Projects in progress: a UK Aid Match team trip to Malawi to visit CBM, Sightsavers, UNICEF and World Child Cancer

In May, Gem Clark, Fund Portfolio Manager for UK Aid Match, and Emma Hayward, Performance and Risk Manager for UK Aid Match travelled to Malawi to visit four grant holders: CBM Global, Sightsavers, UNICEF and World Child Cancer.

One term that was used by all grant holders throughout the visits was ‘poly-crisis’. In recent months and years, Malawi has suffered from multiple crises such as ongoing impacts of COVID-19, the global economic crisis, a cholera outbreak, and most recently a devastating cyclone. These issues are in addition to the already challenging Malawi context, where road quality/access, fuel shortages and increased cost of living are real barriers to organisations delivering projects.

During these visits, the team had a chance to see how the grant holders’ projects were progressing, learn more about how the ‘poly-crisis’ is affecting them, and hear from the communities on how the projects are positively impacting them.

Below is a short write-up for each project the team visited.

Improving access to quality, inclusive and comprehensive eye health services for marginalised rural communities in Central-Eastern Malawi – CBM Global

Through its three-year UK Aid Match project, CBM Global is improving access to eye health services in rural districts in Central and Eastern Malawi. In particular, the project is looking to enable people who are blind from cataracts with sight-restoring surgery. By partnering with the Malawi Network of Older Persons’ Organisations (MANEPO), the project is able to focus its efforts on older people, for whom cataracts are a particular problem.

Only 45% of blind people have access to cataract surgery due to reasons such as lack of eye health workers, services and access. Specialist hospitals are often long distances away from people living in rural areas, meaning there is no option for them to receive the care they need. CBM Global is working to change this by providing training and equipment to eye health workers, and running cataract outreach camps where people can attend and receive specialist treatment.

During the visit, the project delivery team explained that fewer people than expected were attending eye health screenings and surgical camps due to fuel shortages and the cholera outbreak, as people were not wanting to attend large gatherings. Despite this, the team is continuing to reach out to remote communities, ensuring that health workers are trained and have access to specialist equipment in order to treat patients who are able to access community hospitals. These workers will remain in their communities and continue to raise awareness of, and identify, eye health issues once the project ends. Through its partnership with Nkhoma Eye Programme, the project is also supporting two trainee ophthalmic surgeons to complete their qualifications, which will give a boost to the eye health system after the project has ended.

A photo of 6 people stood in an operating room, wearing hospital overalls and masks. — Gem and Emma visiting an operating theatre

Improved access to affordable, quality eye care services for people with and without disabilities in South-West region, Malawi – Sightsavers

Sightsavers’ UK Aid Match project aims to improve access to eye care services in Malawi over a three-year project period. As well as providing cataract surgery to avoid blindness, the project has a specific focus on reaching people who traditionally face barriers to accessing much needed eye health care, including people with disabilities.

In addition to providing eye examinations, and offering treatments and operations which will contribute to overall eye health, the project is working with the Federation of Disability Organisations in Malawi (FEDOMA) to improve accessibility of several health facilities for people with disabilities.

During the visit the team learned that Sightsavers was investigating ways to reach more vulnerable people, such as older people and people with disabilities, through running eye health awareness raising activities and screenings at social protection camps. This has worked well in the Uganda part of this multi-country project, and it was good to see an example of shared learning within the project.

It was clear that the project was transforming people’s lives. At one home visit, a patient and his wife explained how their lives were badly affected by his disability (below leg amputation related to diabetes), as well as visual impairment prior to his cataract surgery. Since the surgery their lives have improved dramatically, and the patient is scheduled for further eye surgery on his other eye.

Left-hand photo: Members of different communities attending an eye health talk at a screening camp. Right-hand photo: An Ophthalmic Clinical Officer screening a patient

Building safe, inclusive and resilient communities for women and children in Malawi – UNICEF

Through its UK Aid Match project, UNICEF ensures that women and children are safe, happy and healthy.

In rural communities in Malawi, UNICEF has established Children’s Corners, where children can learn about their rights and play safely. The project is training child protection workers and supporting structures such as Community Victim Support Units to identify and respond appropriately to child protection issues and cases of violence. The project has also brought safe water and sanitation to communities. As well as improving everybody’s health, this reduces the security risks faced by children and women when leaving the relative safety of their homes and villages to use communal facilities or collect water. Families can access sanitation loans to upgrade latrines, in a model that creates economic opportunities for shop owners and pit emptiers.

