STRATEGY DEVELOPMENT
WORKSHOP
FOR
THE FRIENDS FOR MATIBI (FFM)
DATES:
16-19 September 2012
VENUE:
Matibi Mission Hospital
HISTORY
• 4 October 1993 aimed at HIV clients (60km radius) doing CHBC in
Maranda, Mberengwa in the context of limited medical assistance
• Also aimed at HIV workplace awareness and alerting community about
HIV
• Dr Ashwanden, Ssr Magret, Mr Madungwe (nurse), Redcross facilitators,
Driver Mr Gore
• Fr Stoffel was mainly interested in IGPs including community garden but
became the focal person for FFM correspondences
• Alleviated pressure on Hospital space by engaging home carers to manage
chronic illnesses
• Wished to formulate self-help groups in the community and peer
monitoring for CHBC
• Worked with district and provincial health authorities and local
government
• Mr Madungwe began with training in CHBC facilitated by FACT-Mutare
then at Murambinda Hospital where a similar project was taking place
History continued
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FFM assisted the development of Matibi Clinic to become a Hospital with 125 beds
Infrastructural development e.g. female, male and children’s wards, outpatients hall, staff
residences (9 houses), Munoti Centre, solar powered boreholes
Medicinal supplies, equipment e.g.. Fridges
Donations of cash, clothes and food through Ssr Leoba etc.
Assisted engagement and payment of more nurse aides and installation of Sister in Charge
(formerly Nurse in Charge)
Missereor (from Germany) constructed Matibi Clinic in 1985
When Dr. Ashwandern transferred to Dreifontein where he facilitated the construction of a Nursing
School, Mr Muller remained with Matibi
Dr. Berck did a dressmaking project, donating machines and materials as well as motivating staff
School supplementary feeding and Moyo weTsitsi orphan support (founded by Ssr Leoba) raised
enrolments in ward 3 primary schools. Currently some sisters from South Africa are still supporting
Moyo weTsisti
Stationery kits between 2006-08 kept the schools going eg Home Economics and other prac
subjects
Case study of Olivia Shumba, an orphan who started with FFM in Form 1 and is now going to
university
FFM came to operate in a context of incessant droughts leading to collapsed services but FFM
facilitated with aid in school fees and medical fees, seed fairs to promote drought resistance
History continued
• Apart from FFM, Fr James built a school block, Mushonganeburi
school was supported by Holy Cross Sisters
• Dr Ashwanden facilitated training a nurse in theatre and supported
with machines, beds, 4 sterilisers, 2 distillers, theatre regalia. Other
clinics eg Neshuro send their machines to Matibi for sterilisation.
• Home craft has ever been supported by FFM with materials (Br
Seraffim Fr James, Ssr Leoba, Sister Raphaels) but parents are taking
long to appreciate the importance of the project and hence are
discouraging saying that the skills may not help in finding
employment.
• It can be noted that women who have had skills in Home Craft are
finding it easy to handle many household chores and some of them
are hired to do home décor outside the country.
St Ambrose
• Started 1963 as a boarding boys-only Upper Primary School for
Standards 4-6 during colonial era
• It grew to become a conventional school between 1972 and 1973
when it was teaching a national programme called Remove Class, a
transitional phase between Standards and Grades
• Ceased operation 1975 during liberation struggle.
• 1976 turned into a Home Craft Centre with Sister Gephardt of
Gweru Diocese. Feelings then turned towards the need for a
secondary boarding school (Inclusive Community Meeting on -2012)
• Masvingo diocese Fr Matibini applied for reregistration in 1999 with
a new feeling that the Boarding School should begin from primary
to secondary for quality assurance
• Re-registered and resumed operation in January 2013 and is faced
with maintenance of blocks,
Dentistry
• Matibi hospital used to have dental service
done by Sister Leoba Bramlege who was a
nurse trained to do dental work
• Registered dentists later advocated that only
professionals do dental work, making it no
more possible for able nurses to continue with
the service
Dentistry
• Dental service is both demanded and scarce in the province as a
whole. In Mwenezi district there used to be one dentist at Neshuro
but who is no more.
