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Mozambique

Articles by Mozambique

Palmira Enoque Tembe, Mozambique,

“I’m fine and I am making plans for the future. I know now to get ill is not to die”

Palmira Enoque Tembe, 54, is HIV positive She lives with two sons, who are also HIV positive, and four grandchildren in a small house in Bairro Feiroviaro on the outskirts of Maputo. Three times a week she is visited by Amodefa volunteers and once a week by a nurse who provide medication, food and therapy to the family. “Amodefa counsels me through the difficulties in life,” Palmira says. Palmira found out she had HIV when her youngest child was nine months old. He was diagnosed as HIV positive. Palmira asked her husband to get tested too,“He refused” says Palmira. “He said I was possessed by evil spirits and was trying to kill him and my son". Her husband abandoned the family and Palmira was left to battle the illness and raise the children on her own. “I was terrified. I lost hope. I didn’t want to do anything, just sit in my room and cry,” she says. Now, however, the nutritious food, medication and regular medical check-ups she receives as part of the homecare programme have given her a new lease on life. “I’m fine and I am making plans for the future. I know now to get ill is not to die,” says Palmira, who has started to subsistence farm again. At first she was wary of the service. “It seemed like an advertisement for having HIV and I didn’t want my neighbours to isolate me,” she says. “But now I depend on it.” It was through Amodefa’s new pilot counselling project, ‘Ntyiso’ - which translates as ‘The Truth’ in the local language, Shangaan - Palmira was finally able to open up to her son that he had HIV too. While he had always suspected he was carrying the virus, he needed to hear it from his mother for it to become real.“It has changed by life,” she says. “It has improved our relationship because I no longer feel ashamed.” The Ntiyso is a pilot project implemented in Maputo City and it has its focus on disclosure of the HIV + status to adolescents. It targets mothers, parents and caregivers of adolescents. The main activities are: Education and training of Mothers, Parents and caregivers of adolescents to reveal HIV+ status to their adolescents. Due to the Global Gag Rule this project lost its funding and was forced to close. Read more about AMODEFA's tireless work in Mozambique

農村で行われるHIV検査
06 December 2017

The Global Gag Rule (GGR) cuts deep into sexual and reproductive healthcare in Mozambique

“They call us ‘Muhanyisse’”, says Albertina Machaieie, a nurse working with Amodefa, the Mozambican Association for Family Development. It means saviour in the local language, Shangaan. For 19 years, Machaieie and her team of activists – volunteers who are HIV positive – have been visiting communities in the poorest suburbs of Maputo, bringing healthcare to those with HIV and raising awareness about the disease. This year they provided medical check-ups, treatment, food and counselling to more than a thousand families living with the virus. But the continuation of the home care programme and other vital health services Amodefa offers in Mozambique are under threat following the reintroduction of the Global Gag Rule. The Global Gag Rule, or Mexico City Policy as it is formally known, stops US aid to all health programmes run by organisations who perform or counsel on abortion. The decision, which will deprive Amodefa of $2 million, 60% of its budget, will have devastating consequences for the fight against HIV in Mozambique, where an estimated 12% of the country’s nearly 30 million population are living with the virus. “We estimate half million people across their HIV, tuberculosis, malaria and family planning projects will be affected,” says Santos Simione, the executive director of Amodefa.   Albertina’s team of 60 volunteers has already had to be halved. She says some of her volunteers will continue to visit families, but without funds to cover transport many patients will no longer receive the treatment or counselling they need. For women like Palmira Enoque Tembe, who lives with her two sons who are also HIV positive, and four grandchildren, stopping these visits would sever a vital lifeline. Tembe says she was terrified when she found out she had HIV: “I didn’t want to do anything, just sit in my room and cry.” But the anti-retroviral therapy and counselling Amodefa provides have given her a new lease on life. She is well enough to start subsistence farming again, “and I am making plans for the future. I know now to get ill is not to die,” she says. By the end of October, 14 of Amodefa’s 20 sexual and reproductive health clinics across three provinces in southern Mozambique will also have to close. Nurses at the clinics see around 300 patients a day, mostly girls seeking family planning advice, but also people looking for testing and counselling for HIV and other STDs. “Outside of these service centres young people have little to no access to this information,” says Nalia Chambal, the head of the Tua Cena programme, which is operated through these clinics. “[With the closures] we’ll see a rise in unwanted pregnancies, early child marriage, HIV and STD transmission,” she says – which will mean more girls will drop out of school, and there will be more unsafe abortions. Amodefa works closely with the Ministry of Health to ensure the family planning services it offers, as with its HIV, tuberculosis and malaria programmes, complement and support the government’s own health services. “When we stop, there will be a huge pressure on government facilities,” says Simione. “It will tough on all the country.” But it will be the poorest and most vulnerable that will be most affected, such as those living in rural Nampula, one of Mozambique’s largest and most impoverished provinces, where Amodefa’s ChallengeTB programme is under threat. The programme, which has been running just over a year, identifies and treats patients with tuberculosis, some living more than 80 km from the nearest health centres. As the team of volunteers and staff on bicycles and motorbikes bring awareness and testing to ever-more remote communities, the true scope of the disease is beginning to be understood. In the first quarter of this year, 1,318 people were tested for TB in the eight districts where Amodefa works; in the second quarter, 2,106 were tested; and in the third quarter, the number reached 3,154. More than half of these people were diagnosed to be carrying TB. “We’ve done a lot but there’s a lot more to do,” says Maria Teresa de Fátima, head of monitoring and evaluation for the project. She expects the number of cases will continue to rise over the next two years, before they start to drop off. Particularly at risk are the roughly 2,000 patients currently taking medication. TB treatment must be taken daily for six months, and those who stop because they can no longer access healthcare may develop a multi-resistant form of the virus which is much harder to treat. Mario Vilanque, a volunteer working with communities in Naha in Morrupula district, where 5 new people have just started treatment, said his patients, are “very confident” in Amodefa; “They have seen 10 people cured – now they have great faith.” It wasn’t always this way. When Machaieie started the HIV homecare programme in Maputo, she had to hide her car and go into communities anonymously. “People feared HIV so they feared me coming to them,” she says. It has taken 19 years to change attitudes and break taboos in Mozambique. Now, just as hope is overcoming this fear, global gag rule threatens to force the work of Amodefa and the lives of its patients back into the shadows.

