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IMPROVING PROGRAM MOBILITY

Project Narrative: Africycle would like to Thank the Tour d’Afrique for their ongoing and generous support of Africycle and our partner programs in Malawi. Together we have been able to mobilize programs that are delivering community services to isolated communities across Malawi. The bicycles is able to address a major issue involved in the delivery of programming; the mobility of volunteers and workers delivering programs and resources. In 2010 Africycle worked to help mobilize Canadian Physicians for Aid and Relief(CPAR), Partners in Health(PIH) and Emmanuel International(EI). CPAR is working to deliver Infant and Child Mortality Reduction Programming to over 57,000 households per month, PIH is improving outcomes for AIDS and TB treatment by improving monitoring and adherence practices and EI has established 698 savings programs which have generated almost $100,000USD to be redistributed within within isolated and remote communities in Malawi. The results of these programs provide great hope for overcoming the many struggles families face in a life of poverty. The bicycles have played a major role in improving the capacity and frequency of program delivery, maximizing the resources available and ensuring programming is reaching those in need, delivering the greatest impact possible. Project Summary:
Objective 1. Improve mobility of HIV and TB treatment and adherence programming Activities -Provided 20 Bicycles to Partners in Health HIV and Tuberculosis adherence and treatment workers Outcomes -Improved ability of service providers to increase frequency of visits and tests -Improved response times in emergency situations -Reduced travel time and costs -Over 2700 patients reached - Increased capacity of volunteers - Increased frequency of visits and programming to beneficiaries -Reduced travel time and costs -600 households/mth receiving programming on TDA bicycles - 32 Village agents, managing 8 groups each, totaling 256 groups and communities with access to financial assistance - Frequent group visits - Ability to quickly address problems and queries within groups

2. Improve mobility of Maternal Health programming

-Provided 20 bicycles to CPAR Infant and Child Mortality Reduction volunteers

3. Improve mobility of Village Savings and Loans programming

-Provided 32 bicycles to Emmanuel International Village Savings and Loan agents

The following are reports from each organization outlining the impact of their projects and how bicycles were able to assist them:

CPAR-INFANT AND CHILD MORTALITY REDUCTION PROGRAMME
SUMMARY REPORT ON PUSH BICYCLES DONATED TO CPAR BY AFRICYCLE
The Canadian Physicians for Aid and Relief (CPAR) Malawi is implementing a 3 year Accelerated Child Survival and Development project titled “Reducing the Mortality and Morbidity in Under Five Children and pregnant women in the Communities of Lilongwe District.” with funding from UNICEF. The project is being implemented in 9TAs: Kabudula, Khongoni, Kalumba, Kalolo, Malili, Njewa, Mbang’ombe, Chitukula and Khongoni (half of Lilongwe district) targeting over 4300 villages. The main objective of the project is to contribute to reductions in child mortality and maternal mortality in the 9 TAs of the Lilongwe District by among other things promoting the adoption of 17 family key care practices and proper nutrition practices by households, ensure children under the age of five years of age receive prompt treatment for common illnesses, children under the age of one are fully immunized , pregnant women received 4 focused Ante Natal Care sessions and that at least existing village clinics are functional, providing community case management services and regular feedback reports To achieve this, CPAR is employing the evidence-based IMCI approach to improve child survival and development in Lilongwe District. CPAR is working with the Ministry of Health, through Lilongwe District Health O!ce by involving Community Health sta" as well as trained community health volunteers in promoting the adoption of the good health and nutritional practices through door to door household visits and community meetings. CPAR has, from 2008 to October 2010, trained 1,920 community care-group volunteers from across the 9 TAs who are supporting the door to door visits and community campaigns. Each trained volunteer is supposed to make 30 household visits a months to di"erent households which results in these volunteers covering three to four villages hence requiring bicycles to ease their mobility. For the past three years CPAR has been receiving mountain bicycle donations from Africycle and so far 79 have been received and distributed to both Health sta"s (HSAs) and community volunteers. The last consignment of 20 bicycles was received in April 2010 and was distributed to volunteers from hard to reach areas in May 2010. These push bicycles have been assisting the volunteers a lot as a means of transport from one village to another in performing community health care activities. The donation has really assisted the Accelerated Child Survival and Development Project (ACSD) in speeding up the process of disseminating information concerning the adoption of the 17 family key care practices by family members as the volunteers who received the bikes are able to travel and visit the households on a regular basis contributing to the achievement of 57,600 household visits per month overall from all the trained 1,920 volunteers. There are both male and female

volunteers involved in the activities and both are considered to receive bicycles to ease their mobility.

