A third of our population and all of our future

Kisiwani, Tanzania – testing and support

Carol, aged 12, was tested for HIV at the community clinic in Kisiwani as part of monthly health checks under Mildmay’s Boresha project (2010–2013), partly funded by the European Union (EU). She was among 50 Children Affected by HIV and AIDS (CABA) supported locally because her mother, Fatuma, was HIV‑positive. Of 34 children tested that day, two were HIV‑positive; Carol was not. Due to limited funding, not all eligible children were enrolled, Asha’s son Bakari was included, while his sister Alima was not.

Asha, who was HIV‑positive and had received home‑based care (HBC) from Mildmay‑trained volunteers since 2008, struggled to afford transport to collect antiretroviral therapy (ART) in Same, which led to treatment interruptions and a recent illness with TB. Boresha integrated with Mildmay’s USAID‑funded Maisha Kamifilu project, sustaining family support and linking community care with Ministry of Health services.

What each Boresha child received

Children received regular visits from Mildmay‑trained HBC volunteers; periodic clinic assessments (e.g., Vitamin A supplementation, growth checks, general health reviews) and access to HIV testing; school support (uniforms, exercise books, play materials); monthly meetings with community‑based organisations (CBOs) and children’s clubs for peer support.

Community impact and stigma reduction

Although Boresha officially supported 50 children in Kisiwani, many peers informally attended clinics and clubs and received services by association, broadening impact. Community sensitisation reduced stigma: Aisha, aged five,an AIDS orphan living with her aunt, Hadija, was HIV‑positive, on ART, and living well with supportive peers.

Vulnerable households

Twins Eric and Loveness, aged six, were HIV‑positive and lived with their grandmother, Mariam, a widow supported through an income‑generating activity (basket weaving). Though not enrolled in CABA, the twins received twice‑monthly visits from HBC providers.

Rombo, Tanzania – partnership with faith‑based organisations

Mildmay worked with the Catholic Sisters of Our Lady of Kilimanjaro at the Tumaini (“hope”) Centre, established in 1998. Fifty children received psychosocial support, comprehensive health checks, and monthly sessions (sport, therapeutic play, health education, life skills, and spiritual activities). Nine children were HIV‑positive; others were affected by parental illness or loss. “These children and young people have been empowered in their community,” said Sister Mary Lauda.

Seventeen‑year‑old Brigita tested HIV‑negative and described exploitation risks; life‑skills training and role‑play helped girls anticipate and resist coercion.

Kombewa, near Kisumu, Kenya – Pamoja CBO

Pamoja was one of 35 Kenyan Community-Based Organisation (CBO) partners in Boresha, serving 124 members (with a target of 180) from villages including Kila and Kitmikai. Programmes included counselling for bereaved children, life‑skills education, HIV awareness, advice on abstinence and condoms, and support for young people involved in early sexual activity. Common issues included child labour, school deprivation, inheritance claims by relatives, child‑headed households, and transactional sex (“sex for fish”). Coordinator Julius Owuor emphasised community health education and training community health workers (CHWs).

Project officer perspective:

“Boresha is dynamic,” said Elizabeth Oluoch, Boresha Project Officer, Kenya. “We were increasingly engaged in advocacy, supporting disclosure, building confidence, and addressing stigma among teachers so children could collect medication and be understood.” Programmes also began reaching caregivers via CHWs.

Bondo, Kenya – Bondo Stars AIDS Youth Development Group

Founded by widows in 2001, Bondo Stars partnered with Mildmay to deliver CABA support: food, play, interaction, care and therapy. More than 400 AIDS orphans and other vulnerable children had been supported; 120 children were current members supervised by 30 Mildmay‑trained CHWs.

Activities included care for CABA and people living with HIV (PLHIV), HBC visits, nutrition, counselling, group therapy, children’s clubs and income‑generating activities (IGA). Chair Mary Adero Nyona said: “Now we no longer had bedridden people, they could walk, talk and do their things.” Older members received vocational training (joinery, woodwork, electrical, mechanics) and mentored younger children.

Rarieda, Kenya – Memba Health Unit

Fifty CHWs from 16 villages supported approximately 350 CABA, meeting regularly under a mango tree. Since 2009, CHWs had been trained in HBC, community strategy, adherence, and opportunistic infections; child support under Boresha began in 2010. Jennifer, a CHW, emphasised empowering children’s self‑reliance. Veteran CHW Mama Wilfreda (HIV‑positive, on ART for five years) said: “Because of education, stigma and transmission went down.” Silvanos, a child on ART, reported improved wellbeing and school support.

Key themes across programmes (Tanzania and Kenya, 2010–2013)

• Integrated community and clinic care: HBC, regular assessments, ART access, and linkage to Ministry of Health services.

• Child‑centred support: CABA enrolment, children’s clubs, therapeutic play, and school materials.

• Capacity building: training CHWs and teachers; advocacy to reduce stigma in schools and communities.

• Economic resilience: income‑generating activities for carers; vocational training for older youth.

• Wider reach: informal inclusion of non‑enrolled peers (“gatecrashers”) extended benefits across communities.