Ten years ago, we lost a beloved colleague to HIV/AIDS. In those days, BI did not have a health programme yet and accessing any kind of healthcare was a mission.
The only option for community members to get ARVs (HIV treatment) was to walk a tiring 2 hours to the nearest clinic, and heavy stigma back then made going to the clinic even more difficult. Sadly, many people defaulted on their treatment, fell sick and died. One community member recounts dozens of close friends who had died of AIDS during these years.
The passing of our colleague spurred our active work to reduce HIV stigma through sports outreach days. We would host sports tournaments and offer HIV testing. It was much easier to say, “I am going to the soccer match”, than to say, “I am going to get tested for HIV”.
With time and exposure, the stigma around testing and a positive status loosened its grip. With more people testing, we needed to remove the second biggest barrier: getting ARVs.
In 2012, our community donated the first Health Point as a centralised place to distribute HIV treatment, offer ongoing testing and host support groups. The Health Point integrated with our home-based care work and, over the years, has steadily developed into operating as a fixed outreach point for Nkanya Clinic— functioning like a mini-clinic.
In partnership with the Department of Health, our Health Point became a community HIV treatment pick-up point last year. Nkanya Clinic sends an electronic script to the centralised dispensing system (Central Chronic Medicine Dispensing and Distribution, “CCMDD”), and the ARVs are then packed and couriered to Bulungula Health Point. Community members have the option to collect their medication or to have the Nomakhayas deliver it to them during routine home visits— most opting for the convenient home delivery. Now community members only need to go to the clinic twice a year for routine clinical check-ups.
Between our Health Point and home-based care team, we can closely monitor people living with HIV, checking to ensure they are adhering to their medication. Using the trusting relationships our Nomakhayas have with their patients, we can find out why people may default, troubleshoot solutions and monitor them.
A young man recently fell sick and went to the clinic, where he tested positive for HIV. Even though he was prescribed medication from the clinic, the Nomakhayas observed that his health was deteriorating. Bongezwa Sontundu, our Health Programme Manager, was notified to intervene with the patient. During her visit, she observed that he was depressed and in denial about his positive status. She taught him that living with HIV is not a death sentence and that a person can live a long and healthy life by taking ARVs. It took two more visits and extra support, but the young man is now taking his treatment, and his health has dramatically improved.
Defaults are now irregular occurrences that we deal with case-to-case. Today, on World AIDS Day, we are proud to share that in our community, we have zero defaults.
We still host our sports outreach testing days, provide HIV awareness education during home visits and at schools, broadcast two weekly HIV health shows on our community radio, and distribute condoms once a month to all the spaza shops and shebeens in our area. In just ten years, we have been able to work with our community and government to remove barriers to HIV/AIDS care and dramatically improve the health of people living with HIV.