Some volunteers from Chileka Health Area pose with their bicycles received from Africycle

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Through the volunteers, the bicycles are also being used to assist carrying patients that have been referred from a village clinic to the nearest health facilities to access health services because some of these volunteers are working together with Health Surveillance Assistance in running village clinics. In addition, village based awareness campaigns on Accelerated Child Survival and Development as well as Community Case Management are being conducted on a regular basis by the volunteers because they have transport and are able to travel to distant places. The beneficiaries of the project who are mostly pregnant women, caregivers of under 5 children, local leaders and other members of the community in most areas are testifying about the regular visits and information that they get from the volunteers which has also contributed to reduction in common childhood illnesses and deaths because people are receiving appropriate messages at the right time and in the right form from the volunteers on hygiene and sanitation. CPAR is very much grateful for the support it has received from Africycle but still requests continued support from the donors on more bicycles because there are still more volunteers and government health workers without bicycles. Due to huge demand for bicycles, CPAR ensured that volunteers from each TA have a share of these nice bicycles, see distribution details below:
Traditional Authority Kabudula Kalolo Khongoni Kalumba Malili Chitukula # of push bicycles distributed 3 3 2 2 2 2

Mbang’ombe Njewa Mtema TOTAL

2 2 2 20

EMMANUEL INTERNATIONAL-VILLAGE SAVINGS AND LOANS

THANK YOU! To Africycle and Tour D’Afrique
In April, 2010, Tour D’Afrique, through Africycle, donated 32 bicycles to Emmanuel International Malawi for the SAVEUP program. This is an additional generous donation to the 10 bikes received last year for the same program, which at that point was just getting off the ground. Now, one year later, the program is well on its way towards meeting the targets set for its 2 ! year duration. The SAVEUP program, with funds from CARE International, is hoping to help 17,280 people join a Village Savings and Loans Association, enabling those living in rural areas to generate a brighter economic future that previously has not been possible. The concept is simple: village people organize themselves in groups who are willing to pool a small amount of money on a regular basis. As the fund grows, the group members start taking loans. With these loans, they develop small businesses. The groups follow a precise methodology of saving while at the same time developing their own rules and regulations that govern group choices….for instance, how much money equals 1 share, how large a loan can people take, and what interest will the loan attract, etc. It takes at least one year for a group to go from start up to maturity. To date, 9898 people have joined the 698 groups that have been established. The target for the whole program is the establishment of 840 groups. Of the groups established, 96 were started by the Emmanuel International field staff and 602 have been established by the Village Agents trained by the field staff to continue the process in their communities. Thank you for the bikes!!! These bikes help the Village Agents to visit communities, establish groups and take them through the process to maturity. As of the end of September, 2010, the 698 SAVEUP groups have saved an accumulated amount of Malawi Kwacha 14,809,476.00 (at 151:1 exchange rate, this is the equivalent of US $98,076.00). In addition to savings, each groups contributes weekly to a ‘benevolent’ fund (a way of helping each other through illness and funerals, primarily). The groups have saved Malawi Kwacha 975,587.00 (equivalent to $6,560.00). Attached are 4 stories that demonstrate the effect that the SAVEUP program is having on the lives of people living in rural Malawi. Two of these are follow up stories from 2 people who received bikes from the first donation from Africycle and Tour D’Afrique, Anne Taulo and Ronney Dauda. Their stories are attached. On behalf of Emmanuel International Malawi and the SAVEUP program, thank you, thank you, Africycle and Tour D’Afrique for your generous assistance in promoting the success of this program.

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CCESS STORY FOR ANNE TAULO

SUCCESS STORY FOR ANNE TAULO Anne Taulo , a Village Agents from T/A Chikowi in Zomba District was one of the first VAs who were trained in depth in October 2009. Anne is a mother of an 8 year old son by the name of Brian. She also earns her living through subsistence farming and small businesses. She is also a member in a VSLA group in her community and this is where and how she was identified and trained to be a trusted mentor to form and train other groups even after SAVE-UP closes down. Before Anne joined the VSLA, she used to just depend on selling the surplus of what she could A REPORT ON BICYCLE DONATION FROM AFRICYCLE produce from her farm. “I could not really think beyond my door step, couldn’t think there could be meaningful and profitable ventures to undertake. I couldn’t see where and how I could get -VILLAGE HEALTH WORKERS PROGRAM a reasonable loan with a small interest rate, “ she confessed. “ I have been taking loans and venturing into key to strengthening my group since June 2009 and I community and the public pan This is a businesses from communities, building linkages between resell cooking oil, sell cakes sector in Malawi and improving HIV and TB treatment outcomes. farm. I get high yields and with and I’ve been hiring temporary workers to assist in my some of the profits, I do buy my household needs. Introduction

