NARATIVE REPORT ON STOP TB PROJECT IN MWANZA, MALAWI FOR A PERIOD OF 3
MONTHS.
FROM: Mwanza AIDS Support Organization (MWASO), MALAWI.
TO: THE SECRETARY, CIVIL SOCIETY CHALLENGE FACILITY PROJECT (WHO).
INTRODUCTION:
MWASO was set up in 2003 by a group of people who were tested HIV positive. Its mission is to
change the people’s behavior, restore hope to all HIV+ people and improve the quality of life of
the infected and affected people with HIV/AIDS through the creation of a supportive
environment free of stigma and discrimination. Since 2003, MWASO has been carrying out
HIV/AIDS activities in Mwanza such that it has established 20 PLHIV support groups that have a
combined total of 1071 members, 12 Community STAR (Society Tackling HIV/AIDS through
Rights) Circles which have membership of between 15 to 20 volunteers each and 8 youth clubs
that are scattered across the entire district in T/A Kanduku, Nthache and Govati. The
overreaching goal of MWASO is to promote and improve the lives of all positive people that will
participate in development activities by 2020. In that regard, MWASO carries out the following
core activities: group therapies for positive people, community home-based and orphan care;
early childhood development; HIV/AIDS counseling; nutrition and food security and
environment; income generating activities; youth development and gender and human rights.
On top of the 7 years experience in HIV/AIDS work, MWASO is steered by the Board of
Trustees who are responsible for opening and managing organizational bank accounts, budget
and expenditure review, advising management on financial matters and making sure the
organization operates within the legal framework of the laws of Malawi. On a daily basis,
however, MWASO is driven by management which is headed by the Executive Director who has
vast experience in HIV/AIDS advocacy. He has also chaired a number of district-based and
national organizations that include Malawi Network of AIDS Service Organisations, DACC and
Mwanza Civil Society Network. Below him, there is the Project Officer who has a degree from
the University of Malawi and over 3 years experience in managing donor-funded projects
including those funded by USAID, CIDA and Plan International. On the other hand, MWASO
has a well-experienced Finance and Administrative Officer who has also managed finances for
several projects that include Action Aid International and British High Commission, VSO,
MANASO and other donors.
Below that, there is a team of well experienced technical officers who coordinates various
programmes such as Gender and Human Rights, Youth, HBC/OVC, Nutrition and Food Security
and Information, Education and Communications. Besides that, MWASO has 2 international
volunteers from Volunteer Services Overseas and World University Services of Canada who
work as technical advisors in organisational development and management. With such an
arsenal of dedicated and experienced staff, MWASO is better positioned to implement such a
project. It has been the case before; MWASO will work with various district stakeholders such
as the departments of Health, Social Welfare, Community Development, Youth, Agriculture,
District AIDS Coordinating Committee, CBOs and other Civil Society Organizations. Already,
there are linkages with Mwanza District Hospital through the TB Department whereby the two
institutions are implementing the STOP TB project with funding from World Health Organisation.
MWASO in this year won an award of $16325 to implement a project on Civil Society Challenge
Facility Project of TB in T/A Nthache and STA Govati to the West of Mwanza District due to its
vulnerability of TB and other illnesses for a period of six solid months. (July to December, 2010).
This report highlights all planned activities that were implemented during the first quarter (JulySeptember, 2010) of the project period activities with an amount of $8163 for challenge facility
civil society.
BRIEF DESCRIPTION OF THE PROJECT.
PROJECT TITLE: TOTAL ERADICATION OF TB IN MWANZA DISTRICT
PROJECT AREA: T/A Nthache and STA Govati in Mwanza District.
MWASO in this year won an award of $16326 to implement a project on Civil Society Challenge
Facility Project of TB in T/A Nthache and STA Govati to the West of Mwanza District due to its
vulnerability of TB and other illnesses for a period of six solid months. (July to December, 2010)
But this report will only feature the activities carried out during the first trench of the project with
funding of $8163 for July to September, 2010.
REASONS THE AREA WAS CHOSEN FOR THE PROJECT
The project impact area was chosen as a pilot area for the project due to its vulnerability in the
district to a number of ways for example:
1. The area has got two Traditional Authorities (Nthache and Govati). This means that the
population of the area is very high and vulnerable comparing to the other area. (Mwanza
has got 3 Traditional Authorities namely: Nthache, Kanduku and Sub-TA Govati)
2. The impact area has only 1 health centre serving that big population of two T/As.
