Hawadith Street Initiative: A unique Sudanese childhood charity experience

Abstract

Due to escalating conflicts and resultant economic constraints, different social services in low income and low-middle income countries have witnessed a decline in its standards, and increase in the costs. This situation has led to emergence of large numbers of patients and their families who cannot afford the costs of health services provided by public hospitals. On this background, and the old heritage of the Sudanese to help the needy, the Hawadith Street Initiative (HSI) was established. Named after the street on which it was founded — which translates indirectly to “Accidents Lane”, HSI was established in 2012 by a group of youths, most of them in their twenties of age, and recently graduated. The main activity of the initiative is helping the needy hospital patients, especially with regards to their treatment costs, in Khartoum and other cities in Sudan. Starting with recreational programs for cancer patients, and public campaigns for donation of blood, the initiative’s youths changed their activities. Using the social media, Facebook, they adopted the strategy of communication with potential donors, after sending posts containing brief anonymous presentations and call of help for needy cases. Currently HSI includes more than 2000 volunteers in Khartoum and 17 other cities. The most important achievement of HSI is the establishment of an intensive care unit at a children hospital in Omdurman city costing 435,880 US dollars. HSI demonstrates the possibility of delivering great services with minimum resources, and constitutes a unique organization, worldwide, in a new wave of Internet-based initiatives.

Introduction

In about 2009, there was a group of young people in Khartoum who were offering recreational programs for children with cancer to help them to cope with the disease, and with the side effects and complications of chemotherapy. Little by little, these young people were convinced that those children were in the greatest need for drugs more than entertainment. They began attempts to buy medicines for them and some other needs. After that, the youth activities changed from the different hospitals to Hawadith Street in Khartoum; a street where major hospitals and clinics are located, including Khartoum Teaching Hospital, the historic and largest hospital in Sudan. The youths started to meet near Gaafar Ibnauf Children’s Hospital (GICH) [1], where they were offering assistance to the families of sick children coming to the GICH. Their activities were particularly helpful to those who were referred to the Capital Khartoum from the various regions of Sudan, with ‘signs’ of poverty and confusion (actually they constituted the majority of hospital attendants).

But the major step and the turning point in the history of the initiative came after the creation of a Facebook page titled Hawadith Street Initiative (HSI) in August 2012. This date can be considered as the start of the HIS. But why this name. The word Hawadith is an Arabic word referring to the hospital department of accidents and emergency; the cores of the activities are in the street where these departments are located. The activities of HSI were initially directed to GICH, and then moved to other children’s hospitals, namely, Ahmed Gassim Hospital (Khartoum North), and Mohammed Elamin Hamid Hospital for Children (MEHHC) in Omdurman, then moved to outside Khartoum State, through similar initiatives established in some large towns and cities [1]. The young people presented cases that needed help on the Facebook page. Those who want to donate for buying medicines, or to perform costly laboratory tests or images will deal directly with the patient as the HSI youths provides them with patient’s phone number and other contact details. There, on the Facebook page, a list of telephone numbers of volunteering youths for the donors who desire to be accompanied by an HSI member, and for anyone who wants to donate in kind or financially for the expected needy patients (Figure 1).

Figure 1.

Two of the founders of Hawadith Street Initiative, Ahmed Idrees (right), and Rani Hassan (left).

Usually the HIS members do not receive cash money from donors but they direct those desiring to donate to deal directly with the needy patients, or to pay the HSI debts to indebted pharmacies, laboratories and radiology centres (who agreed to deliver services to the HSI patients and wait to receive the costs when cash is available). In other words, the initiative, in most of the cases, is a link between the donor and the beneficiary (Figure 2).

Figure 2.

One day account page of Hawadith Initative Street showing the voluntary donations and payments to pharmacies (Courtesy of Dr Nazim Haidar).

Thus the HSI has earned a high credibility where it does not receive cash money in most cases. Then, the initiative started to attract large numbers of young volunteers, some of whom are working in various state institutions or the private sector, in many fields, as the HSI accept participations from health and other fields. By now, the initiative membership includes more than 2000 volunteers in Khartoum and seventeen other cities (including 300 volunteers in Darfur). Also, there are branches for the HSI abroad, in particular in the Gulf Region and Britain. Their role is limited to donations in kind and cash (and do not deal directly with patients).

The initiative accepts any form of aid, whatever it is. For example, a Facebook reader of a post for helping a patient needing a drug or blood can directly help the patient, or at least can ‘share’ the post to increase its readership, and then further display the case, where donors can catch the post and help.

For the system to work, HSI members divide themselves into three shifts per day under the chairmanship of an elder member of the group (coordinator). The first shift begins at 10 am to 5 pm, the second shift extends from 5 pm to 10 pm and third shift from 10 pm till the next day morning. On average, the initiative receives about one hundred cases for help per day, in Khartoum, Omdurman and Khartoum North hospitals.

