The Leprosy Mission supports people with leprosy across communities in Mozambique

As The Leprosy Mission’s UK Aid Match project comes to a close, almost 3,000 people in remote communities in Northern Mozambique have received the care and treatment needed to cure their leprosy.  

Photograph: Leprosy Champions and communities members at a Hub of Hope. Credit: Ricardo Franco

With funds raised through their UK Aid Match appeal in 2021, The Leprosy Mission has supported local Leprosy Champions to recognise the early signs of leprosy and refer people for treatment, established 22 Hubs of Hope to create a safe and inclusive space for people affected by leprosy, and empowered farmers to become more climate-resilient.

In remote communities in Mozambique, people with leprosy often face deep-rooted stigma and discrimination, sometimes they are even banished from their communities, despite leprosy being curable. Through the project, 807 volunteers – called Leprosy Champions – have been trained in leprosy detection, meaning they are able to refer people for treatment before disability sets in. Not only do they support patients throughout their leprosy journey, but they educate their community about leprosy, challenging attitudes and fostering understanding and acceptance.

Meet Monihia

A mother of three, Monihia first noticed discoloured patches appearing on her skin and sought help from a traditional healer in her community. Luckily, this healer had been trained as a Leprosy Champion, so was able to spot the signs of leprosy and refer Monihia to her local health post for treatment.

“I was the first person in my community to be diagnosed with leprosy. I didn’t know I had the disease and didn’t understand what was happening to me. I’m so thankful someone knew what was wrong and I was cured.” Monihia.

Hubs of Hope

Today, Monihia finds support and connection at her village ‘Hub of Hope’ – a welcoming community centre that is often the only place in the village with electricity and internet access. Across Cabo Delgado and Zambezia provinces, 22 Hubs have been established, serving as self-care groups where over 1,700 people affected by leprosy join each week. At the Hubs they check each others feet for cuts and grazes, and clean and bandage any wounds to prevent infection. For people with leprosy it is difficult to feel pain in their feet, so making sure injuries are treated and don’t escalate is the best way of preventing disability in the future. Leprosy Champions can also be found at the Hubs, ready to check for suspecting leprosy, offer support, and refer people for treatment.

Photograph: Monihia is pictured outside a Hub of Hope, known locally as a media centre, in Cabo Delgado, Mozambique. Credit: Ricardo Franco

Climate-resilient farming

The Hubs have also become centres of community and resilience. Recognising the growing threat of climate change, which has brought frequent cyclones and crop losses, the project has trained local farmers in sustainable, diversified agriculture. Farmers like Monihia have learned to grow a wider range of crops, such as beans, to improve food security and reduce reliance on a single harvest. Many farmers have also begun selling surplus produce, earning additional income to support their families.

For Monihia, farming has brought not only food and financial stability, but also a sense of purpose and belonging. She and other farmers have joined together to create a community farm, where they grow crops together, and support and teach one another.

Through the dedication of local Leprosy Champions and Hubs of Hubs, people once isolated by leprosy feel welcomed and communities are becoming stronger and more resilient.

Photograph: Gabriel, a government health worker who has been trained to diagnose leprosy and prescribe the antibiotic cure. He travels huge distances on his motorbike to reach rural communities like Monihia’s. Credit: Ricardo Franco

For more information on the project please visit The Leprosy Mission’s website.

In Spring 2025, our UK Aid Match teams visited grant holders CBM and Trócaire in Zimbabwe and Restless Development and Street Child in Sierra Leone.

The visits provide valuable opportunities to connect with grant holders and their delivery partners, strengthen our role as critical friend, and deepen our understanding of project progress and challenges. They also allow time for more in-depth exploration of ideas, troubleshooting, and tailored support – whether that’s navigating technical or financial reporting issues, or better understanding the Foreign, Commonwealth & Development Office (FCDO) approaches to safeguarding, and other important aspects of grant management.

Below is a brief summary of the visits:

In Zimbabwe, CBM is strengthening eye health care services by training health workers to identify people with eye conditions, delivering thousands of sight-restoring cataract surgeries to those who need it, and improving infrastructure across eight district hospitals.

During our visit the team travelled to Gokwe South Hospital and met with key hospital staff and the Provincial Medical Director. They observed surgical processes and aftercare and discussed project implementation and outreach from community health workers with partner staff and clients.