3. Worse enough the area is far away, 50km from the Mwanza DHO and is also serving
people from the People’s Republic of Mozambique with few Health personnel and
inadequate supply of drugs.
PROBLEM IDENTIFICATION
It had been researched at the District Hospital Office, TB Department and found that ¾ of HIV
people are women and were those who were developing active TB in Mwanza District.
(MWANZA District Hospital Office Report).That really posed a great challenge for MWASO’s
goal in fighting against HIV and AIDS in Mwanza. We believe that many people have a latent TB
but do not feel sick because their body’s immune system keeps them from growing and so they
remain in active. If a person has latent TB, it means their body has been able to fight the
bacteria successfully and stop them from causing illness. They have no symptoms and so they
can not spread tuberculosis. In some people, tuberculosis bacteria remain inactive for a lifetime.
But if people with latent TB become infected with HIV, their immune system weakens and they
are much more likely to develop active TB. That is why it is very important to consider TB
infection in people living with HIV/AIDS. The problem was that people don’t know much about
why most of HIV positive people were those who were also victims of the active TB. MWASO
and the District Hospital wanted to take a role in protecting HIV positive people and others from
developing the active TB and have control measures of treatment if one is infected by using
advocacy strategies.
Mwanza District is one of the border district in Malawi that has shared boundary with
Mozambique and Chikwawa District. It was a great challenge for Mwanza District Hospital to
combat TB and HIV together because the district is providing health services to people in
Mozambique and others from Chikwawa District.(Gaga health Centre). Because of that the TB
District Programme was not functioning properly as it was difficult to manage the follow-ups of
all the TB patients being discharged as it is required by the National TB Control Programme of
Malawi due to lack of support from other stakeholders in combating the TB. The Health
Surveillance Assistant in that locality needed to be trained because they were not well
conversant with the new diagnostic measures of TB as well as the Path ways for them to deliver
the TB services properly and benefiting the wider community. As TB and HIV are closely linked
together because of the weakening effect of HIV on patient’s immune system, in PLHIV, TB may
present itself in unusual ways and is harder to diagnose. So it was thought that If left untreated
or if treatment was to be delayed, it would speed up to the progression of HIV to AIDS and
therein laid the urgent need to address TB and HIV simultaneously and Mwanza AIDS Support
Organization wanted to implement a project called Total Eradication of TB in Mwanza District
together with the Mwanza District Hospital, TB Department in order to advocate for early
seeking TB diagnosis and treatment in the area of TA Nthache and STA Govati (Thambani
area).
PROJECT OBJECTIVES:
For the project to have achieved the goal the organization set out these specific objectives:
1. To influence early health seeking behavior of TB suspects through health
promotion.
2. To improve on case finding and good diagnostic practices in order to deliver and monitor
participatory effective treatment.
3. To provide care and support for TB/HIV patients and prevent TB in HIV positive patients
4. To conduct participatory monitoring and evaluation of project activities in order to track
progress and share lessons learnt.
PROPOSED ACTIVITIES:
The proposed activities of the project to achieve the objectives above were:
1. Sensitization meetings to the District Executive Committee (DEC), Local opinion and
religious leaders, in the area of TA Nthache and Sub TA Govati where the project will be
implemented in order to provide awareness and solicit their support to the project.
2. Orientation of 15 HSAs and 15 community members on how to educate the entire
community about the problems of TB, the symptoms and spread of the disease, how HIV
exacerbates the TB epidemic and the basic facts about treatment. These trained people
will have a door to door TB education campaign for a period of six months.
3. Conduct 3 Community Awareness Campaigns on TB/HIV using District Hospital Drama
Group and other Traditional dances as one way of our working partnership.
4. Establish TB clubs in the area of the project to help educate communities and support
people living with TB with food supplement in the form of small scale irrigation activities
for planting maize, vegetables tomatoes and other simple crops for sustainability after
phasing out of the project as one way of TB
Adherence as well as an encouragement to others to seek for early treatment.
A TB club is defined as a number of tuberculosis patients (Usually between 3-10) living in the
same area who attend out- patient appointments together on the same day. The clubs will be of
very assistance in the ways that:

