House of Commons - International Development

Select Committee on International Development Written Evidence

18. Memorandum submitted by World Jewish Aid (WJAID)

EXECUTIVE SUMMARY

I. Introduction

World Jewish Aid is the main channel through which the British Jewish community can express its humanitarian concerns and pool collective resources to aid communities in need around the world regardless of religion or other considerations. The Chembe AIDS Project is one of several projects that have been funded by concerned members of the Jewish community in the United Kingdom.

II. The Chembe AIDS Project (CAP)

Chembe is situated in the southern Mangochi region of Malawi, a sub-Saharan African nation with an estimated population of 11,651,239[156] considered to be one of the world's poorest nations. The economy of Malawi is largely based on agriculture and 90% of the population is living in rural areas.[157] More than 65% of Malawi's population lives below the national poverty line[158] The National AIDS Commission in Malawi estimates that there are approximately 900,000 Malawians infected with HIV. In 2003, approximately 87,000 Malawians died of AIDS-related causes. The majority of these deaths are in the 15-59 age category, leaving 470,000 AIDS orphans in 2001[159]

The Chembe Aids Project (CAP) was originally founded to provide much needed HIV/AIDS education, awareness and prevention in Chembe. The CAP is the first NGO in the Monkey Bay Peninsula, and remains the only HIV/AIDS programme in this region of Malawi. Its HIV/AIDS education programme is directed at young people up to age 17. An important focus of the CAP is providing food and education for children orphaned from AIDS. Twice each week the director of CAP organises a "feeding party" for the children. Many families in Chembe look after their own children and also look after many others who have been orphaned, having lost both parents to AIDS. These "adopted" children are often treated as second class citizens, and it is they who rely most on the feeding parties. CAP also organises afternoon activities for the children in the village. These activities include: HIV/AIDS awareness lessons; Mathematics, English, geography, and history lessons; Time for free play and organised play; Hygiene activities; Nature expeditions; Day trips; and Malawian Drama and culture.

III. Recommendations/Conclusions

In the short-term, as the Government of Malawi focuses on national growth, support needs to be given to local grassroots efforts to supply health services in areas which are not currently served by a hospital. On a more long-term and sustainable level, the Government of Malawi and international donors need to invest in culturally appropriate and locally-driven education programmes, particularly for young children aged 5- to 14-years who have not yet been exposed to HIV. These programmes can then be implemented by local NGOs which are often working in communities that are not being adequately served by government programmes. The Government and international donors can also aid in improving services in local communities by supporting a visiting physician (both local and international) programme. Partnerships need to be developed between Government, international donors and civil society organisations in order to facilitate this process.

MEMORANDUM

I. Introduction

World Jewish Aid (WJAID) provides a channel for the UK Jewish community to express its humanitarian concerns from a Jewish standpoint and pool collective resources to aid communities in need. Since its conception as UKJAID (UK Jewish Aid & International Development) in 1989, WJAID has provided humanitarian aid and assistance to those most in need around the world regardless of race, religion, nationality, age or gender.

In October 2003, UKJAID renamed itself as World Jewish Aid and joined forces with World Jewish Relief (WJR), an organisation formed in the 1930s originally to help Jewish refugees from Nazi Germany. WJR maintains a focus primarily on impoverished Jewish communities in Eastern Europe, while WJAID functions as an autonomous division providing assistance regardless of religion or other considerations.

WJAID manages and sponsors international aid and development projects in response to both natural disasters and human related suffering. It has worked with many organisations including UNICEF, Oxfam, DFID, The Soros Foundation, and the American Jewish Joint Distribution Committee amongst others. Recent projects include sustainable development, education, sustainable income generation, and emergency aid and food security.

II. The Chembe AIDS Project

A. The Situation in Malawi

Chembe is situated in the southern Mangochi region of Malawi, a sub-Saharan African nation with an estimated population of 11,651,239[160] considered to be one of the world's poorest nations. More than 65% of Malawi's population lives below the national poverty line[161] and in 2000, Malawi was among the bottom 7% of countries on the United Nations Development Programme's (UNDP) Human Poverty and Human Development indices. The economy of Malawi is largely based on agriculture and 90% of the population is living in rural areas.[162] Malawi has the second highest HIV/AIDS rate in the world; it is estimated that there is a one in two lifetime risk of contracting the disease. In 1990, the average life expectancy in Malawi was 47 years[163] but children born in 2003 have a life expectancy of less than 38 years[164] due in large part to the likelihood of contracting AIDS.

