The Singida Region: Demographic Information and Socio-economic Patterns
The Singida Municipality covers an area approximately thirty-five km. by thirty km. on the major tarmac lorry route, connecting with Dar es Salaam port via Dodoma and Tanga port via Arusha. It also serves the landlocked countries of Burundi, Rwanda, Uganda, Zamibia and the Democratic Republic of Congo. There has been an influx of people migrating into Singida town from the rural areas, having an impact on the HIV and human trafficking response.
Although Singida region is endowed with natural resources, inadequate application of entrepreneurial skills and investment capital are some of the challenges that confront development endeavours. There is a population of 150,379 in Singida town and the 18 outlying wards.
Networking and Partnership of Faraja Centre CBHC
Faraja CBHC works in partnership with the Local Government, Community Authorities and other implementing partners. This includes the Singida Municipality, Singida Regional Referral Hospital, Makiungu Hospital, Sokoine Health Centre, and Mangua Dispensary. Faraja CBHC works closely with government in the provision of VCT services, awareness on Palliative Care and human trafficking on days of public gatherings. Faraja CBHC also partners with the Catholic Diocese of Singida to give HIV and community awareness raising seminars to youth groups and other faith-based groups and has working relationships with NGOs in Singida. These include, AMREF, Compassion International, Singida Children and Community Centre, SEMA, SIPHA, WAUSI, SIDO, TFNC, and Bakwata, just to mention a few. Faraja CBHC trains and makes use of community volunteers who are often selected in a process that involves the Local authorities. The networking and partnership ensures sustainability and collaboration in order to utilize skills and fill in gaps in supporting the Singida community.
The Vision of Faraja Centre CBHC:
FARAJA envisions a society that is healthy, educated and democratic with a strong and sustainable economic base.
The Mission of Faraja Centre CBHC:
FARAJA is a faith based organization (FBO) striving to improve the health status of women, men, children and youth, especially the most vulnerable by working in conjunction with Government, Non government (NGO) and Faith based organizations (FBO) in the Singida Region and the Catholic Diocese of Singida.
- People Living with HIV and AIDS (PLHIV)
- Most Vulnerable Children (MVC) e.g. orphans
- Clients at the end of life because of terminal illnesses.
- General public for counseling and testing of HIV
- Hard-to-reach-women have no rights to own land and property; they have no rights to voice their ideas or make decisions; majority of these hard-to-reach women are single mothers or widows.
The Faraja Centre CBHC engages in broader social, developmental and outreach programmes. These main programmes include:
- The Counseling and Testing programme – VCT
- Anti Human trafficking – Awareness raising and economic inclusion of targeted people
- The Palliative Care Programme (PC).
- Social programme – MVC & Orphans
- Fund Raising and administration.
- VOLUNTARY COUNSELLING & TESTING PROGRAMME
Faraja Centre CBHC offers HIV Counseling and Testing to all who voluntarily come for it. The Voluntary Counseling and Testing (VCT) programme is done both at the Centre and in the villages as an outreach activity, targeting those that cannot reach the centre due to distance, time, fear or stigma, after awareness has been created. The VCT process consists of pre-test counseling, testing for HIV using a rapid test, post-test and follow-up counseling. HIV counseling is adapted to the needs of the client. It is offered to individuals, couples, families and even children, according to the set national guidelines.
VCT has a role in HIV prevention for those that are not infected, and is an entry point to care for those that are HIV infected. With the increase of VCT, fewer clients are diagnosed at a late stage so they tend to have better health even if they are not on ART. Emotional support is offered to all who test in order to facilitate decision-making following the test and to their family, friends and the community upon disclosure by the client. Faraja Centre has a good referral system for clients to access care and treatment, including antiretroviral therapy at Singida Regional Referral Hospital, Makiungu Hospital, Mangua Dispensary and Sokoine Health Centre.
- Faraja CBHC VCT has tested 52,371 people (26,629 Male: 25,742 Female) between 2005 and October 2016.
- Out of the number tested, there has been an average HIV positivity rate of 4.2%.
VCT results 2005 – 2017
- Faraja CBHC VCT send reports to the District AIDS Control Coordinator (DACC) every month and to the Council HIV and AIDS Coordinator (CHAC) using a tool known as Tanzania Output Monitoring System for HIV and AIDS (TOMSHA) provided by TACAIDS, on a quarterly basis.