TB clubs will simplify TB treatment and promote the adherence of patients living
in a particular area. The TB clubs will provide support by attending follow-up
appointment at the nearest health facility, together.
 The club members usually meet once a week to provide support to each other on
adherence to treatment, share information about the cause of the disease, the
recovery measures available and the possible drug side effects and to help in
identifying likely tuberculosis patients.
 To approach other members of the community for help in encouraging and
supporting patients in completing treatment.
 To seek the help of community elders and influential priests in persuading
patients who interrupt treatment, to recommence and complete their treatment.
5. Procure and distribute T shirts branded with TB messages
6. Conduct monthly field monitoring and supervisory visits
7. Conduct quarterly participatory review meetings with various stakeholders
ACTIVITIES CARRIED OUT DURING THIS PERIOD
At least most of the advocacy activites were done during that first period of funding. For
example on 19th August, 2010, MWASO and DHO TB Department had a sensitization meeting
to all DEC members and other stakeholders to brief them on the project activities in order to win
their support. All 70 members attended to that meeting were very happy to hearing that
MWASO and DHO are implementing STOP TB Project.
- Almost all the DEC members and the stakeholders who attended the meeting agreed to
support MWASO and Mwanza DHO to fighting against TB and HIV together. Speaking on
behalf of the others Mr. Aaron Macheka who represented the District Commissioner for Mwanza
praised MWASO and DHO for a joint project in combating TB in his area with funding from
W.H.O to encourage others to disseminate the message to their people in their offices.
The picture of Mr. Aaron Macheka , the Assistant District Social Welfare Officer at Mwanza
District Assembly.
(Below is the attached snap short of part of the audience during the DEC and stakeholders
sensitization meeting of TB at MWASO Conference Hall).
After DEC and stakeholders meeting, MWASO and TB Coordinators from Mwanza DHO and
Thambani Health Centers together sensitized local leaders at a meeting that was attended by
Sub- Traditional Authority Govati, 13 Group Village Headmen, Village headmen, Civil servants
and a representative of Traditional Healers for the Southern region of Malawi on 21st
August,2010.
-Speaking on behalf of the people of Thambani, the Sub-Traditional Authority Govati
commended the World Health Organization for providing the grant for the Challenge facility for
Civil Society to MWASO in collaboration with the Mwanza DHO for the implementation of TB
project in that area. The STA Govati also emphasized that people in Thambani faces a lot of
problems when accessing the medical treatment especially of TB because the results for
sputum come very late after the person has completely developed the Serious Active TB. ‘’This
project will help us the local leaders to sensitize our subjects on the importance of knowing
one’s HIV status as well as seeking early TB diagnosis and treatment”, Said the STA Govati.
Below is the snap shot of the meeting of sensitizing the local leaders in Thambani area and
standing is STA Govati speaking at the sensitization meeting on behalf of the local leaders.
(Part of the local leaders at the sensitization meeting at the Thambani Headquarters listening
STA Govati.)
-Commenting on at the same meeting the representative of the traditional healers in the
southern region of Malawi, Dr. Zalewa, explained that the project would assist them to have
cordial relationship and partnership with the Thambani Health personnel in referral system to
one another while working hand in hand for the betterment of the whole community.
Below is the picture of the Regional representative of the Southern Region of Malawi, Dr.
Zalewa.
Three days later, there was an orientation of TB aspects in the new diagnostic measures of TB
as well as the Path ways, i.e. learning what TB was, how it is transmitted from one person to
another, preventive measures and the importance of knowing one’s HIV status and early
seeking of TB diagnosis and treatment. This was done from 25th -27th August, 2010 and was
facilitated by the TB Coordinator and his Assistance from Mwanza DHO who were well experts
in their work. The participants for the training were 12 HSAs, 4 Community leaders, one
