MY Project Proposal-HANDA SED Project2014-2018-19Feb''14 HC revMH 2014

HANDASocial & Economic Development Project Southern China

Introduction

The purpose of the TLM Multi Year Project Proposaltemplate and the TLM Multi Year Project Budget template is to help youdesign, implement, manage and evaluate your project.  Both templates represent what TLM considersto be good practice in project design, implementation, management andevaluation.  However, in addition to theMulti Year Project Proposal and the Multi Year Project Budget, you will need touse other tools to design, implement, manage and evaluate your projecteffectively. Guidance notes are attached to this document as a form of supportin addition to the explanatory notes included in the form.

TLM uses the same Multi Year Project Proposal template forall TLM projects regardless of the project's thematic areas, the project's coverage,the project's budget, or the project's implementer (i.e., TLM and / orpartner).  Depending on the nature of theproject it may be appropriate to leave some sections of the template blank.

The completed TLM Multi Year Project Proposaland TLM Multi Year Project Budget provide information to the TLM GlobalFellowship about your proposed project. This information is used to help the TLM Project Ratification Group (aMember Appointed Working Group) decide whether your project can receive TLMfunding.  If your project is funded, thisinformation is also used to communicate the work of TLM to supporters and otherfunders.

Section A: Project Summary

The Project Summary should be no more than two pages inlength.

Section B: ProjectAnalysis

B.1        Background Analysis

Based on information collected during the project's needsassessment, feasibility study and / or contextual analysis, please provide aconcise description of the project's context. You may find the following headings helpful.  However, you should only include informationthat is relevant to the project.

Guangdong

Guangdongis situated in the south-easternmost part of China's mainland and with apopulation of around 105 million is the most populous of China’s provinces. Theprovincial capital Guangzhou and economic hub Shenzhen are among the mostpopulous and important cities in China. It accounts for about 12% of China’s national economic output with the fourthhighest GDP per capita among China’s provinces.

Themajority of the province's population is Han Chinese.There is a small Yao population in the north. Other smaller minority groups include She,Miao,Li,and Zhuang.Guangdong has a highly unbalanced gender ratio that is among the highest of allprovinces in China with over 130 boys for every 100 girls.

InGuangdong the major religions are Buddhism, Taoism, Islam, Catholicism andProtestant denominations. Guangdong has seven religious organizations at theprovincial level, including Guangdong Provincial Association of ChristianThree-self Patriots and Guangdong Provincial Association of Buddhists.

Guangdongused to be the most leprosy affected area in China. About 20% (95,000/500,000)of the leprosy cases in China were detected in Guangdong province in the last50 years. After half century’s leprosy control effort, the prevalence ratereduced rapidly from 11.4/10,000 in 1961 to 0.042/10,000 in 2005. By the end of2011, the number of active cases was only 322, which included 142 new detectedcases in 2005. During the last 5 years, there were about 130 new cases detectedevery year.

Thereare about 3500 people living in Guangdong’s 67 ‘leprosy villages’. Theiraverage age is 65 years old. 77% of these people have grade II disability. 97people are blind and 651 have had limbs amputated. The welfare support thesepeople receive from local government is between RMB 30 and 500 a month. Twovillages receive individual welfare support payments of less than RMB 50 a month.More than 85% of them receive less than RMB 250/month. Most of these people arenot only living in a very difficult living environment, but are lonely andisolated. 15 villages have less than 10 residents. Three of them have only oneperson living there. Very few people are farming their small parcel of land andmost of people have little to do all day long. There tends to be littleinteraction between many of the villagers themselves and there is no chance forpeople to develop their skills.

Guangxi:

GuangxiZhang Autonomous Region is a provincial-level administrative region that lieson China’s southern border between Guangdong in the west and Yunnan in the Eastand has a population of around 49.25 million. The region has some coal and irondeposits to support moderate industrial development and is one of China's keyproduction centres for nonferrous metals. Large amounts of its land are notfarmed. Its per capita GDP in 2011 was 15,800 yuan (US$2,300).

Itis mountainous and has a humid subtropical monsoon climate, which ischaracterized by plenty of sunshine, moderately high temperatures and abundantprecipitation. It is affected by typhoons which can affect HANDA’s work and thevillages. Mountainous geography and poor transportation infrastructure makesvisiting many of Guangxi’s ‘leprosy villages’ challenging. During the rainingseason, many roads may be blocked.

