Little amount, huge impact

By Mark

On of my side jobs is assisting four primary schools with stationery. Kids that cannot afford exercise books and pens receive these via the support programme. So far I hadn't managed to do any 'impact asssessment study' and I simply assumed there would be some effect. So I was sincerely surprised to receive the letter below from one of the benefiting schools. Incredible that a $5 per child per year can has such an impact.

Oh, for primacy schools, the national average pass rate is just 22%. And for poor rural schools like these, that is likely to be even around 14%. So they are really doing well.

How do we help the sick and the poor best?

By Mark
The RCZ Health Department that I work for consists of five rural clinics, two hospitals and a specialised Eye Unit. These institutions are situated in a rural setting and the catchment area consists mainly of people who are struggling to feed their families. Morgenster, also because of its proximity to Masvingo, is attracting people from Masvingo town, of which many are better off.

At clinics currently no fees are charged.

The hospitals strive to assist all visiting patients, and each patient is encouraged to pay the fair drug and consultation fees. Quite a few patient groups, however are (by GoZ regulations) exempted from paying consultation fees. Those that are supposed to pay fees are struggling. For some patients the Poof People Fund is covering the cost of treatment, but this is limited to $500 per month. As a result, the hospitals every month incur a loss of about $5000 (any realistic estimate available?) for invoices not paid.

Morgenster has a monthly income of about $23,000 and Gutu about $15,000 which is not sufficient for a proper running of both institutions. Consequently both hospitals fail to replace obsolete equipment and maintain it properly. Houses and wards are hardly maintained, gutters have corroded away and stocks have not been as planned.

The hospitals have not been able to develop any plans to improve this situation and the Health Services and Community Development Board and the Health Manager have not been able to offer quick solutions. If the Health Department wants to shake of the last bits of its donor dependency syndrome, approaching foreign partners might not be the best way. On top of that, it has become harder and harder to get such funding and worldwide economic conditions have not been good.

Raising more funds within Zimbabwe seems to be a more sustainable approach. Various options exists; Government of Zimbabwe, who used to give grants, drugs and salaries, is a very logical partner, but has only decreased its support to (mission) institutions. Through schemes like RBF and HTF some funding has come, but in much lower levels than a decade ago.

Generating more income via current patients is a very difficult approach. First of all, the health services are offered as part of a missional vision and is focused on the marginalized, the poor. Accessibility is very important. Knowing that current patients are often not able to pay for services excludes the option of increasing prices or use debt collectors. A second path is increasing the number of services to current customers who are able to pay. Morgenster increased its lab services, both hospitals have started accepting medical aid schemes and are now doing some more small surgical procedures in their theatres. Improving services is considered a viable way.

Attracting more clients with current and new services is another mode that has been proposed by the Board. Gutu has established a private ward and Morgenster and the Eye Unit have been pushed to do the same. It has to be observed that this is not in line with the Health Department focus on vulnerable groups and poor people, but can be explained as means to an end. The challenge is that strategy requires financial and human resources, which are not available. Taking these out of the current operational setting is negatively affecting the service delivery to the poor. A risk is also that one might forget the original reason to start private care services and will see this as a core business in itself.

Besides increasing revenue, any organisation should always strive to reduce cost and improve efficiency. Given the fact that no cost reduction exercises have been done in the last decade, it is very likely that the organisation can still reduce significant cost by improving the way business is done.

Now what should be the focus of the Church of the institutions be? Should limited (human) resources be spend on cost reduction, income generation, networking to get more funding partners or improving services to the target population (the poor and vulnerable) without knowing where the means to do provide these services will come from?

As a manager, sent as a missionary to a partner church organisation in a Sub-Saharan setting, this is the challenge I face. Should I join an evangelism outreach team where I will be confronted with abject poverty and evident physical, social, and spiritual needs? This would likely be the perfect time and place to assess how the Church’s Health ministry can assist in its ministry.

Yet the business manager in me will be worried that we will decide to start building a clinic, 650  kilometers from head office, a nightmare of a project to embark on, especially as the communities should really be supporting this project and taking ownership. This will be difficult if the Church would also like to plant its flag, logo etc on it and proudly call it ‘our mission clinic’.

Article in Commission for Witness

Winter

Door: Annemarie

Fijn dat het in Nederland warmer wordt, hier dus niet: met twee truien aan en een muts op achter de computer; thee drinken om warm te blijven; winterjas ipv witte jas aan tijdens visite lopen.

Lennard breng ik lekker ingepakt naar de creche, om hem vervolgens ook weer lekker ingepakt op te halen. In Nederland is er de bij-de-deur-ceremonie van alles aan- en uittrekken. Hier niet. 'Lekker makkelijk' volgens Lennard. Ook praktisch; binnen is het ten slotte even koud als buiten, dus waarom zou je je jas uittrekken als je gaat spelen en slapen? Hij had het in ieder geval niet koud met zijn trui en jas aan onder een dikke deken. Alleen zijn pet hadden ze afgezet. Wel grappig hoor, onze oudste peuter de hele dag met een pet achterstevoren op zijn hoofd.