religious leader, one Tradition healer, and 6 representatives from PLHIV support groups drawn
from Thambani area (TA Nthache & STA Govati) and. During the days of the training period the
participants were accommodate and provided with meals for 3 days, refreshments and snacks
were also provided and transport reimbursements was given on the last day. MWASO and the
DHO Office realized that the HSAs whom were believed to be knowledgeable enough about TB,
had little knowledge and there was indeed a gap among the Health Surveillance Assistance
(HSAs) on TB aspects in the new diagnostic measures of TB as well as the Path ways of TB.
This was evidenced through the comments they made like, ‘’We did not learn this during our
HSAs orientation training and we were telling people what was not true’’, Said, Mr. Mazengera ,
one of the HSAs at Mwanza DHO one of the participants believed to knew more about TB
aspects. Commenting on the training content, GHV Mgwedula one of the local leaders from
Thambani said that the training was very important and would assist the local leaders to
understand more about TB and be able to educate and sensitize the communities by telling
them the true reality of TB. That means that the training was very important both to the HSAs as
well as to the community of Mwanza especially those from the project impact area.
One of the most important advocacy activities during the TB project implementation was the
sensitization awareness campaign meetings that were conducted 3 times in 3 different places
for 3 different days. These meetings attracted many people due to the performances and
messages by the traditional dances, drama, poems, T-Shirts blended with TB Messages as well
as the speeches made by different people both from DHO, MWASO and the custodians of
culture. Before the awareness campaigns, 265 T-Shits were procured and distribute to all the
invited guests as well as all the people took part in the traditional dances on the awareness
campaign days. Mobilization to all the 3 centers was also made before the actual days of the
meetings. These were done by the HSAs by fueling their motor cycles to go to all the paths that
connected the villages where the campaigns were to be conducted. Two banners inscribed with
TB messages were also made with the message inviting people to the meetings as well as
raising awareness about the importance of seeking early diagnosis and treatment of TB after
seeing some of the signs of TB. One banner was elected at the Headquarters of Mwanza Boma
along the road to Blantyre City, the biggest commercial cities in Malawi. The media from
Government stations like Television Malawi (TVM) and Malawi Broad casting Corporation
(MBC), and other private own radio stations like Zodiac Broad casting Station (ZBS), Malawi
Institute of Journalism (MIJ FM), and journalists from local newspapers like Malawi Newspapers
and The Nation News papers were also invited and their presence at the first function of the
launching of the TB Awareness Campaign graced the occasion and made the awareness of the
TB Campaign in Mwanza to be known even the whole Malawi. All the traditional dances were
given relevant messages before the actual days for them to prepare and compose their songs
relevant to the TB Messages developed. These were given to them by the Information,
Education and C Officer from the Mwanza DHO. They were also supervised to make sure that
the TB messages delivered during the awareness meeting s were too relevant and consistent to
our message on the banner as well as on the T-Shirts.
These awareness meetings were conducted as follows: The first meeting was the TB launch at
Chiwembu Ground of Traditional Authority Nthache on 4th September, 2010 in the afternoon.
The meeting attracted a lot of people and all the key players at the district level. At the that
meeting , There were Traditional Authority Nthache, Group Village Headmen, Village Headmen,
MWASO Board members, management and PLHIV Support Group members, Mwanza DHO
personnel led by Dr. Kumpama, a representative of the DHO and TB Office Coordinators for
Mwanza District as well as the Health Surveillance Assistants from the project area. During the
first meeting, there were about 1200 people. Traditional dances, drama group from the DHO,
poems and Speeches were made by different people in authority addressing the same issue of