- Refresher training on HIV counseling and testing including use of new guidelines on VCT has been given by the government.
This programme has been supported by Trocaire, Ireland, Misean Cara, Ireland, MMM friends and family.
2. ANTI HUMAN TRAFFICKING – AWARENESS RAISING
The aim of the anti human trafficking programme is to provide awareness raising and public education about human trafficking. A short introduction, meaning, types, causes and side effects of human trafficking is given initially. Faraja Centre collaborated with the Youth movement for change and was able to provide this education through puppet shows, traditional dances, shared discussions and brain storming questions.
Tanzania is a source, transit and destination country for men, women and children subjected to forced labour and sex trafficking. The incidence of internal trafficking is higher than that of transnational trafficking and is usually facilitated by victims’ family members, friends, or intermediaries offering assistance with education or finding employment in urban areas. Some unscrupulous individuals manipulate the traditional practice of child fostering—in which poor children are entrusted into the care of wealthier relatives or respected members of the community—to subject children to forced labour. The exploitation of young girls in domestic servitude continues to be Tanzania’s largest human trafficking problem, though child sex trafficking, particularly along the Kenya-Tanzania border, occurs as well. Girls are exploited in sex trafficking in tourist areas within the country. Boys are subjected to forced labour, primarily on farms—including as farm labourers, cattle herders, and occasionally hunters—but also in mines and quarries, in the informal commercial sector, in factories, in the sex trade, and possibly on small fishing boats operating on the high seas.
The Government of Tanzania is making significant efforts to comply with the minimum standards for the elimination of trafficking. The government allocated a budget to its anti-trafficking committee for the first time and adopted implementing regulations for the 2008 anti-trafficking law, which formally assign anti-trafficking responsibilities to specific ministries. The government also rescued 22 foreign women subjected to forced labour and sex trafficking in a Dar es Salaam casino and provided them shelter and care, ensured their safe repatriation, and prosecuted and convicted their trafficker.
- Lack of human trafficking awareness in the community.
- The community members do not know where to report cases of human trafficking.
- Lack of employment for youth
- High confidentiality of human trafficking victims.
- To continue providing education on anti human trafficking.
- The victims of human trafficking advised to have voluntary counselling for HIV.
- Psychological rehabilitation to be sought for these victims.
- Faraja hopes to provide a programme of special skills e.g. business skills courses and short courses in Vocational Training.
Faraja Centre CBHC has trained a total of 33 community volunteers to carry out awareness on Anti human trafficking, HIV, AIDS and STI in 3 Wards and 18 Villages. The three wards visited were Kindai, Majengo and Minga with a total of 2,065 attending, (female 1228 and male 778) from September to December 2017.
Income generating training and setting up of IGA activities and SILC for victims
- Empower and improve the social and psychological well-being of victims and demonstrate the benefits that can be reaped by a caring community through shared ideas, education, training and co-operation.
- To enable victims to provide their own source of income by aiding them to set up small businesses.
- The overall impact of the IGA’s is that they are generating income to support their daily basic needs.
- Social benefits include the opportunity to meet regularly, build solidarity, share ideas, interface with local officials and development personnel.
- Important psychological benefits have been observed in that the participants tend to develop an improved sense of self-worth and self-esteem.
- Great challenges face these groups for example- looking for a market for their products.
This project has been funded by Trocaire, Ireland. Misean Cara, Ireland, MMM friends and family
3. PALLIATIVE CARE PROGRAMME (FHPCP)
In the last 10 years Tanzania has seen a significant increase in Non-communicable Diseases affecting children, youth, adults and the elderly which has resulted in an increased burden for the Health Sector and families/community at large. A large percent of these patients need palliative care or/and hospice. FHPCP was started in 2012 to address this situation as there were no palliative services in Singida Municipality. Until this Programme was initiated, there was no treatment for this target group in Singida Municipality; patients were discharged home to die with no treatment, even for control of their pain. Faraja Hospice and Palliative Care Programme (FHPCP) provides home based treatment and care, including morphine for severe pain, for these people. According to the National Policy Guideline on Palliative Care Services (December2012) palliative care is a human right and Tanzania wishes to address it even though the resources of the government for doing so are poor and scarce.