Guangxihas 12 ethnic minorities, and 25 small ethnic groups, of whom 16.37 million areZhuangs, the largest of China’s 55 ethnic groups. It is one of China’s leprosyendemic areas. Since the 1950s, more than 27,000 cases of leprosy werediagnosed and treated in this Province, and more than 15,000 people, althoughcured, are still facing difficulties due to stigma and/or disability. 550 areliving in 26 ‘leprosy villages’.

Thesituation for people living in Guangxi’s ‘leprosy villages’ is similar to thatin Guangdong; life is hard, the housing conditions are generally poor and somedo not have electricity or a water supply. The connection of the villagers withthe outside world is limited due to transport and access challenges. The welfarepayment offered by the local government is less than RMB100 per month onaverage.  

Yunnan:

Yunnanis the most south-western province in China. It shares a borderwith Burma in the west, Laos in the south, and Vietnam in thesoutheast. It has a population of around 46 million.  It is mountainous and most of the populationlives in the eastern part of the province. Yunnan is rich in natural resourcesand has the largest diversity of plant life in China. Yunnan's reserves ofaluminium, lead, zinc and tin are the largest in China, and there are alsomajor reserves of copper and nickel. Yunnan is however one of China'srelatively undeveloped provinces with more poverty-stricken counties than theother provinces.

YunnanProvince is one of the most leprosy endemic areas in China. By the end of 2008,more than 51,000 people had been diagnosed with leprosy in Yunnan province.Although the province has benefitted from the implementation of MDT, and mostthe patients have been cured, there are still about 600 cases still needing MDTtreatment, and about 350 new cases detected every year.

Thereare more than 38,000 people affected by leprosy in Yunnan still facing the dualchallenges of stigma and disability. And about 5,000 people are still living in126 very remote and isolated ‘leprosy villages’ most living in more difficultsituations than those in Guangdong and Guangxi.

Incompletestatistics from Dali prefecture indicate that the average annual per capitaincome in the ‘leprosy villages’ is only about RMB 500 (about USD 72). Many ofthem are still unable to meet their basic needs to prevent hunger, sickness andstay warm.

Were participative appraisals and / or needs assessments conductedduring project identification?  If so,who participated in the appraisals and / or needs assessments?

The current Project builds on lessons HANDA haslearned to date in its work with communities in these areas, and through on-going participatory needs assessment workwith 94 of these ‘leprosy villages’ which have been assessed as having most tobenefit from HANDA’s new full package of physical, social and economicdevelopment assistance.

The needs and problems were identified by HANDAstaff and HANDA committee members (themselves leprosy affected and often fromthese villages) undertaking routine village visits. Needs and problems werecollected and discussed among project staff and target beneficiaries.

Thebeneficiaries are encouraged to participate in all aspects of the project.Involvement in the analysis of their own ‘problem’ and needs increasesawareness and provides a better understanding of their ‘problems’ and causes.Discussing and looking for possible solutions to the problem and planningactivities together also increases their ownership of the project, and ensuresthey will continue the activity after the end of HANDA support.

B.2        History of Involvement

What is the implementing organisation’s history of involvement inthe project location?

TheHANDA Rehabilitation and Welfare Association (HANDA) was founded in 1996 inGuangdong, China, as a non-government and non-profit organization. HANDA is theonly fully registered local NGO working in this field in China. It is based inGuangzhou, Guangdong and has branches office in Nanning, Guangxi ZhuangAutonomous Region and Yunnan Province. It has carried out a range of physical,and social and psychological rehabilitation activities in these provinces sincethen.  This has included: Social Rehabilitation: carryingout advocacy and social activities to improve understanding of leprosy and toreduce stigma and discrimination against people affected by it in thecommunity, particularly around ‘leprosy villages’; PsychologicalRehabilitation:providingopportunities for people affected by leprosy to take part in social activities,to share experiences and draw strength from each other to improve theirself-esteem and self-respect; Physical Rehabilitation:providingself-care education, so that people affected know how to take necessaryprecautions and where needed providing nursing care.  Protective equipment, such as specializedfootwear is provided, as well as tailor-made prosthesis for amputees. HANDAalso carries out eye surgeries. Education: Providing basic educationscholarships for children of people affected by leprosy whose family are livingin hardship.

