TAIWAN LOURDES ASSOCIATION

2006 ANNUAL WORK REPORT

BACKGROUND INFORMATION

HIV EDPIDEMIC DEVELOPMENT IN TAIWAN

The total number of HIV cases by December 31, 2006 was 13,702. In the past two years, the risk factors have shifted from sex to drug use. The transmission rate increased 77% and 123% in 2004 and 2005 respectively because of needle sharing. 4,859 drug users were found HIV positive from 2004-2006, and 70% of them were diagnosed when they were in the prisons.

The government has quickly responded to the HIV transmission outbreak among drug users by introducing harm reduction programs. The government provides free methadone treatment and clean needles although there are still many drug users on a waiting list for methadone. Fortunately, the new HIV cases in 2006 (2,942 cases) have decreased 457 cases than that in 2005 after the effort of implementing harm reduction programs.

THE NEEDS OF CARE AND SUPPORT SERVICES IN TAIWAN

The government provides free antiretroviral treatment to people living with HIV/AIDS (PLWHA), however the patients have to share some of the medical bills. Poor PLWHA cannot afford medical care, especially the drug users.

The lion's share of the government's AIDS budget is spent on treatment and prevention. Only 1% of the budget is spent on care and support.

The PLWHA cannot access social services because of discrimination and prejudice. The disability benefits do not include PLWHA. Therefore, the care and support of PLWHA completely depend on AIDS Non-government Organizations (NGOs).

The human rights of the PLWHA are violated. They are rejected when their HIV status is disclosed in hospital, school, workplace and community. This year the court judged that a residential facility for PLWHA had to move out of a neighborhood.

Any HIV positive foreigner who does not have a Taiwan Identity Card has to be deported. Many of them are married to Taiwanese husbands and have been infected by their husbands. The AIDS NGOs have to fight for their rights and take care of them while they wait for deportation.

There are only 4 AIDS NGOs to provide direct care and support services to PLWHA in Taiwan. The AIDS NGOs are under much pressure and workload as the number of PLWHA has increased dramatically in the past three years. There are very few programs and services for drug users. The AIDS NGOs have to learn and cope with the urgent demands of the drug users.

TAIWAN LOURDES ASSOCIATION

Lourdes Association was set up by the Daughters of Charity in 1996. It is the only Catholic organization for HIV/AIDS in Taiwan. Lourdes Association operates main offices in Taipei (north of Taiwan) and a branch office in Tai Chung (central Taiwan). The PLWHA accounts for about 3/4 of HIV/AIDS population in these two areas.

There are 13 staff members including 8 professional social workers and counselors and 2 care-givers, 2 HIV positive co-ordinators for peer support and activities, and 1 accountant.

It is our goal to improve the quality of life of PLWHA through our various care and support services and programs.

IMPLEMENTATION OF THE PROJECT 

(1)  Case Management:

We contacted more about 4,000 clients through our various services and outreach programs. We opened 390 cases for those clients who have multi-needs. The social workers evaluated the needs of the clients and implemented individual service plans. The needs of 248 clients were completed and 11 clients died.

The basic information about the 390 opened cases:

Sex: 85% were male and 15% were female. The number of female clients has slightly increased more than in 2005.

Age: 37% were 21-30 years old and 38% were 31-40 years old. The numbers of below 20 and 21-30 have slightly increased more than in 2005.

Location: 38% were from Taipei area and 45% were from Tai Chung area. That reflects the accessibility of our two offices in Taipei and Tai Chung.

The sources of the clients: 32% from themselves; 17% referrals from hospitals and public health workers; 21% from the prisoners or ex-prisoners; 16% from outreach work; 9% from their families and friends. The numbers of the clients from themselves and ex-prisoners increased more than that in 2005. It showed that PLWHA broke through the stigma and asked for help. It also showed that our services were well recognized.

The needs of the clients: 62% support, 61% basic needs for living, 60% emotional problems, 56% AIDS treatment and care information.

