Ein Sieg der Armen!

Heute hat der District Kommissioner von Makete das Testzentrum von PIUMA eingeweiht/eröffnet! Das ist ein großer Erfolg und allerseits gab es Lob, dass PIUMA aus dem Herzen der Gemeinschaft heraus den Kampf gegen AIDS aufgenommen hat.

Ich gratuliere den Armen in Makete, die sich trotz Tod, Korruption und Zynismus in Kirche und lokaler Regierung und gegen die Macht der Gelder, die aus Europa (hauptsächlich durch die Missionswerke in Deutschland) zur Verfügung gestellt wurden und die ihrere Frustration und Unterdrückung dienten, nicht haben beirren lassen, in Ihrem Kampf für ihr Leben!

Nun werden Sie gehen und sich selbst beraten und Testen, viele, viele Menschen täglich und das Auto wird bald folgen und die CD4 Maschinen werden bald wieder funktionieren. Auch die, die Kinder retten können.

Kinder dienen vielen Hilfsorganisationen wohl nur zum Spendensammeln.


HIV/AIDS Treatment as a matter of course in a Self Determined Health System

In many places and in many projects around the world it has been shown that it is impossible to implement health care and treatment programs - especially in resource-limited setting with limited professional resources and when diseases reach epidemic proportions – without the active engagement and leadership of the community and of patients.
Sick Have Nots know what they need. If they are given the lead in care and treatment efforts, the outcome is very good: adherence improves and the number of people gaining access to treatment and care increases tremendously.
Positive examples of this phenomenon come from a number of different places including:
Thailand, where whole clinics are run by patients and where clients sometimes make up 80% of the staff
Haiti, Rwanda and Lesotho where HIV projects initiated by Harvard professor Paul Farmer (among many others) have spearheaded the empowerment of community health workers and patients to treat and care for members of their people.[i]
But when Have Nots lead effective and affordable community-based, holistic health care systems, they threaten the financial and emotional benefits that the Elites and the Do-gooders receive by making the world believe that without them as policy makers, experts and implementers of “care for the poor and the sick”, nothing will happen. They receive more money, but nothing comes of it.
This does not mean that there is no role for expert research and or that investment in science and technology-development plays no role here. On the contrary, this sort of aid should be strengthened, as long as the critical involvement and leadership of Have Nots in any truly effective response is recognized.
Have Nots need information about any decision to be on their behalf made and must be consulted for their opinions. Discussions should be public, with coverage by the media. This kind of commitment to openness and participation will lead to a self-determined, affordable, high quality health care system.


A Bright Future: Have Nots on the road to Accountability, Responsibility and Self-Reliance

EAWM is convinced that a decent health care will only be possible in a society where human rights are deeply rooted in the consciousness of the society and where various players are engaged in healthy intellectual competition through open discussion with active participation by the entire public.
EAWM regrets that in the past so called development aid money often did not benefit the Have Nots – instead it ended up being mismanaged and regularly stolen. In our opinion, this includes NGO and FBO money as well as money in the form of private donations to small initiatives. Many times these donors do not put in place effective monitoring systems. Repeated disbursement of funds to local partners and projects that show no accountability for performance may ease the conscience of donors but it leads to frustration for many Africans, in that this kind of aid actually hinders sustainable development[ii].
In spite of the difficulties encountered, EAWM was a happy witness to a number of very positive developments in Tanzania during the course of the project:
Responsible and accountable use of funds is increasingly demonstrated by the government of Jakaya Kikwete and its designated bodies;
The role, the diversity and the quality of the media increase steadily and a free press is valued as an asset for development;
Local NGOs, especially in the field of human rights and education, are getting more organized and vocal;
The crucial involvement of women seems to be on the rise;
Public criticism of leaders is increasingly seen as an asset for democratization and development;
Tax revenue is on the rise and efforts to use this money to gain independence from donor monies with a focus on education and basic health care are appearing on the horizon;
Have Nots through self helped groups are increasingly advocating for higher quality of care and the right use of donor and Tax payers money;
There are many public discussions demanding greater accountability and self reliance.
The decades-old, self-serving alliance of Elites and Do-gooders is being challenged by emerging African civil societies and Have Nots are taking their just part in this development – PIUMA is just one example of this wider phenomenon.