PARTNERS IN HEALTH

She thanks Africycle is a major challenge for clinicians andher a health authorities. Patients with Drug compliance and Tour D’Afrique for giving public strong and precious gift which is diseases that require long courses of treatment such as tuberculosis and district. “With this helping her to change the livelihoods of many people in her area and HIV often fail to take push their medication bike, the communityas prescribed over the longand respect is able to recognise term, particularly when they are not acutely ill. Noncompliance leads to the spread of resistant strains of pathogens within communities and me. Each day I go intothe challenges public health authorities face in providing adequate health therefore complicates the community, I am able to gain more knowledge and I always come with aWorker (VHW) program implemented by services with limited resources. The Village Health little moneyPartners In Health (PIH) was created primarily to address these issues. as a fee for service. Imagine. Because of this push bike, I have already finished my target of 8 groups Bicycle Donation and am ready to add more since we still have In April 2010, Africycle donated 10 brand new bicycles and community demand for more VS&L groups. Really this 10 recycled mountain bicycles making a total of 20 bicycles. This donation was meant to improve our health services deliveries push bike has helped we are working and this has proved to be quite effective. me to build the capacity, form in the communities groups, mentor them and supervise them in an easy Bicycles Distribution way. Once again, thanks to Africycle and Tour D’Afrique and EIM for changing our lives,” she concluded.

Asked about her future plans, Anne said she would not stop forming and training groups till the local demand is satisfied since she has a strong push bike and as she is able to get a little something as a fee for service which helps her to repair her bike when there is need to.
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SUCCESS STORY FOR RONNEY DAUDA Microfinance institutions in Malawi offer financial services that support a diverse range of small

SUCCESS STORY FOR RONNEY DAUDA Microfinance institutions in Malawi offer financial services that support a diverse range of small businesses and entrepreneurs who do not benefit from the formal Banking sector. The commercial banking sectors usually have stringent conditions that do not favour small scale entrepreneurs in their rural and urban settings. But this is not the case with the Village Savings and Loans Associations (VSLA) methodology which provides unique opportunity to people who are otherwise marginalized from the services offered by banks and believe they can’t access credit. The SAVE-UP Project promotes local capacity building for Village Agents who will form and train many VSLA groups. The goal is for quality VSL groups which will continue even after the project ends. This is how RONNEY DAUDA found himself to be the first Village Agent to received a push bike from Africycle through Tour D’Afrique in March 2009 after being identified, selected and trained in depth as a Village Agent in October 2009. RONNEY DAUDA is a trusted mentors who live in T/A Chikowi in Zomba District. He is married to a very beautiful wife and has 3 children. He belongs to Tiyanjane VSLA and he has been saving with the group and accessing loans since February, 2009. RONNEY has been venturing into different businesses and the profits he got was used to buy clothes and food for his family. He even opened a small shop in his village where he sells paraffin oil (Lamp oil). RONNEY provides his family through subsistence farming and savings from his VS&L group. The 43 year old VA was quoted saying, “I used to keep my money in a hole within my house, and I could spend my money anyhow, but with VS&L I have learnt how to save and proper use of my money. RONNEY explained that the trainings and loans through the VSLA methodology and mostly the pushbike which he received from Africycle have been very useful. “I am well equipped to train more groups in my area without any hindrances on the resources. I have already surpassed my target of forming 8 VS&L groups to 11 groups, and this has been so because of this strong and beautiful push bike which
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always pushes me to form, train and supervise more VS&L groups. Through the same VS&L methodology, I am now able to change the mindset of people in my own community and as a VS&L member I can pay school fees for my children especially for my daughter who is in Form 3. I am even able to provide other necessities to my community as I am now able to resell Paraffin oil and hire some people for labour and pay them. For instance, I hired a man to build my toilet and renovate my house at a fee of about MK5, 500. Is this not helping?” During their share out as their group reached its maturity phase (9 months), Mr RONNEY had saved about MK12, 400 and this is the money which he used it for building a toilet, renovating his house and hiring labour. ”I couldn’t dream of rebuilding my house in such a short period of time. “Really, VS&L has changed my life and even the community at large as it is able to access Paraffin and match sticks at a short distance. Asking RONNEY about his future plans, RONNEY continued by saying many thanks should go to Africycle and Tour D’Afrique and EIM staff for making VA life easier and helping in changing the mindset of many people in his district. He said he is planning to open a big shop in his area. He concluded by saying that VS&L really works with people who are marginalized from services offered by Banks and other MIFS as people can’t get credit; VS&L has been an answer to that.