The National AIDS Commission estimates that there are approximately 900,000 Malawians infected with HIV. In 2003, approximately 87,000 Malawians died of AIDS-related causes. This figure is expected to rise to over 100,000 adult deaths annually by 2005. The majority of these deaths are in the 15-59 age category, leaving 470,000 AIDS orphans in 2001.[165] The number of orphans is predicted to reach over half a million by 2005. A USAID study in 1998 estimated that 36% of all Malawian children have lost one or both parents to AIDS[166] and that figure is undoubtedly higher now. The AIDS epidemic has greatly affected the country's economy and ability to produce sufficient food rations. Over half of the country's hospital beds are occupied by HIV/AIDS patients severely paralysing the already feeble healthcare system.[167] In certain professions, including teaching and agricultural extension work, workers are dying at a faster rate than replacements can be trained.[168] Malawi has been crippled by HIV/AIDS and is in great need of support.

B. Chembe

The village of Chembe covers a 5,000 square metre area. It traditionally relied on fishing but now harvests maize due to a fish shortage. There is a population of 11,000, at least 800 of whom are orphaned children; 1,300 families who have no food in their homes depend on emergency relief for food. There is a cycle of related problems in Chembe due to the high HIV/AIDS rate. People are unable to work, hungry children miss school, women with no money to feed families resort to prostitution increasing HIV/AIDS and HIV/AIDS in children and orphans.

C. The Chembe AIDS Project (CAP) Overview

D. Caring for AIDS Orphans

Children orphaned as a result of AIDS are particularly vulnerable. Older children may have missed out on school and economic/agricultural opportunities as they have nursed their parent(s) through illnesses associated with AIDS. In addition, if the family had any financial resources when the parents were healthy, these have probably been exhausted paying for medications and funeral costs.[169]

The CAP has a programme providing food and education for children orphaned from AIDS. Twice each week the director of CAP organises a "feeding party" for the children. The children look forward to it greatly. She organises small competitions and prizes. The children then get a bowl of nutritious porridge which they sit down to eat after the fun and games. When all the children have been fed (between 400 and 1,500 depending on the prevailing situation) some adults who are starving are also given porridge, if there is any left. Some of the children cannot attend the parties, as they have to stay in the fields protecting the crops from the baboons that ravage the crops close to the village, so these children often go hungry.

Malawian custom calls for families and communities to support the members of the community who are in need, but the traditional caretakers—men and women of reproductive age—are the ones most likely to be dying of AIDS. Many families in Chembe look after their own children and also look after many others who have been orphaned, having lost both parents to AIDS. These "adopted" children are often treated as second class citizens, and it is they who rely most on the feeding parties, which are the only parts of the week they look forward to. The adoptive families often ensure that their own children go to school but often do not have sufficient funds to send their "adopted" children to school as well. CAP organises afternoon activities for the children in the village. These activities include: HIV/AIDS awareness lessons; Mathematics, English, geography, and history lessons; Time for free play and organised play; Hygiene activities; Nature expeditions in co-ordination with the Malawian National Park Authority; Day trips to Liwonde National Park; Malawian Drama and culture; and Malawian folk tales.

The CAP is well established in the area and maintains a positive working relationship with local villages. Community members gain the knowledge to continue HIV/AIDS education within Chembe and in nearby villages. They also help with the construction of a clinic and are involved in a "food for work" programme.

III. Recommendations/Conclusions

The growing number of AIDS orphans in several countries throughout Africa has put a terrible strain on many social services, including health services and educational services, as well as the traditional family and community structures. The problem is particularly dire in rural areas which are not easily accessible by NGOs or by government facilities.

