Update from the Isibani Health Team – Sindy and Ncami

Mobile Clinic
The mobile clinic visits Isibani twice a month and since we started working so closely together there has been a huge improvement in the level of service. The Isibani health team are able to make sure that we screen all patients and do vital signs to make things easier for the clinic staff. Because we are able to do the initial screening the clinic staff are able to see many patients each day,  +/- 300 per clinic day. After we have done the screening we make sure that those who are very sick are seen first so that they can be sent to hospital for further management.

Club Day
In addition to the twice monthly clinic days, the pharmacist from our local hospital, Emmaus, also comes every other Monday to hand out chronic medication including ARV’s.  This is far more convenient for our clients as they live in and around Winterton and on surrounding farms and a trip to Emmaus hospital is expensive and time consuming. We have seen that having medication easily accessible helps to minimize the number of defaulters.
The Isibani health team is also on hand to screen patients and to ensure that those who have side effects and develop other sickness are referred to hospital.  This is particularly important because we have seen clients become resistant to treatment and develop other diseases which need to be treated immediately to prevent complications.
When people come to the clinic or to collect their medication we make sure we give health education on different topics, we have found this to be very effective and our clients are happy to participate.

HCT (HIV counselling and testing) and adherence training
It is so good for us to see that there are more people who come for testing especially males as they have been a reluctant group in the past.  Even if they test positive we are seeing a change in attitude where they take their status more seriously, listen to our advice and ensure they start on treatment.
It is not good that people are still living lives that expose them to the risk of HIV but if they do choose to risk exposure we are thankful at least that they choose to take action to know their status.
We also do patient literacy, this is a workshop attended by all clients who have tested positive and is compulsory before they start on ARV treatment. The purpose of the workshop is to help clients understand the importance of adherence to the treatment and to be aware of minor and major side effects. It also helps them to know the danger of not taking treatment properly or defaulting. We make sure that we do further adherence training with those who have defaulted the treatment and try to identify the reason for their default..

This year in March, we had a male client who came in having had half of his foot amputated. The wound was so bad and smelly that it was the first time for both of us to see something as bad as that.  The good news, though, is that with regular cleaning and dressing changes the wound completely healed and the client is so very happy.
Whilst doing home visits around the township we came across another client who is diabetic, she had very bad sores (ulcers) on her left leg. She had been advised that she may need an amputation but she decided to stay at home until we were able to visit here. Again with regular cleaning and dressing changers the healing is going very well.  There are so many other dressings we are doing and we are so proud that they we have been able to help so many people.
For most people a trip to Emmaus Hospital is expensive, impractical and can involve very long waiting times.  That is why so many people after surgery or treatment fail to return for dressing changes.  We are always happy to help with these cases as we have seen so many times the importance of keeping wounds clean so they can heal properly and not cause further infections.

Home Visits
We spend at least four days each week conducting home visits to our clients.  They may be people who are just starting treatment, those who are very sick or some who are disabled.  For us it is so good that we have a lot of time to see our clients and to spend time with them, not just dealing with the medical condition but talking with them, praying with them and sharing the word of God with them.

Every time we see a client we pray to God for His mercy because we cannot do this work on our own.  It is only possible because He is our pillar of strength. Without God, there is no way to do anything.

Ncami : Don’t wear a mask, just be yourself.
Sindy : God is the light, lets share it with those who need it.


Issues with Birth Certificates and ID books

A case was reported to me where children were not going to school because they didn’t have birth certificates, they were staying at home doing nothing whilst other children went to school.  I went to the school and talked with the principal to see if he could help, the children are now at school just like all the other children and their mother is so happy she was singing the praises of Isibani and said that Isibani really did bring the light to their situation.

Sometimes we come across families with missing birth certificates or ID books, this does cause challenges when they want to enroll in school or later in life when they want to find a job.  It is possible to obtain these documents but can mean a few trips to home affairs.  Isibani are able to help by letting our clients know exactly what documents they should take, this saves a lot of wasted trips.

Helping with food parcels and other challenges
Part of my role at Isibani is to help with delivery of food parcels, we deliver to a few farms around the Winterton area feeding those who can’t feed themselves.  Often when visiting with a food parcel we come across other challenges in the household.  We recently found a young mum who has 4 children, she is an orphan and has no ID book.  Without an ID book she cannot claim social grants for her children, she does not have a birth certificate herself and with both parents deceased it becomes more difficult for her to get an ID.
We were able to assist by taking her and her aunt to home affairs where they were interviewed,  the young mum and the aunt are interviewed separately about their family structure and then the answers compared to ensure they were telling the truth and the identity of the young mum can then be confirmed.  After the interviews are successfully completed the ID application can be made.  She is now waiting for her ID book to be issued.
She was very happy to have received help as she has suffered for a long time without an ID book.

We are able to help lots of people with ID books and birth certificates, mostly this just involves giving them information about the process but in some cases we assist further by offering transport assistance and we also follow up on the progress of the application.  This is necessary in extreme cases of poverty or for our disabled or vulnerable clients.

Feeding at the primary school
We have recently started a feeding programme at our local primary school, Celimfundo.  The department of education provides one cooked meal to all children attending school but we know that for some children this may be the only decent meal they have each day.  We are now working with the school and providing a further meal to children as they leave school.  More than this, by being present at the school and meeting the children, we see those who clearly have other social problems, in these cases we can accompany the child home, meet the family and see if there are further areas where we can offer help.
The community are very grateful for the support we are offering with food for their children.
We also deliver meals to people who have health problems and are struggling to look after and feed themselves.  We pre-cook these meals and deliver them to our clients who then just need to warm them up at mealtimes.  Reaching out to these clients is an important part of our work, they need to take their medication with food and when they have no food they tend to default on their medication creating further health problems.  We are able to assist these clients until they get back on their feet.

