WE-ACTx is actively seeking tax exempt donations of goods and services to support our programs in Rwanda. We are actively seeking donations of food, vehicles, laptop computers, video cameras, cell phones, clothing, children’s toys, sporting goods, and materials to support our income-generation programs. For further information on donations, please contact us at: us@we-actx.org
Mail your tax deductible donations made payable to WE-ACTx to:
WE-ACTx—584 Castro Street #416, San Francisco, CA 94114 415-863-4676 x3
WE-ACTx is a US based, 501C3 tax exempt organization, EIN# 56-2572210
WE-ACTx appreciates your interest in volunteering with us – at both our US admin office, and at our clinics/programs in Rwanda. Please send your bio/resume to us@we-actx.org and tell us about yourself, your skills, your interests, and we will get back to you. Thanks again for your interest!
In keeping with our efforts to build local capacity at all levels, technical, administrative, fundraising, and program-related, WE-ACTx has assisted our Rwandan staff in establishing a local Rwandan affiliate organization, WE-ACTx for Hope, through which some of our non-clinical programs are currently operating, and through which all non-clinical WE-ACTx programs will be administered as local capacity permits. Currently, three of our programs are operating through WE-ACTx for Hope.
WE-ACTx’s income generation and food provision activities seek to address two major barriers in fostering health and wellness for Rwandan women, children and families struggling with HIV: poverty and lack of sufficient nutrition. In resource-poor settings, good nutrition is often lacking, which causes immune suppression and thus increases vulnerability to disease and may negatively influence a patient’s capacity to adhere to HIV treatment regimes. Of interest however, all of our patients report extremely high adherence to therapy, even when it is a struggle because of low food availability. Extreme poverty and lack of food may also negatively influence the mental health of those struggling to deal with disease and illness. WE-ACTx seeks to address these issues through facilitating links with small-scale income generating activities and helping to provide access to grants and funds when possible, and through the provision of supplemental nutrition through our support groups, education and training programs, and patient’s clinical and research visits. We hope to expand our services in this area of the coming year.
In January 2005, WE-ACTx developed a longitudinal cohort study , enrolling nearly 1000 women in the Rwanda Women’s Interassociation Study and Assessment (RWISA). With the approval of the Rwandan government Ethics Committee and the Institutional Review Board of the Montefiore Medical Center in the Bronx, NY, RWISA is the largest research study in Rwanda, led by both US and Rwandan investigators. RWISA follows 936 Rwandan women, 710 HIV+ and treatment naïve at study enrollment, and 226 HIV-negative. Most of the HIV+ women have initiated antiretroviral treatment, and by participating in the study to help assess the effectiveness and toxicity of ART in treatment naïve women, assess the influence of post-traumatic stress symptoms on wellness and treatment adherence, and the impact of nutrition on HIV disease progression and response to therapy. RWISA staff are integrated into grassroots partner organizations, to ensure follow-up and study retention, and to provide psychosocial support.
Although the Rwandan Government has made primary school free for all children, addition school-related expenses prevent the poorest of Rwandans from taking advantage of this free education. Uniforms, school supplies, books, food and transportation are among them. The government also provides a small number of secondary school scholarships to the most qualified students. All other students need to pay a small fee to attend school. Often, this fee is equal to or greater than a family’s entire annual income. WE-ACTx Children’s Education Network is a volunteer-driven initiative to increase access to formal education and nutrition for children of WE-ACTx’s grassroots partner organizations. The program is small at present, linking children from one grassroots partner community with a US church and other institutional membership to “sponsor” children throughout their educational careers. WE-ACTx acts as an administrative conduit to the program, organizing purchase of school uniforms and supplies, payment of fees directly to the schools of the children, and provision of nutritious breakfasts for the children, their younger siblings, and breastfeeding and pregnant mothers. The grassroots partner organizations from which the sponsored children come organize the daily breakfasts and distribute school supplies purchased through the program.