Jasper houdt niet van een hoofddeksel. Zijn oplossing: snel in de luieremmer gooien als mama even niet kijkt. Inderdaad, heel effectief. Gelukkig valt zijn haar ruim over zijn oren, dus toch nog warme oren.

7 million have no access to hospitals: Biti

Source: http://www.newzimbabwe.com/

10/06/2013
by Staff Reporter

HALF Zimbabwe’s population of 13 million people is not using conventional medicine due to poverty, according to Finance Minister Tendai Biti.
As a result, thousands of Zimbabweans are dying needlessly every year as they seek help from traditional healers and self-styled prophets.

Biti, speaking during the launch of the Poverty Income Consumption and Expenditure Survey Report last Thursday, said the government had to review its expenditure to increase health services access for the poor.

He said: “Half of the country’s population is not using modern health services and facilities, varikuenda kumapostori nen’anga, the marabous and the igwes.

“It’s frightening that after 33 years of independence, 50% of the population does not have access to modern health facilities.”

President Robert Mugabe and Prime Minister Morgan Tsvangirai last year spent US$45.5 million on foreign travel, accounting for 1.2 percent of total public expenditure.

Biti says the government should urgently cut non-essential expenditure – including foreign travel for government officials – and redirect resources to the health sector.

Zimbabwean 'taken to village court for failing to give husband best chicken pieces'

A Zimbabwean man assaulted his wife and dragged her to a village court last week where she was found guilty of disobeying custom by failing to give him the juiciest pieces of chicken.

By Peta Thornycroft in Johannesburg 2:48PM BST 15 Oct 2012

Nomusa Sibanda, 24, gave her husband the gizzard, wings and one drumstick and ate the chicken breast and second drumstick herself, according to local newspaper, The Sunday News.

Jabulani Ncube, 40 was incensed and beat up his wife who fled to her grandmother's house.

The next day, he forced her to attend the village court where he complained to the traditional leaders in the Nkayi Communal Land, 100 miles north east of Zimbabwe's second city Bulawayo, that his wife was "uncultured and disrespectful".

He warned that he would seek a divorce if she again failed to give him the drumsticks and breast which in traditional culture are due to the man of the house.

Mrs Sibanda was unrepentant and told the court: "How long shall I slaughter chickens and not taste the back portion?"

She was found guilty of ignoring custom and fined a chicken, as was her grandmother Gogo MaDawu for failing to teach her granddaughter "how to treat her husband and dish out meals". 

source: http://www.telegraph.co.uk

A nice summary of How Zimbabwe is for travelers at the moment

From: http://www.zimbabwesituation.com/aug13_2012.html#Z14
By Ross Borden On August 6, 2012 ·

On an 8-day trip to Zimbabwe, Matador co-founder Ross Borden saw a country still trying to find its feet after a disastrous decade, but far from the crisis portrayed in the media.

WHEN I WAS ASKED TO SPEAK at the 37th World Congress of the African Travel Association, hosted this year in Victoria Falls, Zimbabwe, the preconceptions I had about the country began to run wildly through my mind. Here are a few that I was dead wrong about, and one that I wasn’t.

1. Zimbabwe is dangerous.

According to multiple people I met who live there and work in the tourism and safari industries, if you want to go to Zimbabwe, the best months for both adventure and wildlife are September, October, and November.

At Matador, we believe most travel advisories and American perceptions of overseas destinations being ‘dangerous’ are way overblown. I enjoy visiting places that some consider dangerous, so I was interested to see how Zimbabwe stacked up to others that struggle with this stigma — Brazil, Colombia, Iran.
The big cities are where most violent crime is concentrated. It wasn’t a surprise then that Victoria Falls, as well as the couple national parks we visited, felt just about as safe and friendly as a place can get. In fact, Vic Falls has such a small town feel that other journalists joked it had the vibe of a US National Park in the off-season.

2. Zimbabwe’s wildlife has all been wiped out.This was a big one for me since I love seeing wildlife, and it was my strongest misconception going in. I’d read well-documented reporting that, following the fast-track land reform program Robert Mugabe instituted in 2000 targeting political opponents and white farmers, many of the well-protected wild areas and national parks had fallen victim to unchecked poaching, and that much of the country’s wildlife had been completely wiped out.
I was relieved to see troops of baboons and packs of warthogs trotting along the road from the airport after we flew in, but nothing could prepare me for getting woken out of a dead sleep at 3am on the first night in Victoria Falls, to the sound of four bull elephants destroying trees outside my hotel room at the A’Zambezi River Lodge. This herd of wild elephants wandered right into the garden of our hotel to gorge on all the tasty things planted there. The hotel manager wasn’t pleased the following day, but I was beyond stoked to spend over an hour that night following them (very cautiously) around the grounds and watching them destroy the hotel’s landscaping.
Keep in mind this encounter wasn’t even inside a nature reserve — once we made our way to protected areas like Hwange National Park, the numbers of elephants we saw increased dramatically, and we also spotted lions, hippo, water buffalo, hyena, kudu, zebra, and water buck. I was thrilled with the amount of wildlife we were able to see in a short period of time, and after speaking with different naturalists we ran into, it seems like the wildlife in most places is on the road to a full recovery.