TLMIsupported the HANDA capacity building project in Guangdong and Guangxi between2004 and 2010 and the HANDA Social and Psychological Rehabilitation Project inGuangzhou and Guangdong since 2003 and Yunnan since 2009.

TLMTrading also supported the HANDA Quilt project by taking orders since 2008.

American LeprosyMission has supported HANDA Physical Rehabilitation Project since 2002.

What previous experience does the implementing organisation have ofthe work outlined in this proposal?  Ifthis is a continuation of an existing project, give details.

HANDA has substantial experience carrying out physical,and social and psychological rehabilitation work with ‘leprosy village’communities.  It has started economicdevelopment work more recently.

It has been carrying out physical rehabilitation worksince 2000 in Guangdong, since 2003 in Guangxi and since 2001 in Yunnan. It hasbeen carrying out social and psychological rehabilitation work since 2003in Guangdong, since 2004 in Guangxi andsince 2006 in Yunnan. It has been carrying out economicdevelopment work since 2005 in Guangdong(mainly organize vocational training workshop and provide small loans), since 2008 in Guangxi and since 2009 in Yunnan.  

What previous experience does the implementing organisation have ofworking with this or similar target beneficiary groups?

As noted above, HANDA has substantial experience workingwith ‘leprosy villages’. 10 of the villages HANDAwill work with in this project have not previously been worked with.

What lessons havebeen learnt from previous experience of this project and other projects, andfrom the experience of other organisations? How have these lessons informed the design of this project?

HANDA’s approaches have been constantly evolving anddeveloping over time, and as funding and resources allow.  Approaches are constantly being refined andare tailored to the capability of the individuals and groups worked with.  For example, after years ofgiving self care training and wound care service, most people have mastered theknowledge of self care and applied it in daily practice. The focus for thesepeople has moved to mutual support and awareness raising and establishingstructures within the village for those who have serious physical disability tobe taken care of by fellow villagers. HANDA staff have also learned that in workingon economic rehabilitation of individuals who have started or are going tostart income generation activities, it is also important to keep an eye to thewhole community’s development. Villagers are encouraged to take the leadingrole in each aspect of the project, with project staff providing necessaryassistance when required. In recent year social andpsychological rehabilitation activities have focussed more on the localmedia and making full use of HANDA’s website, wechat and weibo (Chinese twitter).  This allows a much larger impact among alarger population.

Of note recently has been the changes coming from theHANDA’s last end of project evaluation. This is discussed in section B6 below.

B.3        Problem Statement

Based on your problemanalysis, whatare the problems facing the target communities that the project will address?

Most of the people livingin the ‘leprosy villages’ in Guangdong, Guangxi and Yunnan were all diagnosedin 1950-1970s when there was not an effective cure for leprosy. During that erathe policy was to quarantine affected people in isolated ‘leprosy villages’.They were cured with MDT but the late treatment left most with serious nervedamage and various deformities to their hands, feet or eyes. Lack of self-careknowledge to protect anaesthetic limbs and heavy labour in their farming livesaggravated their disabilities. Insensitive hands and feet lead to seriousulcers, and then osteomyelitis or squamous cell carcinoma. Many of these peoplehave lost their fingers, hands, feet or even lost their lives. Lagophthalmas(inability to close eyes) and insensitive corneas have lead to keratitis andloss of sight.

Many people affected byleprosy in these villages, and in some cases, their children, are stillexcluded from mainstream society and are refused many public services. Formany, decades of living isolated lives in remote villages have led to a lack ofconfidence and self-esteem. Many dare not communicate with the people inneighbouring communities or to request government services or stand up fortheir own rights, as they are afraid of being refused or being treated badly.Some have even lost hope and become indifferent to both themselves and others,even in their own village.

Physical disabilities, poorliving conditions and community infrastructure, and little communication orother engagement with the outside world and a lack of economic opportunitiesare poverty characteristics in these villagers. Some people in these ‘leprosyvillages’ are unable to even meet their basic needs to prevent hunger, sicknessand cold. For older residents their physical state means there is littleopportunity to undertake work to improve their economic situation, howeverthere is scope for younger people to learn new skills and take advantage of the(limited) opportunities available to them.

What are the main causes of these problems?

