Korte beschrijving van het project
Het project voorziet in dienstverlening en verstrekking van faciliteiten in de gezondheidszorg.
Er wordt gewerkt aan bewustwording, voorlichting, preventie, basiszorg, 'family-planning' e.d.

Doel van het project
Het doel van het project is het verbeteren van de primaire gezondheidszorg; het verbeteren van de levensstandaard van mensen in rurale gebieden; het verbeteren van het geestelijk, lichamelijk en sociaal welbevinden van de mensen in Benue State en het toegankelijk maken van gezondheidszorg.

Huidige stand van zaken
Speciale aandacht wordt gegeven aan kwetsbare groepen, zoals: vrouwen, kinderen, jeugdigen, armen, lichamelijk en geestelijk gehandicapten, alsmede diegenen die leven met HIV/AIDS/TBC. Er wordt vooral gefocust op kansarmen. Het accent ligt op het welzijn van de 'community'. Ten gevolge van de instabiele politieke situatie in Nigeria, worden de armen armer.

Behoeften van het project
Geld is o.a. noodzakelijk om de kosten van vervoer te betalen: Hoge benzineprijs in combinatie met hoge verzekeringspremie. Men beschikt over een Toyota Hilux die noodzakelijk is, omdat de infrastructuur erg slecht is en de afstanden enorm zijn.
Veel onbetaalde rekeningen van ontslagen patiënten verslechteren de financiële situatie.
Gebrek aan fondsen hebben tot gevolg dat de opleidingen voor gezondheidsmedewerkers niet toereikend zijn.

Contactpersoon van het project
Primary Health Care HIV/AIDS programme, Adikpo
Sr. Dorothy Agbasielo
St. Monica's Hospital / Holy Rosary Convent
P.O. Box 44
Adikpo
Catholic Diocese of Makurdi
Kwande Local Areas
Benue State, Nigeria
Tel: +08042683462 / 08043224076
E-mail: srdotagbasielo@yahoo.com

Donaties
Indien U een donatie wilt geven ten behoeve van dit project, dan kunt U een bedrag overmaken op rekeningnummer 40.67.06.859 van de ABN-AMRO te Venlo ten name van B.W.G. Staarink en/of M.D.C.L. Pleumeekers te Venlo, zulks onder vermelding van de naam van het project: Primary Health Care HIV/AIDS programme Adikpo, Benue State, Nigeria.

An Overview of Primary Health Care HIV/AIDS programme, Adikpo
Sr. Dorothy Agbasielo
St. Monica's Hospital / Holy Rosary Convent
P.O. Box 44
Adikpo
Catholic Diocese of Makurdi
Kwande Local Areas
Benue State, Nigeria
Tel: +08042683462 or 08043224076
E-mail: Srdotagbasielo@yahoo.com

Title: Integrated Health Programme

Introduction/Background
The catholic diocese of Makurdi is part of the Abuja ecclesiastical province. The diocese developed its health programme over thirty years ago. This is guided by the teachings of the church and its own philosophy of caring for the sick, the diocese provides health care for a considerable part of the state's population and their neighbouring states like Nassarawa and Jalingo.

The diocesan health program started as a modest programme, this programme today evolved into one of the largest non governmental or mission programme in the country. She approaches health care holistically to improve the mental (psychological), physical and social well-being of the people of Benue State. For this reason, the name integrated health care programme came to birth from medical programme.

The integrated health programme of the catholic diocese of Makurdi has five secondary health care facilities and thirty-two rural/primary health centres scattered all over the states covering fifteen LGAS. The programme contributes about twenty-five percent of health care services in the state.

Besides provision of quality of care in curative services, the diocesan health programme also provides substantial preventive services, primary health care services/HIV/AIDS awareness campaigns, prevention and care interventions in the communities and health facilities.

Primary Health Care Services
The diocese pioneered primary health care (rural health care services)HIV/AIDS responses in the state since 1986 and 1990 respectively.

The list of catholic mission primary health care, HIV/AIDS, home base care facilities and their distributions.

Executive Summary
The diocese has great interest in the existence of PHC/HIV/AIDS as part of her health services. The diocese in her vision statement envisages a future where the dignity of human life is respected, people live health, productive and integrated lives bound together in communities in which love, trust and justice reveal the presence of the kingdom of God.
The diocese in her mission statement aspires to offer health services that affirm human dignity especially the poor and the marginalized. It is therefore appropriate that our effort and struggles in the health care deliveries focus on the poor and the marginalized at he grass-root and rural areas.

Definition
Primary health care is a radical approach, which aims at achieving health in the community in a way that is accessible, affordable, and acceptable to the community. The communities rather than the hospital becomes the focal point, health rather than medical care the main emphasis, and community participation and involvement the basis of all health care deliveries activities. Everybody in the community is encouraged to participate and get involved in the promotion of health status of individuals and prevention of ailment or diseases in the community. We also take into consideration the World Health Organization definition of primary health care as an essential health care based on practical scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at the cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It is the first level of health care as close as possible to where people live and work, and constitute the first element of continuing health care process.

Activities done
- We bring the healing ministry of Jesus Christ alive to those whom the health care might otherwise be inaccessible.
- We minimize communicable disease in our working places and communities.
- We develop and maintain a holistic approach to health care provision, which embraces communities and health care workers.
- We recognize the special needs and preserve the dignity of the marginalized especially women, children, youth, the poor, those with physical and mental disability, and those with HIV/AIDS/TB, the deaf, dumb and vulnerable.
- We improve the standard of living of people in the rural areas.
- We aim to achieve health for all by the year 2000 plus in spite of gender inequalities.