From the visit, it was clear that displacement and loss of livelihoods caused by the cyclone has increased the urgency of child protection needs. Children face exploitation in return for food and shelter, and malnutrition is rising due to the cholera epidemic. UNICEF has responded directly to these issues by extending psychosocial support and psychological first aid to survivors of the cyclone and ensuring children have access to safe corners within their communities. In addition, through the sanitation loans, families have reduced the impact of the cholera epidemic in their communities.

A woman and a man wearing blue uniform, stood in a sanitation shop and holding a portable toilet — Left-hand photo: Sanitation workers in a sanitation shop. Right-hand photo: Children drinking from the new safe water tap

Two children drinking water from a water tap — Left-hand photo: Sanitation workers in a sanitation shop. Right-hand photo: Children drinking from the new safe water tap

Reducing child mortality in Malawi whilst increasing wellbeing and quality of life – World Child Cancer

In Malawi an estimated 1,100 children develop cancer every year. Due to the lack of health care knowledge and training on identifying early warning signs and symptoms (EWSS) of childhood cancer, only a quarter of children diagnosed will survive.

Through its two-year UK Aid Match project, World Child Cancer is delivering training for health workers and supporting families to ensure that cancer can be diagnosed early, and that treatment is completed. The project is working across 14 Districts in South and Eastern Malawi to improve the quality of life and wellbeing of children and their families affected by cancer.

Often when there is detection of cancer in a child, the first point of contact is a community hospital, where staff lack advanced knowledge and means of diagnosis and further treatment. Now that they have been trained in EWSS, community health workers are able to quickly refer families to District or Central hospitals for further tests. In addition, the project is supporting Queen Elizabeth Central Hospital (QECH) via outsourcing an independent pathology lab, which allows for immediate, free testing for families and significantly speeds up diagnosis and treatment. Although the current ‘poly-crisis’ has increased the cost of transport, immediate travel to QECH is essential to ensure children can get the treatment they need. The project is offering support to families through transport grants and providing welcome packs on being admitted to the hospital. This is perceived as essential psychosocial support to families who commute from long distances without the basic items they need to stay in hospital.

Another important part of the project is the provision of play therapy sessions, designed to reduce the fear and anxiety children often feel when undergoing treatment. Through UK Aid Match, Malawi’s first paediatric oncology Play Therapist is now trained and offering support to children and families on the ward at the QECH.

By removing some of the economic and psychological barriers to seeking treatment, World Child Cancer is making sure that treatment isn’t abandoned, which increases the child’s chance of becoming cancer free and living a healthy and happy life.

A woman and children sat in an area using crayons and paper to draw pictures — Aida, Play Therapist, leading a play therapy session

A thank you

We would like to take this opportunity to thank all the organisations and individuals involved with these visits. We really appreciated all your time and continued hard work.

In January, UK Aid Match Fund Director Sarah Donachie, accompanied by Fiduciary Risk Officer Bridget Hall, and FCDO colleagues Bruce Reilly and Nicola Currie for the Open Societies team, visited Bangladesh to see how three fund projects were getting on.

They enjoyed warm welcomes from the RNLI/CIPRB, World Child Cancer/ASHIC and British Red Cross/Bangladesh Red Crescent programme teams, and from the communities they are supporting.

Here is a short write-up of what we saw from these visits.

Preventing childhood drowning – RNLI

The RNLI has been working with the Centre for Injury Prevention and Research Bangladesh (CIPRB) in Kalapara sub-district over the last 3.5 years to keep children safe from drowning through their UK Aid Match project.

In Bangladesh, drowning is the leading killer of children, with vulnerability at its peak between 9am and 1pm when parents must work to feed their families and are unable to provide close supervision.

Many are are faced with an impossible situation, and paid-for childcare is out of reach especially in rural communities, even for those that could afford it.

Through this UK Aid Match programme, 300 Anchals – community-based creche facilities – have been established, offering a safe environment for over 5,000 children aged between one and four years.

They are run by local women, or ‘anchal-maas’, to provide a secure place away from open water for children to play and learn important early childhood development skills.

Access to a free anchal place has reduced a child’s risk of drowning and provided essential early childhood development support. The programme has also empowered women in the community by providing them with opportunities to work.