The impact of the project was clear. Many people who had once lost their sight to cataracts shared how their lives had been transformed. With restored vision, they could return to work, care for their children, re-engage in their communities, and feel less of a burden to their families. Strong coordination between trained community health workers and local eye health champions  – trusted community members who raise awareness and encourage uptake – has significantly increased demand for services. In fact, when our team visited a local eye camp, so many people attended that the event was extended an extra day to accommodate them.

Further, a key strength of this project is CBM’s expertise in disability inclusion and its partnership with HelpAge Zimbabwe. This collaboration has been instrumental in reaching older people, often an overlooked group when it comes to healthcare services in Zimbabwe.

As eye health continues to be a low priority in many countries with constrained healthcare budgets, projects like this are often the only way people can access essential services. CBM is making important progress on sustainability, particularly through strengthening local health systems and building long-term capacity, and their advocacy and training of community health workers and local eye health champions is critical to embedding lasting change.

As the project enters its final reporting stage, we look forward to hearing more about the longer-term social, economic and wellbeing impact of improved eye health, and how these lessons can shape future approaches.

Photograph: A patient at a CBM eye camp. Credit: ©CBM UK/Thabani

In Zimbabwe, particularly in rural areas, climate change has brought increased droughts and extreme seasonal weather, leaving livelihoods at risk. Trócaire’s three-year project focuses on supporting local agricultural capacity to boost incomes, diversify crops and enhance resilience amongst farmers.  

Although security concerns cut our team’s visit short, preventing a trip to the project site, they held productive discussions with Trócaire and their three local partners Caritas Masvingo, Musasa Project Trust, and Organisation of Rural Associations for Progress (ORAP), visiting their country office in Harare and chatting remotely. The team heard how the project is working in collaboration with the Department of Agricultural Technical and Extension Services (AGRITEX) to bring more sustainable farming to life, such as utilising seed banks and local crops, along with traditional planting and pest control methods. By learning to grow a wider variety of crops and try out alternative composting methods, farmers are better prepared to face unpredictable weather. The impact is already visible, with participants sharing how lead farmers are passing their skills to others and community farms are thriving due to newly developed water infrastructure.

In the project communities, men traditionally control household finances, and women are often left without a say and face heighted risk of Gender-Based-Violence (GBV). By building strong ties with local authorities, including the Victim Friendly Unit (VFU) of the Zimbabwean police, the project has set up one-stop centres where women can get information, support, and a safe space to resolve GBV cases. These centres have opened the door to new referral pathways and host sessions on women’s rights, bringing men into the conversation too. Internal Savings and Lending (ISAL) groups are also progressing well. Not only are the 31 project-backed groups working closely with local authorities to ensure long-term sustainability, but five more have been launched by participants to start in their own communities, drawing on lessons from their training and empowering farmers to learn from each other.

These approaches on building local ownership are key to ensuring sustainability once the project ends. In addition to collaborations with AGRITEX staff and VFUs, local Environmental Management and Water Point committees have been set up and have started making independent decisions, indicating a level of community confidence. As the project moves forward, we look forward to seeing how these partnerships are translating into long lasting change.

Photograph: A farmer with her crops. Credit: Trócaire

In Bombali and Moyamba Districts, Sierra Leone, Restless Development’s ‘Power Up’ project works to keep girls safe through community-driven protection measures, and improve their life chances through access to formal and informal education and life skills training. In the project communities, harmful practices such as early and forced marriage, and sexual and gender-based violence (SGBV) pose significant challenges, contributing to high rates of teenage pregnancy, and subsequently high numbers of adolescent girls out of school.

During our visit to Bombali District, the team observed lively and engaging life skills and empowerment sessions for out-of-school girls, and listened in on school-based Boys’ Club activities. They also met with mentors and community leaders to hear how the project is progressing, and representatives from Bombali District Council Officials who expressed strong appreciation for their involvement in the project such as engaging in project reviews and selection of communities.  

Photograph: Emma Hayward (Senior Performance and Risk Manager) with Bombali District Officials and members of the Restless Development Sierra Leone Leadership Team in Makeni

With support from the project, communities have established ‘safe spaces’, where adolescent girls can spend time together, share experiences and take part in basic literacy, numeracy and life skills sessions run by mentors. Girls have established their own rules for these spaces, which now include accessibility adaptations for those with disabilities, and crèche facilities to enable young mothers who have dropped out of school to participate.

