Cabrini-2013-Program-Report-FINAL

Program Report 2012-2013 (01 October 2012 – 30 September 2013) Cabrini Ministries Program Report // 2012-2013 A special thanks to our funders: Anonymous Donors, Bonino Foundation, Bristol-Myers Squibb Foundation, Cabrini College, Cabrini Health Australia, Cabrini Mission Foundation, Centers for Disease Control and Prevention, ELMA Foundation, ICAP (Columbia University), Missionary Sisters of the Sacred Heart, PACT, PEPFAR (US Government), SAFAIDS, Sahee Foundation, Solon Foundation, United States Agency for International Development, and individual donors worldwide Cabrini Ministries Program Report // 2012-2013 TABLE OF CONTENTS Letter from Executive Director Letter from Deputy Executive Director Executive Summary Organization information History Vision / Mission / Values Staff and Leadership .9 Situation in Swaziland 11 Programmatic Overview 13 Health Care 14 Service Delivery .14 Program Impact 22 Key Accomplishments 23 Strategic Partnerships .25 Child Care 27 Assessments 27 Service Delivery .27 Program Impact 32 Key Accomplishments 33 Strategic Partnerships .36 Social Services 36 Program Development 37 Service Delivery .38 Impact and Expansion 39 Agriculture 40 Food Security Programming 40 Program Transition 40 Monitoring and Evaluation systems .41 Organizational Development 43 Identified Emerging Issues 43 Strategic Priorities 46 Becoming a “Social Service Organization” .47 Future Projects 48 Get involved 50 10 Appendices 51 Cabrini Health Care Analysis of Services 52 Clinical Cascade Results and Exits 56 Cabrini Impact Mitigation Analysis of Services 57 Cabrini Ministries Program Report // 2012-2013 LETTER FROM EXECUTIVE DIRECTOR Dear Friends of Cabrini Ministries, I greet you with joy from the Lubombo Lowveld of Swaziland It is truly a year of joy for the people of this region because this summer we are experiencing rain – lots of life giving rain For those of you who are familiar with the 20 year drought this area has endured, you know how important this is The changes here go deeper than the weather Everywhere I look, I see the new joy that accompanies lives being restored! I also greet each of you with thanksgiving and gratitude for your prayers, interest and support for the people of this area As you read this report I am sure you will also give thanks with me for the enormous work being done by this small faith-based and community-based organization You will see what your support, interest and prayer have wrought and where you have brought this area over the last 10 years: from grave sickness, death, poverty and abandonment, to life and hope for today and for the future In this last year, Cabrini Ministries has continued its work with the HIV/AIDS and TB afflicted people of the area, as well as the orphaned and vulnerable children whom this great pandemic has produced Despite the daily struggles and real risks, we are moving from acute care to chronic care as more people are alive and working We are moving to more children being able to live with their families and guardians due to the increasing stability of some homesteads We are moving from emergency support to once again dreaming about what the future can hold Your support this year has also allowed us to make a dream come true a new Social Service Department is now serving homesteads facing situations which Health Care and Child Care have observed and reported, but have not been able to adequately address The family unit has truly become the center of our work God’s great love is poured out like a river in the desert and the desert has become a place of life Many blessings to each of you Sr Diane DalleMolle, MSC Cabrini Ministries Program Report // 2012-2013 LETTER FROM DEPUTY EXECUTIVE DIRECTOR My Dear Friends, It’s been a great year of us working together to fulfill the mission of Restoring Life and Rekindling Hope It takes so many people to make our work possible and we are deeply grateful to all of you for your interest, prayers, donations and support Without you our Cabrini family here on the ground couldn’t continue this work of love Cabrini Ministries in this past year realized our desire of opening a Social Service Department The impact of this movement is immense As a Catholic faith-based organization we continually think about how we can best serve and love the people in this area with HIV/AIDS, TB and those impacted by these diseases Our underlying framework utilizing a psychosocial approach to care allows us to compliment the significant gains that have been made in the scientific world regarding HIV In Swaziland there has been a steady upward trajectory in health care delivery More people know their HIV status, more eligible people are on treatment, and families and communities are starting to stabilize Despite all the scientific advances there are still a large number of families who lack the necessary resources – physical, emotional, intellectual or spiritual – to adhere to treatment regimens Many factors converge to contribute to this challenge, including poverty, education, and social beliefs Our Social Service Department is able to assess the challenges and barriers that families face in trying to manage adherence and the lack of governmental social welfare