Welcome to WM15 – HIV and AIDS ZAMBIA * has a population of over 11 million people * some 10% are currently living with HIV * life expectancy at birth is just 40 years for men and women * 87% of the population live on less than US$2 a day * there are about 750,000 orphans aged 0 to 17 due to AIDS * church institutions provide 50% of formal health services in rural areas and 30% in the country as a whole * the ecumenical Churches Health Association of Zambia (CHAZ) is one of the four national recipients of Global Fund grants to provide ART * 100,000 people are on anti-retroviral treatment (ART) accessed through 293 sites across the country * our partner, the United Church of Zambia (UCZ), has its own integrated HIV/AIDS programme Contents: ZAMBIA 1 HIV and AIDS: The Zambia – Scotland Connection 1 Q&A 2 Temptation, Barbed Wire and Country Dancing in Zambia 4 Livingstone Women Making A Difference 5 Postcards from Zambia 5 Prayer Focus 6 The Strength of Christian Spirituality in the Face of HIV/AIDS: 6 Suggested readings: 7 Please Pray: 7 HIV and AIDS: The Zambia – Scotland Connection The Lothian Zambia Partnership has developed a partnership with LIWOMADI (Livingstone Women Make a Difference). Recently the HIV/AIDS Project made a grant of £12,000 over three years. Martha Baillie, Manager of Waverley Care’s Solas Centre in Edinburgh, and Eunice Sinyemu, African and Ethnic Minority Project Officer at HIV Scotland (a member of the Kirk’s HIV/AIDS Project Group) visited LIWOMADI recently. They write: “Both our organisations have been developing and delivering services in response to the growing number of Africans in Scotland - it has taken time to establish credibility and trust and there is still some way to go – there is a reluctance to come forward and link with services, let alone be open about living with HIV. So it is helpful to learn how such challenges have been tackled in a country like Zambia where HIV prevalence is high at 16%, especially in the Livingstone and Kazangula area where at 33%, it’s the highest in the country. We also felt that it was important as members of the Lothian Zambia Partnership to have a link between community services and a broader sharing of responses to HIV beyond the clinic and treatment setting. “Stigma and discrimination are still surprisingly high - although they don't seem to be a barrier to testing, as treatments are free and seem to be working well. But stigma is certainly a barrier to getting support and to maintaining self esteem and confidence. Services are generally good in Livingstone, where there are several NGOs, missions, two hospitals. But not only are services almost non-existent in Kazungula, but people we met in villages felt there was not enough knowledge of HIV and - because of distance and lack of transport - it is not easy to go for HIV counselling and testing. “We visited three villages in Kazungula - Nyawa,Makunka and Siachabakubi. Each took three hours to reach by van on sandy tracks. There’s no transport in the villages and no passing transport. The nearest health clinic is two hours by van – much longer if you have to walk. But there’s a strong community response, particularly in supporting orphans and creating income generating projects that raise income for the orphans and wider community. There’s strong partnership and collaboration at district and provincial level. Much effort goes into coordinating responses and planning - still early days, but we were impressed. Work is put into mainstreaming HIV, partly to reduce stigma, but also as part of prevention in schools, media and workplaces. Maybe we need to rethink our prevention work in Scotland! “LIWOMADI has done so much in the last seven years with little bits of project funding from time to time. They are now ready to plan long term development and sustainability. We’ve helped them look at what their developing role might be in working in the villages and in supporting people living with HIV and AIDS in Livingstone too. We’re looking at sustainability both of the organisation as well as local projects and communities. Some of this is about information and training, some about income generation and some is about acting as advocates to link into other opportunities. For example, the basic needs for all villages are accessible water, primary education, health clinics and some form of community transport. These are beyond the remit of LIWOMADI, but as they gather information during their own work they can feed this back. Often they are the main point of contact. So we’re working with them on governance, management and other issues involved in running a full time organisation. “On a personal level it has been a humbling and joyous visit. We both recognise the task is enormous. But the more we get to know LIWOMADI and the volunteers the more