1. The     long history of misinformation and misunderstanding in general society     about leprosy is the main course of social stigma and exclusion. Most     people (especially people living in neighbouring communities) still have     little idea about the realities of leprosy in the 21st century and are     scared to have any contact with the people affected by leprosy.

2. Decades     of isolated life have made many of the villagers lose hope and their     longing for life.

3. Physical     disabilities and a lack of resources or knowledge to care for these     disabilities lead to ill-health and further disability.

4. Poor     living conditions and limited community resources compound these problems.

5. Economic     opportunities are limited by age, disability, remote locations, limited     access to arable land and a lack of opportunities to develop new skills.

6. People     with skills have limited opportunity to develop and use them.

B.4        Project Beneficiaries

Who are the direct beneficiaries of the project (i.e., those peoplewith whom the project works directly)? How were they identified?

The project’s direct beneficiaries are around 2,500 people living in94 ‘leprosy villages’ and 11 other communities in Guangdong, Guangxi and Yunnanprovinces, 69% of whom are men and 31% women. Not all people will receive thebenefit of all parts of the project’s services and activities. The fullbreakdown is provided in the table below.

The beneficiary villages were identified byHANDA staff and HANDA committee members (themselves leprosy affected and oftenfrom these villages) undertaking routine village visits.

Who are the indirect beneficiaries of the project (i.e., thosepeople with whom the project does not work directly but who will benefit fromthe project)?  How were they identified?

Indirect beneficiaries are the approximately 1966 non-leprosy affected people living in the ‘leprosy villages’.  These are primarily family members.  Villages in Yunnan tend to have much largernumbers of non-leprosy affected villagers and family members.  There are around 121 non-leprosy affected villagers in Guangdong, 45 in Guangxi and 1,800 in Yunnan.

How many direct beneficiaries are there?  Please indicate the number of female directbeneficiaries and the number of male direct beneficiaries.

There are approximately 2,500direct beneficiaries, as shown in the table below.

How many indirectbeneficiaries are there?  Please indicate the number of femaleindirect beneficiaries and the number of male indirect beneficiaries.

There are approximately 1966 indirect beneficiaries approximately (1,053 male and 913female).

B.5        Relevance

What strategic directions /priorities in the TLM Country Strategy are relevant to this project?

The project is wellaligned to the TLM Country Strategy with its focus on working throughpartnerships with local organisations and because of the project’s significantfocus on Yunnan Province.

This project is alsowell aligned to the new Global Fellowship Strategy as it directly addresses thefirst three areas of strategic focus – leprosy services, Dignity andEmpowerment and social integration – and directly targets the first threelong-term aims – ‘people affected by leprosy have timely access to qualityleprosy services’, ‘people marginalised by leprosy, disability and other causesrealise their worth and are empowered to overcome challenges’ and ‘communitiesare free from stigma and discrimination towards people affected by leprosy anddisability’. In particular the project is a partnership between TLM and aleprosy people’s organisation which is a specific 5 year aim.

What contribution will thisproject make to these strategic directions / priorities?

The project directlyaddresses the first three areas of international strategic focus – leprosyservices, dignity and empowerment and social integration – through delivery ofphysical rehabilitation services and through its social and psychologicalrehabilitation activities within leprosy-affected communities and withinbroader society.

What government policies /strategies are relevant to this project?

One of theregulations from the working guidelines for (2011-2020) issued by the ChineseMinistry of Health, National Centre for Disease Control and the China LeprosyAssociation, was to promote the elimination of discrimination against personsaffected by leprosy and their family members.

Another regulationwas to work closely with local NGOs, jointly carry out physical, psychologicaland social rehabilitation for people affected by leprosy, and to help them toreintegrate into the society.

What contribution will thisproject make to these policies / strategies?

Atthe higher level, the government is promoting the strategy of “HarmoniousSociety”, which includes the equal rights of everyone in society. The projectwill work to expose the issues which compromise the rights of the peopleaffected by leprosy and disability, and try to work to promote the “HarmoniousSociety” by protecting and promoting the rights of the people affected byleprosy.

Therights of people affected by leprosy are included in government policiesrelated to all disabled people. HANDA will work with The Disabled People’sFederation to promote the rights of people adversely affected by leprosy as apeople facing the challenges of disability.