• Taking it as a separate income generating project needs a different
account to be opened
• The project can take a clue from the eye project at Morgenster
Mission which has a separate account for their Eye Project
• It could be done by a visiting doctor once per fortnight because the
demand is not steady
• Community leaders are willing to mobilise for the dental service as
a way of advertising to raise the demand and they believe that
people are going to demand the service as has been the case with
Eye and X-ray services
CONTEXT
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Information about FFM was not reaching to communities as widely e.g. Some knew Fr Stoffel as a donor but did not know about FFM
Started in an environment where communities were not knowledgeable about HIV but now the project is very welcome
Village authorities supported FFM from start noting the pressure from sick subjects who needed help unconditionally
Other communities used to send their patients to Matibi from as far as Ngundu in Chivi to Sandawana in Mberengwa adding to pressure on nurses
but the CHBC programme engaged the communities successfully and the pressure on health facilities is now less
Government was finding it difficult to finance staff engagement but FFM paid allowances for up to 20 staff members who were not on government’s
pay sheet through a facility known as the Bruno Allowance named after Mr Bruno Muller until June 2013
Government is still faced with critical incapacities to cater for staff allowances so that if no assistance is given then many staffs are going to lose jobs
as many as 20
More than 1/3 of staff at Matibi is seconded from the district being attracted by the Bruno facility. As such the facility may not have to cease, or at
least it should find a replacement of some kind. All in all, about ½ of all staff may be affected directly or indirectly.
Matibi friends are a faith-based organisation who have supported the church at Matibi in many forms (e.g.. Décor cloths, chairs, candles, garments).
Indirectly they have partaken of evangelisation e.g. in educating and leading by examples, e.g. building the new church where communities actively
participated e.g. carpenters)
Currently FFM is operating in a context where government is battling with making social services free-for-all e.g. maternity, under-fives, elderly (65+),
mentally ill, TB/OI/ART. Now the hospital has faced challenges in meeting the financial gaps since government has limited resources to support free
services leading to deficits caused by advance expenditure based on government directives and promises. FFM has here and there assisted to cover
some of these gaps e.g. in assisting the mentally challenged.
FFM engages a non-discriminatory stance in terms of religion
VHWs have severally forked out their personal resources e.g. money, soap, groceries to assist know patients in the community because of erratic
procurement of allowances . Government and the Holy Cross Sisters used to assist VHWs and CHBC Care Facilitators with these incentives but have
slowly failed to meet the level of need further leading to ceasing services.
Sanitation toilets (30% of ward 3), clean/safe water 55% [District Environmental Health Dept.]
VISION
• A healthy, educated and self-sustaining Matibi
community
Issues shaping the vision
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Dura-walling of mission premises due to marauding animals and trespassers. As a result it is posing a challenge to
making the place neat.
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The hospital is near a township but it is not capable of manning the gates (employing guards).
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More houses/flats needed because some houses are housing too many families.
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Blair toilets are now full, some of them collapsed (3 closed for siting reasons, 1 collapsed, 4 full)
2 Muchingwizi Flats, 2 for Hostels the wards, 2 Mushonganeburi side, 2 church site, 2 at Hospital. There remains only 2
toilet blocks (1 with 5 holes and another with 1)
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Food aid for chronically ill clients used to facilitate voluntary disclosure of sero-statuses and this should go on if an
AIDS-free generation is to be achieved
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Preschool, primary school and supplementary feeding proving pertinent to cater for orphans and vulnerable
children, some are transferring from nearby schools
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CHBC clients are beginning to decline seeking treatment due to erratic supply of food
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Community garden serving too many people on smaller area so FFM may assist expand the facility. Gardeners are
faced with too steep slope from the well and they travel over 60m to fetch water. More boreholes needed at least
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Insufficient water/sanitation facilities and community volunteer support meaning risks of outbreaks
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Matibi community faced with recurring droughts and erosion of household economies threatening to reduce
school enrolments
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Communities from over the river Muchingwizi find it difficult to cross to the hospital during rains. HIV clients need
to revive support groups but find it difficult due to lack of food and livelihoods support. Visiting patients at home
is still necessary to prevent chronically ill clients to slide back into bed as well as to prevent overcrowding of clients
at outpatients department. Outreach also critically needed for rehabilitation patients e.g. metal cases and the
disabled.
Vision contd.
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Expansion of internet network needed for workers to enjoy the service
Murerezi river has a big donga which makes it difficult for ambulance service to General/provincial
hospital (105km). Worse, the Runde and Save bridges are uncross-able during floods. Via Neshuro
165km; via Zvishavane 182km.
Staff residences at St Ambrose CPS is shared with Home Craft and very insufficient. The junior
grades find it difficult to use the toilets because of too big holes for their age. Next year introducing
grade 5. Need for computer lab to house +/- 40 computers. Currently have 9 PCs and a laptop
donated from FFM.
Community leaders promised to actively mobilise communities to own FFM as their own project.
They remember drought relief episodes facilitated by FFM. They however, witness thousands of
school fees defaulters due to reduced FFM support in that side. VHWs and other volunteers need
support for their vital contributions.
Matibi bridge has been a bone of contention between politicians and the electorate.
Muchingwizi Dam scooping is a necessary and urgent move because it receives rainwater once a
year which is needed for garden, hospital sewage, livestock, building, general laundry etc.
