In 1996 a small clinic was set up by Dr. Bea Andersen – Schipper, Director of Mount Elgon Orchards Ltd.

For 12 years the clinic was operating form a residential house on the farm until in 2008. During this period the main external donor was the Foundation SOK from the Netherlands. With the help of the DEG (German Development Bank) bank the company was able to build a new health facility. The new facility is well equipped and fulfills a regional function.

The new hospital employs 25 staff and offers the following services:

• Out patient department with 2 clinical officers for diagnosing and treatment
• Treatment room for minor surgery 
• Laboratory
• Dental services
• Pharmacy
• Antenatal services
• Ultrasound
• Physiotherapy and Orthopedic clinic
• Child care clinic
• Inpatient department with maternity and 16 beds
• Ambulance

 Per year more than 30.000 people visit the facility and more than 1.000 patients are admitted.

In Kitale town we have established a workshop where we make appliances for disabled people. Out clients often have disabilities with which they were born like for instance clubfoot and cerebral palsy or disabilities due to infections during childhood or later in life like polio and meningitis.
If our clients need corrective operations we assist them with the cost for the operation in Kijabe Hospital near Nairob

The company believes that the responsibility of combatting the HIV epidemic does not stop at the gate or with it’s own employees.
Below is an outline of the company HIV/Aids program.

Introduction

Mount Elgon Orchards is located right on the Ugandan border, close to the epic centre of the start of the Aids epidemic. From the screening of blood donors during the last 5 years it has become clear that about 25 % of the population is infected with HIV.
The community is very closely knit with many behavioral customs that have a unwanted effect on the spread of the disease such as: having many wives ( sometimes 3 or 4), using the services of “free women”, leaving the partner easily, mass circumcision, witch craft practices involving cutting skin.

Because the community is quite isolated geographically they have not been much exposed to the national activities in the field of creating HIV/Aids awareness. The stigma to the disease is still very big.

Since 1998 the farm has made an effort to try and develop more awareness among the people and thus reducing the stigma. This has proven very difficult until recently, early 2005 the drugs became available at a much lower cost. Suddenly the hope for treatment was bigger than the fear for the stigma and people started coming forward.
This is a very encouraging development which should not be stopped.

Activities to address the HIV/Aids epidemic
Already in place before 2003

• Regular awareness meetings with NGO’s, Aids patients from outside, MOH, Min of Labor (OH&S)

• Counselling nurse in the clinic

• Free HIV Testing facilities in the clinic

• Condoms available on the farm, supplied by MOH

• TB treatment available on the farm supplied by MOH

• STI treatment available on the farm supplied by MOH and privately

• Peer training completed for 20 employees

• Formation of a community based organization dealing with Aids: 4 A’s.
Andersen Action Against Aids. This group is active doing drama at community gatherings and is often invited to perform by other communities.

• Training of the clinical officers of the farm clinic on the use of ARV drugs.

• Training of senior personnel in HRM department on counselling employees with HIV/Aids.

• One senior HRM staff specifically to deal with gender issues.

Developments in 2004/2005

• Anti Viral Drug Therapy available to employees via the Kitale Aids Project
Cost : ksh 500 per month. 50 % for employee, 50 % for Company
Other costs for company: CD4 count Kshs500, other lab tests, supportive medication.
Transport: ksh 200 per trip to Kitale, at least 10 trips per year.

By July 2005 the drugs should be available on the farm.

• VCT on the farm.
9 employees trained as VCT councellors.
3 community members trained as VCT councellors

• Voluntary HIV testing for all antenatal women available. PMCT available in the maternity.

• New awareness campaign on the farm on the need to know your status.

• Extended sick leave for employees with HIV/Aids. If return to work is not possible a family member will be employed in stead.

Even though many activities have been started to combat the disease it has taken a long time for people to use the facilities that have been in place. This is mainly due to the fact that they fear that the knowledge of their status will have an effect on their employment
Another factor is the stigma in the community.
Now that the treatment cost has been reduced considerably and has become within reach for the employees they are more willing to come forward.
The first brave employees have started the treatment early 2005 and the results have been very good. This has been the best promoter for other people to get to want to know their status.

The farm has responded quickly to this trend and has trained, with the MOH/NASCOP, 9 employees to become VCT councellors. Now the farm is able to operate an official VCT centre and to dispense ARV’s. Currently 180 patients on ARV treatment and 300 on support treatment.

There is still a problem with the additional costs of transport and all the tests involved in the treatment and the support medication.

Achieved between: 2005 - 2008

• Built a new VCT centre with more spacious rooms and better facilities 2008
• Acquired a CD4 machine 2007
• Train more VCT councellors 2008
• Develop the nutritional support program by setting up a specialized vegetable garden. Achieved through cooperation with TICAH , real IPM and DEG in 2007
• Develop a program for support of the aids orphans with foster parents and educational support. Children’s home was opened February 2008 with 17 children. A new Home is to be built as from April 09 for total of 30 children.
• Continuous education of the employees and the community on the new developments in the field of HIV/Aids. Is ongoing through mobile VCT which was started in June 2008
• More for financial support to treat more HIV/Aids people in this very poor rural area. Via DEG bank. We are now able to give free prophylactic drugs and carry out all the necessary investigations: X ray , CD4, Blood chemistry etc.
• To change from voluntary counselling and testing to active recruitment for  counselling and voluntary testing. Through the mobile VCT.

Plans for 2009

At the workplace.
Program for the community is well developed. This guarantees the anonymity of the employees. However the VCT uptake of the employees is not yet 100%. The focus in 2009 will be to increase the uptake by more active group counselling and offering testing at the workstation, just like mobile VCT in the villages.
In order to do this the HR office and the managers will have to be prepared for an increase in need for counselling and understanding of the impact of a positive status on the worker by the management.
The farm mobile VCT campaign will have to be preceded by an overall health awareness campaign which will include HIV/Aids, TB and Malaria and family planning.

In the community
Aids Orphans and other vulnerable children will have to be identified in the communities where the employees hail from. The most desperate cases will be enrolled in the children’s home( up to 30) the other children will have to be fostered by other families in the community with support for those families to be able to feed the children , give proper shelter, food and education.
The nutritional status of vulnerable people in the community will have to be enhanced. The nutritional program will have to be intensified by giving more education in the community on suitable food products that can be grown and assistance with horticultural inputs.