Houses of Hope: Housing for People with HIV and Their Caregivers In Shyira, Rwanda

Summary: The community of Chatham, NJ will provide financial and community support to Shyira Hospital in rural Rwanda, Africa, to build housing for people living with HIV/AIDS and to improve housing for the local and visiting professional medical staff who provide their care.

Vision: To connect the “all-American” community of Chatham, NJ with a community far removed in terms of location, economics, race, culture, and history, by assisting people who have HIV/AIDS and receive care at the Shyira Hospital to improve their medical outcomes and quality of life, and support their sense of human dignity.

Location: Chatham is located in north-central New Jersey about 25 miles west of New York City in Morris County. As a community, Chatham is committed to strong family values and, for generations, has inspired residents to stay or return to raise their families. In all schools, religious institutions, scouting groups and other youth organizations the message of caring for others rings loudly through fund raising, collection of items, and service activities. Children in Chatham are privileged to have access to a broad range of sports, extensive opportunities to study music, theater and art, and outstanding school programs. In general, the residents of Chatham are highly educated, informed, affluent and active in volunteer projects to help others.

Rwanda is located in Eastern Africa, in the Great Lakes region. It is a very densely populated, mountainous country, and land, though fertile, is difficult to obtain. Shyira is located in northwestern Rwanda near the border with the Democratic Republic of the Congo. The community was severely scarred by the Genocide of 1994, during which approximately 800,000 Rwandans died in 100 days of ethnic violence. Residents of Shyira suffered again in the ensuing conflicts in 1997 and 1998, when the Rwandan rebels returned across the border from the Congo. Many who live in and around Shyira lost their land, houses, and families. Many more fled to refugee camps. As a result of the years of fighting, a third of the households are headed by women and some are headed by orphaned children. The average income in Shyira is less than half the Rwanda national average, at less than $100 per year. Most people in the area of Shyira are subsistence farmers, raising beans, potatoes and other crops.

Statement of Need: Of the estimated 40 million people in the world with HIV/AIDS, 25 million live in Sub Saharan Africa. It is estimated that every day 14,000 people in Africa are newly infected with HIV/AIDS. In Rwanda, the HIV prevalence ranges from 2 to 13%, depending on location. Shyira, although in a rural area, has a relatively high HIV rate, due, in part, to the systematic use of rape during the genocide and ensuing fighting. Recent testing of pregnant women with no health complaints suggests that between one in twenty, and one in ten, are infected with HIV. Now, 10-12 years after the Genocide, the symptoms are starting to surface, and these people, already devastated by war, are combating their new tragedy-AIDS.

The HIV Program at Shyira Hospital offers free HIV testing and counseling, and all pregnant women seen in prenatal consultations are tested for HIV. The Rwandan Ministry of Health assigned the Columbia University School of Public Health’s multi-country AIDS program (MCAP) to administer the anti-retroviral treatment program (ART) at Shyira Hospital. Begun in June 2005, Shyira Hospital’s HIV Program receives the medicines in a timely fashion, and always has appropriate on-site supervision. The Shyira HIV/AIDS Clinic follows 550 patients, 170 of whom are on antiretroviral treatment. The vast majority are women, many of whom are widows, or separated from their husbands; many are ostracized by their families. Some of these patients, who are gaining weight and strength on anti-retrovirals, are nevertheless wondering why they’ve been allowed to live when they cannot even support their families. Many do not have their own homes, and are forced to live in crowded conditions with other family members, or to rent houses, using up what little income they have.

For example, Claudine is a 30 year old woman with HIV/AIDS. She was raped by a soldier in 1994 and says this is how she became infected with the HIV virus. She has no husband and no children. She currently lives in temporary housing with her younger sister. Her family house was destroyed in 1994 by soldiers, so she has some land on which to build a house but no means with which to build it. She makes a small amount of money doing some commerce at the local market. She also gets a small amount of money from the HIV association of which she is a member. She would be an excellent candidate to receive help in building a house.

Supported by the MCAP Program funds, there is an excellent local staff at Shyira Hospital providing care for those with HIV. Almost all are highly educated Rwandan nationals. Unfortunately, the Hospital’s antiquated nursing dormitories are overcrowded. While many of the nurses and other staff are from the same region of the country as Shyira Hospital, only a small percentage are from the immediate vicinity, and so need some place to stay. Recently, 12 new nurses and lab techs were hired, and it is very hard to find a place for them. They are on-call two nights a week, and can be called in to the hospital at other times for emergencies. Two of the recently hired staff have families with small children whose children sleep on the concrete floors. These are professionals who have received the best health training the country offers and have given up the chance to live in more comfortable cities in order to care for the rural poor. Take, for instance, Théophile and Simon. Théophile is the head laboratory technician. He has upgraded the quality of the Hospital’s lab enormously since his arrival, and is responsible for the quality control of the HIV tests. In other centers, false positives and false negatives have caused serious problems, but Shyira’s lab has so far been 100% correct in the samples sent to the national lab. In addition, he has introduced biochemistry tests to the hospital which are necessary for following patients on anti-retroviral treatment. Simon is a nurse who helps in the pharmacy during the day which distributes the specialized medicines the HIV patients receive. At night, he undertakes general medical call. Because he speaks English, in addition to French, Swahili, and his native language Kinyarwanda, he has been able to work with a pharmacist visiting from New Zealand. Like Théophile, he was in the top 10% on national examinations and could have served anywhere. But the two of them share one 2 meter by 4 meter room, and take turns which one sleeps on the bed and which one on the floor. There are 8 other young men in their group home in 6 other rooms. They have an outdoor wood-stove kitchen, an outdoor shower and the latrine next to their building recently collapsed, so they have to use the latrines in an adjacent building.