Musaverima Dam water can as well be tapped to serve the hospital since it is perennial located
3km south of the hospital.
Need for a nursing school in the district to harness local human resources since even the
neighbouring districts Chivi and Chiredzi also have none, even Zvishavane district in the next
province Midlands. Thus the nursing schools are concentrated only in the eastern half of the
province.
Vision contd.
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Congestion in postnatal ward e.g. not meeting the national standard of 3 days before discharge after delivery, 4
more beds needed
No gadgets to facilitate diversion therapy in the hospital wards e.g. television
Staff ward is needed for nursing sick staff as a way of maintaining a felt-fair environment to retain staff
Currently we have 18 houses (15 for other staff, 3 docs) for 70 staffs thus 1 house shelters an average of 10
people. We need 5 more houses.
Home Craft department needs a craft workshop as well as a storehouse and a classroom. Currently we use 1 room
for combined cooking, sewing and storage etc. We can also expand Home Craft to become a poly-disciplinary
vocational training centre to incorporate boys as well because the idea is to help those that might have been
unfortunate in the conventional schools.
Need to motivate staff through staff competitions e.g. FFM Worker of the Year Award. Targeted support is needed
in issues such as nutrition, maybe through shows or field days.
Some talents are fading away without being recognised e.g. poets and dramatists
Other institutions have own transport. We need maybe a staff bus to ferry staff about once to and from town etc.
We have 7 primary and 2 secondary schools in ward 3. Primary school has expanded recently to include Early
Childhood Development (ECD) ranging from 3-year olds implying need for supplementary feeding.
Need for compartmentalised hospital wards for privacy of patient consultation
Retention of doctors needs active strategies e.g. vehicles as benefits
Need for scanning machine and currently there is only 1 old machine
MISSION
• Safeguarding steady access to quality services
for the general wellbeing of Matibi community
VALUES
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Commitment to duty
Diligence
Transparency
Honesty
Teamwork
CRITICAL OBSTACLES
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Economic instability
Under-communication
Poor coordination
Discontinuity
Political hijacking
Incompatible cultural expectations
STRATEGIC, LONG-TERM
GOALS/DIRECTIONS
1. To facilitate comprehensive healthcare for
Matibi community
2. To meaningfully involve individuals and
groups of Matibi community in home-grown
livelihood activities
3. To build the capacity of Matibi community to
access and enjoy competitive educational
services at all levels possible
INSTANT GOALS/OBJECTIVES
• 1.1. To contribute to the prevention of, and
improving awareness on preventable diseases
in Matibi community
• 1.2 To assist Matibi Mission Hospital in
meeting the treatment needs of Matibi
community
• 1.3 To facilitate comprehensive care and
sustainable support for the chronically ill
and/or disabled in Matibi community
Objectives contd.
• 2.1 To rehabilitate existing water sources and
expand their capacities to cater for
community gardens and livestock
• 2.2 To empower out-of-school youths in
Matibi community with survival vocational
skills
Objectives contd.
• 3.1 To assist St Ambrose Matibi Primary
School in meeting its infrastructural and
technical needs to offer valuable ECD and
primary Education
• 3.2 To contribute to improving accessibility of
secondary education in ward 3 of Mwenezi
district
• 3.3 To facilitate enhanced local-based staff
development and retention at Matibi Mission
INDICATORS OF SUCCESS/
BENCHMARKS
Objective
Indicator
1.1 To contribute to the prevention of,
and improving awareness on curable and
non-curable diseases in Matibi
community
• Quarterly rates of mortality and
morbidity related to preventable
diseases at hospital level
1.2 To assist Matibi Mission Hospital in
meeting the treatment needs of Matibi
community
• Number of patients treated versus
those transferred
• Records of drug availability versus rate
of uptake
• Records of equipment availability and
functionality
1.3 To facilitate comprehensive care and
sustainable support for the chronically ill
and/or disabled in Matibi community
• Rate of bed occupancy by chronically ill
patience
• Number of outreach visits to
chronically ill patients and those with
disability
Indicators contd.
Obj.
Ind.
2.1 To rehabilitate existing water sources
and expand their capacities to cater for
community gardens, livestock and
hygienic needs
• Number of rehabilitated water sources
• Number of households benefiting from
water rehabilitation
2.2 To empower out-of-school youths in
Matibi community with survival
vocational skills
• Number of out-of-school youths
graduating from vocational training
• Number of self-help projects started
by graduating vocational students
Indicators contd.
Obj.
Ind.
