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Lusaka, Zambia
Power of Love Nsaka
Community Care Center
Project No: F31
Project Managers:
Suresh & Alka Subramanian
Contact Info: info@poweroflove.org
www.poweroflove.org
The Nsaka Community Care Center in Lusaka is spearheaded by the
Power of Love Foundation, a US-based nonprofit organization formed
around a simple belief: that the battle against the AIDS epidemic,
the greatest humanitarian crisis in the history of man, can be
won.
The Power of Love Foundation works to fight the AIDS epidemic
on a grass-roots level. They are presently engaged in building
five community care centers (Power of Love Care Centers) across
Zambia. The goal is to build and run a cheaper hospice, get more
people engaged in care giving and increase the productivity of
individual caregivers.
Primary among these community care centers is Nsaka Community
Care Center in Lusaka, funded in part by a grant from Family Care
Foundation.
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Power of Love Care Centers
With a series of small grants, we have launched an innovative comprehensive
project in Lusaka, Zambia, in partnership with a number of local organizations
and communities. This integrated HIV project is envisaged as a pilot
to be eventually replicated in urban and rural Zambia. While the pilot
project is targeted toward children, the scaling up phase will target
children and the general population.
In Zambia there are a total of 10 hospices (of which 7 are fully functional)
for providing free palliative/in-patient care for terminally ill clinical
AIDS cases. For the most part, the hospices are run by medium-large
NGOs with per hospice capital costs of $100,000+, and operating costs
in the $400-$600/bed/month range.
The number of HIV infected children in Zambia is over 100,000 in Zambia
and around 30,000 in the city of Lusaka. There are a total of 15 hospice
beds specifically for (the 30,000) children with clinical AIDS across
Lusaka.
Our vision is as follows: Build a comprehensive, community-owned system
of prevention, care and support to target the invisible, but increasingly
large population of children and orphans infected and dying of AIDS.
The operational goals for the first 12 months of operations are:
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To reach and cover 25% of all HIV positive children
(in the pilot community);
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To build and operate a hospice with capital costs
of less than $50,000 and operating costs of less than $200/month/bed
(comparable costs are $100,000+ in capital costs and $500 - $600/month/bed);
Hospice - Land for the first hospice has been donated by the community
and zoned for construction. The hospice will be built on lessons learned
from a study of best practices among hospices. The focus will be on
leveraging technology and lessons-learned to hit our target capital
and operating costs. The hospice will:
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Operate an OPC (out-patient clinic) on site.
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Operate a mobile-clinic to specific areas within the
target communities to:
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Provide neighborhood-based medical response to the
sick children;
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Support the community health workers;
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Follow up with cases discharged from the care-center.
Community Health Workers - The goal is to train a team of community
health workers (CHWs) in basic medical response and implement the Hospice/OPD/Mobile
Clinic’s instructions around medication. These workers will respond
to the most common symptoms like fever, diarrhea, vomiting, dehydration,
cough, impaired respiration and pulse, and will have a basic knowledge
of how antibiotics work – so they can manage a regimen for a patient.
A few of the CHWs may be trained to manage an IV once a pick-line is
set up and is started (subject to Zambia Medical regulations). In addition
these CHWs will also be trained in HIV counseling and basics of community
health.
Family Care Givers - The goal here is to train one member in every family
where we identify a sick child with basics of first-line medical response.
The intention here is to make the first line of medical response ubiquitous
with the problem. The Family Care Givers (FCGs) will work in teams under
a CHW and will be trained to reach out to the CHWs (as needed) who then
reach out to the Hospice as needed.
Community Service Program - The goal here is to build a unique community
system of volunteer Family Care Givers who: Agree to undergo a training
program in care-giving and get certified; Agree to provide a certain
number of hours per week of care giving at patient level and in the
hospice.
Community Income Generating Program - The community health workers (CHWs)
and the Family Care Givers will be included as beneficiaries in a “basket
of earnings” generated by the community’s income-generating
activity (IGA). The intention of the IGA is to build into the system
a source of sustained financial motivation for the CHWs and the FCGs.
At this time micro finance programs are already in place and these will
also be continued and targeted toward CHWs FCGs and caregivers of sick
children in the community.
How This All Ties Together - There are a number of pieces to this project
– some of which are already in place and working. The key is the
building of a comprehensive model that integrates all the individual
pieces.
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Identify patient (child) and database them –
by trained CHWs
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Care at Home – by trained Family Care Givers
and CHWs
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Outpatient Care – Mobile Clinic and at the Hospice
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In patient Care – at the Hospice
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Prevention – a PMTCT program for expectant,
sero-positive mothers
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Prevention of opportunistic infections – an
antibiotic prophylaxis program for HIV positive
children, managed by the CHWs
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Economic support for the CHWs, the FCGs and the hospice
through a Micro-loan program and a community IGA income basket.
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