Um Gisma: the icon of Hawadith Street Initiative (HIS)

Um Gisma has become the icon of the HIS. Her real name is Rowah Dermot, from South Kordofan State. Her nickname came after her eldest daughter Gisma. Um Gisma came to Khartoum after being referred to GICH to treat her daughter, Gisma, who was suffering from renal failure in 2009. As the length of stay for Um Gisma in Khartoum was getting longer, her demand for money became pressing. She needed to meet medication expenses as well as the living costs for her five children who accompanied her to Khartoum. She started making and selling tea and coffee near GICH. Only a chance led some members of HSI to gather at Um Gisma place to drink a cup of tea and to hear her story. They succeeded in providing a good amount of money to meet her ongoing expenses. This chance was the magic act which pushed the work of the initiative, and markedly changed the life of Um Gisma. She, then, became a vital member of the group. As the initiative was lacking a headquarters, she provided her clients’ seats as benches for members to sit on and meet to manage their issues. Also, she carried what looked like ‘secretarial’ work for the HSI, receiving visitors in their absence, and acted like their treasurer for donations. She unlimitedly offered her motherly life experiences and solved the members’ misunderstandings which are common among those who stand up for any public action. By time, Um Gisma herself became a major helper for patients and their families, by the virtue of her warm relations with the hospital staff. The health of her daughter Gisma improved, and she completed her secondary school study, and joined Ahfad University for Women to study psychology. With a great contribution from a young Consultant Pediatric Nephrologist at GICH (Dr Safaa Abdelhameed Madani), she could rent a house and the rest of the kids had a chance to continue their basic education.

For all these reasons, the initiative group chose Um Gisma as the best representative for the opening of the intensive care unit (wholly built by the HSI efforts), at MEHHC in Omdurman, in recognition of her favours [2], and also for encouragement of the youth to be involved in the field of voluntary works (Figures 3 and 4).

Figure 3.

Entrance of the intensive care unit built by Hawadith Street Initiative at Mohammed Elamin Hamid Hospital for Children in Omdurman.

Figure 4.

Um Gisma, and a child recovering from cancer beside her, inaugurate the intensive care unit built by Hawadith Street Initiative at Mohammed Elamin Hamid Hospital for Children in Omdurman.

In conclusion, Um Gisma vividly demonstrated that anyone can contribute effectively in the community service, even if he/she is extremely poor, or illiterate.

Establishment of intensive care unit in Omdurman

The most important achievement of HSI is the establishment of the intensive care unit at MEHHC in Omdurman [3]. The unit occupies an area of 185 m², within the hospital buildings, and has a capacity of seven well equipped ICU beds, in addition to other equipment such as computers and office furniture.

The total cost of the Unit was 435,880 US dollars, which was donated by the Sudanese people (at home, and abroad), some donations were in kind, in form of equipment, furniture or building materials. The unit was inaugurated by Um Gisma in May 2015 accompanied by a child recovering from cancer. This unprecedented achievement was widely covered by national and international media (Figure 5).

Figure 5 (A&B).

The unprecedented achievements of the Hawadith Street Initiative was widely covered by national and international media including Sky News Arabia [3].

Problems faced by the HSI

The HSI is facing a number of problems, mainly due to the spontaneous nature of the start of the initiative and for factors beyond the founders’ wills. Till now, the initiative is not registered officially as a voluntary non-governmental organization (NGO). The HIS founder achieved remarkable steps in the process of registration. That is the reason behind the use of the title ‘initiative’ and not ‘organization’ pending the official registration. Another problem is the loss of members, most of them are unemployed, and without a genuine income.

Of note, is the conflicting figures about the activities of the initiative; necessitating the service of a professional statistician, and a genuine statistical unit to develop an accurate statistical and archiving system for the initiative. The site of the HSI is in need for more development, preferably by information technology (IT) expert advisor.

Prospects for the future

The experience of HSI with its unique flexibility and enthusiasm of its members is amenable for further development. A twinning, or a link, can be created between the initiative and National Health Insurance Authority as it is the sole body that provides medical services to the public at a low cost. With the expansion of the work of the initiative, a need for an administrative and accounting system, narrowed as possible so that the members are not drawn into bureaucracy works affecting their actual field performance. Of note, is that the near registration of the HSI as an NGO imposes the election and establishment of administrative and financial systems, budget, statistical system and establishment of headquarters. All these duties need the training of the inexperienced youths to handle such duties.

Lessons from the experience of Hawadith Street Initiative (HIS)

1. HSI is part of a trend that has its roots in traditional Sudanese self-help groups that mobilize communities to help in times of need. These include Nafeer (a volunteer team that provided relief to flood victims) [4], and Sadagaat (Sudanese Charity group focused on raising funds and distributing them to the needful Sudanese families and Individuals) [5].

   It had been shown, clearly, from the experience of this initiative, the great role that could be played by civil society organizations in providing effective services through the manipulation of the community values such as magnanimity, and the love to do good, even with the lowest capabilities (even with non-existence of potential, as in the case of this initiative).

2. The Um Gisma tale represents a model experience in improving the capacities of the individual in a poor situation. With little effort, and devoid of any support, Um Gisma moved from being a recipient of aid to the provider of care to herself and to others (for example, she helps patients, and constitutes an important role in a charity organization and even could enable her daughter to learn in an eminent university).

3. The experience of HSI defeated the bad and wrong excuse that lack of equipment or funding can be a reason for not initiating any projects to serve people.

4. Of note is the great response by the people to the initiative calls of help. This is an extension of the old heritage of the Sudanese to help the needy, represented in concepts such Alnafeer (A “nafeer” is a Sudanese social tradition that comes from an Arabic word meaning “a call to mobilize.”)[4].

5. Such experiences have national and humanistic facets, involving youths from all tribes, ethnicities, religions and social backgrounds. The Initiative may play a role in the cohesion and unity of the country and its renaissance as a one nation.

6. The HSI made a good and noble model of how to benefit from social media (such as Facebook, Tweeter or Youtube), and that patients can be helped by its electronic widespread readerships, low-cost and easy accessibility. This scenario can be applied by similar organizations working in health and other fields.