Humana People to People

Humana People to People

Towards reduction of the TB burden in the mining sector of Southern Africa



Tuberculosis (TB) in the mines has been and remains an issue in Southern Africa. Despite efforts in addressing TB over the years, none of the earlier interventions sufficiently responded to mineworkers, ex-mineworkers and their immediate families as a key target group.


ADPP Mozambique is leading in implementing the TB in the Mining Sector in Southern Africa (TIMS) programme across 8 countries with the aim of providing TB screening services to 218,500 mineworkers, ex-mineworkers and their families. TB Alert is a technical partner in the delivery of interventions that are being undertaken by local members of the Humana People to People network in Botswana, Malawi, Namibia and Zambia and with strong partners such as Partners in Health in Lesotho, SAfAIDS in Swaziland and Ariel Glaser Pediatric Healthcare Initiative in Tanzania. The programme is funded by The Global Fund through the Wits Health Consortium.


TB and the Mining Sector of Southern Africa

The World Bank indicates that, of the estimated 500,000 mineworkers in South Africa’s mines, approximately 40% originate from Mozambique, Swaziland, and Lesotho. Many of these workers come from the neighbouring countries of South Africa such as Mozambique, Swaziland and Lesotho. Other countries with large mining sectors like Zimbabwe, Zambia, Namibia, Botswana and Tanzania attract significant numbers of people dedicated to mining both in large scale mining operations and small and artisanal mining sites.


Mineworkers in the Southern African region have among the highest rates of TB in the world (2.500-3.000 TB cases out of 100.000) with 10 times more TB than among general population (250/100.000).


The Stop TB Partnership refers to the mining industry as a “perfect storm” of conditions that interact to put miners and their communities at a higher risk of contracting TB, as well as create barriers to effectively treat the disease. By the nature of working conditions, mines have higher instances of lung diseases. Cramped and informal living situations allow the diseases to spread more easily. Miners tend to travel between mines and their home communities, leaving their families for long periods of time. This separation has shown to increase the likelihood of risky sexual behavior and the prevalence of HIV. It can also move the burden of care for sick people back to their home communities, where there might be less access to treatment options and the disease can be easily spread to caregivers and family members.



ADPP Mozambique leads efforts to identify & treat TB patients in TIMS Programme

TIMS is a coordinated approach to increase case detection or identification rates amongst mineworkers through a targeted approach of active case finding and contact tracing amongst hotspots of mineworkers in the Southern African region.


ADPP Mozambique’s approach has resulted in the provision of TB screening services to hundreds of thousands of key population groups and facilitated TB diagnostics for mineworkers and their family members who were found with TB-like symptoms. ADPP Mozambique and its implementing partners’ activities have also improved adherence to TB treatment, and increased awareness on TB as a disease and how to minimize infections through door-to-door campaigns, local radios sensitization campaigns, and training ex-mineworkers to be peer educators on TB health.


Field activities have been led by dedicated and trained Field Officers who have worked closely with community volunteers and health facilities. Field Officers have played a crucial role in the daily door-to-door TB screening and awareness raising campaigns. In TB screening and TB case identification, they use a screening questionnaire to assess at-risk-groups for TB symptoms. When a person is found with symptoms, Field Officers follow up to facilitate testing TB. This sometimes includes collection of sputum, which is then transported for examination by professional technicians at medical centers, or referral of the person to the health facility for testing. TB diagnosis is not always straightforward and a person with symptoms can often be tested more than once before they are found with TB, hence significant follow up is required from the Field Officers.


Engagement of local stakeholders

The engagement of local heath stakeholders assists in building linkages and synergies to achieve TIMS goals. An example is how nurses are pivotal in the TIMS TB treatment actions. A case in point is the role of Sister Lucia Sheehama.


Among others, Sister Lucia Sheehama, a Wellness and Health Nurse has been instrumental in the establishment of a partnership with Dundee Precious Metals, a mining company in Northern Namibia.  Sister Lucia runs a first-aid clinic at the mine and was very supportive in presenting TIMS activities in Namibia to mine management and in the daily organisation and planning of activities. During the month of March 2017, she dedicated health awareness activities at the mine specifically to TB and sent weekly reminders to supervisors about the screening being done by DAPP Namibia (a Namibia implementing partner of ADPP Mozambique), encouraging them to send their employees for screening.


She says of the TIMS programme: “Before, you could watch someone getting sick and you would have to wait until they were seriously sick before you could refer to a health facility. With the TIMS program, you can rule out the possibility of TB early on”. Sister Lucia is particularly proud of the joint screening and awareness activities organised in the mine on World TB Day with 117 mine workers and 2 of DAPP Namibia’s Field Officers.