How will the projectencourage and challenge policy makers to increase the entitlements of projectbeneficiaries?

To get government support and recognition of its work, HANDA helpspolicy makers to develop their understanding of the real situation of peopleaffected by leprosy. It is not easy tochange their attitude to the people affected by leprosy and support HANDA’swork, but it is always important to keep them informed about this work and tryto get them understand. HANDA provides information about the peopleaffected by leprosy to the government and submits activity reports to thegovernment regularly. HANDA has a focus on strengthened communication andunderstanding with the government, including inviting government officials toparticipate into activities, as well as trying to participate in the activitiesor meetings organized by the government.

B.6        Methodology

How will the changes brought about by the project address theproblems identified in B.3 above, and the causes of these problems?

Disability

HANDA’s specialisthealth/nursing staff and prosthetics technicians will provide nursing and othermedical support, provision and maintenance of professional prosthetics,provision of other protective and mobility aids.  However there will be a strong focus onempowering people with the necessary knowledge and skills to take care ofthemselves and help each other is the essential to prevent them from furtherdamage or deterioration of their deformity. The mobile team will also encouragethe villagers to set up self-care groups and mutual help systems among themselves.

Social exclusion and psychological distress

HANDA’s specialist socialworkers will work with individuals and groups to develop social development andrehabilitation programmes for each village and, where required, for individualswithin them.  These activities will becarried out by HANDA staff and volunteers.

Public education activitieswill be carried out by staff and volunteers with maximum involvement ofvillagers and government officials from surrounding areas. The presence ofpeople affected by leprosy and their experience and positive image will changepeople’s attitudes to leprosy. The close interaction between volunteers andpeople affected by leprosy will send a very strong message that there isnothing to be afraid of in having close contact with people affected byleprosy, and that discrimination makes no sense. These activities will besupported through the mass media, internet, and with printed materials.

Staff and volunteers willassist the villagers to organize visits and exchanges to neighbouring villagesor towns to overcome fears and establish direct contact with the outsideworld.  

The project will have astrong focus on use of volunteers as motivators and agents of change to breakdown stigma within villages and in surrounding areas.  They are also a cost effective way to carryout many social development activities. A volunteer management/coordinatingteam will be set up so that the volunteers can organize and manage theseactivities with minimum input from the project.

The project will also havea strong focus on advocacy with the Centre of Disease Control and Prevention(CDC) and/or Dermatology Institute (DI) in each area. These organisations arethe ‘leprosy villages’ local authority and have resources to assist villagersto develop themselves and realize their hopes. However, as leprosyrehabilitation is not a government priority they have little incentive to participatein this project. For this reason, the project will create opportunities forthem to be involved and encourage them to do so. They will be actively treatedas the key partner, and will be invited to be involved in village needsassessments and public education activities. All the project reports will besent to CDC or DI, and they will be invited to evaluate the project.

Limited economic opportunities

In 9 villages withpotential for village economic development (generally those with younger andfitter populations), the project will support villagers to establish amanagement group to lead village development. Staff will organize training andestablish connections with technical support agencies or individual experts toprovide technical support to these villages in the future. Seed funding andinfrastructure development support will also be provided but the focus will beon making use of local and government resources wherever possible.

How have project beneficiaries been involved in the design of theproject?

The target beneficiarygroups’ needs were identified by project staff and HANDA committee memberswhile conducting routine village visits. Needs and problems were collated anddiscussed between project staff and targeted beneficiaries. The committeemembers are elected by the villagers themselves. They are the representativesof the villagers and they not only live in the leprosy village, but also visitother villages to collect information on the needs of those people. Thecommittee members participated in the whole process of the project design, andthe project has been approved by the standing committee.

How will project beneficiaries be involved in project implementationand management?

The involvement of peopleaffected by leprosy themselves is a key principle of the project. Allactivities undertaken try to include people from the villages in their design,organisation and implementation as much as possible. This is for two reasons.First, the activities end up being better because of this input. Secondly,involvement helps the villagers develop skills, experience and self-confidence.  

The activities organized inthe ‘leprosy villages’ all revolve around the beneficiaries trying to addresstheir specific issues and need. Information exchange and communicationactivities are focussed just on the project beneficiaries. The committeemembers will also participate in most of the activities.

