Mamelani’s Community Health Programme nurtures resilience and contributes towards community health through a range of activities. The Wellness Workshops offer safe spaces where people can come together to learn about their health and wellbeing. Through the workshops, participants are supported to make informed choices and take action to improve their health and the health of their families. The Follow-up workshops provide a space for participants to explore the barriers that they face with regard to their health and to find collective ways to address these issues. The Community Champions Programme supports grassroots leaders to grow and develop interventions that can have a positive impact on those around them. The Community Adherence Clubs provide community-based care to HIV positive patients who, through the programme, can access treatment from community-based settings, instead of needing to access care and treatment from the clinic, thereby lowering the pressure on the public health system. The Grandmothers Network – our newest intervention – supports a group of active grandmothers who are leading change and supporting others in their communities.
The methodology used in the Community Health Programme draws on a popular education philosophy and adult education theory regarding how to create an engaging learning environment for adults. We believe adults learn best when their lived experience and knowledge is acknowledged, affirmed and incorporated into the learning process. Our role as facilitators is to create an engaging learning environment that builds on the existing knowledge of the group, while adding new information to deepen the understanding of participants so that they can make more informed choices regarding prevention and treatment of the health conditions and other challenges that they face.
We run a series of community-based health education workshops over an 8-week period in which we share essential health information. In these workshops we create safe spaces in which people can talk honestly about the challenges they face and ask the questions they fear to ask elsewhere. We use a participatory methodology – promoting learning from each other and mutual support within the group. The workshops are attended mostly by unemployed women from HIV support groups, home-based care groups, church groups and community action groups.
The wellness workshops are attended mostly by women, who in many cases, are the primary caregivers for their families. If these women do not have access to correct information regarding health, nutrition and accessing clinic services, they are often left to make decisions based on inaccurate information that can result in poor management of health conditions, and often leads to worsening of symptoms and the creation of unnecessary problems along with the extra financial burden that is placed on the family through illness. The information and support provided in the workshops assists these women in being able to make informed choices and best care for themselves and their loved ones.
Many of the participants who attend the workshops are not only struggling with health-related issues, but also face family-related difficulties. They often come into the workshop space with high levels of stress. Although the workshops are not specifically therapeutic, increasingly, we have seen that when trust is built, how healing these spaces can be. We have so many stories of women who speak of the psycho-social benefits of the workshops. They speak about how sharing their experiences with others and how feeling heard and valued has had an impact on them. They also share stories of the power they feel that comes with this increased health knowledge, as well as the motivation and pride that comes with being able to share this important information with others. For us, this is an important aspect of the support that the workshops offer.
The Wellness Workshops cover a range of health topics including infectious diseases (HIV/AIDS, TB and STI’s) as well as Chronic Diseases of Lifestyle (Obesity, Hypertension and Diabetes). There is also a focus on the role nutrition can play in improving health and to explore this content practically, each workshop series is followed by a healthy cooking demonstration. The workshops aim to strengthen the well-being of participants from a holistic perspective, working with their physical, emotional and spiritual well-being. The workshops are facilitated in isiXhosa or English and have been facilitated for over a decade in townships and informal settlements across the Cape Flats.
The following topics are covered in the sessions:
Within 6 months of the workshops, facilitators return to the groups for follow up. The purpose of the follow up process is not only to refresh information or add new information, but also to explore the existing barriers faced by participants that impact on their health and wellbeing.
We have developed inputs that assist group members to explore the issues they face with, including family-related issues and community challenges such as difficulties connected to disclosing HIV status, unemployment and substance abuse. We do not only focus on challenges, but also explore areas of agency and resourcefulness. The follow-up workshops provide the space for psycho-social support and debriefing to help groups process some of the personal difficulties they are faced. The sessions take the groups through an exploratory process looking at self, family and community – unpacking areas of difficulty as well as areas of strength. It is inspiring to see what emerges from the sharing of these stories, particularly when time is taken to honour and affirm the resilience and strength that people carry!