From Thandi

Social Case Reports from Xoli

Aside from our residential facility, Isiphephelo place of safety, we also have an outreach programme which we call Isiphephelo Outreach.  We work with our local community in their own homes and on the streets coming across many wide ranging social issues.
Here is an update on a few cases that our auxiliary social workers have been dealing with recently:

Absenteeism from School
Three girls staying in our local township, Khethani, were reported to us as they were not attending school  (2 siblings and their friend). They were counselled about the importance of school and the advantages of attending school and they eventually agreed to return.
It was identified that the friend had run from her foster mother in Bergville -Oliviershoek and had been staying with the 2 girls in Khetani.  In a situation like this where a child has run away it is important that proper procedures are followed so we reported the case to the local social worker who was able to conduct her own investigation.  After meeting with the girl and the foster mum the social worker was able to return the child home and she is now back in Oliviershoek and attending a new school.
One of the siblings decided to leave Khetani and moved to Loskop to attend school there,  she since returned to Khetani but is not attending school,  again the case was referred to the local social worker.

The other sibling is back and school but came to the office to complain about her sister hiding her school uniform and books meaning she had missed 5 days of school,  she told us she wanted to leave school now and go to live with her Aunt.  We counselled her again and she agreed to return to school.  The school principal asked for a meeting which went well and the child is now back in school and we have regular follow up sessions with her to monitor her progress.
Unfortunately absence from school and moving from one home to another is not uncommon.  Children grow up with so little stability in their lives.  We intervene where we can and offer counselling, support and advice.

More challenges with schooling
A family from Lesotho came to our office to explain their children were attending school some distance away and they could no longer afford the taxi money so their children were being forced to drop out of school.
We were able to talk to the principals of both their existing school and the local school in Khetani and it was agreed that the children should be transferred to the school closer to home.  The parents were very happy and thankful.
Often community members don’t feel able to tackle situations like this alone.  A huge part of our work is to advocate for the best interests of our clients.  We are thankful that community members feel they are able to share their problems with us and we are then able to work together to find a solution.

Behavioural Problems
A mother came to us for advice regarding her son,  she had taken new children into her home and her own son had started “behaving strangely”, he was jealous, angry and didn’t want to help out with chores.
We attended the home and met with the family to conduct counselling and suggested a few practical things to help them resolve conflict.
The mother returned to our office to say her son is so amazing, he has drawn a roster and each child takes a share of duties, we were delighted to hear about his progress and the mother was also happy that we could talk with her children.
Staff and volunteers at Isiphephelo come from far and wide, we have local Zulu volunteers as well as volunteers from England, Australia, Germany, Belgium, USA etc, some permanent and some just visiting   We are privileged to be able to attend training courses dealing with child behaviour and often have volunteers running sessions for us in these areas.  It is great when we are able to put some of the theory into practice and to see the amazing changes that can be made in a household.

Visits to ex Place of Safety Children
We visited some children who had previously lived with us at the place of safety, we wanted to check how they were doing and we gave them some clothes, they were very happy to see that they are still being recognised and loved by us.
One child, a girl of 16 years is still receiving counselling, she was the victim of a recent sexual assault by a family member.  A medical report was done and a police case opened.  The family on perpetrator’s side wanted to have negotiations with the victim’s family in order that a settlement could be reached and the case would be withdrawn but the family of the victim refused.
Negotiations and subsequent compensation are a very common way of settling abuse cases in this area so it was very encouraging to us that the victim’s family showed support to the girl and wanted to pursue the proper course of law.

Long term client
It is always good to hear success stories from our long term clients, we have known and assisted one particular lady for around 7 years now, after many years of only getting casual jobs she has secured a full time job as a domestic worker with a family in Emmaus.  For years she has been struggling financially and searching for jobs and she has finally found something.  She moved her two youngest children leaving an older sister with neighbours in Khethani, we will monitor this child to ensure she has sufficient food, is taking her medication correctly and is generally well and cared for.  The client was very happy that every month she will receive the sum of R800-00 and she will be able to save some from this money and make her children happy.
It is not uncommon for guardians to leave their children to go off to find work.  Because this lady is from Lesotho she does not have a South African ID book and getting work is therefore so much more difficult,  as long as we have known her she has worked in the fields doing whatever casual work she could find.  She has survived various health challenges and poverty through sheer determination, the goodwill of neighbours and assistance with food parcels.  We are delighted she has now found work.

Home Visits
We have continued to conduct home visits in and around Khetani meeting with clients who needed help with their health, family unification and also for counselling sessions to the victims of rape. We were happy to have a LifeLine facilitator visiting for the second time and offering monitoring and coaching for us specific to the cases we are dealing with.  She helps with any challenges we have and will visit us again soon.
We are blessed to be able to work with and partner with other organisations such as LifeLine to work together to serve the community.  LifeLine focus on counselling around sexual abuse and we have learnt a lot from them.

Counselling Sessions
Last week we were called in a nearby school to offer counselling to three girls children who are the victims of rape and sexual abuse.  The children talked freely during our counselling sessions and the counselling will be conducted weekly with these children for as long as they want or need it.
Whilst we are grateful that schools contact us to deal with situations such as this it is always heartbreaking to discover more cases of abuse.    We are thankful for our team of staff and volunteers who give their time and love so freely to reach out to others.
Isiphephelo outreach is an important part of our work and these are just a few stories and updates from our recent cases.
Please keep the people mentioned here and our community at large in your prayers.

From Xoli