Associação Moçambicana para Desenvolvimento da Família

The Mozambican Association for Family Development (AMODEFA) was formed in 1989. Like most IPPF Member Associations, the initial focus of the organization was family planning, but over the years it has diversified to cover a broader range of sexual and reproductive health (SRH) requirements, including emergency obstetric care, pre- and post-natal care, and services dedicated to the prevention, treatment and management of HIV and AIDS. 

As the high HIV prevalence rates demonstrate, there is a desperate need for sustained efforts on this front. AMODEFA has responded to the challenges of HIV and AIDS with a community-based, clinic-based approach linked to home-based care. With private sector sites, mobile and community-based service points, the Member Association raises awareness and combats HIV and AIDS stigma and discrimination, and provides referrals. AMODEFA uses the HIV, Gender and Sexuality link through comprehensive sex education in schools and outside schools to drive HIV prevention. 

AMODEFA staff, is supported by hundreds of volunteers, a youth action movement, peer educators and community-based distributors (CBDs). 

In its advocacy role, AMODEFA has provided advice and influenced the Ministry of Health, Ministry of Education and Human Development, Ministry of Gender, Children and Social Action, Ministry of Justice, Secretary for Youth and Employment and Parliament to adopt supportive national legislation and practices, particularly with regard to adolescents and youth. 

The Member Association works with governmental and non-governmental organisations, such as the National HIV and AIDS Council, PLASOC, the Network for Sexual and Reproductive Rights and with private sector such as ECOSIDA. 

AMODEFA's donors include UNFPA, OIM, Global Fund, AFRIKAGRUPPERNA, DIAKONIA and JFT. The Organization is a member of PLASOC - Platform of Civil Society Organizations for Health, RDSR - Sexual and Reproductive Rights Network, CECAP - Coalition for the Elimination of Premature Unions. 

cover page
24 July 2014

“Stigma is still my most serious challenge”

This publication shares the experiences of people living with HIV. Men and women from Ethiopia, Mozambique and Swaziland talk about HIV-related stigma and describe their courage, inspirations, suffering, resilience and determination to trigger change. Their stories demonstrate how stigma and discrimination can hinder access to vital support and care and the prevention, testing and treatment of HIV. National and international organizations working on HIV-related issues have an immense responsibility towards people living with HIV, to change the unjust reality revealed by these personal stories into a better one. We must increase our efforts towards ensuring everyone enjoys a dignified, stigma-free life – one where every human being is valued and free of discrimination.