early TB Diagnosis and treatment. One hundred and fifty T-Shirts blended with TB Messages
were distributed to all the invited guests and all who took part in the dissemination of the
messages through the performances and the media as well on the launching of the TB
awareness campaign at Chiwembu. All that was done on that day was featured by the media
both on the nation broadcasting Station and private ones as well as in the newspapers.
(Attached is the story captured by one of the news reporters during the day). People were
sensitized on how a person is infected by TB, Signs and symptoms of TB and measures on how
to prevent yourself and control measures as well as the importance of Walk-in to health centers
for early TB diagnosis after one felt one of the mentioned signs of TB by the TB coordinator and
the DHO Representative. Speaking at the same function, Traditional Authority Nthache
appealed to all his subjects especially the Group, and Village Headmen to encourage their
people to go for early TB diagnosis and treatment after s one has seen one of the signs
mentioned by the TB Coordinators and the health personnel. He also commented on the ill –
treatment made by some of the health personnel at the DHO or health centers that also
discourages people to seek for early and proper treatment. Speaking on the issue, Dr Kumpama
assured TA Nthache and all the people present at the function that it was the duty of the DHO
Office to see to it that all the people are served equally and promised all the people to visit any
health centre and will be received and treated equally both to patients or people having the TB
diagnosis without the consent of the doctor. (Below is the attachment of the snap shot of some
of the events during the function).
Mr. Machilika Matemba, the Executive Director of Mwanza AIDS Support Organization
(MWASO) speaking at one of the awareness campaign meetings. (The message on the
banner has been translated in our mother language and it says: ‘’Go and seek early TB
diagnosis and Treatment, TB is a curable disease why late today?
During the STOP TB awareness campaign meetings there were traditional dances and one of
them is the famous traditional dance called BEN and was one of the means of attracting people
as well as disseminating TB messages. (Above is the picture of Malawian traditional flag put on
by the BEN dancers with TB T-Shirts on with the WHO and MWASO Logo on it while dancing at
one of the functions). During the 3 awareness campaign meetings, the invited guests to the
meeting were given a lunch allowance and refreshments and snacks. The participants to the
traditional dances were given a group allowance and refreshments as well as snacks.
Women at the BEN Dance singing together TB SONGS while putting on TB –Shirts.
Below is the picture of the HIV/AIDS Coordinator for MWASO, Chrissie Chizowa, dancing
together with the women on TB Songs showing people that being HIV positive is not the end of
life but the beginning of a new life.
During the awareness meetings people were very happy with the TB messages but surprised to
hear MWASO members advocating for early TB diagnosis and treatment together with the
health personnel unlike before when MWASO was only advocating for people to go for HTC
services in the district. This project has made MWASO to be known by all the people that
members of the organization though HIV positive are capable of implementing any project as
shown during the project implementation period. The project also assisted to reduce the stigma
and discrimination that was there to PLHIV in Mwanza because they were regarded as not
important and fruitful subjects of the area and the flag of MWASO was raised high with the project.
One of the unforgettable moments during the awareness meetings were the testimonies made
by the TB Patients. (Those who were once infected by TB but they were discharged because
they completed the dosage of TB without defaulting. That also attracted a lot of people because
at first people had negative attitude towards those who were TB Patients and were stigmatized
and discriminated against. But due to the testimonies made by these TB Clients and other
speeches the bad impression people had on TB was removed and they all geared to support
them. People had an opportunity of asking questions to these TB Clients and were well
answered by them with assistance from the TB Coordinators especially on technical aspects but