”imara kama simba” – “strong like a lion”

Dependable Partners: PIUMA

PIMA UISHI KWA MATUMAINI - “Test and live with hope”
A member of the Bulongwa Lutheran Hospital staff was the first person to publicly disclose his HIV/AIDS status in Bulongwa. That was in 2005. Kabuyu Kyando went on to become the first chairmen of a local self-help group for people living with HIV/AIDS group[iii] known as PIUMA, an acronym from a Kiswahili slogan meaning “test and live with hope”.
He and others spoke out in a locally produced video[iv] which was shown on many occasions during outreach efforts where PIUMA members personally witnessed about their lives with the virus and became their own best advocates. It took great courage for them to speak out.
The group was officially constituted on 1st of December 2005 and met the man who would become the President of Tanzania during his campaign visit to Makete District on the 2nd of December 2005. That day, Jakaya Mrisho Kikwete praised the commitment of PLWHA in fighting the spread of the disease and hugged the youngest PIUMA member.
For its outspoken promotion of the interests of PLWHA and of their families and home villages, PIUMA became very popular and took over many duties related to the work of the Care and Treatment Clinic including:
Organizing VCT;
Assisting with the daily routine in the clinic;
Advocacy and mass education through village outreaches and film shows;
Organizing youth hip hop song contests;
Fighting corruption and the theft of funds designated to help the poor and to care for AIDS victims amounting to several hundred million Tanzanian Shillings (that is, several 100.000 Euros).
Ultimately, PIUMA would go on to adopt an anticorruption code in early 2007 and to develop regulations for its practical implementation based on their experiences fighting corrupt, larcenous elites.

PIUMA demanded that the local Lutheran Church bishop resign because of the embezzlement of about 272 Million Shillings (2003/2004)[v] during his tenure. PIUMA has also insisted that this stolen money should be paid back to the poor by the Lutheran church in Tanzania and Europe. After the lock-out by the SCD of the Lutheran Church of Tanzania, PIUMA became EAWM’s main partner to achieve its aim to help more PLWHA in Makete District. PIUMA has emerged as a proactive partner interested in genuine progress for the people and in the careful use and documentation of funding. It is a refreshing change from relationships tainted by corruption and theft of donor money[vi].
[i] Paul Farmer the founder of Partners in Health International http://www.pih.org/home.html started to treat HIV/AIDS patients on a larger scale in Haiti by antiretroviral drugs in 2002 under the extensive use of patients as health care workers. The same happens at clinics in Thailand where treatment experienced patients work as adherence counselors.
[ii] Brian Cooksey, Tanzania Development Research Group “Elixir or poison chalice? The relevance of aid to East Africa”; 8th ASEA CONFERENCE & NAIROBI STOCK EXCHANGE GOLDEN JUBILEE Nairobi, 23-26 November, 2004
[iii] Mr. Kabuyu Kyando worked for years in the hospital’s laundry became an advocate for the rights of the patients, the first elected chairman of PIUMA and was finally unlawfully expelled by the hospital.
[iv] The video was called “tunauhakika maisha yetu” - “we are sure for our life” and many local leaders and patients were interviewed and the video was produced under very low cost by volunteering of professional Tanzanian journalists.
[v] According to an external audit by Ashvin Solanki & Company, certified public accountants in public practice registered tax & management consultants P.O.BOX 1537) and Mbeya (MOSES AB & COMPANY, certified public accountants in public practice, P.O. BOX 2412
[vi] The program’s assets were officially handed over to PIUMA under informed consent of the main donors (i.e. EAWM and ADA - the government owned Austrian Development Association)