impressed we are with their commitment, dedication and love. It’s a fantastic example of a community based grass roots response.” Q&A Dr Dermot Gorman is Consultant in Public Health Medicine at NHS Lothian and chairs the Lothian Zambia Partnership. Why did NHS Lothian initiate the partnership? The Lothian Zambia Partnership began in 2004 with the then Chair of NHS Lothian and Director of Public Health recognising the importance for developed health systems in wealthy cities such as Edinburgh to offer advice and support to those working with fewer resources. Lothian has a lot of HIV expertise, well developed services and internationally recognised research in this field. So it was from an altruistic perspective as well as self interest that LZP started. The self interest stems from the relative influx of African people coming to live and work in Scotland in recent years. Inevitably they need healthcare and an understanding of the context from which they come is very important to NHS Lothian in designing services. What does NHS Lothian get out of it? The benefits are for NHS staff who have opportunities to widen their clinical experience and view their clinical workload from a different perspective. It allows the NHS to network effectively with a wide range of important organisations working in African health in Scotland and has also improved our links in African countries, where partners here can give us introductions to important local African organisations. What can NHS Lothian contribute? NHS Lothian’s contribution is primarily in terms of releasing staff and encouraging staff to contribute to the Partnership. We are also active in promoting the model to other NHS Boards in Scotland and to NHS links throughout the UK. What have you personally got out of the partnership? I came into Public Health inspired by the late Dr George Bath who was a key figure in Scotland’s initial response to HIV in the 1980s and 90s. The opportunity to contribute in a very small way indeed to the efforts to improve health care to people living in very disadvantaged circumstances has been very rewarding. Public Health is about working at the population level to make things better for communities and the principles are the same, even if circumstances in Edinburgh and rural Zambia seem very different. It is fascinating to see international development policy working on the ground and learn a little about how international aid agencies, DFID and other organisations work together. Locally, improvements are being made in healthcare for people from Africa within Scotland and that’s encouraging to see. Why is it important to have faith communities like the Church of Scotland involved? Faith and religion are very important parts of their lives for many people living in Africa and churches provide much of the healthcare in Zambia. When African people settle in Scotland the church is often a central focus for their lives. Consequently, faith based organisations are both knowledgeable about the issues facing African people in the UK as well as having in depth understanding of the situation abroad. They are well positioned to change things especially as they have connections and links established over 150 years. Dr Gordon Scott is a Consultant in Genitourinary Medicine in Edinburgh and involved in HIV and AIDS care since the early 80s. What have Lothian clinicians been able to share with colleagues and institutions in Zambia? A mixture of things. Some clinical training either on ward rounds or in clinic. This is often "permission giving", acknowledging that what the doctor or clinical officer is doing is less than perfect, but actually they can't be expected to do any more in the circumstances.We also give talks on aspects of treatment to staff, including nurses, eg post exposure prophylaxis, appropriate antibiotics for treating STIs. I have also done some lecturing with Dermot at the college for students training to be Clinical Officers. What have Lothian clinicians learned from colleagues and institutions in Zambia? How lucky we are! What have you personally learned and gained from your visits to Zambia and the partnership generally? I have a much better understanding of cultural aspects affecting patients from Southern Africa, and would hope that I provide improved care specific to their needs. Has involvement in the partnership changed your view of faith communities and Faith Based Organisations (FBOs) and their ability to deliver appropriate HIV services and care? Absolutely. Faith communities in the developed world often come over as idealist or somewhat divorced from reality, but the organisations I have seen in Zambia have been fantastically realistic and pragmatic without in any way compromising their spiritual beliefs. Temptation, Barbed Wire and Country Dancing in Zambia In 