The solution to this crisis needs to be multi-faceted with short-term responses to meet urgent needs and long-term solutions to reduce the prevalence of HIV/AIDS. The children and their communities have short-term needs which need to be met, but in order to stem the crisis and make any sort of sustainable changes, there also needs to be more systemic and preventive action. In Malawi, it will take a long time to achieve the Millennium Development Goals and change attitudes towards HIV/AIDS, but there are several actions which can be taken in the meantime.

A. Short-term responses

There are few local NGOs operating in the rural areas of Malawi and other African countries. Those, such as the Chembe AIDS Project, which endeavour to provide short-term assistance in these communities, often have difficulties attracting funding. Services such as the feeding parties and educational activities are carried on primarily by volunteers. Without medical facilities in the area, volunteer-staffed clinics, such as the CAP clinic, are the only health services available for Chembe residents. Support needs to be increased for local grassroots efforts like this which are filling the gaps of the incredibly strained national health care and social welfare systems in Malawi.

B. Sustainable solutions

Education about HIV/AIDS and methods for prevention is particularly important for young children who have not been exposed. The National AIDS Commission of the Government of Malawi suggests that the five to 14-years age group should be targeted as this age cohort has the lowest prevalence of HIV/AIDS.[170]

The cultural norms of the society are such that abstinence education alone is not an effective means of prevention. Even teaching about the proper use of condoms is not effective unless there is an inexpensive supply to be had by the general public. Faced with the choice between food and condoms, most people would choose food. While more than 85% of women and more than 91% of men in Malawi could identify two or three ways of avoiding HIV/AIDS[171] fewer than 3% of women reported using a condom with a spouse or cohabiting partner and fewer than 30% reported condom use with a non-cohabiting partner.[172] For men, the statistics are only slightly better. Just more than 5% report using a condom with a spouse/cohabiting partner and fewer than 39% with a non-cohabiting partner.[173] In addition, while 70% of women reported knowing a place where they could be tested for HIV, only 8% reported actually being tested.[174]

Thus, culturally appropriate and locally-driven education programmes have the greatest chance for success. The National AIDS Commission has set out a number of goals and steps to achieve these objectives in their October 2003 Call to Action. However, the government has not yet dealt satisfactorily with critical issues such as corruption and restoring macro-economic stability and has not followed through on past policy commitments.[175] According to Transparency International, the Malawian government is perceived to be highly corrupt, receiving a score of 2.8 (on a scale of 0—highly corrupt to 10—highly clean) and ranking 83rd (out of 133 countries) in Transparency International's CPI (Corruption Perceptions Index).[176] Currently, a large portion of the population has to rely on the services of local and international NGOs to receive HIV/AIDS education and services. The Government of Malawi and international donors need to strengthen the link with local villages and support services that civil society organizations are endeavouring to provide. One key aspect is support of visiting physician programmes (local Malawian physicians and international volunteers) who can regularly visit regions that are not currently served by a local hospital. In addition, strengthening the link between government, international donors and local civil society efforts should enable the organisations on the ground to increase and improve the educational and preventative programmes that they offer.

An appendix was also submitted "Letter from Volunteer: Avital Elyashiv." This has not been printed. Available in full at http://www.chembe-aids.org/page1.htm

March 2004

156 CIA World Fact Book retrieved on 10/3/04 from http://www.cia.gov/cia/publications/factbook/geos/mi.html Back

157 ibid. Back

158 Statistics on International Development retrieved on 11/3/04 from http://www.dfid.gov.uk/sid2003/ Back

159 UNAIDS, UNICEF, WHO. 2002. Malawi: Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections. 2002 Update. Back

160 CIA World Fact Book retrieved on 10/3/04 from http://www.cia.gov/cia/publications/factbook/geos/mi.html Back

161 Statistics on International Development retrieved on 11/3/04 from http://www.dfid.gov.uk/sid2003/ Back

162 CIA World Fact Book retrieved on 10/3/04 from http://www.cia.gov/cia/publications/factbook/geos/mi.html Back

163 http://www.atlapedia.com/online/countries/malawi.htm Back

164 CIA World Fact Book retrieved on 4/3/04 from http://www.cia.gov/cia/publications/factbook/geos/mi.html Back

165 UNAIDS, UNICEF, WHO. 2002. Malawi: Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections. 2002 Update. Back

166 Children on the Brink, 1998. Back