The full workshop series is offered to an estimated 300-500 women annually. The content of the workshops is tailored to the needs of each specific group. The workshops are facilitated weekly throughout the year to groups of between 15-20 people at a time.
We provide individual psychosocial support so that participants from the workshops to support them to focus on taking steps to improve their health. These counselling sessions often provide the first opportunity for people to reveal their HIV status, express their fears and share their challenges. Where necessary, participants are referred to partner organisations for specialised services. For this reason, it has been key for Mamelani to build a strong network of partner organisations to be able to refer appropriately.
Roughly 2000 people have been reached through the wellness programme in the last 3 years. 90% percent of the participants were unemployed women. Approximately 1500 women completed the 8-week health education workshop series, followed by healthy cooking demonstrations and follow up workshops. An estimated 200 individuals accessed one-on-one counselling and referrals.
“I see all these conditions in my community, but I don’t know what to do about them. Now I understand what I can do. Lack of Knowledge destroys people’s lives. The more you know, the more you can take action”
“I enjoy this space because we feel safe and we trust our teacher that when we disclose our status or talk about our problems she won’t talk about it to other people or she won’t judge us. We don’t get such time and space in our communities to talk about our challenges.”
“For me I’ve learned a lot about eating foods that are healthy. I was a big meat lover and never liked eating vegetables even though I was diagnosed with high blood pressure. Now that I have attended this workshop I have drastically changed the way I eat, I am very thankful for Mamelani for bringing this workshop to us.”
“For me this workshop was heaven sent as I am a health worker in my community. Even though I don’t have the proper qualifications, the information that I got here, especially the one about chronic illnesses, it is so important, because most of my clients suffer from these. I myself did not have much knowledge about this. Now I can confidently talk, guide and advise them in living healthier lives with the illnesses they have.”
“In this workshop I learned a lot about my body and how my body works – learning about the importance of resting enough, drinking a lot water and changing the way I eat. I loved the part about learning the importance of adhering to you treatment as this one the biggest challenges facing our communities – people not finishing their medication. I am also using this information with my neighbours and people from my community.”
“In this workshop what I learned I will take it and use it with my grandchildren. I was very excited every time Thursdays when we went to this workshop, because we are old people we never thought that we can still learn more about health issues, but now I am going to be the one who will be telling my grandchildren about these different illnesses, thank you Nomvuyo for being patient with us, as old as we are!”
“I have learned a lot of new things… my father has Diabetes but I did not know much about this disease, now I have all the information I need to take care of him. Sometimes I would get angry with him when he would pee himself, but now that I’ve learned more about this disease and now I understand what he is going through. I always thought this was a disease for older people but now I have also learned that I can also be at risk because of the genes in my family. Since getting this information I have started to take better care of myself – I want to be a role model with my kids so they can see that I have changed and chosen a healthy lifestyle so I can live longer for them.”
“I am well informed about the different types of TB. At our clinics, they didn’t get enough time to explain how and why people are infected with MDR, XDR TB and how dangerous it is. I am willing now to volunteer to have a talk in our clinics because I know it will be easy to share the information I learned from the wellness workshop.”
“Now I know how important it is to follow doctor’s instructions about my chronic illness. Sometimes I felt lazy to fetch my treatment. I used to be in trouble with health workers at my clinic because I am a defaulter but now I know why I have to stick on my appointments. On my first visit I didn’t take it seriously. The information about cholesterol drove me to go back for a further check-up as the doctor diagnosed me with it. This workshop means a lot to me. I appreciate it so much – if I didn’t attend it, I will miss information and be making bad choices for my health. I also appreciate that it was free and I didn’t pay for transport cause it was in my area. Thank you Mamelani. We are appreciating what you did for us.”
“As young people we are expected to care for our elders, but we don’t understand the conditions they have. Now we understand and can help them and be patient with them. And we can even prevent the same thing from happening to us”
“This workshop has taught me something – I had always ignored this kind of information, thinking it won’t do real harm, but now I know these things can be fatal for my family.”
“The cooking session gave me more interest – I didn’t know how to cook without using so much oil. When I am cooking food I always cook it with meat – a meal was not good to me without meat – but now, the facilitator taught me something good – I am ready to show and share this info with my wife too!”