most of the questions were right away answered by the TB Clients themselves.
Blow is the picture of one of the TB Clients giving testimony at one of the awareness campaign
Alfred Kapise, one of the TB patients giving his testimony on how he got TB diagnosis and
treated by the health personnel at one of the TB awareness campaign.
Above picture is of Mr. Jonas Eliya one of the TB patients and PLHIV giving testimony on how
he got infected with HIV and TB while answering questions from audience at the meeting at
Kalanga Ground. (You can imagine how the children and other people are feeling after hearing
his testimony by touching their heads).
Mwanza DHO Drama Group called TIKAMBE dancing without shame while disseminating TB
and HIV/AIDS messages. In their song there are saying TB is a curable disease and if one is
infected just go to the health nearby or DHO hospital get treatment and you will be cured, all
your power restored and you will dance the same as we are doing here.
Below is the picture of one of the audience s asking questions to Mr. Jonas Eliya on the
testimony he gave concerning TB.
.
The awareness campaigns attracted a lot of people and not only Malawians but others
volunteers who came to Malawi to in health department. Olive, is one of the Peace Corp
Volunteer from USA working at Thambani Health Centre appreciating the good work done by
MWASO with funding from W.H.O was among the audiences at the two functions of both
Thambani and Kalanga TB awareness campaigns. Seating next to him is the TB Coordinator for
Kalanga area and HAS and working at Thambani Health Centre.
Below is the picture of the drama people showing the back sides of the STOP TB
PARTNERSHIP T-Shirts.
Gule wamkulu is one of the cloud pullers in Malawi and was also invited to be part of the
performances in all the three awareness campaigns. Below is the snap shot of its costume and
dancing styles.
Dr. Zalewa, one of the Traditional healers and member of the region South for traditional
healers speaking at one of the function during the STOP TB Awareness campaigns said that he
was very happy that today that MWASO STOP TB Project has made them (the traditional
healers) to be recognized and work as partners of health Mwanza DHO unlike the past when
they were regarded as not important doctors who could confuse the patients. ‘’ I am very glad
today that now government through the health department Mwanza DHO and Thambani Health
Centre has now recognized us that we are also very important people to patients and the
community as a whole. What you should know is that once someone falls sick the first treatment
is being sought from us and we the traditional healers, are very important in one way or the
other because when one has been bewitched we there to help and to cure that but it is very
impossible and difficult for us to diagnose that one has HIV or TB therefore the project will assist
us to refer patients coming to them after knowing the sign s and symptoms of TB and HIV and
AIDS. I am also commended the World Health Organization for considering MWASO with the
funding for the project but our requested is for the orientation of all the Traditional healers in my
area of the project for the proper referral system to go well.’’ Said Dr. Zalewa, one of the
traditional healers.
Below is the snap of Dr. Zalewa speaking at one of the awareness meetings.
One of the HSAs from Thambani Health centre Mr. commended MWASO for the proposal
development and coming up with the idea of networking all the people working in health related
issues. He assured all the people to seek for early TB diagnosis as early as possible when felt
one of the mentioned signs of TB. He also appealed to all the people who were on TB treatment
by then and all those who were on treatment that period to form a TB club in their respective
areas within their locality in a nearby distance and the DHO through the TB Coordinator and
HSAs together with MWASO are there to assist and support them in all their endeavors. He also
appealed to all the local leaders to encourage their subjects to go for a walk-in –for the TB
diagnosis and the health personnel is there ready to assist them any time and any day.
Below is the picture of Mr. …………………………………….the HAS for Thambani area speaking
at one of the functions of STOP TB Awareness meetings.
ACHIEVEMENTS
During the project implementation, there were a number of achievements made as follows:

All the planned activities were done properly and we managed to reach 5000 people
during our awareness meetings.

Though it was a sun (summer) period in Malawi during the awareness campaigns but
many people flocked in to our functions due to the mobilization tools used. These were
done through the printed T-Shirts and banners, Traditional Authorities Nthache and STA
Govati, the Group Village headmen as means of communication and the Information,
education and communication by the DHO department by going in all the villages around
mobilizing people for the meetings.

The traditional leaders were very cooperative during the project implementation
though they were busy people but they sacrificed themselves for the benefit of their
people,

The traditional dances visited and given the messages were all conversant with the
messages given to them and that made them easily incorporated them into their
performing songs (dances) and dissemination of message was simple and well
understood by the communities.

The DHO TB department and all the HSAs from the area where we are implementing
the project were very cooperative and they supported us very much in all the
meetings.(Providing us with a vehicle when going for the meeting).

The Mwanza District Assembly also supported us a lot during the project
implementation who gave us a go ahead with the project plans and encourage us to visit
them and ask wherever possible.

More people are now aware of TB and importance of seeking early TB diagnosis and
treatment hence the establishment ten TB Clubs out of the 7 planned ones in the
proposal. The following are the names of the TB Clubs that are operation:
1. Chikoleka in Chikoleka Village STA Govati
2. Kamphirimo in Mgwedula Village STA Govati
3. Tithandizane in Kayera Village STA Govati
4. Govati in GVH Govati STA Govati
5. Tchale in Tchale Village STA Govati
6. Chamwalira in Chamwalira Village STA Govati
7. Kalanga GVH Kalanga STA Govati
8. Gwirenchira in Gwirenchira TA Nthache
9. Kasuza in GVH Kasuza TA Nthache
10. Chiwembu in Chiwembu Village TA Nthache

TB Clients were mobilized by the HSAs to give testimonies and they contributed to
the awareness campaigns to be more meaningful and beautiful.

All the invited guests to the functions were present. That shows that we had a lot of
support for the project from both government as well as civil society organizations in
Mwanza.
CHALLENGES

The number of T- Shirts printed were not enough comparing to the demand during the
TB awareness campaigns and we forget to budget for the cups to make the function
colorful

The sample T-Shirt that was sent to us from your office arrived late after we had
already printed the 265 T-Shirts. Though not exactly of yours but they portrayed the
same and simple messages but we translated in our mother language for the masses to
understand. Only the STOP TB was not changed as you can see from the pictures.

Transport was the main problem because the vehicle we were using was the
ambulance from the DHO and sometimes it was also supposed to be used to ferry
patients to and from health centers. This sometimes delayed our programmes but we
managed to accomplish all.

The awareness TB campaigns were done during the summer (hot) period and it was
difficult to start them at a scheduled time of 1:30pm instead we were very flexible
because we went there for the community therefore we had to wait for them until 3pm
sometimes but all went on well and achieved our objectives.

Last year we experienced dry spell in Malawi especially Southern Region of Malawi
and this affect the production of crops in Mwanza. The TB Clients need nutritional food
supplement inform of maize and vegetables for them to adhere to the treatment hence
reducing the default rate. The 10 clubs that were formed were promised to be assisted
with various farming implements and inputs for them to have food next year as we are
approaching the planting season. We expect to provide them with maize seeds,
vegetables as well as the fertilizers. The HSAs are ready to assist the clubs in their
locality.
LESSONS LEANT
Wider consultation is very important before project planning and implementation to
seek for other people’s views that also helped us to achieve our intended objectives and
accomplished all the activities within a short period of time.
Working in partnership is very important for sharing of resources and referring of
patients to one another for the benefit of all the community and not working in isolation
or competition (refer to comments by the traditional healers’ representatives.
Everyone in the community has a role to play and other groups of people seem not
important in the community can be of assistance in the project planning as well as
implementation period for sustainability of the project. (Traditional healers mobilizing
people for TB Clubs and refer patients to health centers.
Community involvement is very vital to all stages of the project and encourages
ownership of the project after phasing out (TB Clubs owned by the community and HSAs
themselves in their respective villages).
WAY FORWARD

To orient the other Traditional healers for them to have one voice on TB messages
and referral system.

T o support the TB Clubs with their activities for the sustainability of their clubs

All the local leaders to be oriented in future in both HIV and AIDS as well as TB in
order to reduce stigma and discrimination

To scale up the project and cover the whole district with STOP TB Project as many
local leaders are approaching MWASO to go into their areas and start the project after
seeing the good fruits of the project from Thambani area. (People in Thambani are no
longer vulnerable to TB due the project)

To seek for funds to have an exchange visit to any organization that is implementing
STOP TB Project outside Malawi while contributing to achieving MDG number 8.

To seek funds for reliable transport for MWASO activities as its catchment area is the
whole district and most areas are terrain. (MWASO has no even a motor cycle but rely
upon borrowing from other stakeholders that also hinders performance of our activities)

To train more HSAs in Mwanza District for them to carry out the good and true
messages of TB in Mwanza by way of contributing to MDG Number 6 and 8 of
Combating HIV and AIDS, Malaria and other diseases and global partnership for
development respectively.
REPORT SUBMITTED BY:
MACHILIKA MATEMBA
EXECUTIVE DIRECTOR
MWANZA AIDS SUPPORT ORGANIZATION-MWASO
MALAWI.