1998, South Leith Parish Church began a partnership with a secondary school north of Lusaka. Since then adults and children have travelled in both directions. Groups of up to nineteen people aged 15 to 75 years have met for two weeks of work, worship and fellowship. During a trip in March 2006, the group helped build a large barbed wire fence to protect the herd of cattle. They discovered many ways to interact including dancing in Scottish and African styles. As well as sharing multicultural activities they ran workshops for the 750 secondary pupils at Chipembi Girls School. Donna Gilmour, a nurse, with Kerry Mathieson, a 15 year old pupil at Trinity Academy in Edinburgh, delivered a course on HIV and AIDS. It was well received and elicited some powerful contributions. There were thoughtful questions from girls who clearly knew about physiology and the effects of HIV. All the pupils in the workshop were invited to send a letter to the United Nations regarding the ‘Keep the Promise’ campaign. To everyone’s delight one of the letters was used by the UN as part of their awareness raising efforts. Headteacher Mrs Dorothy Munansangu heard from Dr Catherine Sozi, the Zambian Coordinator for UNAIDS: “Following our visit to your school last week, it is my pleasure to officially inform you of the recognition of a letter submitted by a student, Ms Namwene Phiri, on the theme, ‘Keep the Promise. Stop AIDS’. Her letter to the UN challenged policy makers of the world to take action and make universal access to prevention, treatment and care related to HIV/AIDS a reality for all, especially children. Ms Phiri’s letter was written with passion and conviction and has inspired peoples across the world, who have read it in a presentation created by UNAIDS and displayed in New York, Toronto and Geneva“ The school’s depute head, Mr Albert Chituka (in photo above) arrived in autumn 2007 to study for a Master’s degree in agriculture at the Scottish Agricultural College, Ayrshire. Mr Chituka, will be supported by the World Mission Faithshare programme as well as the congregation during his year-long stay. We hope to make another trip to Zambia in March 2009, aiming to improve the quality and quantity of water in the school as well as doing more workshops. Livingstone Women Making A Difference This small self-help organisation was formed by a group of concerned women in 2001 with the aim of making family life better by tackling problems such as HIV/AIDS, poverty and corruption. It works with families, orphans and vulnerable children in Livingstone and Kazungula, both largely rural districts of Southern Province, where HIV prevalence is the highest in Zambia at 33%. Livingstone is capital of the Southern Province of Zambia, a tourism centre for the Victoria Falls, lying 10 km south on the Zambezi River, and a border town with road and rail connections to Zimbabwe. Its population of 115,000 is swelled now by Zimbabwean refugees. Kazungula is a small border town where four countries meet. Its ferry crosses the river to the town of Kasane in Botswana. These cross-border links and transient population heighten the risks of HIV transmission. LIWOMADI gives HIV education and helps form HIV clubs in schools, promotes ‘positive living’ among HIV infected people and informs communities on anti-retroviral treatment. While ART is available free of charge, it can only be accessed through three medical centres, all in the town of Livingstone itself. They also offer voluntary counselling and testing, as well as other activities related to the amelioration of the effects of HIV and AIDS; community schools, income generation, micro loans and organic farming initiatives. These last three in particular are being supported by a Church of Scotland grant. They’re also involved with other NGOs in promoting appropriate community care for HIV orphans and other vulnerable children. Another initiative to address HIV stigma and discrimination and build self-confidence among positive women is a beauty contest, where character and knowledge about HIV are judged, alongside looks. Charity Mulenga (the Director) and Maggie Nanyangwe visited Scotland in June 2006 for the CIVICUS World Assembly in Glasgow, invited by Edinburgh-based advocacy group ImpActAIDS. They led a workshop on “HIV/AIDS – from global goals to local action: new initiatives in thinking and acting together”. It concluded that “leadership entails utilising people already engaged in community activities and supporting them through training, giving them authority and recognition through community awards. The important issue is for communities to feel ownership.” This is at the top of LIWOMADI’s agenda. Postcards from Zambia Zambia is a diverse country in southern Africa, and has borders with Tanzania, Malawi, Mozambique, Zimbabwe, Botswana, Namibia, Angola