It was clear that the mentors are highly trusted by the girls and respected by communities and school staff. Restless Development’s mentor programme is a well-established volunteer network in Sierra Leone, and all Restless Development Sierra Leone staff, including the Hub Director, started their careers as Restless volunteers, creating a strong sense of pride in and ownership of the organisation’s programmes. Mentors serve as positive role models for adolescent girls and they told our team they are confident that their experience in the Power Up project would support future ambitions, such as studying social work or becoming teachers.

Photograph: Restless Development Mentor, Zainab, delivering a Life Skills session at the safe space in Mapaki community.

Our team also met a dynamic Link Teacher, who has been trained by the project on safeguarding and inclusive teaching practices. His approach created a safe, trusting classroom environment, an important factor in keeping girls in school. Boys in his class demonstrated strong engagement in the Boys’ Club activity and spoke passionately and in an informed way about the importance of girls’ empowerment and protection, as well as their own responsibilities in supporting this, reflecting the project’s influence on shifting attitudes.

Photograph: Our team with girls and mentors from the Restless Development Safe Space in Mapaki community, Bombali District. Photo credit: Restless Development

Girls, boys, and both male and female caregivers have been meaningfully involved in shaping community action plans and in holding duty bearers accountable for their delivery. Community leaders shared how local-by-laws, developed from these community action plans, have successfully empowered girls and supported their education. Results seen so far include a reduction in teenage pregnancies, several early marriages being stopped, and the banning of discoramas (night time dance parties) during term time to reduce distractions from schooling and keep girls safe from harm.

Our team are looking forward to supporting the project further as it continues in its final stages.

Across four districts in the north of the country, Street Child, through its local partners, are working with 2,000 caregivers to support them to overcome the economic and social barriers that are keeping 4,500 children from attending school.

In many of the project communities, caregivers identify finances as the biggest obstacle to sending their children to school. To address this, the project is supporting 2,000 caregivers to establish small businesses, through distribution of small Family Business Support (FBS) grants and business skills training. The team saw that businesses are up and running, and caregivers reported that their financial ability to keep children in school is improving as a result of business and savings activities.

But money isn’t the only challenge, some children face different barriers, including caregivers not valuing education, children not wanting to attend school, and for those who have a disability, ongoing stigma and challenges with accessibility. These children are also supported by social workers through counselling and family mediation to shift attitudes and encourage school enrolment. Caregivers spoke of understanding the value of education in a new way as a result of these interactions.

During our visit it was encouraging to see that families have formed strong, trusting relationships with Street Child family business officers and social workers, shown through warm receptions, emotional storytelling, and the staff’s deep knowledge of family histories.

Photograph: Aisha’s mother selling mangoes in Makeni, Bombali District

Another aspect of the project is to support the safeguarding and protection of children. Government-mandated Child Welfare Committees (CWCs) have been revitalised through the project by re-establishing inactive ones, electing new members and training them in child protection and safeguarding. These CWCs include diverse community members such as chiefs, teachers, police, faith leaders and students, ensuring children have a wide range of trusted individuals to turn to if they feel unsafe. Efforts to strengthen links between CWCs and government-run Family Support Units (FSUs) and the Police are also taking place, meaning more serious child protection cases can now be referred and managed more effectively, making homes, schools, and communities safer.

Photograph: Our team and Street Child staff in Koinadugu District, meeting the Director of the Ministry of Social Welfare, Gender and Children’s Affairs

CWC members told us they are confident they will continue their work once the project ends after 2025, as they have learned a great deal and are motivated by the positive changes they’ve seen – such as increased peace in their communities, and reduced teenage pregnancies, rape, gender-based violence, and fighting. We look forward to seeing how these community initiatives continue to thrive through the final stages of the project.

Photograph: Emma with Saiyo and her daughter – participants in a previous Street Child UK Aid Match project – explaining how their business has grown over the past three years in Kabala, Koinadugu District

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.

As EMMS International’s three-year UK Aid Match project in Nepal comes to a close, people with life-limiting illnesses and conditions are receiving the support they need, and long-held stigma around palliative care is starting to shift.

In Nepal, the concept of palliative care is still very new, and people are often unable to access the services they need to live comfortably and manage their illnesses or conditions, which can be extremely isolating. As well as this, children often take on extra household chores, as the work in the household expands when one family member needs the others to care for them.