The community legal education and training project provides tools for educating Rwandan people infected with and affected by HIV/AIDS, about their basic legal rights around health care and HIV to empower them to take action to resolve legal problems they may face. In summer 2006, WE-ACTx held an eight-week legal education program for the leaders of its grassroots partner organizations at the Icyuzuzo Clinic in Kigali. The trainees formed Dufatanye (Rwanda Community Law Anti-Discrimination Network), to support their efforts in community legal education, conflict resolution, and advocacy for Rwandans living with HIV/AIDS. Rwandan law graduates helped to design and implement these trainings and have since been working with Rwandan and WE-ACTx affiliated pro-bono law experts in the US to prepare community legal education handbook on HIV/AIDS and the law in Rwanda. The handbook serves as the basis for training grassroots groups, trauma counselors, clinicians and law students in Rwanda, bringing concrete Rwandan HIV/AIDS anti-discrimination and health care law and policy to people with HIV/AIDS, the Rwandan legal and human rights community, and to clinicians involved with AIDS care and treatment. The handbook was completed in fall of 2007 and has received approval of various Rwandan government HIV/AIDS and health entities. It includes special emphasis on pregnancy-related care and addresses gender-based violence, both of which are critical issues in Rwanda. It addresses both international health and human rights law, and most importantly, Rwandan constitutional law, and is currently being translated in the local language, Kinyarwanda. While the handbook and training curriculum includes a chapter on children’s issues under Rwandan law, a separate and more detailed companion handbook on children’s issues under Rwandan law is in the early stages of preparation.
With initial seed funding from the Stephen Lewis Foundation, private donors, and recent support from the Human Rights and Democracy Fund of the US embassy in Rwanda for translation of the Legal Handbook into the local language and further trainings in the country, we are building on the solid foundation of WE-ACTx’s primary health care services to help Rwandans address sexual and other forms of violence against women and children and remove barriers to health care access in Rwanda.
Handbooks
Know Your Rights! A Community Handbook on Health-Care Rights and Other Laws
(Download PDF documents below)
WE-ACTx for Hope participates in a countrywide collaborative HIV prevention and outreach program in which large scale community mobilization and sensitization campaigns are implemented throughout the country. WE-ACTx for Hope trains HIV+ peer educators within our grassroots partners using a ”train the trainer” model, imparting skills in basic HIV prevention and positive living with the goal of creating an informed cadre of Rwandan grassroots health educators throughout the country. WE-ACTx for Hope holds workshops with grassroots organizations and collaborates with WE-ACTx’s family program and trauma counseling activities.
In-house sewing and crafts cooperative
WE-ACTx has organized its own in-house sewing and crafts cooperative, INEZA, to make dolls, clothing accessories (hand bags, computer sleeves, etc.) and other crafts for sale in the international market as an effort to develop a sustainable source of income for women on HIV treatment. Over the past year, we have developed a marketing and distribution arrangement for clothing accessories products with Connect USA. We are planning to develop markets and production capacity for Rwandan domestic sales as well, linking our production with overall economic development efforts in country. The women who make up our cooperative are paid weekly wages, receive transportation and food supplements, and of course, are provided with HIV care and treatment – and YOGA!
WE-ACTx developed pediatric AIDS care and a family based support program in 2005, Medical care is made possible through the generous and on-going support of the Keep a Child Alive (KCA) Foundation, for the continuous operation of the Keep a Child Alive Center of Excellence Icyuzuzo Clinic. The family support program was made possible by a two-year grant from the Ronald McDonald House Charities. Recently, we received a very generous donation from Madonna’s Ray of Light Foundation to continue and expand our services to children and families. We currently support and provide care to over 600 HIV+ children and adolescents in our three clinics, providing comprehensive pediatric care in the context of their family care – at the same sites and at the same time as their mothers or caregivers receive their own HIV care. The support program includes monitoring of HIV status, monitoring of anti-retroviral therapies and importantly, concomitant monitoring of mental health status. Each HIV+ child receiving care in our programs receives a home assessment prior at the time of initiating. These home visits allow us to assess the therapeutic environment, anticipate potential barriers to treatment adherence and thusth thus to provide a supportive foundation and individualized care plan for each child. Finally, the Family Program also includes a weekly support group for these children. The support group includes a healthy meal (a large majority of the children are nutritionally depleted or are at risk of serious nutritional deficit) and transportation to the support group. The activities of the support group are appropriate to the age of the child; for example, older children engage in ongoing discussion of HIV, HIV care, and the implications of HIV disease for their future. There are special groups for adolescents who have been abused. Younger children enjoy organized playtime, sports and have some access to child life and art therapy. With support from the Ray of Light Foundation and dedicated professional Yoga instructors, WE-ACTx now offers Yoga classes to the kids, families, and staff of WE-ACTx.
Clinical goals for these children include the provision of state of the art HIV medical care which includes full access to ARV therapy, to reverse disease progression. ongoing medical monitoring, and all medically indicated prophylaxis and treatment of opportunistic infections and other co-morbidities. We have learned from our two years of experience in assessing HIV affected children within their home environments, that 20% of the children in the program will exhibit signs of serious depression and/or PTSD, and we therefore also provide psychological monitoring and care.