Having discovered that patients with terminal illness had no care, especially of their pain, more investigation was done by us. It was found that there is a definite need for hospice and palliative care in Singida. Faraja Centre CBHC saw that this population could be served and cared for from the Centre. It had a Doctor with 35 years of medical experience in Tanzania who was very interested in helping to solve this problem. FHPCP began as a Pilot Programme in 2012. Very soon the number of patients increased to the point of convincing the Programme that palliative care, especially End of Life Care, was needed in Singida.
Firstly, the Medical Officer in Charge, and Nursing Officer in Charge of Singida Regional Referral Hospital were contacted to get their opinion as to whether there was a real need. They were very enthusiastic and encouraging. The Municipal Manager was contacted and gave us permission to contact the Local Government Leaders in the various Wards. Ocean Road Cancer Institute (ORCI) Dar es Salaam was visited. It was found that they had no arrangement for follow-up and care in the patients’ local areas, but the Palliative Care Department agreed to communicate and to facilitate ongoing care locally for Singida patients. Also at this time the Tanzania government issued a National Policy Guideline for Palliative Care Services (Dec2012). Palliative Care was a totally new concept to the patients needing it but, when it was explained to the patients and their families, it was readily accepted and welcomed.
FHPCP contacted and took the advice of Hospice Africa Uganda (HAU), which pioneered Palliative Care in Africa, and decided on a Home Based Programme model instead of an institution. It was decided to follow on the 20 years experience of HAU and to adapt it to our local situation. FHPCP began as a Pilot Programme in Singida with one medical doctor, one nurse and a part-time driver. The plan has been to start small, build on our experience and to expand when and if possible. From its beginning in August 2012 until the end of 2017 the Programme has enrolled 303 patients out of which 176 have died. At any one time there are between 85-95 patients currently being cared for by FHPCP.
4. SOCIAL DEPARTMENT IN FARAJA CBHC
The social welfare department was officially started in 2010 to contribute to the increase of literacy levels in Singida under the supervision of a Social Welfare Officer at Faraja CBHC. Prior to this time, the programme had existed as a part of the Home-Based care programme. The major activity of this department is to assess, identify and interview the Most Vulnerable Children (MVCs) together with their families for school support. Students are identified through their parents after being tested and found that they are infected by HIV. Others are identified through school teachers, the Home Based Care team and the Palliative Care team, from the community of Singida Municipality.
The program aims to provide support to students for primary schools (ordinary level), secondary school and college. The department works closely with the development sector in the municipality, the Singida Children and Community Centre Outreach Africa and the Compassion International by the Anglican Church.
- Students are supported with school fees for A level, College and private students, uniforms, examinations fees, school security contribution, remedial tuition, desks, school maintenance/construction, stationary and transport for boarding school students.
- 780 students were supported for education between 2005 and 2010, when the programme was still under the home-based care programme, before the programme was officially launched.
Total number of children supported in year 2017 was 102
- Twenty six students graduated from different colleges from 2010 to 2017, pursuing different professions and are now working in various places in and out of Singida between 2010 and 2017.
- Eight students are getting one meal a day from Singida Children’s Community Centre. Adults living with HIV are encouraged to go for food at the centre when there is need.
Some students fail to get good results as they follow peer groups in the streets. Later they end up being trafficked.
Many students lack proper nourishment and so cannot concentrate on their studies.
This education program is funded by Christlicher Entwicklungsdienst (CED), and in October 3 staffs were invited by CED to celebrate 25 years of CED foundation as well as fund raising in Munich, Germany. It was wonderful to witness the enthusiasm and generosity of our donors there.
Other donors of Faraja students group are Misean Cara, Dundalk Credit Union, Ireland, Roundfort, Ireland, MMM friends and family.
5. Fund Raising and administration
At Faraja we greatly value our partnership with donor agencies, Church groups, individuals, and the generosity of our friends and families who have supported us over the past year. Our work is 95% donor dependent. This was brought to the attention of our Health Unit Management Committee in February 2017. A team was formed from local people to do fundraising so as to sustain the centre in its many financial needs.
CED Germany invited 3 staff to attend a fund raising event in Munich, Germany for one week in October 2017. It was wonderful to see the enthusiasm and generosity of so many supporters gathered for the week. Although the time was very busy with radio and television broadcasts, speaking to donors and attending a Church fundraiser – we also had time to make a trip to the Bavarian mountains by cable car.
A financial administrator is in place in Faraja and all donations and funds are overlooked and checked by the financial administration team.