Pastoral Activities and Services for people with AIDS Dar-es-salaam Archidocese

PASADA – An Overview

The month was August. The year was 1992. A small group of people with HIV gathered to seek mutual aid and support in Tanzania’s largest city, Dar-es-salaam. This act led to the creation of a new social service agency called the Pastoral Activities and Services for people with AIDS Dar-es-salaam Archdiocese (PASADA) with the aim of providing people living with HIV/AIDS all the support they needed. Since its inception, this agency, operating under the Roman Catholic Archdiocese of Dar-es-salaam, has grown rapidly in order to meet the exploding demands of the HIV pandemic in the Dar-es-salaam urban area.

PASADA strives to reach the poorest of the poor living with HIV and provide them with holistic care and support services. Although sponsored by the Roman Catholic Church, the services offered by PASADA are available to all individuals without discrimination of any sort and completely free of charge. PASADA offers a number of services to its clients and also carries out educational programs at the community level with the objective of reducing stigma and discrimination and promoting behavioral change, thereby hoping to limit the spread of the virus.

On an early Monday morning, I visited the agency which lies about 20 minutes from downtown Dar-es-salaam. The main entrance was filled with clients, most of them women carrying their children. They were waiting for their names to be called by the nurse. I walked passed the women and made my way into the main courtyard. I stood in the middle and as I looked around I saw all the different counseling rooms. Patients were seated on benches, others lined up at the dispensary waiting for their medication. The centre was busy at such an early time of the day; confirming that the services provided here are crucial and essential in the lives of all its clients.

With the funding it receives from the Stephen Lewis Foundation, PASADA offers a myriad of services for those suffering from HIV/AIDS. “There is nothing like PASADA in the whole of Tanzania,” said Jovin Tesha, Research and Advocacy Officer at PASADA. Usually, clinics and centres only provide a limited number of services for those living with HIV; you rarely find a place that offers all services under one roof, but this is what you get at PASADA; all the necessary services including: Voluntary Counseling and Testing (VCT), Medical Assistance, home based and palliative care, support given to orphans, vulnerable children, and people living with HIV/AIDS, (PLWHA) groups and the community education program. PASADA is equipped with over 130 full time employed staff, with 22 of these staff working in the satellite dispensaries throughout the Archdiocese, usually as VCT counselors and HBC nurses. The staff consists of Medical Officers, Assistant Medical Officers, Clinical Officers, Counselors, Laboratory Technicians, Nurses, Social Workers, Finance and Administrative officers as well as support staff. I spoke with a number of PASADA clients and the clients/patients were all satisfied with the services they received. They constantly told me, “Where would I be without PASADA?” They were very thankful.

Walking from corridor to corridor, I was informed that PASADA has reached its limit in terms of upward growth. It is because of this that PASADA’s 2003 – 2008 strategy has decentralization as its focal point. Their plan is to create numerous “mini” PASADA services throughout the 42 parishes of the Dar-es-salaam Archdiocese. It is implementing this strategy because they want to bring services closer to those who need them. They want to actively involve community members in the fight against HIV/AIDS, to reduce stigma and discrimination and to identify and mobilize community resources. With the numerous services offered at PASADA, this agency faces a number of challenges. For example, to continue offering quality services, it has to deal with the increasing number of clients. It has to invest more in decentralization, increasing involvement from the community, rather than merely vertical expansion. As well, implementation of the ARV program is proving to be difficult. It requires coordination at the national level, intensive staff training and increased workloads as well as a committed effort from clients and field workers with regards to adherence. Currently, PASADA feels that other equally essential social aspects of the fight will be overshadowed and abandoned due to the efforts required to correctly implement ARV. Due to this agency’s wealth of experience in HIV/AIDS, they are often asked to provide workshops to other organizations wanting to set up similar services. They usually agree to this, but they in some instances due to lack of the resources and overworked staff, they have said no to some organizations. Something that has to be decided on in the near future is if PASADA should set up its own structured training unit with a dedicated staff and budget? In spite of these challenges, PASADA is successful and making a difference in Dar-es-salaam.

During a conversation with one of the employees it was mentioned that there lies a great problem with the HIV+ men. They seldom become involved in activities because they tend to hide their status from others. As a result, since they are the ones with the decision-making powers in sexual relationships, they end up transmitting and spreading the virus. PASADA intends on developing strategies to raise awareness about this issue so as to motivate men to be honest about their status with their partners. They need to be accept an more active role in fighting the transmission. PASADA also needs to invest more in eradicating stigma and discrimination in communities so that clients don’t have to go through unnecessary humiliation, isolation and pain. This becomes even more critical when we are talking about orphans and vulnerable children.

After talking to clients and coming face to face with the services provided at PASADA, I was aware of the strengths of this organization. I have never seen any organization offers this kind of holistic nature of approach. Walking through the doors, you will find services covering all types of care and support needs for those in the community people living with HIV/AIDS. I feel a sense of relief every time I am told that services here are free of charge; this means that everyone in the community even the very poor have access to the same quality of services. The staff I met were extremely motivated, willing to help and most of all, qualified. As I looked around to observe the way in which the clients related to the staff, I could feel a sense of comfort and openness between the two sides. I was ensured by the staff that although Tanzanian culture does not foster much confidentiality and secrecy, at PASADA, there is guaranteed confidentiality for all their clients.

Many organizations providing services to people living with HIV need to learn from PASADA; it is a success story in Tanzania and hopefully, more and more of these kinds of agencies will be put in place and made readily available for those in need.

Before leaving PASADA, I was told about one grandmother who is making a difference in her local community. This grandmother was one of the grandmothers that came to Toronto, Canada, for the ‘Grandmother to Grandmother’ get-together during the International Aids Conference in August 2005. A journey made possible by the Stephen Lewis Foundation. Empowered and thankful, she had the opportunity to connect with other grandmothers. She was very happy to finally come face to face with the organization that was making a difference in her life, the Stephen Lewis Foundation, through PASADA. Upon returning to Tanzania, this woman confronted the government and ministers about a number of issues. She was not impressed that the ministers and governments did not know about PASADA and the difference it is making in their communities. Her efforts have paid off resulting in the Minister of Community Development, Gender and Children, sending a letter asking PASADA to allow them to visit the agency. Indeed, organizations such as PASADA need to be recognized for their hard work in ensuring that people living HIV obtain the support they need.

For more information about PASADA, please contact the Executive Director, Mary Ash at +255 754 748402. P.O.BOX 70225, Dar-es-salaam, Tanzania. Phone: +255 22 2865451, Fax: +255 22 2866618. Email: or

Link

Development Studies

Health Studies

MultiMedia

-Document with details of PASADA Services

-Video Interviews

·  Interview with Jovin Tesha: Research and Advocacy Officer at PASADA

·  Interview with Patient #1: Grandma

·  Interview with Patient #2: Mother