Turning the Tide of HIV/AIDS: St. Francis Health Care Centre
This morning we set out to visit St. Francis Health Care Centre, which is also located in Jinja. As we approached the gate, we saw a throng of people at the entrance, holding signs and singing. St. Francis staff wore t-shirts emblazoned with the St. Francis logo and on the back it said ‘Help Turn the Tide of HIV/AIDS in Africa’. Clearly the Turning the Tide Campaign is resonating at the grassroots!
We were welcomed by Faustine, St. Francis’ founder and executive director, and went for a tour of the health centre. St. Francis cares for over 9,800 registered HIV/AIDS clients, providing comprehensive care for people living with HIV and AIDS. With two doctors, and a committed group of counsellors, nurses and social workers, the clinic sees an average of more than 70 clients daily, seven days a week. In addition to dispensing antiretroviral drugs to those who need them, St. Francis also treats opportunistic infections such as malaria, tuberculosis, and HIV-related diseases such as oral thrush and Kaposi’s sarcoma, and reaches out to clients through home visits and counselling.
St. Francis has developed a number of programmes to assist grandmothers and orphans and vulnerable children in the community. In August 2006, St. Francis sent two grandmothers – Theresa and Sylvia – to attend the Grandmothers’ Gathering hosted by the Stephen Lewis Foundation in Toronto. At the time, there were five grannies associated with St. Francis. Inspired by the African and Canadian grandmothers they met at the Gathering, the women returned home and organized a meeting of more than 300 grannies in the community. The grannies described their needs – from school support to clothing and bedding, food to medical care – to the St. Francis staff. Soon, the organization began offering programmes specifically for grannies, and started a number of granny groups to help reach those who were most in need.
Angela, the capable young coordinator of St. Francis’ grandmothers programme, described how the organization currently reaches more than 120 grannies in five groups. Many of the grandmothers are caring for large numbers of orphans, and a number of them are HIV positive themselves. They hold regular meetings, participate in a savings and loan programme, and some do beadwork and make crafts to generate income. St. Francis helps to buy school uniforms, pay for supplies, transportation and other school-related costs for primary-school aged children, and boasts a thriving community garden where the grannies can access a steady supply of fresh vegetables. Each week, St. Francis sends out a team – a doctor, nurse, counsellor and Angela – to the homes of grandmothers who have fallen ill, so that they can receive timely medical treatment and home-based care.
At a large gathering of grannies, Stephen asked the group what they needed most. The grandmother who spoke on behalf of the group was unequivocal – the grannies want their grandchildren to be able to attend secondary school and further their education. Few children are able to continue schooling beyond the primary grades, because the school fees and costs associated with secondary school make it next to impossible for orphans and vulnerable children to attend. St. Francis has helped to bridge the gap by providing vocational training for youth – teaching them a skill such as carpentry, farming, or brickmaking – so that they will have the opportunity to earn a livelihood once they have finished primary school. But many of the grannies dream of a time when their grandchildren will have the opportunity to complete secondary school and have the chance to attend university.
Later, we went into the community. Our first visit was to the home of a grandmother-headed household. As we approached the house, I thought that we were being greeted by a large group of schoolchildren. It turned out that all of the children gathered there – 26 of them – were being cared for by their grandmother, Beatrice. It was shocking to see one woman caring for so many children. Angela translated as Beatrice told us she had lost nine children to AIDS. She showed us around her four-room house, pointing out where the older children sleep, and the room where she stays with her youngest grandchildren. St. Francis helps buy school uniforms, pay for supplies, transportation and other school-related costs for Beatrice’s grandchildren. She is also taking part in the local granny group and the granny savings and loan programme.
One of the unique things about St. Francis’ granny groups is that many of them have undertaken a savings and loan programme. There are five groups of grandmothers – 120 grannies in total – participating in the programme. Each group has selected a chairperson, treasurer and two money counters, and has entrusted one granny to be the keeper of the ‘bank’. There are three locks on the box that serves as the bank, and the keys are given to three separate people – that way, all decisions about the use of funds will have to be made by the group. The grandmothers set the ground rules for themselves – they decide how much money is required to participate, how long the programme cycle will last, and how the loan programme will work.
Every two weeks, the women gather together to buy ‘shares’ – at the group we visited, a share costs 500 Ugandan Shillings (UGS), roughly $0.25 CDN. Group members can purchase up to five shares at each meeting, adding their money to the group kitty. They grandmothers also pay into a ‘social fund’ that is used for emergencies within the community, such as when a grandmother’s house burns down or there is a death in the family and they need help with funeral costs. But the programme isn’t merely about saving money each week – women in the group are able to take out loans (up to three times the amount that they’ve contributed) from the group, and are given twelve weeks to repay the money with a small interest rate. The savings and loan programme cycle lasts for 9-12 months, at which point the women divide up the cash according to the number of shares each member has purchased. At the end of the year, each grandmother receives her initial investment, plus the interest paid by those who took out loans.
At the meeting, one of the grandmothers took out a loan for 20,000 UGS – about $10 CDN – to buy additional seeds and tools for her small vegetable business. After the meeting, we visited the home of another grandmother who took out a loan from the savings programme. She purchased a pig with the money, and was able to turn her investment into a thriving business. Pigs generally produce large litters – between 6 and 10 piglets at a time – twice a year. The granny was able to sell the piglets and pay back the loan, and now keeps a number of pigs, which provide a steady source of income for her family.
It has been amazing to see so many different programmes for grandmothers on this trip – at Hillcrest, at PEFO and at St. Francis. While all of them share the common thread of having regular granny group meetings, each of them has responded to the unique needs of their community. Despite all that they have been through, the grannies have shown an exuberance and resilience that is truly inspiring. In each community, Stephen has spoken to the grandmothers about the work being done by Canadian grannies to raise awareness, funds and advocate on behalf of African grandmothers, and each group was bowled over by the incredible dedication and commitment of women half a world away.
At the end of today’s visit, Stephen, Aissatou and Idah left for Entebbe, to catch their respective flights. (Stephen is continuing on to Kenya and the Congo, and Aissatou is returning to Canada). It was sad to see them go – it has been an inspiring series of visits, and it is hard to believe that we’ve seen five projects in the last week or so. Thomas and I will remain in Uganda for the next several days to film feature stories and visit Reach Out Mbuya with Idah… Stay tuned for more posts from the field!