supports The interventions of the Social Service Department creates a safety network to alleviate these struggles by providing food, health care, child protection, legal assistance, and individualized human rights advocacy, to name just a few supports As families become stronger and more cohesive, they rely less on Cabrini Ministries’ help and steadily move to a more independent functioning I am proud of the steady quality improvements in Cabrini Ministries over the years The most important factor in all of this is the staff at Cabrini Ministries, who each day grows in its own capacity to love as Jesus loved and to know what it means to love United in this work of love, Sr Barbara Staley, MSC, LCSW Cabrini Ministries Program Report // 2012-2013 EXECUTIVE SUMMARY For over 40 years the Cabrini Sisters have been serving in Swaziland During that time, their work has always been driven by a connection to the community and a willingness to focus on the most pressing needs During the past decade, that work has been dedicated to helping those people infected and affected by HIV/AIDS and Tuberculosis This care delivery has largely been carried out through Cabrini Ministries’ work in Health Care and Child Care The commitment to the community and its needs has never changed, yet this year represents a significant period of transition for the organization The work of Cabrini Ministries is moving from crisis care to chronic care The primary focus is still on keeping people alive and ensuring that they are cared for, but now more people are able to think about transitioning toward the future – a luxury many in the area haven’t had for over a decade The most concrete example of this transition is the recent formation of the Social Service Department Originally designed to address the community needs that exist between our work in Health Care and Child Care, today the nascent department is providing a solid framework for addressing the holistic needs of the community we serve In this report, you will read about the impact of the Social Service Department as well as the on-going efforts of our existing departments The programmatic year for Cabrini runs from October 1st through September 30th and this report seeks to draw together a detailed overview of significant activity that has occurred in this period It pulls from a variety of data sources and reports to present a broad understanding of the organization and its impact While it is impossible to capture the breadth of what Cabrini does by simply looking at statistics, the following figures provide a quick snapshot of what has happened this past year:      A total of 2,806 individuals received direct care from Cabrini Our Health Care staff provided clinical services for 1,932 clients o 872 HIV+ patients were given access to life-saving ARV medicine including 123 new initiations o 89% of those initiated on ART were alive and on treatment one year later 874 Orphans and vulnerable children were served through Cabrini Child Care o 151 of those received a full complement of comprehensive services o 333 healthy child physicals were conducted at area schools The Social Service Department assessed 1,067 individuals on 131 homesteads o 177 interventions have already been initiated In addition to the Social Service Department, several new initiatives have been launched: a Medical Circumcision Clinic, on-site laboratory services, expanded community health education, outreach academic enrichment, enhanced OVC support groups and new strategic partnerships Cabrini Ministries Program Report // 2012-2013 ORGANIZATION INFORMATION Cabrini Ministries Swaziland is a Catholic faith-based and community-based not-for-profit organization (Section 21: R7/26820) working in the Lubombo lowveld of Swaziland to show God’s love in action through service Cabrini Ministries is based at St Philip’s Mission and operates for the good of the larger community including the chiefdoms of Mamba, Ngcamphalala, and Gamedze with recent expansion into Shongwe, Mkweli and Nceka Our work is fundamentally about meeting the psychosocial needs of our community which includes addressing issues of health, nutrition, education, and protection, as well as ensuring mental and spiritual wellbeing Service delivery is primarily achieved through three integrated departments: Health Care, Child Care and Social Service Individual interventions are necessary, but can only be adequately assessed and understood in the context of family and community This contextual understanding of the people served by Cabrini is the core of Cabrini Ministries’ effectiveness in responding to and providing for the many challenges experienced by the people we serve History Cabrini Ministries is founded on the work and principles of the Missionary Sisters of the Sacred Heart (MSCs) and their founder, St Francis Xavier Cabrini The sisters have worked in Swaziland for over 40 years after originally coming to the country at the request of King Sobhuza II in 1971 For the first 25 years, the work at St Philips Mission was focused on education, basic health care, skills building and spiritual formation By the early 1990s, the Cabrini sisters were considering leaving the country because their work in community development had yielded