We do these through the following
- Health education and campaign
- Home visitation and home base care
- HIV/AIDS awareness/campaign, prevention and eradication
- Maternal and child health care services
- Baby friendly and exclusive breast feeding method
- Immunization against all the killer diseases
- Family planning
- Antenatal/postnatal care
- Deliveries
- Treatment of STIS
- Onchocerciasis treatment
- Referral of severe cases
- Training/workshops
- Laboratory investigations
- Voluntary counselling and confidential testing (VCT)
- Supervisions
- Curative treatment
- Diseases control
- Supply of drugs and regulation of prices
- Maintain on going relationship with the communities through regular meetings, monitoring and evaluation
- Working with orphans of PLWHAS
- Accessing anti retro-viral drugs
- Nutrition education for babies
- Community mobilization
- Promotion of better housing with good ventilation
- Provision of physical structures for health care deliveries.

Financial/Sustainability
The program has been looking for a way toward sustainability. It has been very hard and terrible. The problem here is that the cost of fuel/petrol, transport and maintenance of vehicle escalate and every year staff salaries and motivation require financing. These are extremely huge expenses on the project. These make sustainability very difficult.

Problems encountered
- Difficult to mobilize some communities-no means
- Poor financial base
- High cost of drugs from the pharmacists and other supplies making services thus reducing the access to care and support to the poor.
- The cost of insurance for the Toyota Hilux has become very high
- It is becoming more difficult to cope with the HIV/AIDS endemic and to care properly for PLWHA because of insufficient funds, staff and drugs
- Difficult to maintain our vehicle for movement
- Many unsettled bills for discharged patients/clients
- No external aids
- Poor infrastructures in the rural areas
- Inadequate trainings for health workers due to lack of funds
- Some worn out equipment
- Recurrence/regular communal and political crisis, which lead to the destructions of many of our health facilities in the rural areas.

Some of these problems are due to the situations in our state and country at large. Nigeria is in a terrible state. The politicians are making the matter worse for the state. There is conflict of the mind and Benue State has her own conflicts. Because of political disagreement, some of the local government areas have no chairmen. Presently the workers in the federal health institutions are on strike, as government could not pay for their salaries, which is very unjust. These have caused a terrible breakdown in health care activities even to maintain their square meals are difficult. Nevertheless, many people are suffering.

Strengths/Progress
- Staff commitment/dedication and support
- Cooperation of staff and well-wishers
- Unity between the team leader and the community
- Community involvement/participation and cooperation
- Regular meetings
- Good building for meeting/workshops
- Variety of services and activities in the PHC/HIV/AIDS Programme
- Affirmation from local communities
- Support from CAFOD on capacity building
More outreach health facilities in 5 LGAs
- Increase in the staff recruitment/employment
- Increase in the training of staff for capacity building
- Purchase of four-wheel drive double cabin Hilux through the world Mercy assistance
- Gift of five bicycles for the village health workers through the LGAs
- Gift of a motorbike through PATHS
- Building of a simple hall for meetings/conferences with an office and two WC toilets and bathroom
- Extension of pastoral health care unit for care and support of PLWHAS
- Above all God's loving mercies/protections in all the goings and comings. His strengths and energy that have sustained all of us and enabled us to carry out the activities and the work of PHC/HIV/AIDS
- Procurement of seventy-five plastic chairs for meetings/workshops to reduce the cost of spending money on the hiring of chairs for meetings and workshops.

Conclusion
In as much as we make effort, work hard and struggle to keep the program alive and active, we cannot do everything and there is sense of liberation in realizing that. This enables us to do something and to do it very well. It may be incomplete, but it is a beginning, a step along the way, and an opportunity for the Lord's grace to enter and do the rest. We may never see the end results, but that is the difference between the master builder and the worker. We are the workers, not the master builders, ministers not messiahs. We are the prophets of a future not our own (Archbishop Oscar Remerio). May the good Lord bless you in your good intention for us.

The role of mission in Benue State in the provision of PHC services in the state (Summary)
- Taking health care services to unreachable areas
- Provision of health care services at the affordable cost to the poor
- Improving the health state of rural dwellers through health education
- Provide machinery in achieving the goal for health for all by World Health Organization (WHO)
- Helps in installing physical, spiritual and emotional upbringing to the needy
- Helps in prevention of the killer diseases
- Provision of home base care to the sick
- Creation of employment opportunities
- Development of strategies in her institution to limit the spread of HIV
- Helps to eradicate stigmatisation towards HIV/AIDS through awareness and counselling
- Develop a health programmed based on charity, justice and equity
- They observe special needs and preserve the dignity of the marginalized
- They treat conditions without discrimination
- They establish centers to meet special needs of physical and mentally disabled in our communities
- Draw up policy on procurement of genuine drugs based on guidelines on essential drugs list
- We offer employment opportunities to our youths to uphold their dignity and upliftment of self-esteem.

While the mission assumed the responsibilities of providing these roles, we strongly solicit the support of the government and donor agencies.

Sr. Dorothy Agbasielo St. Monica's Hospital/Holy Rosary Convent