Palmira Enoque Tembe, Mozambique,

“I’m fine and I am making plans for the future. I know now to get ill is not to die”

Palmira Enoque Tembe, 54, is HIV positive She lives with two sons, who are also HIV positive, and four grandchildren in a small house in Bairro Feiroviaro on the outskirts of Maputo. Three times a week she is visited by Amodefa volunteers and once a week by a nurse who provide medication, food and therapy to the family. “Amodefa counsels me through the difficulties in life,” Palmira says. Palmira found out she had HIV when her youngest child was nine months old. He was diagnosed as HIV positive. Palmira asked her husband to get tested too,“He refused” says Palmira. “He said I was possessed by evil spirits and was trying to kill him and my son". Her husband abandoned the family and Palmira was left to battle the illness and raise the children on her own. “I was terrified. I lost hope. I didn’t want to do anything, just sit in my room and cry,” she says. Now, however, the nutritious food, medication and regular medical check-ups she receives as part of the homecare programme have given her a new lease on life. “I’m fine and I am making plans for the future. I know now to get ill is not to die,” says Palmira, who has started to subsistence farm again. At first she was wary of the service. “It seemed like an advertisement for having HIV and I didn’t want my neighbours to isolate me,” she says. “But now I depend on it.” It was through Amodefa’s new pilot counselling project, ‘Ntyiso’ - which translates as ‘The Truth’ in the local language, Shangaan - Palmira was finally able to open up to her son that he had HIV too. While he had always suspected he was carrying the virus, he needed to hear it from his mother for it to become real.“It has changed by life,” she says. “It has improved our relationship because I no longer feel ashamed.” The Ntiyso is a pilot project implemented in Maputo City and it has its focus on disclosure of the HIV + status to adolescents. It targets mothers, parents and caregivers of adolescents. The main activities are: Education and training of Mothers, Parents and caregivers of adolescents to reveal HIV+ status to their adolescents. Due to the Global Gag Rule this project lost its funding and was forced to close. Read more about AMODEFA's tireless work in Mozambique

農村で行われるHIV検査
06 December 2017

The Global Gag Rule (GGR) cuts deep into sexual and reproductive healthcare in Mozambique

“They call us ‘Muhanyisse’”, says Albertina Machaieie, a nurse working with Amodefa, the Mozambican Association for Family Development. It means saviour in the local language, Shangaan. For 19 years, Machaieie and her team of activists – volunteers who are HIV positive – have been visiting communities in the poorest suburbs of Maputo, bringing healthcare to those with HIV and raising awareness about the disease. This year they provided medical check-ups, treatment, food and counselling to more than a thousand families living with the virus. But the continuation of the home care programme and other vital health services Amodefa offers in Mozambique are under threat following the reintroduction of the Global Gag Rule. The Global Gag Rule, or Mexico City Policy as it is formally known, stops US aid to all health programmes run by organisations who perform or counsel on abortion. The decision, which will deprive Amodefa of $2 million, 60% of its budget, will have devastating consequences for the fight against HIV in Mozambique, where an estimated 12% of the country’s nearly 30 million population are living with the virus. “We estimate half million people across their HIV, tuberculosis, malaria and family planning projects will be affected,” says Santos Simione, the executive director of Amodefa.   Albertina’s team of 60 volunteers has already had to be halved. She says some of her volunteers will continue to visit families, but without funds to cover transport many patients will no longer receive the treatment or counselling they need. For women like Palmira Enoque Tembe, who lives with her two sons who are also HIV positive, and four grandchildren, stopping these visits would sever a vital lifeline. Tembe says she was terrified when she found out she had HIV: “I didn’t want to do anything, just sit in my room and cry.” But the anti-retroviral therapy and counselling Amodefa provides have given her a new lease on life. She is well enough to start subsistence farming again, “and I am making plans for the future. I know now to get ill is not to die,” she says. By the end of October, 14 of Amodefa’s 20 sexual and reproductive health clinics across three provinces in southern Mozambique will also have to close. Nurses at the clinics see around 300 patients a day, mostly girls seeking family planning advice, but also people looking for testing and counselling for HIV and other STDs. “Outside of these service centres young people have little to no access to this information,” says Nalia Chambal, the head of the Tua Cena programme, which is operated through these clinics. “[With the closures] we’ll see a rise in unwanted pregnancies, early child marriage, HIV and STD transmission,” she says – which will mean more girls will drop out of school, and there will be more unsafe abortions. Amodefa works closely with the Ministry of Health to ensure the family planning services it offers, as with its HIV, tuberculosis and malaria programmes, complement and support the government’s own health services. “When we stop, there will be a huge pressure on government facilities,” says Simione. “It will tough on all the country.” But it will be the poorest and most vulnerable that will be most affected, such as those living in rural Nampula, one of Mozambique’s largest and most impoverished provinces, where Amodefa’s ChallengeTB programme is under threat. The programme, which has been running just over a year, identifies and treats patients with tuberculosis, some living more than 80 km from the nearest health centres. As the team of volunteers and staff on bicycles and motorbikes bring awareness and testing to ever-more remote communities, the true scope of the disease is beginning to be understood. In the first quarter of this year, 1,318 people were tested for TB in the eight districts where Amodefa works; in the second quarter, 2,106 were tested; and in the third quarter, the number reached 3,154. More than half of these people were diagnosed to be carrying TB. “We’ve done a lot but there’s a lot more to do,” says Maria Teresa de Fátima, head of monitoring and evaluation for the project. She expects the number of cases will continue to rise over the next two years, before they start to drop off. Particularly at risk are the roughly 2,000 patients currently taking medication. TB treatment must be taken daily for six months, and those who stop because they can no longer access healthcare may develop a multi-resistant form of the virus which is much harder to treat. Mario Vilanque, a volunteer working with communities in Naha in Morrupula district, where 5 new people have just started treatment, said his patients, are “very confident” in Amodefa; “They have seen 10 people cured – now they have great faith.” It wasn’t always this way. When Machaieie started the HIV homecare programme in Maputo, she had to hide her car and go into communities anonymously. “People feared HIV so they feared me coming to them,” she says. It has taken 19 years to change attitudes and break taboos in Mozambique. Now, just as hope is overcoming this fear, global gag rule threatens to force the work of Amodefa and the lives of its patients back into the shadows.