Committee members (who as noted earlier are from the‘leprosy villages’ themselves) have a central role in the ongoing monitoringand in evaluating the project. Questionnaire and interview surveys will becarried out with the beneficiaries, which will involve them into the evaluationprocess and gain their comments and feedback about the activities and theproject more generally.

How will project beneficiaries be empowered to access theirentitlements?

The project will advocate for and lobby localauthorities (including CDC and DI) to allow villagers full access to theirlegal entitlements.  It will do thisdirectly, and wherever possible by supporting villagers to approach theseauthorities themselves.

How have churches been involved in the design of the project?

Churches have not been directly involved in the designof the project. That has rested with people affected by leprosy and HANDAstaff.  However, Christian groups are involvedin implementation of some project activities (such as volunteeractivities, self care training, wound care, public education, etc.) and throughlong-term involvement have influenced the shape of this new project.

Will churches beinvolved in the project implementation and management?  If so, how?

In some villages, there are sisters living in the village taking care ofthe elderly. They receive training and support from HANDA staff.

A Catholic group (led by Father Roberto) has been working in the leprosyvillages in south-western Guangdong, providing physical rehabilitation. HANDAworks closely with this group, providing support from its prosthesis technicianand footwear technician, who visit to produce suitable prosthesis and footwearappliances when needed.

HANDA has a long and close relationship with a Christian group offoreigners in Dongguan.  This groupprovides funding support and are also involved in advocacy activities.  They also provide volunteers for HANDA’svolunteer programme.

How will the project methodology contribute to localownership of the project?  How willstructures established by the project be locally owned and continue to be inplace after project funding has ended?

The project is overseen by HANDA’s Committee.  As noted above, thecommittee members are elected by the villagers themselves. They are therepresentatives of the villagers and they not only live in the leprosy village,but also visit other villages to collect information on the needs of thosepeople.  This Committee will continue inplace after the project ends.  

Wherever possible, the project seeks to develop villagers’skills so that they can continue to plan for and carry out activitiesthemselves with as little support as possible from the project.  It is hoped that these activities willcontinue without project support in the future. Support for these activities is sought from nearby local communities andvolunteer groups.  These volunteers areset up to provide their support with limited input from the project.  It is hoped that these relationships between villagesand outside volunteers will continue to develop after the end of the project

How have therecommendations and lessons learnt from previous evaluations of this andevaluations of other projects (including those of other organisations) informedthe design of the project?

Previous evaluations haveidentified a number of areas for consideration. These have been addressed in the design of this project.

It was recommended thatfuture projects should be smaller in size or have a significantly larger budgetto ensure that quality services can be implemented in an equitable fashion.This project is targeting just 94 ‘leprosy villages’, those where HANDA feelsit can have a significant impact.  Notall project services and activities will be carried out in all villages. Services will be ‘targeted’ on villages where they are most neededand will have the greatest impact. Physical rehabilitation activities will becarried out in a large number of villages because this service is essential tothe welfare of villagers and is relatively low cost to carry out.  Social and psychological activities, whichare more labour-intensive, will only be carried out in 43 villages, where theyare most likely to have a big impact. Finally, given the advanced age of villagers and limited opportunitiesavailable in many villages, economic development activities will only becarried out in 9 of the 94 project villages.

It was suggested thatthought should be given to find ways in which volunteers could be compensatedfor their efforts and commitment. This should not be financial. To address thisthe project is focussing on targeting the ‘right’ volunteers for the job, andproviding them with a quality experience. Training will be provided and a volunteer management team established toprovide suitable support and ‘pastoral care’.

There will also be anincreased focus on a mutual self-help spirit between to reduce the reliance onoutside assistance.

The evaluation recommendedimprovements to HANDA’s monitoring systems. HANDA has worked with LMNZ to develop a new project results framework(objectives etc and logframe) and also monitoring and evaluationframework.  

How will the project demonstrate TLM's distinctivenessas a Christian organisation?

HANDA, are a secular, grass-roots leprosy organisation,although some HANDA staff and volunteers are practicing Christians.   As noted above, HANDA collaborates with Christian organisations todeliver support in villages. God does not always work through Christians to fulfilHis plans and vision – Scripture is full of examples of this.  ThroughTLM’s funding for this project our and His vision (Leprosy Defeated, LivesTransformed) is being fulfilled in a place where TLM does not have a directpresence.

