PLHA's Involvement Critical. 14/9/10

What we would like is to have a centre that offers HIV testing, CD4 count, ART, OI (opportunistic infections) treatment

AllAfrica

Harare — When the National Aids Council hit the news last year amid allegations of not channeling the requisite minimum of 50 percent of the Aids levy towards the procurement of ARVs, there was a loud outcry from PLHAs.

Understandably, the feeling was that the body entrusted with looking after their welfare at national level was not taking its job seriously. For them, ART is the only sure way to sustained quality living.

The call for Meaningful Involvement of People living with HIV and Aids in all programmes concerning HIV/Aids has continued to grow. More and more PLHAs feel that they are being sidelined for a bigger picture, which does not serve their primary interests.

Thelma Gara, a 36-year-old HIV+ woman from Sunningadale, says that the suburb has seen no real meaningful development of HIV programmes although there are some organisations who work in the area.

Thelma is a teacher and a single parent of two children of school-going age. Sunningdale is one of the better high-density suburbs in the capital city but most of the residents are not very well off.

"What we would like is to have a centre that offers HIV testing, CD4 count, ART, OI (opportunistic infections) treatment here in this area.

"Sunningdale is very large and right now we have to go to Beatrice Infectious Diseases Hospital and this costs us money for transport and food because when you are collecting your tablets you practically spend the whole day there.

"We are just told of these policies. We take no meaningful part in coming up with them. There are even organisations that are getting money from donors using our plight as a selling point.

"But when it comes to the actual use of that money, it all ends up with the lion's share in the organisation leaders' pockets and just peanuts coming to us.

While the point is valid, there is a salient fact that most PLHAs are not cognisant of.

The National Aids Council policies and actions are crafted to deal with the HIV pandemic from a holistic point which goes much further than the provision of testing facilities and ART to PLHAs.

The national body must also ensure that new infections are reduced as much as possible and the best way of doing this is through thorough education of the whole populace on available information concerning HIV.

PSI, the organisation that runs the New Start Centres in the country, has been largely instrumental in running practical programmes to deal with HIV.

They have introduced CD4 count services for free at their centres and have clinics that offer services like male circumcision and female tube ligation as mitigatory measures against the further spread of HIV.

But they also channel a considerable portion of their resources towards awareness and education campaigns. One of the current programmes that they are involved in is the training and empowering of community theatre groups in spreading the HIV message in their locales.

The importance of correct awareness campaigns cannot be over-emphasised as illustrated by an account of a disaster that hit an Eastern African country several years back.

It is said that a religious leader of a certain region said that he would take the responsibility for educating his people on HIV. He was told that male circumcision and the use of condoms were the best way of preventing HIV in the absence of abstinence.

Within a few months, the prevalence and new infections rates of the area had increased drastically.

Asked what exactly he had been telling his people, the leader's answer was, "I told them what you said. Condoms will prevent HIV, if they are circumcised!"

Just as providing ART is one of the key targets of NAC, containing HIV and preventing new infections is also integral to the national body's efforts to deal with the pandemic.

Thus the money that is being used on awareness campaigns is not being "misused and wasted" as some quarters have alleged.

But on the other hand, the concerns of PLHAs like Thelma Gara for easier access to ART and support services in the management of HIV are also of primary concern to those affected and infected.

But instead of continuously crying for a larger share of an inadequate cake, perhaps it is time that more PLHAs come together to harness their own resources towards providing for their own needs.

Simbarashe National Network for People Living Positively with HIV, a Mhondoro-based organisation won the NAC Best Practice Award in 2009 for the way in which they have taken control of their own destinies.

The rural network has sourced funds to build their own resource centre which has a herbal garden for members to get palliative care for opportunistic infections to reduce the cost of medication.

"Many of us used to suffer from sores in the groin area and sometimes we would be unable to access antibiotics and ointments. But now we have herbs here that have worked wonders and such ailments are stories of the past for Simbarashe members," Evangelist Richman Rangwani told a gathering attended by the deputy minister of Health and Child Welfare at the centre last year.

Simbarashe has gone on to train its own community-based activists against gender-based violence and home-based care-givers. They hold awareness campaigns in their constituents once a month, moving from one ward to the next.

With over 1 500 members, just US$1 from each member towards any project makes an impact. Added to that, the group has structured fundraising activities and has twice undertaken sponsored walks from Mhondoro to Harare in their quest to get the things that they need.

The organisation has also gone one step further in that its membership is not just for PLHAs. There are many members who are HIV negative, but who have joined because they have realised that the network is working for the good of the whole community.

The NAC 2010 figure for infected people needing ART stands at 570 000. If each one of these people were to pay just US$1 a month towards those goals that they feel NAC and the organisations under its umbrella are missing, that would add up to US$6 840 000 a year.

That may not seem like a huge amount, but it could easily upgrade several rural clinics to enable PLHAs to access ART without having to walk 40km as in the cases that have been reported in Manicaland.

It could also be used to install more CD4 counting centres and other key areas. And as launching platform, there are bound to be many well-wishers who may not be PLHAs but who would gladly donate in cash and kind towards such projects.

It is not a secret that one way or the other, almost everyone in Zimbabwe has been affected by HIV, even if it is not everyone who is infected. The example of Simbarashe shows that this is a possibility and not a dream.

With many community based organisations already on the ground across the entire country, existing structures could be used to administer the funds to cut down on administrative costs thus having the bulk of the money going directly towards the intended targets.

While it would be unrealistic to imagine that such a move would end all the problems that face PLHAs in fell swoop, it really would be a starting point for positive living for many.

To start off with there would be actual MIPA in action and the views of the PLHAs would have more impact on national policy formulation as there would be demonstration of the practical ability to envision a way forward and act on those visions.

There would also be other practical offshoots like the improvement of quality of life through the programs undertaken and even creation of employment.

And not the least important aspect, PLHAs would shed the mantle of victims and prove that they are no different from the next person, they just have a health condition that needs permanent medical support.