TB Contact Tracing and Treatment Adherence

Once a patient has been identified as a TB case, the Field Officers carry out contact tracing, which is to screen all people the person has been in contact with including family members and neighbors. Due to the way in which TB bacteria is spread (through the air, speaking, coughing, singing etc), it is important to also screen the people around the TB patients who have had close physical contact with them.


As there is high co-infection rate for HIV and TB, once a person is diagonised with TB, she/he is recommended to undergo HIV testing to ensure immediate early HIV treatment.

Read Reuters latest article on how Zambia is tackling the HIV & AIDS and how DAPP Zambia is assisting

DAPP Zambia’s Total Control of the Epidemic program received a unique visit from Lyndsay Griffiths of the Thomson Reuters Foundation. The 3 days visit was from 26th – 29th of November 2017 and was primarily to cover the HIV and AIDS community based programs in which DAPP Zambia is  contributing to fight the epidemic.


The visit ended up with three interesting articles on how DAPP Zambia, a member of Humana People to People, fights the HIV epidemic together with people in rural Sinazongwe. The first article is now out.



You can read more about the article here:

From Zimbabwe to Zambia – a Tale of Two Soils.

Each country in Africa has a unique story to tell when it comes to its soil. Varying in quality and with disparate challenges – their unifying feature is that the soil provides an important source of livelihood to many that live on it. Protecting these soils against factors such as over-cultivation and climate change is critical to ensuring sustainable futures for millions of citizens. Humana People to People works with its member countries to identify challenges and empower those living on the land to overcome them and protect their soils. Here is a brief tale of two countries the Federation has worked with to date.

Agriculture occupies a central place in Zimbabwe’s economy and has the power to significantly reduce poverty, and create sustainable economic development. However, like many countries in the region, Zimbabwe faces widespread land degradation problems. Accelerated soil erosion, due in part to growing pressures on the land, is an ever increasing threat to agriculture and livelihoods. It is estimated that 10 percent of the country’s soils are under high risk of erosion and that arable lands lose 17.8 million tonnes of soil nutrients each year due to land degradation. In the Mashonaland central province, the majority of the soils are deep and fertile. However, year in year out large-scale commercial and conventional farming has heavily eroded once fertile top soils. Many now occupying the land are resettled farmers who are not equipped with the necessary skills around soil husbandry to cultivate their soil and are not adhering to practices such as maintaining contour ridges. This pressure on the land has and will continue to heavily impact productivity. The region accounts for 8.5 percent of the country’s total population which is growing rapidly. The consequent necessity for intensification of food production means the management of soils will become increasingly important today and in coming years.

DAPP Zimbabwe is working with farmers to protect these vital soils – which are an irreplaceable lifeline and a key to a sustainable future. Through climate smart agricultural techniques and improved farming practices – farmers are empowered with the necessary techniques to regenerate their land. Improved practices produce fertile land which becomes the foundation for stronger communities. These communities are now able to produce higher yields and farm profitably and sustainably.

Just across the border in Zambia – the soil tells a different story for now. Zambia still has vast swathes of fertile soil – which has helped to create a buoyant agricultural sector. And to date it has largely been spared from the adverse impacts of land degradation by conventional farming and soil mismanagement. However, the production of charcoal poses a growing threat to Zambia’s soils. Charcoal production is so large scale that many of Zambia’s major towns are ringed by widening areas of land degradation. Additionally, the wheel ruts of trucks that are used to collect the charcoal create runoffs into channels which promote the initial stages of soil erosion.

DAPP Zambia has been working in a number of districts on rural resilience initiatives and soil fertility management technologies. These programmes educate local farmers and communities on the impact of charcoal production on the soils and environment, teaching farmers sustainable tree management and alternative, more viable, farming practices. Through DAPP Zambia’s farmers’ clubs, communities are able to stave off the effects of over-cultivation, grow climate resilient crops and protect their soils.

Humana People to People understands the necessity of protecting the soils in countries where they are most at threat. We work to ensure that the soils are recognised as an important lifeline and a key to a sustainable future for millions of citizens not just in Africa but across the world.

Let Us End AIDS’s negative impact this World AIDS Day!

World AIDS Day takes place on the 1st of December each year. It is an opportunity for people worldwide to unite in the fight against HIV and AIDS. Humana People to People invites the wider community in contributing towards ending the AIDS epidemic.


Globally, Humana People to People members join forces with leading international health agencies and organizations, including UNAIDS to gain control over the HIV epidemic through the 90-90-90 agenda.


DAPP Namibia through the Total Control of the Epidemic (TCE) program joins the global commitment to ending AIDS by 2030. TCE carries out intensive campaigns in targeted areas, to ensure that everyone at risk gets tested.