What specificknowledge, skills and experience are required by staff to implement, manage andevaluate this project?  What training dostaff require to develop the knowledge and skills required to implement, manageand evaluate this project?

As HANDA’s staff are very experienced in physical andsocial and psychological rehabilitation activities they require littlesignificant training.HANDA will howeverfocus on improving its monitoring and evaluation and its reporting ofthis.  LMNZ will provide ongoing supportand mentoring in this area.

B.7        Equity andInclusion

Are some groups of project beneficiaries moredisadvantaged than other groups of project beneficiaries?  For example, arewomen more disadvantaged than men, are children more disadvantaged than adults,are rural communities more disadvantaged than urban communities?  What are the causes of these disparitiesbetween groups of project beneficiaries?

As discussed earlierproject participants face geographical (remote locations away from maincentres), social barriers (stigma based prejudice), physical barriers(disabilities), institutional barriers (institutionalised discrimination) andeconomic barriers (low incomes) which prevent them from claiming entitlementsby making it difficult to access the officers they need to claim them from butalso reduce the likelihood of them being accepted.  All project participants are significantlydisadvantaged.

Women do tend to beside-lined in village affairs and have less opportunities for social andeconomic development.

Minority ethnicgroups living in rural area also tend to be disadvantaged in Chinesesociety.  Minorities account for at leasthalf of the population in the ‘leprosy villages’ in Yunnan. There does nothowever seem to be much disadvantage between the different groups within thevillage.    

How will the project support project beneficiariesand other stakeholders to address the causes of these disparities?

Thisproject was designed to focus in all its activities on the empowerment of womenand their full engagement in all activities. Training on Gender issues has beenprovided to all project participants to ensure a good understanding of genderissues and tools for promoting gender equity. The guidelines for all projectactivity specify that the active participation of female villagers must beensured in the whole project cycle as well as the project activity. Monitoringis done to manage this on an ongoing basis. Special activities have also beenorganized which by their design or nature naturally encourage the involvementof the female villagers, as well as allowing men’s involvement.

Fiveof the staff in the project teams in Yunnan and Guangxi are from minoritygroups.  It is very important to havesomeone who understands the language and culture of people we are working with.Activities such as organizing charity tours to the leprosy village, bringingpeople to participate in social activity and give performances to audiences,promote handmade products by the villagers were designed for minority groups.  HANDA are trying to promote the culture oflocal minority to the general public.  

B.8        Environment

What resources will be used by the project and willany waste products be produced by the project?

The project willhave limited environmental impact.  

How will the project safeguard the environment?

The project willhowever promote improvement of, and sustainable use of, the localenvironment.  This will benefit thewelfare and health of villagers and also improve the usefulness of theirproductive land.  All economicdevelopment activities will have a significant focus on environmentalsustainability, and will try to use organic farming practices.  This will add value to the products produced.

B.9        Coordination

Please give brief details of other organisations working in the samelocation and / or with the same beneficiaries.

Bless China International also works in theleprosy field in Yunnan in Diqing, Honghe and Xishuangbanna prefecturesproviding self care training, education and other physical support activities. Activitiesare coordinated to ensure good coverage and no overlap of activities.                                                                                                                                                        

JIA Work Camp Coordination Centre organizesvolunteer camps in the leprosy villages in Guangdong, Guangxi, Yunnan.

Dermatology Institutions (DI) or Centres ofDisease Control (CDC) are responsible for all the ‘leprosy villages’ in China. Thegovernment organizations (DI/CDC) mainly focus on the leprosy controlactivities. They are responsible for the treatment of all active cases. Theyalso provide basic welfare payments and some basic medical service to thepeople living in some of the ‘leprosy villages’. The project actively works toencourage these organisations to provide more support to villages.  The project will only provide services orsupport in villages where it is clear that these organisations will not. HANDA as a NGO has to get theirapproval to work in these villages.. They may not provide much support toHANDA’s activities, but as a government department have the power and authorityto stop HANDA from carrying out activities in the villages if they chose to.

Disabled People’s Federations (DPF) in Guangdongand Guangxi areamong the biggest government organized non-governmental organization (GONGOs)in China. They have a big influence on the government and also have goodresources to assist people with disabilities. Access by people in the ‘leprosyvillages’ as ‘people with a disability’ to their services is of significantassistance in improving access to resources to improve their quality of life.They could also be an important party to influence the government and help toregain the rights of the disabled people.