The following services were provided through the case management program:

Financial aid: some PLWHA do not have means to pay for insurance premium, rent or living expenses, especially those who have just been released from the prisons. We provided financial aid to clients in need for 752 times with a total amount of US$30,938. 50% of the financial aid was for living expenses, 43% for rent and 7% for medical expenses.

Residential facilities: we have houses to provide temporary accommodation to those who are rejected by the family or unemployed. 56 times people stayed in our residential facilities and 15 of them were drug users.

Referral services: we referred 74 times clients to other organizations, such as drug programs, homeless care, nursing care, financial aid agencies, etc.

We made 1,983 telephone calls to give support to PLWHA.

(2)  Counseling Services

We provided 759 counseling sessions to PLWHA who were emotionally disturbed and had difficulties in their lives. These aim to help the client to achieve independent living through our case management and counseling.

(3)  Outreach Services

We regularly visited HIV outpatient clinics and inpatient wards in 6 AIDS hospitals. We contact potential clients through out-reach work. Some people are reluctant to access resources unless they are familiar with the workers. We also visited some clients at their homes when they were house-bound or needed support. In 2006 we visited 1,183 times people at hospitals and homes.

(4)  Peer Support Services

Lourdes Association operates two Friendship Centers for PLWHA in Taipei and Tai Chung. It is our goal that our HIV friends support each other through our various programs and activities. People infected with HIV/AIDS in Taiwan live a very isolated life.

3,133 participants visited our Friendship Centers. Our HIV positive staff members and volunteers welcomed and chatted with them during their visits.

We organized 20 HIV/AIDS workshops (with topics related to treatment and self-care) with 214 participants.

We organized 45 support groups and buddy services (for gay men, heterosexual people, family and newly diagnosed people) with 265 participants.

We organized 38 different recreational and outing activities with 555 participants. The Christmas parties attracted about 180 HIV friends!

We organized two weekend residential workshops with 33 participants. We tried to give spiritual care through deep sharing, meditation, painting, music and psychodrama.

(5)  The Work with Drug Users

There were 3,369 prisoners found HIV positive as of 2006. In Taiwan, all the prisoners infected with HIV/AIDS are segregated and can not participate in any activities in the prisons. Since the number of prisoners infected with HIV had dramatically increased, Lourdes Association social workers and volunteers put more effort in giving counseling and support to prisoners and providing case management to those ex-prisoners.

upport given to the prisoners infected with HIVA/AIDS: We recruit volunteers from different cities. Most of them are religious and Catholics. 44 Social workers and volunteers made 824 visits to 25 prisons and detention centers island-wide and gave information (HIV treatment, self care, harm reduction information) and support to 1,200 prisoners.

Preparation for leaving prisons: The social workers and the therapist volunteers gave individual or group counseling. The social workers helped the prisoners who would be released shortly through individual counseling.

Partnership with University Students: We co-operated with Catholic Fu-Jen University and Chau-yang University, the social work and psychology students provided 16 group activities in two prisons.

Correspondent services: The social workers and volunteers gave support and information through 403 letters.

Ex-prisoners Services: We provided case management to 175 ex-prisoners and 15 of them stayed in our residential facilities and about US$13,750 of financial aid has been provided.

Advocacy: The discrimination against prisoners is very strong in Taiwan. Therefore, negotiating with prison officers on behalf of prisoners has been one of our major tasks. We also gave HIV awareness education to prison guards and non-HIV prisoners in order to eliminate the discrimination and prejudice.

(6)  HIV/AIDS Information and Publication Services

Information Service: We provided 2,212 times information services through telephone calls, e-mail, web message board and MSN. 73% of them were people infected with HIV and 37% were non-HIV people. As the people infected are getting younger, they were more likely to access information through modern technology. It also provided the nature of confidentiality.

Publication Service: We published 1,000 copies of a monthly newsletter with the latest HIV/AIDS information on treatment and self-care. We obtained the permission from British and American AIDS organizations to translate and publish their HIV/AIDS booklets on treatment and self-care. These publications were easily understood by PLWHA. In 2006 we published a booklet for the family of PLWHA and a booklet for people newly diagnosed with HIV. Both publications were sent to the AIDS hospitals, prisoners, AIDS NGOs and PLWHA, and could be downloaded on our web site.