In collaboration with our grassroots partners and the Rwandan government, WE-ACTx has provided VCT services since October of 2005, with both fixed and mobile teams, testing over 24,500 women, children and men. Our mobile teams coordinate with our grassroots partners to bring the services deep into the community, with advance outreach.. VCT is provided in a family-centered model, with each family member offered testing, and all family members of People Living with HIV/AIDS (PLWHA) being encouraged to test. Our mobile and community-oriented approach increases the likelihood of reaching vulnerable populations, including orphans and traumatized women, who are less likely to seek VCT in centralized medical settings. Identifying HIV infection in multiple family members, and referring them to immediate medical care prevents the family from sharing their medications (which results in inadequate treatment and can lead to virologic resistance to antiretroviral treatment), or having to choose which members will receive treatment—all will be treated appropriately. For families with HIV infected children, additional counseling and support are provided through our grassroots partners, to help ensure that their special needs are met.
Our community-based and family-centered testing also allows us to reach more pregnant women. In Rwanda less than half of pregnant women access prenatal care or deliver their infants in attended medical settings, and thus do not access VCT or programs for Prevention of Mother to Child Transmission (PMTCT). Linking pregnant women to these services is a key goal. As important feature of VCT is to link it to medical services for immediate care, which both ensures early initiation of ART for those who need it and for most patients mitigates the distress and anxiety of a positive diagnosis, in that they are able to take action. WE-ACTx is working with our partners and health officials to implement this replicable model of service, demonstrating that a full access public health approach to HIV testing and care in a community is both feasible and affordable, resulting in a renewal of health for the entire community. With the help of a generous grant from the Stephen Lewis Foundation for 2008, we will be expanding this important program.
WE-ACTx’s initial intervention toward accessing HIV medications for Rwandan women survivors of sexual violence and genocide involved working with the grassroots women’s groups to identify their needs for access to HIV education and treatment services, providing them with technical assistance and access to medical experts to develop concrete action plans and strategies to access the HIV treatment programs being developed by the Rwandan Ministry of Health; and helping them develop, budget and implement proactive access initiatives and models of HIV care delivery in which HIV-positive women play a key role in their own care and mobilize local communities. With such support and resources, women can provide leadership and develop solutions for a successful grassroots response to AIDS.
Centreville Clinic
Our flagship clinic in Centreville houses our Collaborative Research Program (RWISA) as well as providing clinical care to our patients. The building houses WE-ACTx’s head office in Kigali. A range of primary health care and clinical services centered through the Centreville Clinic are generously supported by the MAC Global AIDS Fund, one of our earliest funders.
WE-ACTx has designed and implemented community-based HIV clinical services and primary health care programs in 3 clinics utilizing this community based nurse-practice model through partnerships with grassroots women’s organizations and the government of Rwanda. Nearly 5000 HIV+ individuals have entered care with WE-ACTx, with nearly 1300 requiring ART, and 70% requiring prophylaxis of opportunistic illness. We provide clinical care and treatment for HIV to women, children, and men, who are into care by our grassroots partners via collaborative community outreach and mobilization programs. Patients needing further care and hospitalization are referred to district hospitals and supported by WE-ACTx’s community trained nursing and other support service staff.
KCA Centre for Excellence
Icyuzuzo Clinic
Our second clinical care project, a partnership with a local NGO, supported by the Keep A Child Alive Foundation, and individuals.
Nyacyonga Centre de Santé
(Community Health Center)
Our most recent clinic project: With support from American Jewish World Service and the generosity of private donors, WE-ACTx updated this district health center on the outskirts of Kigali in 2006 and early 2007. Nyacyonga Centre de Santé (Community Health Center) is one of ~130 publicly owned facilities operated by the Government of Rwanda through its decentralized District Health system. These health centers are extremely important to the communities as the first site for community access to all needed services, including prenatal care, birthing, well-child care including vaccinations, diagnosis and treatment of acute illnesses such as malaria and endemic infectious diarrhea, and HIV evaluation, care and treatment with antiretroviral (ARV) medications. WE-ACTx has partnered with the District to provide technical assistance in provision of high quality cost-effective HIV care, integrated into the community’s care. This required significant upgrading of the physical plant, such as provision of running water and electricity to all patient areas and an improved array of equipment to allow a full spectrum of high-quality services.