This project has now come to an end, however the RNLI and CIPRB have secured additional funding from the Government of Bangladesh to continue their work in drowning prevention. The team will be launching a significant new programme (called the Integrated Community-Based Centre for Child Care, Protection and Swim-safe Facilities Project) in the coming period for young children across Bangladesh to survive and thrive to their full potential, with comprehensive attention to physical, cognitive, social, and emotional growth and development. Watch this space for a podcast exploring this further in the near future.

Large group of people sit on red rugs around a square in conversation — The UK Aid Match team from MannionDaniels and FCDO, meet with parents of children who attend the Anchals to understand their perspectives on how the RNLI and CIPRB project has impacted them.

Improving paediatric oncology outcomes – World Child Cancer

With only a quarter of children who develop cancer in Bangladesh each year ever receiving a diagnosis and as few as 45% of those surviving, World Child Cancer’s three-year UK Aid Match project has been working across the country to improve access (to treatment), care and quality of life.

In Bangladesh, the long-term treatment required when a child has a cancer diagnosis often pushes an entire family further into poverty. This project’s focus has been on strengthening the health system and working across the seven leading government paediatric cancer units to ensure long term change is affected so those that benefit from it will not just be the thousands of children, their families and health workers, but also children who are diagnosed with cancer in future years and their families.

It was evident from the visit that the project is operating within a resource-constraint environment, and the COVID-19 pandemic significantly worsened the situation for children with cancer in Bangladesh given the additional pressures on the health care system and limited mobility (as the majority of available care is in Dhaka city). The project team have adapted well as a result but the challenges associated with health care service delivery following the pandemic appeared to continue. Despite these challenges, the project has been able to introduce psychosocial support, which was not previously an element of the care offering and has evidently provided much needed support to children and families in their cancer journey.

Women, men and children smile to camera in a hospital setting — The UK Aid Match team from MannionDaniels and FCDO, with World Child Cancer and ASHIC at their Shelter providing accommodation for families undergoing care in Dhaka city.

Protecting and securing women’s livelihoods – British Red Cross with Bangladesh Red Crescent

With this UK Aid Match project, the British Red Cross have been working with the Bangladesh Red Crescent in the slums of Barishal in Bangladesh, where monsoons and flooding are inescapable and life for women is hard.

Back in November, we shared an overview of the project on the UK Aid Match website explaining how it has been supporting the women living here. They often miss out on an education, struggle to make a living, and are frequently raising families alone and suffering violence just because of their gender.

This project has supported women’s small businesses to thrive through vocational training, apprenticeships and small cash grants (to help set up microbusinesses).

The outcome? They are earning an income, building savings and helping their communities to flourish.

Groups called Women’s Squads are also raising awareness of issues like menstrual health and gender-based violence, and within these Squads, women have a platform to stand together and have their opinions heard, amplifying their role and voice in society and reduce their isolation.

The visit highlighted that despite the delays experienced as a result of COVID-19 the project team have made significant progress: there were several areas that had created clear benefits for project participants, specifically the opening of bank accounts and linkages to other service providers such as government welfare schemes. A large number of project participants had set up a bank account for the first time as a result of the project support and this formal financial inclusion had clear benefits such as reported increases in savings and access to wider and more diverse supply chains and markets. Alongside this, many members of the Women’s Squad shared that, through the project, they have been able to create more linkages to local government who have been more responsive to their requests for support.

Related, the meetings with the Women’s Squad highlighted the significant progress that the project has supported in terms of women’s empowerment. The women we met shared positive stories of how joining and being part of the Squads had supported them to have greater influence within their communities and households, and they shared that they were better able to address issues such as child marriage, domestic violence and child labour.

Female jeweller sits in her workshop — Left-hand picture: A jeweller supported by the Bangladesh Red Crescent’s Women’s Squads, Bangladesh. Right-hand picture: A wife and husband who own a chai stall, supported by the project.

Husband and wife in sari look to camera in their chai tea stall — Left-hand picture: A jeweller supported by the Bangladesh Red Crescent’s Women’s Squads, Bangladesh. Right-hand picture: A wife and husband who own a chai stall, supported by the project.

A thank you

We would like to take this opportunity to thank all the organisations and individuals involved with these visits. We really appreciated all your time and continued hard work.