“My aim as a married man is to teach my family about eating healthy and making sure we leave all those junk foods we used to eat – and start to practice a healthy life from now on, so that I won’t see my family getting unnecessarily sick.”
“I am planning to make a garden of my own in my backyard to grow fresh and healthy food for myself. I will convince my friends to be more involved and active in this project of mine – I will try to show them how to live a healthy lifestyle.”
Mamelani has partnered Medecins Sans Frontieres (MSF-SA) to pilot Community-based ARV adherence clubs in Khayelitsha. Mamelani facilitators have been trained by MSF in how to recruit eligible patients and in how to facilitate the sessions. We have started running groups where we are dispensing treatment and facilitating routine check up’s every two months. We are really excited about the potential of this model in that it allows us, in a very tangible way, to support HIV positive patients with regards to treatment adherence, and also to lower the burden on the system – both objectives that are central to the purpose of our work. To learn more about the model, click here.
We have also initiated a grassroots leadership initiative, in which women who have attended the wellness workshops are selected to participate in a capacity building process to support their initiatives. These ‘Community Champions’ have become beacons of hope and resources for health information, referrals and support within their own area. Each Champion is supported in building her personal vision and supported through a 1-year mentoring process to have the skills and resources to make a positive contribution where it is most needed. In 2016 we began working with a new group of Community Champions. We have worked with a total of 45 individual Community Champions since the start of the programme in 2011.
Community Champions are selected from our Wellness Workshops based on the initiative they have shown to improve the health of those around them. The programme runs over 18-months, working with participants from different communities. In the first six months, they attend a series of personal development workshops. The workshops acknowledge the valuable work that these women are doing, as well as create a safe space for them to share their stories and therefore learn from each other’s journeys. The process also assists the women to identify local resources and networks, identify gaps in their initiatives and set personal goals towards achieving their vision. The relationships that have been built amongst the Champions were seen as a resource by the group.
At the end of the process, each woman is matched with a mentor who provides ongoing support for one year. The mentors, who are Mamelani facilitators, walk alongside these women to support them in building their initiatives. This programme has fostered deeper relationships between the women themselves, as well as between Mamelani and the communities in which we work.
“I am a very strong woman: I have been through abuse in my life, but I survived and it made me strong. Now I use my strength to help other women. I am glad that I came to the workshops, to tell the story of my community. Being a Community Champion has helped me to stay strong about the work I do in my community”
Mam’ Mickey started the Yiza Ekhaya soup kitchen to care for vulnerable people in Kuyasa. She feeds 250 people a day from Yiza Ekhaya.
Mam’ Mickey started the Yiza Ekhaya soup kitchen to care for vulnerable people in Kuyasa. She feeds 250 people a day from Yiza Ekhaya.
“During Community Champion Training I gained skills in communication and how to be patient when you are working with people. The mentor has helped me with so many things – it was not easy for me when things were hard at the soup kitchen, but now I am learning to keep record of the finances, looking at the budget, sticking to the needs of the soup kitchen. Mamelani assisted me with finding funding to be able to get food for people who need to eat, especially those who are taking medication. I am where I am today because of Mamelani, with a big thank you – Phambili Mamelani Phambili!”
Vuyokazi is now a home-based carer.
“Mamelani Projects is such a great organisation. Basically, human empowerment is the main purpose of their existence and I am a true example of that! Since the first day I got involved with their programme, my life changed to be better. They first shared the wellness programme through workshops that were very powerful. The topics are very important for everyone’s health. Their focus was on chronic illnesses in connection with nutrition and how to assist people living with different illnesses. They encouraged us to know more about the food we eating, what it does in our bodies and how to cook food in a healthy way. Through their help I have become an informed and helpful person in my community. They inspired me and reminded me of my childhood dream to become a nurse. I feel very lucky to have attended the programme because it helped me to fulfil my dream by assisting me to do a Home Based Care course. I thank Mamelani and their humble facilitators for all their support”.
Patricia has established a crèche that is registered as an NPO and is caring for children in her area.
