AHN Workshop Maputo, Mozambique 21 – 23 November 2008 African Twinning Project A strategy for heart health in Africa

A programme with only one project – A great idea with little participation The Kenyan – Danish Twinning Project “The Nairobi Eastland’s Children’s Heart Education Project”

Here we have the “twins”

Facts about Kenya Population: 31,5 mio Mortality 2002 Heart disease Mortality 2002 Stroke Mortality Rheumatic Heart Disease 360 Smoking prevalence m:66,3% f: 27,3 % Research number of publications on cardiovascular disease: 3 from 1991 – 2001 Number of cardiologists 12 WHO: “The Atlas of Heart Disease and Stroke”

2002: from Paddy Murphy WHF requesting Heart Foundations to facilitate establishment of heart foundations in Africa “The African Twinning Project” DHF joined the project Why: As a rather wealthy, big and well structured organisation we felt we had an obligation to offer our help to some of the poorest people in the world After consultation with the Ministry of Foreign Affairs we decided to approach Kenya Through Paddy Murphy we got in contact with Elizabeth Gatumia

We invited her to Copenhagen on our expenses Agreed about the twinning, though non of us really knew what it was DHF expected it to be about exchanging knowledge and experience KHNF felt that primary need was funding

2003 Kenyan Heart National Foundation was established a legal national organisation DHF started to receive requests for money DHF realised little by little that twinning was impossible without funding The most urgent was a sponsor We found funding opportunities in DANIDA’s funding department for “Minor Projects”

2004 We asked KHNF for a draft of a concrete project Project on prevention of rheumatic heart disease was presented at the African Heart Network meeting

2005 Meeting and study trip to Nairobi with the aim to make an application to the Minor Project Fond Project focus: Prevention of Rheumatic Heart Disease

The project has received two grants: Euro for first project from 1 August July 2006 from DANIDA Euro from DHF Euro for second project 1 February 2007 – 1 February 2009 from DANIDA Euro from DHF

Project purpose: That the population of Nairobi Eastlands has knowledge of RHD and seeks preventive treatment when getting the first symptoms That KHNF become a strong and independent foundation/association who can work without financial support from Denmark

What did we do? Training teachers in schools Training pupils in schools

What did we do? Training of staff in Nairobi Eastlands clinics

What did we do? Training of staff in churches

What did we do? Organisational capasity building: 1.Memberships 2.Local committees

What did we do? Events

What did we do: Advocasy

We had no data. After 2 years intensive advocacy the District Health Information Record Office has integrated rheumatic heart disease in their data collection in Nairobi.

Nairobi City Council, City Education Department has integrated training prevention of RHD in Nairobi’s schools curriculum

Minister of Sanitarian Health and Prevention has declared her support and training RHD prevention is now a possible part of school curriculum though out Kenya

Results Highlights: Local commitees 9 Patients clubs 1 Kenyan-Heart Clubs in schools 65 Teachers has receives training in schools 65 Talking walls 12 Clinics have received education 108 Seminars for church representatives, participants 54 World Heart Day World Heart Day

We will receive an external evaluation commissioned and financed by DHF very soon. It is conducted by Dr. Bongani S.A. and Dr. Fred Bukachi, Kenya.

This was about the successes but what about the difficulties?

We have been very alone We have learned the hard way We still have to improve the sustainability aspect of the project Lack of collaboration with Kenyan Society of Cardiology (Probably now in place) Lack of data and statistics Difficulties in understanding each other, cultural differences Fundraising in Kenya Governance Making professional applications/understanding Logical Framework Approach

Suggestions: First: WHF – Heart Foundations/Associations in Africa (Twinning) 1.Define a framework for Twinning 2.Investigate funding opportunities by scrutinising development aid programmes in a number of countries and private foundations 3.Encourage more developed countries heart foundations to take part 4.Establish a supporting programme Help to make applications Help to tackle problems during the project Exchange of experiences

Second: Button up advocacy 1.Investigate a number of developed countries aid programmes to see to which extend they contains support to combat NCD’s in developing world, and if not 2.Create an advocacy programme where national heart foundations/associations and cardiac societies advocate for NCD in development programmes for health We will need to make internal marketing in order to have support from other foundations/associations and cardiac societies 3.Liaise with other NGO’s

From Norwegian Heart and Lung Associations Annual Report

We can do it with CVD’s if we want to do it. Lets start now

Yesterday is gone. Tomorrow has not yet come. We have only today. Let us begin. Mother Theresa