such positive results Unfortunately, as the millennium came to a close, Swaziland was faced with a triple crisis of drought, unemployment and – most damaging – the HIV pandemic In the span of less than a decade, an entire generation of Swazis had been devastated and the social fabric of the country began to unravel Bright young people who had been educated through the hard work and sacrifice of their families along with the support of the sisters were dying just Sr Anne Maria counsels a child as their working lives were beginning Families in the early 1980s were left without their children and consequently the social safety net they had expected to exist in their later years of life Cabrini Ministries Program Report // 2012-2013 In 2002, in response to the crisis, a strategic decision was made to refocus the apostolic mission of the Missionary Sisters of the Sacred Heart All resources, human and financial, were shifted to respond deliberately to the havoc caused by HIV and TB With the support and encouragement of the local leaders, a free hostel was established to care for orphans and vulnerable children of the area Initially, 50 children were enrolled, 98 showed up on the first day and none were turned away The work in health care moved from the clinic-based to home care-based since most clients were simply too sick to travel What started as emergency palliative care eventually evolved into a systematic approach of educating, testing, and linking to care In 2006, Cabrini Ministries was officially incorporated as a Swazi notfor-profit organization In recent years, the southern Lubombo region of Swaziland remains an area remarkably underserved by care providers The ongoing impact of HIV, along with the co-morbidity of TB and the resulting number of parentless children is compounded by continued years of drought and high unemployment These realities intensify the problems already associated with poverty, food insecurity, and low levels of education of the people living in these remote rural chiefdoms Since its inception, Cabrini Ministries has established a strong track record demonstrating creativity, determination and competency in responding to community needs The organization provides health care services of the highest quality to the people in the catchment area and maintains on-going cooperative partnerships with families and neighbors in the care and upbringing of children orphaned or vulnerable due to HIV/TB In the last decade, Cabrini has served over 6,000 people living with HIV and/or TB and provided care to over 1,500 orphans and vulnerable children What began as just a few people doing what they could to help their neighbors has evolved into a full service organization deeply rooted in the community, providing comprehensive integrated care as well as targeted care to thousands of others In 2013, a Social Service Department was launched in order to better meet the multifaceted needs of the homesteads receiving services from the organization and to enhance the quality of care provision Cabrini Ministries Program Report // 2012-2013 Vision / Mission / Values VISION: Restoring life… kubuyisela imphilo MISSION: Sharing the love of Jesus Christ through  Health Care Services for HIV, AIDS and TB at the homesteads and access to health care and supportive services for HIV, AIDS, and TB  Care of orphans, vulnerable children and extended families/guardians  Economic strengthening and skills development of local people through employment VALUES:     Hope Mercy Passion Quality Care Kwetsemba Sihawu Kutinikela Kunakekela ngelizinga lelisetulu Staff and Leadership Cabrini currently has 55 staff members and operates with the following service departments: Health Care Outreach, Child Care and Social Services They are supported by work in Administrative Services, Maintenance, and Transportation Of the current staff members who are employed, all but five are African, with the vast majority coming from the catchment area served by the organization Executive Team The Executive Team of Cabrini is comprised of five staff members who are responsible for decisions related to the day-to-day operations of the organization The members are:  Sr Diane Dalle Molle – Executive Director  Sr Barbara Staley – Deputy Executive Director  Mr Pius Mamba – Cultural Liaison  Mr Bongani Khumalo – Director of Health Care Outreach  Mr Mzamo Sikhondze – Director of Human Resources Board of Directors The official board of Cabrini Ministries is comprised of members of the Provincial Council of the Stella Maris Province of the Missionary Sisters of the Sacred Heart of Jesus However, the duties of advisement and oversight of the organization have been delegated to a local Swazi Board comprised of the following members:  Nathi Gumede (Chairperson) Executive Director, Conciliation Mediation and Arbitration Commission 10 Cabrini Ministries Program Report // 2012-2013 10 APPENDICES Cabrini Health Care Analysis of Services 53 Clinical Cascade Results and Exits 58 Cabrini Impact Mitigation Analysis of Services 59 52 Cabrini Ministries Program Report // 2012-2013 Cabrini Health Care Analysis of Services Report for the period of Oct 2012 - Sep 2013 53 Cabrini Ministries Program Report // 2012-2013 TOTAL Clients Served (18)