Success Story: Maud Mbambo

Zoë-Life Community Project
This project aims to build capacity and strengthen comprehensive HIV services at a community level. It targets those working with already existing, high impact organisations that offer services to community members. By doing this Government Health facilities will be decongested, allowing non-government organisations to provide comprehensive HIV services to their community members.

CIMCI (Community Integrated Management of Childhood Illnesses) is a programme which Zoë-Life runs to assist community care givers (CCGs) to manage childhood diseases within the community. Prior to this programme, the local clinic would be responsible for the management of illnesses, which led to an overburden on stressed resources. CIMCI trained CCGs now teach households how to treat infections and when to refer a child on to a clinic or hospital. The outcome is a reduction in children dying from diseases, which are easily curable or manageable through medication. While CIMCI is a programme that addresses the needs of children between 0-5 years old, it also addresses the health needs of the mother who is vital for the survival of her child. Grandmothers and/or other caregivers are also assisted through the programme as their health needs are met and they are encouraged to look after themselves.

Maud’s Story

success-maudApproximately four years ago, Maud began working at Zoë-Life. As a qualified nurse, she had been working in the field of HIV/AIDS and childhood ARV initiation research at the University of KwaZulu Natal. At Zoë-Life, her position is that of Clinical Officer and her role in the Community Project is to train CCGs to work within the community setting at a household level. CCGs transfer the knowledge they have learnt during training to household members regarding key family health practices. Maud’s involvement in this project has seen two types of intervention: firstly the positive impact that it has had on the health of children and adults within the community, and secondly, the impact that it has had on the confidence levels of the CCGs, who are now certain of their role in the community, and are working within a defined structure of a programme. Prior to the programme, CCGs were unsure of their role, and were not as effective as they could have been.

One of the CCGs Maud trained met a 25 year old young mother, who was on her way home from the clinic, with her two week old baby.  The mother had had a caesarean and had had her sutures removed that morning but was not feeling well. The CCG accompanied her home and was horrified at the sight that met her. The young woman’s home was a filthy, tiny room with rotting wooden walls and a disintegrating cement floor – certainly not a healthy home environment for a baby and a woman recovering from surgery. The main house, belonging to the landlord, was no better with parts of the house so derelict that they could not be used. Four adults and a child, under the age of 5, were living in this house. The garden stank with refuse, which had built up behind the house as the household, and neighbours, used it as a dumping ground. The young mother had no food for herself or her child, no blankets or suitable bedding and heavy rain had soaked the floor and all of her possessions.

On her return the CCG approached her supervisor for assistance and she in turn called Maud. Maud linked the CCG to an organisation called Masakhisane, which provided the young mother with food and baby clothes, and sent her to her local community hall where a group of women would determine how best to assist her. When she arrived she was so sick that the women took her to the hospital for medical care; her wound had become sceptic in the unsanitary living conditions and required cleaning. Once she was discharged from hospital she was delivered home with many items, such as a heater, baby bath and blankets. Masakhisane also arranged a place for the young mother and baby to live at Tshelimnyama. A woman from the church came forward to offer to pay the rent for the young woman for six months, and has continued to do so, into the 8th month.

Through their interaction with the young woman they discovered she was without an ID book, making it impossible for her to find work in the formal sector. With the assistance of Masakhisane, she has applied for her ID, and awaits her documentation. In the meantime she has found piecework and is able to provide food for herself and her child.

success-maud-1Maud took photos of the household and showed them to the supervisor of the CCGs who in turn reported the state of the household to the local Councillor. The DSW was brought in to help clean up the mess (in particular all the refuse) and the family is living in much cleaner, healthier conditions.

Since Maud last met with them, both mother and child are doing well. The baby is 8 months old and is healthy and crawling. The mother has joined the support group at Open Door Crisis Centre and receives food and nappies every Friday. She has also joined the Masakhisane Ladies Group and is supported by the church.

Maud’s story highlights the effectiveness of the community programme in that it shows the ability of CCGs to examine a particular situation and act accordingly to meet the needs of community members, both adult and child. It is clear that the CIMCI programme provided by Zoë-Life, while directly targeting children, has had the added benefit of affecting others indirectly. Not only do CCGs ensure that the health of the community is being addressed but they are also able to link people to organisations and community groups which can assist them in other areas of their lives. This shows a wonderful community effort, which has changed the life of a young woman, her child, and a family of five.

There are many examples of the fantastic work being carried out by Maud and the team of CCGs. One of which is worth mentioning as it highlights the desperate need for CCGs who are able to think beyond what they are simply taught. It also shows that although there are facilities available to communities, they are not always accessible due to the dire economic situation that many South Africans find themselves in. Maud and CCGs went to visit households in the Marianhill area only to find that the parents were not immunising their children. When Maud enquired as to why this was happening it was revealed that although there was a local clinic, it required taking two taxis to get there – an expense which many families just could not afford. So children were only being immunised at birth and not visiting clinics again for necessary immunisation. Parents were instead traveling to nearby Pinetown as the clinic there was easier to get to. However, the parents were turned away (children untreated) as the Pinetown clinic felt that the parents should be attending their local clinic and not adding to their clinic workload. When Maud heard this story she immediately reported it to the facilitator who approached the Department of Health. Their response was to organise a mobile clinic, which should be in operation by the end of the year, for community members to attend.

The Response of CCGs:

success-maud-2When Zoë-Life first introduced the community project and CIMCI to the CCGs, they were not very keen to become involved. However, it has become increasingly clear, over time that the CCGs have gained in confidence and knowledge and are now able to act in a way that benefits community members enormously. According to Maud, CCGs are now certain of their role in the community and feel confident to walk into any household, ascertain the most pressing need, and respond immediately with the correct information. Prior to the intervention they were an unstructured group who did not have a plan of action so were not able to intervene in a productive way.

While the CCGs are sad that the programme is coming to an end, they have communicated that they are at the point where they feel confident to carry on with their work and assist their community because they have a plan and a structure in place. CCGs know their position and role and what they need to do to carry it out.

Life After Zoë-Life:

Now that funding for this project, and her time at Zoë-Life, has drawn to an end, Maud has been using her experience and the skills she has gathered at Zoë-Life to volunteer in her community. She believes that the knowledge she now possesses will prove invaluable to her community. Her links with various organisations, with the CCGs, and with municipality have given her confidence to go out and continue the good work in a volunteer capacity for a couple of days a week.