and the Democratic Republic of Congo. Solve the clues below to find out about some of the sights and people of this beautiful country. Did you know? There are over 750,000 orphans due to AIDS in Zambia Fishermen fishing on the Kafue river, south west of the Zambian capital L_ _ _ _ _ Ladies from L_ _ _ _ _ _ _ _ _ _ supporting HIV work in the town named after the famous Scottish explorer David. Children in Kitwe in the northern part of this region of Zambia, named after the orange metal found here used to make wires called the C_ _ _ _ _belt The largest waterfalls in the world, on the border between Zambia and Zimbabwe, were named after the English queen at the time; Queen V_ _ _ _ _ _ _ Sunset over the river from which Zambia takes its name – the _ _ _ _ezi Prayer Focus The Strength of Christian Spirituality in the Face of HIV/AIDS: Rev. Rosemary Nsofwa Mulumo, Community Development Secretary, United Church of Zambia HIV/AIDS is an epidemic within other social diseases of poverty, gender inequality, violence and overall human rights abuses. The Church is therefore challenged to the core of its belief to provide care and love, to be Christ-like and provide hope. Silence, shame and stigma are the worst killers of people everywhere, which are the root causes. Genesis 1:31, “God saw everything that he had made and indeed it was very good.” God breaks the silence in our communities; regardless, we face so many tragedies that at times there is no room for laughter, or so it seems. God breaks the silence of despair, picking up the pieces, rebuilding lives after disasters, opening doors after failures and sorrow. Hope, therefore, is central to the Christian life, sin is a state of bondage that rules over and distorts human life, and God’s original plan is to restore back to good our broken souls. Christian therapy is therefore care and love. Community approach is imperative; to touch individual lives in the advent of HIV/AIDS, we should not lose the soul which lies within the well-being of a person. Suggested readings: Numbers 12:1-16 and Philippians: 2:1-5 Charity Mulalami, a second year B.Th student at the UCZ Theological College in Kitwe offers this reflection for prayer: In this world that we are living in, no one can ever run away from the realities of HIV and AIDS. It is therefore important to know that AIDS is real and it’s in our church and that even if we are not infected we are affected. In Numbers 12:1-16 we see how Miriam’s leprous condition affected the rest of the Israelites. But would the Israelites say: “No, let’s leave her here because she is the one who has this condition, therefore we are not affected at all”? Of course not! Those who did not have that sick condition could not move on in their journey towards the promised land without her. So when our family members, friends and church members are infected we become affected because they are part of us and we are part of them. In Philippians: 2:1-5 Jesus is being set as an example to us of how in humility we should be able to consider others, not just looking into our interest but also the interest of others. Are we a source of encouragement to these people? Do we show and give them that love they long for in this condition, and is our attitude that of Jesus? The Church, therefore, must be there for people living with HIV, to encourage, comfort and be compassionate to them. For Christ came for people such as them. They are in need of him as their physician, a God who heals even up to today. For Jesus gives hope to those in hopeless situations and when no one seems to be there for them Jesus promises to never leave nor forsake them. Amen Please Pray: God bless Zambia Guard and guide her people Comfort and support those dying of AIDS Give treatment and hope to all those living with HIV Bless all HIV prevention programmes In Christ’s Name Amen AFRICA ZAMBIA Pray for: * CHAZ as it co-ordinates and develops the ecumenical work of the churches in delivering healthcare, especially building capacity in the field of anti-retroviral treatment for HIV - Dr Simon Mphuka is Executive Director * the UCZ (United Church of Zambia) HIV/AIDS Programme and Rev Rosemary Nsofwa Mulumo as she encourages awareness about HIV/AIDS and its impact on the community * the UCZ Theological College and all its staff (especially Rev Deepak Yohan) and students, that they may be fully equipped to lead and inspire congregations in appropriate HIV prevention and AIDS care * the National AIDS Council that it may be inclusive in its membership and effective in coordinating and delivering resources across the country * Government ministers and politicians of all parties that they may give effective leadership, especially in the face of continuing stigma * continuing co-operation and fruitful links with NHS Lothian and all