Founded on the idea, “Only the people can liberate themselves from HIV and AIDS the epidemic”, Total Control of the Epidemic (TCE) empowers communities to fight HIV and AIDS. The TCE Field Officer receives professional training in matters to do with HIV counseling and testing, Home Based HIV Testing, basic ART treatment support including HIV+ viral suppression initiatives. By committing to Home Based HIV Testing, TCE is contributing to achieving 90% of people getting to know their HIV status.


We are inviting you to watch 5 films, each less than 3 minutes long. The short films are showcasing the unique developments happening under TCE Namibia as they respond to fighting the negative impact of HIV and AIDS.


Visit this link to access the 5 films: 





Tree Planting in Malawi is about protecting the future 


The negotiations in Bonn, at the 23rd annual conference of the parties (COP) ended on a high note with renewed focus to do more actions to reverse climate change effects. A growing coalition of states, cities and organizations have committed to meet emissions reductions targets. African states and organizations in particular are made the most of their presence at the conference by voicing their concerns and ideas – pressuring developed nations to commit to more ambitious reduction targets. Africa is likely to be the continent affected most by climate change. Malawi is one such country – with high population growth, rapid deforestation, and widespread soil erosion, its agriculturally based economy is particularly susceptible to climate change’s negative consequences. 

Malawi was previously heavily forested. However, over the years, people have been cutting down the trees and burning them where they fall to open up areas for farming – this is commonly known as “slash and burn” agriculture. In the past, these areas were farmed for one to three years, and then the farmer would move on, cut down some more forest, and start all over again. Whilst the population of Malawi was small, the environment was able to recover as the trees would regenerate. However in July 2011, the World Bank estimated that Malawi’s population has doubled every 25 years and in 2011 it stood at 17.2 million - this has meant that there is increased pressure on available land. According to the Food and Agriculture Organization of the United Nations (FAO), forest cover is now just 34.4% of the total land area of Malawi (UN data 2010). This has fallen from 41.4% in 1990. The challenge for Malawi in the future, with its rapidly growing population, is to help communities to develop a more sustainable approach to environmental protection. 

DAPP Malawi works with local communities to plant trees to build their capacity to mitigate the impact of climate change. Tree planting serves multiple purposes such as protecting against erosion, improving soil fertility, producing nutritious fruits, or producing firewood. Examples of species planted are: Jatropha, Moringa, Cassia, Avocado, Guava, and Papaya. One tree which farmers are mostly encouraged to plant in their field is Albizia Lebbeck locally known as Mtanga tanga which possesses properties of nitrogen fixing in the soil. The rural farming communities in the districts of Chiradzulu, Zomba, Lilongwe and Dowa have planted over 15 million trees between 2009 – 2016. 

The Farmers’ Clubs program has imparted knowledge and skills to farmers to help in the adaptation and mitigation of climate change. Member farmers took a leading role in mobilizing non–participating farmers into constructing firewood saving stoves. The farmers organized education campaigns in their communities to educate their neighbours on the effects of harmful environmental practices such as the slash and burn and the careless cutting down of trees. It was through the practical comparisons of cooking using firewood saving stoves and using the traditional non-climate friendly, three stone cooking method that community members understood the importance of constructing the stoves.

The integration of tree planting is essential for increasing biomass cover, soil fertility enrichment and supporting the normal rainfall cycle. The tree planting campaigns carried out by DAPP Malawi have helped to assist in the absorption of carbon – as the trees act as carbon sinks. Additionally, DAPP Malawi has also worked with community members to create woodlots. These woodlots and the provision of tree seedlings has ensured the firewood saving stoves are even more effective.

Monica Changoyima from Jekeseni village is one of more than 30 000 rural farmers who actively planted trees at the Farmers’ Clubs project in Malawi. Changoyima was one of the community members selected as a beneficiary of the tree seedling distribution, she explains “DAPP Malawi noticed that as much as we had trees in the nursery we did not have the right agro forestry skills to care for the trees. So they came in with instructions on how we should plant the trees”. According to Changoyima the tree planting activities have significantly empowered members of the community. She says that most people are now aware of the importance of trees in the rain cycle.

“If we have a lot of trees in the forest we are increasing the chances of having good rainfall. Due to the destruction of forests the country has experienced changes in the climatic conditions,” states Changoyima. The women also realize that due to the unavailability of energy alternatives people are always going to rely on firewood for energy. This will have a great effect on the environment as well as increase their drudgery as they fetch for wood for various household uses. As such the wood-stove methods and introduction of tree-planting processes have helped reduce the impact of this.  At rural small-scale farm level the impact is visible as the soil has improved its fertility and humidity and hundreds of thousand trees have been planted – ensuring the sustainability of livelihoods in the region.