International Federation of Red Cross and Red Cresent Societies - 23 September 2003
Pekka Reinikainen in Nairobi

This will be followed by a publication, already on the production line, about a Kenya Red Cross project in Majengo, a Muslim-majority neighbourhood of Mombasa. A third booklet will concentrate on Somali Red Crescent HIV/AIDS work in Somaliland.

"This best practise publication is very important for the Ethiopian Red Cross. It is an invaluable guide for our expanding community and home-based care programme," says Masresha Tefer information and education officer of the ERCS.

"Having the experience of the Tigray branch to spearhead our best practise series is recognition of the HIV/AIDS work of the Ethiopian Red Cross Society and its branches," says Patrick Couteau, the Federation's Health and Care Advisor in Nairobi and editor of the series.

The booklet documents the ERCS pilot project on community and home based care in Tigray, a project initiated in 1999 with the aim of outlining a home care and support strategy as part of the national HIV/AIDS prevention and care programme.

Since then, five more of the ERCS's 30 branches have followed Tigray's lead and started their own programmes. A further scaling up to 19 branches is currently on its way.

Ethiopia has some 220,000 people living with AIDS and 2.2 million who are HIV-positive, out of a total estimated population of over 64 million. A quarter of a million HIV-positive Ethiopians are under 14 years of age, while 1.2 million children have been orphaned by the epidemic.

However, the health service delivery system in Ethiopia only covers around 40 per cent of the population. The ERCS has frequently stepped in to fill the gap, establishing a network of pharmaceutical dispensaries in areas where public health services are lacking.

"Community- and home-based care is the only feasible alternative in an environment where already nearly half of hospital beds in urban areas are occupied by people with AIDS-related illnesses," says Masresha Tefer.

The Tigray branch has over 12,000 members and 3,500 trained volunteers, 30 of whom are involved in the home-based care activities. They are joined by 248 trained family care providers.

Thanks to their efforts, most beneficiaries are able to continue working, due to improved family care at home and access to treatment for opportunistic infections. The Tigray branch has trained PLWHA to use sewing machines so as to allow them to run small tailors shops to generate income for their families.

Another major milestone would be a decline in stigma and discrimination, and the signs are that affected communities are finally beginning to break the silence surrounding HIV/AIDS. The very existence of HIV is being acknowledged.

The Tigray lessons-learned booklet was delivered straight from the printers to the 50 participants of a Red Cross Red Crescent HIV/AIDS satellite meeting, held in Nairobi over the weekend ahead of the 13th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), which runs until 26 September.

Selam Seje, who as well as being the principal author of the booklet, collected most of the necessary information, interviewing people involved in the project, received a standing ovation from the Red Cross Red Crescent delegates. "The commitment of the Tigray branch volunteers was and is remarkable," she said. "Their dedication to their clients was praised by the PLWHA."

"This best practices publication is a great example of National Societies supporting each other by sharing lessons learned. That this is just the first in a series shows how strong the scaling-up of HIV/AIDS programming in the East Africa region is," said Bernard Gardiner, head of the Federation's HIV/AIDS unit in response to the launching.

Masresha Tefer, Selam Seje and Patrick Couteau are preparing to facilitate translation of the booklet into Amharic, Ethiopia's official language. Masresha hopes that a Tigragna translation could also be printed allowing Tigray residents to read the report in their own indigenous language.

Best practices, as defined by UNAIDS, is a continuous process of learning, feedback, reflection and analysis of what works and what does not in a given activity.
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