Red Cross in Guangxi is a key partner of HANDA in Guangxi, asHANDA has not officially registered as an independent NGO in Guangxi.Partnering with the Guangxi Red Cross legalizes HANDA’s activities there.

YWCA in Guangzhou has good volunteer resources and hasexperience in organising social activities to enrich the life of the people whoare excluded by general society.

Other NGOs or volunteer groups are important partners for HANDA, as manypublic education and advocacy activities rely on the participation ofvolunteers and other the involvement of other NGOs. Other volunteer groups,including the Guangzhou Youth Volunteer Association and volunteer societies indifferent universities etc. have extensive volunteer resources and have astrong relationship of cooperation with HANDA. They have strong experience inorganizing volunteer activities as well.

SomeCatholic individualsandgroups, includingFatherKim from Korea, Father Yang from France, a group of sisters from north Chinaand Father Roberto from Italy provide some physical support as well as food and other welfare supportto some villages in Guangdong, Guangxi and Yunnan.

How will project activities be coordinated with theactivities of these organisations?

BCI staff in Xishuangbanna, last year invitedHANDA’s technician to visit and build new prostheses for the needy people inleprosy villages where they work. The technician provided training on how tomaintain and repair old prostheses. The CDC in Yunnan organizes annual meetingsamong the NGOs who are working in the leprosy field.  This meeting is HANDA’s main platform toshare experiences with other organisations and promote better coordination.

HANDA has built up stable relationship with JIA,sharing volunteer resources and organizing volunteer activities together.Volunteers help to conduct baseline surveys, organize recreational activities,collect stories, etc.

HANDA’sstaff have a long-term relationship with communities in the areas where theywork and with state and other organisations working in these areas.  HANDA makes a point to visit theseorganisations during each visit to each area in which it is working.  If there is more than one partner or possiblepartner in one location these meetings are usually coordinated to bringtogether all partners at the one time. HANDA is also a regular participant innational level leprosy coordination meetings, which occur at leastannually.  

HANDAhas an agreement with the Father Robertoandmost other charity organisations to ensure that duplication is avoided. Theytend to focus on the material needs leaving HANDA to work on the villages’other needs.

TheGovernment Organised Non-Government Organisations (GONGOs) (DPF, Red Cross,YWCA) provide material assistance to disabled people in some places. Theproject encourages this and supports them to do this effectively andappropriately. These organisations do not make much effort to address socialand psychological issues.

B.10     Risk Management

Use the table below to showthe possible risks to the success of the project, and the likely impact andprobability of these risks.

How have these risks been considered in the designof the project to mitigate their impact / reduce their probability?

Risk 1: HANDA will manage this riskthrough good communication with relevant government departments. Care will betaken not to offend or embarrass them and to try to connect positive resultsfrom the project with the government’s achievements, so as to encourage them toput more effort into activities aligned with the project.

Risk 2: Care will be taken to provide regular reportsand information to the relevant departments, try to invite them to participatein the activity so that they have better understanding about the project and bemore willing to support it. If possible, the project will try to develop moregovernment departments as partners, and turn the risk to an advantage.

Risk 3: The project will address this by arrangingwork schedules according to the weather or season.

B.11     Sustainability

How will the benefits of theproject be sustained beyond the lifetime of the project?  If project activities are to continue afterproject funding has ended, how will these activities be supported?

Implementingthis project will develop the capacity of HANDA in this type of work and morebroadly as a local NGO.  These skills andthis experience will remain with HANDA staff and its governance team after theend of the project.

Self-careskills are designed to remain with villagers long-term as they focus onchanging people’s daily practices. Similarly, social development work willbuild skills and psychological resilience which will always remain with thepeople involved.

Economicdevelopment activities are designed to build upon themselves, with businessplans being developed which will see some of the profits reinvested back intofuture developments such as expansion or hiring technical advice.  Also, links will be made between peopleinvolved in these activities and local individuals and (government andnon-government) organisations interested in supporting these activitieslong-term.

It isalso intended that the project’s relationship and advocacy with government andnon-government organisations will change the way they look at these villagesand people affected by leprosy and that this changed perspective will continueto lead to gradual change in these organisations dealings with people affectedby leprosy.