VSLA IS EMPOWERING WOMEN At the heart of SAVEUP project is the Village Agent (VA). SAVEUP hopes to make Village Savings and Loans (VSLA) a scale up programme sustainable in the sense that the group formation and training skills are built at local level. Those with the skills will continue the VSLA activities even after the end of the project. It is a cost effective program: Village Agents work in their own communities where they receive a service fee from groups that they establish. The bikes that they receive when they are trained as VAs can be maintained through the service fee they receive. With bikes and training materials, the VAs are able travel to meet and train their groups on time. Many thanks to Africycle and Tour D’Afrique for their generous donation of 32 bikes this year (and 10 bikes last year!) for the SAVEUP Village Agents. This support amplifies the potential for the SAVEUP project to improve and change lives of many people in the districts of Machinga and Zomba where this program is being implemented.
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Meet Beatrice Bonongwe. Beatrice lives at Chapatila Village, GVH Mbando, TA Mposa in Machinga District. She is 26 years old, is married to Sumati Bonongwe and has two children, a boy of 7 years old and a girl of 6 months. Beatrice has a story to tell about VSLA methodology and the benefits to her as a village agent and, above all, about her precious gift which is no other than a push bike from Africycle and Tour D’Afrique. “For sure my life before joining VSLA in my community had another story. My husband was failing to support our family fully, we couldn’t have basic things at our household, couldn’t have a saving culture as we could earn a living from our farm produce. I did not have enough kitchen utensils so I would always borrow from my neighbours which brought shame to us most of the time. But after joining the VSLA in my village, all the shame is gone as I am having my own and enough utensils. Really gone are the days when a lady or a wife in my village could hardly have enough kitchen utensils and wrap cloths (zitenge). Since I joined my VSLA, I have applied for five loans amounting to K9, 000.00 which I ventured it into a pan cake business. From the profits which I made, I used it to buy farm inputs. After selling the produce, I got K17, 500.00 and from the profits we bought kitchen wear kits, clothes for the family and some was used to buy soap and food. My life as a Village Agent isn’t all that difficult as all the things that could make the VAs life easier are at my door step. As you can see am ready to go to my work with my beautiful push bike and I am sure to meet the group on time.” Beatrice wants to thank Africycle and Tour D’Afrique and EIM for making her work easier and above all, for the knowledge which she is acquiring day to day as she interacts with the community. Asked about her future plans, Beatrice says she and her husband plan to save and build a house by the end of this year. According to her, nothing could have been done for her family if she had not joined the VSLA group in her village. “It has brought love to my family and my community at large as we are able to chat and help each other in times of emergencies and good times,” she concluded.

