent on a growing group of over 130 volunteers who desire to assist their sick and dying neighbors. While dependent on donor funding, the projects attempts to be accountable and transparent with biannual financial reports. And finally the project is open to outside evaluation and suggestions for improvement.

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