Women’s Equity in Access to Care and Treatment (WE-ACTx) is a US-based 501C3 international community-driven women’s treatment and health access initiative operating primarily in the East African nation of Rwanda. The initiative was launched in 2004 by US-based AIDS physicians, activists and researchers with extensive experience in providing and advocating for care and treatment for HIV positive women in the US and internationally. Our administrative headquarters is located in San Francisco, CA. We also have a local program office in Kigali, Rwanda, which now numbers over 60 local clinical, and other program and support staff. The US office is staffed by one part-time coordinating director and several dedicated volunteers with expertise in clinical, care and systems, mental health, clinical research, legal and advocacy, and administration and finance. These experts provide thousands of hours annually of program and management oversight and technical assistance/capacity building services for the Rwandan WE-ACTx team, as well as collaborating directly with public health officials and Rwandan health scientists on direct service and clinical research programs
In the 100-day genocide of 1994, an estimated 250,000 Rwandan women experienced multiple episodes of brutal rape, torture and violence. Many of women contracted HIV, likely as a result of the this brutality. In late 2003, the women learned that the perpetrators of their rapes who were jailed while waiting trial at the International Tribunal were receiving highly active antiretroviral therapy (ART), while their victims died of AIDS. Women’s Equity in Access to Care and Treatment for HIV (WE-ACTx) was created in early 2004 in response to a request from these women for help in accessing ART. Working collaboratively with five local genocide survivors associations, the Rwandan Ministry of Health and the Rwandan National AIDS Program, WE-ACTx founding members mobilized resources and we acted to develop a treatment program for the survivors. The first patients received comprehensive primary care by June of 2004. Since then, our programs have expanded in both size and scope, but our deep commitment to helping Rwandan survivors of genocidal rape and sexual violence, and empowering HIV-infected and affected women and children to take charge of their lives and become leaders in the fight against AIDS, guides our vision and continuing efforts.
Our primary mission is to increase women’s and children’s access to primary health care and treatment in resource-limited settings at the grassroots level. We are committed to a locally driven, collaborative model of primary health care and treatment provision—one in which high quality clinical care, psycho-social support, poverty-mitigation, capacity-building and self-advocacy are all key elements in achieving the highest possible attainment of physical and mental health for the HIV-infected/affected women and their families with whom WE-ACTx works.
Sunday, March 21, 2010—Congregation Sha’ar Zahav
290 Dolores Street (at 16th St.), San Francisco
Reception at 6:00 P.M., Talk at 7:00 P.M.
$54 minimum suggested donation (RSVP required)
Join provocative author, Ayelet Waldman (Bad Good Mother: A Chronicle of Maternal Crimes, Minor Calamities, and Occasional Moments of Grace) and her husband, Pulitzer Prize-winning author, Michael Chabon (Manhood for Amateurs: The Pleasures and Regrets of a Husband, Father and Son) for a vibrant discussion about their creative and life partnership.
Patrons are invited to join us at a pre-event reception to learn about WE-ACTx’s work in Rwanda, meet co-founder and Medical Director, Dr. Mardge Cohen, and admire quality hand-crafted items made by Rwandan women patients and partners of WE-ACTx.
Wine and hors d’oeuvres will be served.
Primary Health and Empowerment of Women and Girls female student WE-ACTx’s model of primary health care service delivery is guided by a commitment to local women’s empowerment, decentralized health service delivery through the public sector, program planning based on community-identified needs, and a family-centered model of health care and support service delivery.
Our HIV treatment and other clinical care services are wrapped around primary care and other support services organized through deep community outreach via local grassroots partner associations. Currently WE-ACTx works with 24 local partner associations in various capacities, providing training and support to association members, and collaborating in the implementation of a variety of prevention and education & support services for community members, i.e. mobile counseling and testing services (VCT), trauma counseling for both women and children who receive testing services or have been subject to sexual violence, home visits by nurses and peer advocates to assist children and parents with medical follow-up, including nutritional needs and mental health issues, assistance with design and implementation of income-generating activities for association members, training in rights and legal self-advocacy for HIV+ persons, and support for children’s education and nutritional needs.
Our vision is to progressively deepen community-level skills and capacity-building for HIV infected and affected women and their families in providing gender sensitive health and social support services to vulnerable women, children, and families, and to efficiently link those needing HIV treatment and clinical care immediately into high quality clinical services, and support services which we know to support adherence to treatment regimes.
Women's Equity in Access to Care & Treatment