SUCCESS STORY OF CHRISTOPHER MAMU (TA MPOSA) “Africycle and Tour D’Afrique’s generous gift has shortened long distances and made me to be on time with groups.” Emmanuel International Malawi is committed to building the capacity in the VSLA methodology through their Field Officers to the community based trainers, the Village Agents (VAs). The VAs will continue providing services when the program finishes with a provision of training materials and a push bike. Africycle and Tour D` Afrique have provided 32 push bikes for the
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Village Agents working in Emmanuel International’s SAVEUP program. The Village Agents receive a fee for their service when they set up new village savings and loans groups. Part of these funds are used for bike maintenance. VSLA has changed the lives of many people in the implementing areas of Zomba and Machinga District. Christopher Mamu is a 30 year old man married to Rose who is 22 years. They have 2 children, Ikira, a boy child and Elizabeth who is 8 month old. The family of Christopher Mamu lives at Maya village, GVH Mamu, TA Mposa in Machinga District. “I was really behind in development activities and I could not be appointed to any position in my own community to pursue, I could not even see the benefit of joining any developmental activities; hence, I was not known or popular in my own village.” He continued by saying that, “I could not receive much respect in my family and my area since they were unable to see my capabilities, and as a father I was even failing to play my role,” he explained. Christopher Mamu`s life started to change when he joined one of the VSLAs in his own community of Manja in this year of 2010. He has saved 10,000 MK and has managed to apply for three loans from his group amounting to 11,500 MK. He ventured this money into a dry fish reselling business and made a profit of about 14,000 MK. With his money, he managed to buy four zitenji, one pair of sandals and three skirts for his wife. He also bought two pairs of trousers, one for him and one for his first born son and two dresses for their eight month old daughter. The remaining money was used for saving and home use. “After being selected and trained as a Village Agent and on top of that having a push bike which I can change gears! This gift really has added more respect, recognition and fame to me.” narrated Christopher Mamu with a yes face while touching his beautiful bicycle, the generous gift from Africycle and Tour D’Afrique. “Each time I go into the field, I add more knowledge and I feel that am employed as I always walk out with a fee for service.” He continued by thanking Africycle and Tour D’Afrique for making his work easier. “It has brought respect to my family and community at large.” Asking Christopher about his future plans, he said that he has good plans for his family since he has seen the beautiful side and tasted the sweetness of the VSLA methodology. He and his wife plan to bring together the money after sharing out from their VSLAs, so that they can do a big business and build their own six bed roomed house.” We will never walk out of the VSLA cycle since it has brought a big change to our family and community at large.” he concluded.
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PARTNERS IN HEALTH-HIV AND TUBERCULOSIS TREATMENT
A REPORT ON BICYCLE DONATION FROM AFRICYCLE VILLAGE HEALTH WORKERS PROGRAM This is a key to strengthening communities, building linkages between community and the public sector in Malawi and improving HIV and TB treatment outcomes. Introduction Drug compliance is a major challenge for clinicians and public health authorities. Patients with diseases that require long courses of treatment such as tuberculosis and HIV often fail to take their medication as prescribed over the long term, particularly when they are not acutely ill. Noncompliance leads to the spread of resistant strains of pathogens within communities and therefore complicates the challenges public health authorities face in providing adequate health services with limited resources. The Village Health Worker (VHW) program implemented by Partners In Health (PIH) was created primarily to address these issues. Bicycle Donation In April 2010, Africycle donated 10 brand new bicycles and 10 recycled mountain bicycles making a total of 20 bicycles. This donation was meant to improve our health services deliveries in the communities we are working and this has Bicycles Distribution Table 1: shows the category of bicycle beneficiaries Category VHWs Site Coordinators Responsibility These are the immediate supervisors to the village health workers. They do home visits to the village health workers and their patients Number of bikes received

VCT Counselors ART clerks

10 This group is responsible for the community HIV Testing and counseling 4 Are responsible for tracking patients who have 3 missed their appointments on clinics days. These are the patients who are on ART as well as on TB medication Are responsible for identifying patients who are on social and economic need and referred to PIH for assistance. 3

Program on social and economic rights (POSER) assistants

Justification: we decided to distribute these bicycles to the mentioned category of PIH employs in order to make sure that our services are really reaching the target group which is the community. It is no secret that the donation has boosted up our services delivery in the community.

Table 2: shows the impact of the donation

Distance travelled by Approximate time Number of patients users saved served The maximum distance The coming in of the Through this donation covered by the bicycle bicycles has really we are able to reach users differs but the eased the transport out to 2742 patients maximum distance so problems as well as who are on TB and far is 32 km. Before the time saving. The ARVs medication donation this distance distance which was across the district. was covered on foot covered on foot for 6 hours is now being covered in 1.5 hours and this has tremendously improved our home visits by our site coordinators and POSER assistants to patients, Community HIV Testing and Counseling, and default tracking of patients who have missed their appointments

Comments by users “Before receiving the bike my job was tough and I wanted to resign but now I can visit up to 15 patients, thanks to Africycle” said Alfred Thoza one of the site Coordinators for Magaleta. “The issue of patients defaulting is become a thing of the past because am making my home visits regularly” commented one of the ART Clerks. “Had it been that this donation was made two years ago 80% of my catchment area population could have already gone for HTC by now” said one of the VCT Counselors.

Conclusion We would like to thank Africycle for the timely bicycle donation. Without this donation the lives of our employs who work in the community could have been miserable and their quality of work could have been poor. Currently we are having 674 village health workers who are supervised by the site coordinators but the number is likely to go up. We are still appealing to all well wishers including Africycle to still consider us in the future because the demand is still high.