Local Shyira, Rwanda contacts: Doctors Caleb and Louise King are medical missionaries at Shyira Hospital. Caleb and Louise are both physicians and have been living in Shyira since April 2003. They were asked by the local Rwandan bishop, John Rucyahana, to come help rehabilitate the hospital, which had been devastated by the war and genocide. When they arrived, there were about ten staff and the hospital had been demoted to a health center. Under Caleb’s leadership, Shyira Hospital is now a District Hospital and supervises 15 health centers, with a total drawing area of over 300,000. A new maternity ward was built in 2004 and another building was recently added for X-ray and training and treatment of HIV patients. The hospital staff has grown to 100 and the 100 bed hospital is now housing over 100 patients a night—some sleep on mattresses on the floor. Caleb and Louise met at Harvard where they went to medical school and did their training. Caleb is a Pediatrician and Louise is an Internist. They have four children, Sara 11, Hannah 9, Caleb Jr. 7, and Lydia 4. They are committed to improving the health of people in and around Shyira, in all ways possible; including the spiritual healing that comes from Jesus Christ.

Funding Goal: To raise a minimum of $30,000 by December 2007. The funds would be used to support the building of housing for people with HIV/AIDS receiving treatment at Shyira Hospital, and to finance the renovation of staff housing for those who care for the patients.

Project Objectives:
1) To construct housing around Shyira Hill for people with HIV/AIDS: Caleb and Louise King will contact the HIV associations in the Shyira area (there are four; and each person is required to be a member to receive anti-retrovirals) to get names of two people from each association who are in need of housing. Caleb and Louise will scout out the sites and screen candidates. The recipients will be required to have their own property, i.e. funds won’t be used to buy property. Local design, materials and labor will be used to build the houses, which will be constructed to withstand rain and wind, and include stone floors, tin roofs, two bedrooms and a cooking area with a chimney. Each home would also include rain water collection (for potable and wash water) and a pit latrine. The approximate cost of each house, including labor and materials, would be $2,000 (for 8 houses in the initial phase, for a total of $16,000).

2) To renovate housing for health care workers at Shyira Hospital: Improve current group housing for the hospital staff caring for people with HIV/AIDS. This would involve painting, new roofing where there are leaks, decent plumbing, improved kitchens and extensions on existing housing. Estimated cost is $9,000.

3) To renovate housing for visiting and teaching medical staff at Shyira Hospital: Among its many important functions, Shyira Hospital is a training facility for medical professionals from other areas of Rwanda and other African countries (such as Uganda and the Congo). It also benefits from visits from medical experts from other continents, including Europe and the U.S.A., who come to teach and share the work of Shyira Hospital. Such visits are sometimes limited by the lack of places for people to stay, and the hospital guest housing that does exist is very rudimentary. Louise and Caleb would oversee the renovation of guest quarters, to add solar panels (to allow for electricity more than the 2 hours per night currently available by generator), solar water heater to provide warm washing water, and expand the structure to accommodate more visitors. Estimated cost is $5,000.

Timeline: To have funds raised by December 2007 and housing built and used by March 2008.

Funding Vehicle: Chatham United Methodist Church in Chatham, New Jersey is the funding vehicle for the "Houses with Hope-Rwanda" project for Shyira, Rwanda. Chatham United Methodist is a thriving faith community committed to supporting many missions’ projects on the local, national and international level. Having the personal touch of the King Family’s presence in Shyira, Rwanda will allow donors to have an update on how their financial contributions are being put to work. The Kings write a quarterly newsletter about their work and this can be provided to donors via email upon request. Email Amy Ball to receive this newsletter.

Donations are tax-exempt and will be acknowledged in writing for tax purposes. Checks should be written to "Chatham United Methodist Church” in the memo section please put -“Houses with Hope-Rwanda”. Donations can be mailed to:

Chatham United Methodist Church
Houses with Hope-Rwanda Attn: Barbara Whalen
460 Main St.
Chatham, NJ 07928

Submitted by: Amy Ball, Chatham, NJ, USA mrsamyball@yahoo.com 973-635-0482
Julie Convisser, Charlottesville, VA convisserjm@earthlink.net
Louise and Caleb King, Shyira, Rwanda (calebkking@yahoo.com, Shyira Hospital, B.P. 26, Ruhengeri, RWANDA)