“At the time, my life was miserable. I just stayed at home for the whole day doing nothing after my daughter had left to school and I started getting bored and frustrated. When I joined the group I felt a change in my way of thinking and surprisingly, no more stress. The workshops were really very interesting – making me grow to understand more about my lifestyle, my body and my health. When I finished the wellness programme, I was chosen as one of the Community Champions. During this process is when I planted the seed for the passion I have for children and how I can put this passion into my community. The workshop inspired me and motivated me to be curious to know more about the resources that we had in my community. For me was a BIG learning process. It also made me to believe in myself – gaining more confidence and focusing on what I really want to do for my community. Now, I have been trained in computer skills and early childhood development. I am running my crèche and providing support to my community. Some of the children, their mothers are at work and they are happy because their children are safe. Other mothers need to be out there trying to find work, and so I am helping them, even if they can’t pay the fees for the crèche yet. I feel so proud of myself. I didn’t know I could be this light in my community”
Nosibongile Dube is a community leader.
“I am Nosibongile Dube. Mamelani opened my eyes to many things that I didn’t know. Mamelani helped me with skills that I wanted to be able to help my community. I am proud to be a home-based carer now so in my community I can help people with their different problems. I can face anything now. I can face my personal problems. I know I have a person to share my things with – my mentor this year has helped me. I want to say thank you Mamelani. You must grow big and help many people like me”
“It taught me how to handle the problems in my community, how to solve each case, step by step and how to share your views in the community. I learn to give and receive from people – something new in my life.”
“It’s good to know that we as community members have a role to play in making sure our communities are better, safer and that we live in empowered communities.”
“It helped me to boost my self-esteem. It taught me to be strong as a person because you face many obstacles and how you must overcome them. I also learnt about what resources there are in my community and where to find help.”
“The workshops made me stronger now – I know that I am not alone.”
“I feel like a new person after letting go of this baggage. I call it my baggage because I’ve been dragging it for all these years. It feels like a load off my shoulders. Thank you Mamelani for bringing light back in my life.”
“I think these kind of healing sessions must not be something that is done by only our facilitators, I think we should do this at our homes as well, our children, our families need these kinds of spaces, I think it would help to create healthy and happy families.”
“In our culture, we grew up knowing some things are better kept a secret, you don’t talk about your family secret or scandals and these are the things that grow this anger and resentment in our hearts. I think sessions like these are really healing to the soul.”
“The River of Life was the best medicine for me, after doing it I’ve learned to deal better with my anger I had towards my brother and my sister. I am willing to communicate and support them now emotionally. My personal goal is to keep controlling my anger.”
“For me this was not just a journey but a journey of new beginnings, I feel like a new person, I act like a new person, I think like a new person. I have left of my years of dragging my baggage and feeling sorry for myself. Thank you Mamelani I wish you have come in my life much earlier I would have been very far now. My goal is working more with the children in my church and using all these skills to try and save them even before they start all these negative things.”
“Things like these are very rare in our communities, where you are given a space to grow and learn, for me this an opportunity to play a bigger role in my community.”
“Thank you to Mamelani for recognising us as community workers and being willing to grow us and our community projects.”
“For me this journey was very informative, it gave me personal growth. I am taking back all the information, skills and advices I got from here back to my community. Now that I have better understanding of my community, I want to make it my goal to involve them more in the work that I’m doing in my area. I have learned that we can achieve a lot if we work together rather than in silos.”
“The River of Life was the most powerful exercise for me of all the different exercise I did. This training has made me open up and be more vocal. Before this I was a very shy person. My goal now is taking all that I have learned back to the youth I work with.”
“Mamelani has built my confidence. I now have positive thoughts about myself and my potential!”
“All the skills I accumulated from Mamelani, I’m going to use them in my community, I have already been working with community people for some time, but now I feel strong enough to do more.”
“Sometimes it’s not about keeping these things bottled up, but it’s just you don’t have people you trust enough to off load to. I am very happy I am part of this group, thank you to you guys for making me feel it’s safe to talk about these things.”