3.1 To assist St Ambrose Matibi Primary
School in meeting its infrastructural and
technical needs to offer valuable ECD and
primary Education
Number of structures constructed
Annual students’ pass rates
Rate of uptake of technical-vocational
subjects
3.2 To contribute to improving
accessibility of secondary education in
ward 3 of Mwenezi district
Number of breakthroughs towards having
a functional secondary school at Matibi
Mission
3.3 To facilitate enhanced local-based
Number of breakthroughs towards having
staff development and retention at Matibi a functional nursing school at Matibi
Mission
Mission
INFRASTRUCTURE ASSESSMENT
Programme
Programme
1. Comprehensive
1. Comprehensive
healthcare support
healthcare support
In place
In place
Gaps
Gaps
Activity 1.1 WASH
Activity 1.1 WASH
• Staff members are
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• Staff members are
digging and utilising
digging and utilising
rubbish pits but during
rubbish pits but during
rainy season they are
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rainy season they are
unusable
unusable
• Bins are available but
• Bins are available but
are now old
are now old
• The hospital has a big
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• The hospital has a big
rubbish pit to empty the
rubbish pit to empty the
bins
bins
16 households of
• 16 households of
Muchingwizi flats need
Muchingwizi flats need
blair toilets
blair toilets
Houses of Mbare area
• Houses of Mbare area
have had their blair
have had their blair
toilets closed due to
toilets closed due to
siting reasons
siting reasons
Church site and primary
• Church site and primary
school need 2 blair
school need 2 blair
toilets and 10 squat
toilets and 10 squat
holes respectively
holes respectively
• Mushonganeburi
• Mushonganeburi
suburbs need 2 blair
suburbs need 2 blair
toilets
Infrastructure contd.
Programme
In place
Gaps
2. Sustainable livelihoods
intervention
• 1 functional borehole
• 8 dysfunctional
• A total of 5ha garden
boreholes
(Vhure 2 = 0,8ha; Vhure • Silted dam (6000 cubic
1 = 1,3ha; 3 other
metres)
smaller gardens = 2,5ha; • Dam structure vs size
hospital garden = 0,5ha;
and soil erosion leads to
Home Craft grapes
siltation
garden = 0,5ha and
Home Craft vegetable
garden = 0,5ha)
Programme
In place
Gaps
Infrastructure
contd.
3. Enhanced
educationalisation
assistance
ECD & Primary
Home craft
• Primary school
operating at minimum
scale
• The classes (total 197
pupils) full showing
serious business
• Home craft centre
manned by 3 staff
members
• Sewing machines,
charcoal stoves, ready
supply of fibre for fibre
work
• Play centre available but
has no materials
• School borrowed
furniture from church
• No houses for 7
teachers
• No offices, no library,
too small computer
laboratory
• Using only one
classroom for the
various disciplines
• Primary school and ECD
using same blair toilets
posing a risk to smaller
kids
• Need for play centre
materials and more
classroom blocks
IMPLEMENTATION PLAN
Activity
Responsibility
Resources
1.1 Rehabilitating 8
dysfunctional boreholes
by March 2015
Hospital Administrator
• Pumping pipes
• Pumping arm
1.2 Procuring
medical/surgical/sundry
materials as an on-going
exercise
Matron
• Budget for drugs
1.3 Monitoring services for HOD Outpatient
people with disabilities
Department
and the chronically ill as
an on-going exercise
• Outreach vehicle and
fuel
Implementation contd.
Activity
Responsibility
Resources
2.1 Putting back
Muchingwizi dam into
operation by mid-2014
Hospital Administrator
• Earthmoving machinery
2.2 Upgrading Matibi
Home Craft Centre into a
functional multidisciplinary vocational
centre by December 2015
Head of Home Craft
• Building materials
• Learning kits for various
vocations (home craft,
carpentry, motor
mechanics, welding,
cookery)
Implementation contd.
Activity
Responsibility
Resources
3.1 Renovating worn-out
Teacher in Charge of St
structures, constructing
Ambrose
required infrastructure and
procuring provisions by
2014
Budget and community
support
3.2 Mobilising stakeholders Teacher in Charge of St
towards establishing a
Ambrose
secondary boarding school
at Matibi Mission by 2017
Bureaucratic will and
community support
3.3 Mobilising staff
incentives for hospital and
school staff and
stakeholder support
towards establishing a
nursing school at Matibi
Mission
Bureaucratic will and
community support
Sister-in-Charge of Matibi
Hospital
DISSEMINATION PLAN
Activity
Adopting
strategic
plan
Timeframe in Quarters
Q1
Review of
implementa
tion
World
Health Day
Commemor
ation
Q3
Q4
Q5
Q6
Q7
Q8
Q9
Q10
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Launch of
strategic 3year plan
Staff
orientation
Q2
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Q11