3. Hyperinflation will make buying things a total hassle.After seeing years of news coverage on the hyperinflation of Zimbabwe currency, I was expecting that money would be a pain in the ass and I’d have to carry around bricks of 10 billion dollar notes to buy a beer or some lunch.
But the currency of Zimbabwe has become so worthless they’ve retired it completely, and the country now operates on a mix of foreign currencies, including the South African rand, the GBP, the euro, and most commonly the US dollar. It’s difficult to assess how this transition has affected prices for ordinary Zimbabweans, and although some things are more expensive now, it’s nice not having to do insane math to convert currency. There are a couple ATMs in Vic Falls, but I’d recommend bringing a decent amount of US dollars to get you started. The only Zim dollars you’re likely to see are those sold by kids in the street as novelty souvenirs. They got me…I paid $5US for a stack of worthless old Zim notes. I just had to own a real 10 trillion dollar bill.

4. Beyond the wildlife, there’s not much to see/do in Zimbabwe.If I were Zimbabwe, I’d brand my country as a destination for adventure travel in addition to safaris. Here are a few options that stand out:

• Rafting the Zambezi – Both above and below the 350ft-tall, 5,600ft-wide Victoria Falls, the Zambezi River flows through dozens of tight gorges that make for wild rapids. To get the best of the rafting season, make sure you go somewhere between August and December.
• Bungee jumping / Rope swinging / Zip-lining – All three of these activities can be done from the same place — the bridge spanning the gorge right below Vic Falls, which also marks the border with Zambia. My favorite was the rope swing, where you basically step off a 390ft bridge and “free fall” until you’re only about 30ft above the river and do a massive pendulum swing out across the gorge (way scarier than the bungee jump).
• Micro-lite flying over and around Victoria Falls – This can be done from the Zambia side of the gorge and is the best way to see Victoria Falls, even better than a helicopter, not only because it’s cheaper but because you can FEEL the falls in addition to seeing them.
• Fishing – If you’re into sport fishing there are some great day trips you can take up the Zambezi above Victoria Falls, with plenty of river monsters to be pulled out of the murky water up there.
• Swimming in Devil’s Pool – This is the one thing I was really hoping to do, but unfortunately the water was way too high to do it safely during our visit. What is Devil’s Pool? When most of the rainy season’s water has drained out of the jungle and passed over Victoria Falls, the water on the Zambia side of the gorge becomes low enough to hang out in a hot tub-sized swimming hole right on the edge of the plunge. The best time to do this is October to January.

5. Since tourism has been on the decline for years, Zimbabwe won’t have many high quality hotels and safari lodges. From the A’Zambezi River Lodge, where wildlife mills around the garden 24 hours/day, and the more upscale, colonial-style Victoria Falls Hotel (great for evening cocktails), to the over-the-top luxury of a tented safari in the bush at The Hide in Hwange National Park — you’ve got a wide range of high-end resort and hotel options.

6. Given the repressive regime of Mugabe, border crossings will be difficult and expensive.It always seems that the shadier a government is, the more difficult its country will be to pass in and out of — especially overland. I was pleasantly surprised to find how easy it was to cross the border to Zambia for the day and come back to Zimbabwe that afternoon.

When we did the bungee jump/rope swing off the bridge (the operation is technically in Zambia), we weren’t even required to buy a visa, and when we drove over the bridge later that week to spend a full day in Zambia, we were only in line for about 5 minutes at the crossing.

7. Robert Mugabe is still running a full-blown dictatorship.This is the one thing I had correct going in. It’s great to see a country recovering, but very sad and disheartening to see one that’s a shadow of its former self, where political opponents die in “fires” and “car accidents” on a regular basis, or just disappear altogether.
As a tourist, you’ll be far from the crosshairs of Mugabe’s henchmen. But I felt really bad for all the amazingly friendly Zimbabweans I ran into, who were either ignorant of Mugabe’s ways or too scared to talk about it openly. At the end of the day, it’s easy to feel conflicted. Part of me wanted nothing to do with a country run by such a government, and part wanted to enjoy this amazing country and not punish its citizens for the mistakes of its government by avoiding travel there. I’d encourage you to pick the latter and go enjoy Zimbabwe.