(7)  HIV/AIDS Education and Advocacy

HIV/AIDS-awareness education: We are often invited to give talks to public health workers, social workers, teachers and prison officers. Our emphasis is on issues of discrimination against PLWHA, the difficulties they encounter and how to work with them. In 2006 we gave a total of 159 talks with 7,232 participants. Sister Teresa, the Executive Director, and Paul Hsu, the vice-Executive Director were invited as lecturers in the Correction Officers Institute of the Ministry of Justice and about 3,000 correction officers attended the 67 lectures.

Advocacy: In Taiwan, people infected with HIV/AIDS suffer discrimination in health care, employment, housing and education. We co-operate with the PLWHA rights group for improving their human rights. Sister Teresa Hsieh is a member of HIV/AIDS Advisory Committees of the Center of Disease Control and Taipei City Department of Health. She is actively involved with the policy making issues.

(8)  Outreach work in China:

In partnership with German Misereor, Sister Teresa Hsieh and Paul Hsu visited Xi-An, Shen-Yang and Ji-Lin Diocesan Social Service Centers in 2006 and gave training to those Sisters and lay people who worked with HIV/AIDS. We also gave social work training to the Priests and staff members of the diocesan social service centers.

(9)  Volunteers recruitment and training

Volunteers are our valuable resources and most of them are Catholics and the friends of our staff members. Considering the prejudice against the PLWHA, we were lucky to have 107 volunteers in 2006.

Services: 48 volunteers provided services to PLWHA in our Friendship Centers, 35 volunteers visited HIV prisoners in the prisons and 12 volunteers helped with administration services.

Training: We organized 2 recruitment training courses and 4 in-service training courses for those who provided direct services.

HIV positive volunteers: We gave special training to 12 HIV friends to be our “buddies?and gave support to newly diagnosed HIV positive people. These volunteers needed extra supervision and training because they were easily affected by other HIV positive people’s life experience.

(10)  Training of the work team

Staff members are highly encouraged to attend training, courses, workshops and reading groups in order to improve their competence and professional knowledge, skills and values. They are also encouraged to participate in the development of the work and the management of the organization. It is our belief that the clients will obtain better services if the staff members have better training and our organization has sound management.

Training: This year staff members participated in 69 times training courses and workshops in the areas of case management, working with drug users, harm reduction psychotherapy, family therapy, empathy training, spiritual care, etc.

Reading groups: The staff had 45 times reading groups and discussion. The reading materials were related to personal development, family therapy, group dynamics and counseling to drug users.

Training Abroad: Paul Hsu, the senior social worker had drug and harm reduction programs trainings and visited many AIDS programs in Los Angeles and San Francisco for two months. He also attended the International AIDS Conference in Toronto. All the other staff members benefited from his rich experience abroad which he shared upon his return.

Interior Supervision: The supervisor met with the staff members regularly. The staff had individual supervision monthly and group supervision bi-monthly. This year 145 individual supervisions and 37 group supervisions were conducted. Sister Hsieh also had 37 times individual supervision for management and personal development issues.

External Supervision: We are in partnership with United Way Taiwan. Their Supervisor assesses and evaluates our project twice a year. At the end of the year, Doctor Frank Wang, a social work professor was invited to evaluate our various programs with all the staff members.

Subsidiary and Participation: All the staff members have clear job descriptions and responsibilities. They participate in a staff meeting every other week and are involved in decision making. Sister Teresa, the Executive Director, Paul Hsu, the vice-Executive Director and Cathy Su, the supervisor meet regularly for the running and the development of the organization.

Team support: All the staff members attended a day retreat in summer and two-days retreat in winter. So that we could have deeper sharing about our work experience and personal reflection during the retreats.

AIDS NGOs group supervision: We organized 3 NGO AIDS workers group supervision sessions at which the AIDS workers from different organizations could share their experiences. Social work professors were invited to lead the groups. 53 participants attended these supervision sessions.

(11) Financial Report in 2006

The source of income