With funds raised through their UK Aid Match appeal, EMMS International’s Sunita project is changing this, developing caring communities in partnership with healthcare professionals, teachers, and community groups.

The Sunita project offers a holistic approach to palliative care through cost-effective and sustainable health and social care services. Healthcare professionals and community workers have been trained to recognise the needs of those requiring palliative care, ensuring people can get the right support sooner and more effectively. This mix of community and healthcare training ensures people living in remote areas – who are unable to access a hospital – can still be supported within the community. For people who are able to travel for care, a dedicated wing at Green Pastures Hospital (GPH) in Pokhara is available where patients can receive specialised treatment and access vital pain relief and resources such as counselling.

Stories of change

When Ramesh was 17, he suffered a life-changing fall that left him very sick and feeling hopeless. His mother Lakshmi became his main carer. Through the Sunita project, Ramesh and Lakshmi now have a growing community of support around them. They receive home visits from community nurses and doctors so they are less isolated, and travel to GPH for specialised treatment and essential medicine.

Photograph: Ramesh at home

83-year-old Jit was born with no legs below his knees, affecting his ability to walk. His son Dal works as a builder and is proud to take care of his father, albeit he did this alone. Now, they are both supported by Ganga, a Female Community Health Volunteer who lives nearby in their community. After receiving training through the Sunita project, Ganga visits Jit around four times a week, and guides him on better sleeping positions so he is comfortable, supports his care needs, and provides crucial updates to his medical team in Sahodar so they can keep track of his progress.

Photograph: Ganga, Jit’s Female Community Health Volunteer

Advocacy, community support and caring societies

One of the most powerful aspects of the Sunita project has been its focus on the holistic, human side of healthcare. Dr Dan Munday, palliative care consultant at GPH and adviser to the Sunita project, explains how palliative care training goes beyond end-of-life support, shaping compassionate communication skills that can enhance other areas of health care too. “We are now gaining pretty good evidence that palliative care is a way of enabling people to develop those interpersonal skills, which then go across the whole practice. And they’re not just to do with end of life care or people with advanced illnesses but actually it’s something that strengthens your work with anybody.”

Empathy, compassion, and advocacy are central to this approach, supporting not only healthcare professionals, but volunteers and teachers. By centring local voices and investing in community volunteers, the project demonstrates that palliative care can be both accessible and deeply meaningful, even in remote regions. As palliative care becomes more recognised and accepted, teachers trained through the project are now able to provide child carers with additional support so they can continue with their studies.

 “So that’s what we need, to actually work on all the aspects…. not just the physical aspects of things, but the social, the spiritual aspects and psychological aspects. You need a person who’s empathetic to cater to the needs of the patient or their family.” Dr. Amrita Shrestha, paediatrician and palliative care physician at GPH.

Photograph: Outskirts of Pokhara in Nepal, where Ramesh (mentioned above) lives

The legacy of the Sunita project

The project’s strong emphasis on holistic approaches and breaking stigma around palliative care is key to building evidence to support the Government of Nepal’s national care strategy, laying the groundwork for future policy and government action.

Not only is immediate impact from the project clear to see, but a rise in female leadership in palliative care in Nepal is also providing hope for a long-lasting future.

Take Dr. Amrita for example (quoted above). Encouraged by the success of the Sunita project, she has pursued specialised training and completed a fellowship in palliative care. On top of being a skilled clinician she has become a passionate advocate for children’s palliative care, an area that is critically underserved in Nepal.

And it is not just health care professionals. Arati has always been drawn to research and found herself leading a team of researchers under the Sunita project. Their work has contributed to multiple palliative care studies, with findings shared at national and international conferences, giving vital voices to patients and caregivers through data and evidence.

Dr. Bishnu Dutta Paudel Bucha, Professor of Medical Oncology and President of the Nepalese Association of Palliative Care is certain that the work of the Sunita project is shaping the way for palliative care across the whole of Nepal. “This finding of the Sunita project is very, very helpful if we really can use it to amplify in other districts of Nepal”.

These initiatives show that the Sunita project has not only paved the way for creating sustainable change, but with continued momentum palliative care in Nepal and beyond can be given the attention it deserves.  

Read more about EMMS International and the Sunita project.

And follow them on social media to learn more from health care professionals involved in the project.