Associação Moçambicana para Desenvolvimento da Família

The Mozambican Association for Family Development (AMODEFA) was formed in 1989. Like most IPPF Member Associations, the initial focus of the organization was family planning, but over the years it has diversified to cover a broader range of sexual and reproductive health (SRH) requirements, including emergency obstetric care, pre- and post-natal care, and services dedicated to the prevention, treatment and management of HIV and AIDS. 

As the high HIV prevalence rates demonstrate, there is a desperate need for sustained efforts on this front. AMODEFA has responded to the challenges of HIV and AIDS with a community-based, clinic-based approach linked to home-based care. With private sector sites, mobile and community-based service points, the Member Association raises awareness and combats HIV and AIDS stigma and discrimination, and provides referrals. AMODEFA uses the HIV, Gender and Sexuality link through comprehensive sex education in schools and outside schools to drive HIV prevention. 

AMODEFA staff, is supported by hundreds of volunteers, a youth action movement, peer educators and community-based distributors (CBDs). 

In its advocacy role, AMODEFA has provided advice and influenced the Ministry of Health, Ministry of Education and Human Development, Ministry of Gender, Children and Social Action, Ministry of Justice, Secretary for Youth and Employment and Parliament to adopt supportive national legislation and practices, particularly with regard to adolescents and youth. 

The Member Association works with governmental and non-governmental organisations, such as the National HIV and AIDS Council, PLASOC, the Network for Sexual and Reproductive Rights and with private sector such as ECOSIDA. 

AMODEFA's donors include UNFPA, OIM, Global Fund, AFRIKAGRUPPERNA, DIAKONIA and JFT. The Organization is a member of PLASOC - Platform of Civil Society Organizations for Health, RDSR - Sexual and Reproductive Rights Network, CECAP - Coalition for the Elimination of Premature Unions. 

cover page
24 July 2014

“Stigma is still my most serious challenge”

This publication shares the experiences of people living with HIV. Men and women from Ethiopia, Mozambique and Swaziland talk about HIV-related stigma and describe their courage, inspirations, suffering, resilience and determination to trigger change. Their stories demonstrate how stigma and discrimination can hinder access to vital support and care and the prevention, testing and treatment of HIV. National and international organizations working on HIV-related issues have an immense responsibility towards people living with HIV, to change the unjust reality revealed by these personal stories into a better one. We must increase our efforts towards ensuring everyone enjoys a dignified, stigma-free life – one where every human being is valued and free of discrimination.