its partners and stakeholders * Charity Mulenga as she directs the work of LIWOMADI and all its volunteers and service-users EUROPE SCOTLAND Pray for * Rev Dr Robin Hill, to be nominated as new Convenor of the Project Group, at the same time giving thanks for all that Shirley Brown has given in her five year term of office * the World AIDS Day event at the Scottish Storytelling Centre on 4 December jointly hosted with the United States Consul in Scotland, that it will effectively raise the profile of the Project * the commissioning of the renewed Church of Scotland HIV/AIDS Project by the Moderator on 11 December * the wide-ranging work of HIV Scotland in raising awareness, influencing policy and supporting agencies, especially Roy Kilpatrick, its Director, and Eunice Sinyemu and her work among minority communities * the work of Waverley Care, its Director, David Johnson, and the care and support services offered through the Solas Centre and its manager, Martha Baillie * Dr Dermot Gorman in NHS Lothian and all who encourage a holistic vision of HIV public health and our commitment to share resources with Africa * Dr Gordon Scott and HIV clinicians across Scotland as they respond to growing numbers of infections and the broader challenge of poor sexual health -------------------------Back Page------------------------------------ WORLD AIDS DAY Encourage your congregation, home group, Guild or Youth Fellowship to have a special event or service around World AIDS Day (Saturday 1 December). Find out if there is something happening in the wider community which you and your congregation could support. You can see more about LIWOMADI if you watch Songs of Praise on BBC1 on Sunday 26 November. The programme, to come from Greyfriars Kirk in Edinburgh, will feature footage of Zambia as well as celebrating the Lothian Zambia Partnership. This year the Project has not produced its own prayer or worship material, so we encourage you to use either of the services designed by our partners at the Ecumenical Advocacy Alliance or Christian Aid. You can download these resources at www.e-alliance.ch and www.christian-aid.org.uk Sustained prayer at home and in congregations is a vital ingredient of all that the Church of Scotland HIV/AIDS Project is about. But so too is sustained giving. We have committed ourselves to supporting partners around the world for another three years, £12,000 to LIWOMADI for example. We need congregations to commit to go on supporting us. So encourage yours to take up a special offering around World AIDS Day or Christmas to allow us to continue the work. Inside this issue of WM is a copy of our new information/donation leaflet “Our generation...” Please order bulk copies for your congregation from The Church of Scotland HIV/AIDS Project 121 George Street, Edinburgh EH2 4YN 0131 225 5722 hivaids@cofscotland.org.uk Please pray for the protection and good health of all the staff and family members serving overseas with World Mission AFRICA Malawi: Helen Scott, Andy and Felicity Gaston Zambia: Jenny Featherstone [EA], Colin Johnston [EA] AMERICAS Bahamas: Scott and Anita Kirkland, Terry and Virginia Purvis-Smith Bermuda: Alan and Elizabeth Garrity Trinidad: Garwell and Claudette Bacchas ASIA Bangladesh: Helen Brannam [EA], James Pender [EA], David and Sarah Hall [EA] Sri Lanka: John and Patricia Purves MIDDLE EAST Israel and Palestine: Tom and Pam Sinclair, Anthony and Darya Short ON LEAVE Israel: Jeneffer Zielinski, Jane and Ian Barron MINISTERS AND FAMILY MEMBERS IN MAINLAND AND CONTINENTAL EUROPE Belgium: Andrew and Julie Gardner France: Alan and Lucie Miller Gibraltar and the Costa del Sol: Stewart and Lara Lamont, John and Jeannie Shedden Hungary: Aaron and Edit Stevens Italy: William and Jean McCulloch Malta: David and Jackie Morris The Netherlands: Robert and Lesley Ann Calvert, John and Gillian Cowie Portugal: William and Maureen Ross Switzerland: Ian and Roberta Manson, Melvyn and Doreen Wood [EA] = Ecumenical Appointments An up-to-date list of Church of Scotland members serving with other agencies overseas is available on our website and by request at the address below. KEEP IN TOUCH: If you would like to find out more about the issues raised here, please visit our website at www.churchofscotland.org.uk/worldmission or contact us at the address detailed below. We would be delighted to hear from you. 121 George Street, Edinburgh, Scotland, EH2 4YN email: world@cofscotland.org.uk WANT THE LATEST NEWS? Would you like to receive weekly our email bulletin “Update”, featuring current news and events within the World Church? Subscribe to our free service by sending your contact details to wmeditor@cofscotland.org.uk Issue WM15 Editorial Team: Carol Finlay, Nigel Pounde, Alex King World Mission is not responsible for the content of external websites.