News
Getting more people tested and treated for HIV, caring for the sick, helping people understand how to care for themselves —these are the tasks of faith-based organizations (FBOs) helping people with HIV in local communities.
As the 21st International AIDS Conference (AIDS 2016), to be held in Durban, South Africa, 18-22 July 2016, approaches, with its clarion call to “Access Equity Rights Now,” faith-based organizations (FBOs) such as the Methodist Church of Southern Africa (MCSA) Health Desk and the Southern African Catholic Bishops' Conference Orphans and Vulnerable Children (OVC) Programme continue their vital grassroots work.
Studies during the last decade have increasingly noted and acknowledged the growing role of FBOs in HIV/AIDS care and treatment in sub-Saharan Africa.
Continuing stigma and discrimination directed at people living with HIV and AIDs have made interventions, even by FBOs, difficult. Depending on the context, FBOs in Southern Africa have established strategic “pockets of services” in an effort to make health services and information accessible to communities. FBOs also partner with service providers already on the ground to enhance the quality of services rendered to communities.
“Stigma reduction has always been key in our work because our churches, from the onset, had to deal with this rampant scourge which delayed our meaningful response to the HIV virus. We are still playing catch-up, and stigma continues to thwart our efforts to deal effectively with the challenges,” said Pearl Moroasui, MCSA health desk coordinator. MCSA operates in Botswana, Swaziland, Mozambique, Lesotho, Namibia and South Africa.
Sister Priscilla Rakhetsi, from the Catholic services, agreed. “Our projects struggle when it comes to testing for the HIV virus because most of our orphans and vulnerable children and their guardians are not willing to be tested because of the all-pervasive stigma at the heart of the communities we serve. Parents and guardians believe that if their children test positive then they too are positive. Tuberculosis is classified as one of the opportunistic infections with the highest incidents and people are quite happy to be screened and treated for TB because it does not carry as much stigma as HIV.”
The two FBOs partner with local clinics to test people, and when necessary, initiate anti-retro-viral treatment (ARV). Many times, community members are unwilling to go to nearby clinics because of the discrimination they suffer at municipal health facilities, where patients are separated according to ailments and those directed to the HIV room are treated disparagingly and contemptuously.
“Many of our clients claim that the nurses are not professional, are uncooperative and lack empathy. They often openly brand patients as ‘HIV positive,’ treat them abominably and discuss their patients’ status in their communities, openly violating the Hippocratic Oath around confidentiality,” Rakhetsi said.
Even before treatment, stigma plays a part because most people are scared of being seen going for testing.
Some churches have made it a policy to conduct counseling and testing at every gathering or conference, and the demand is growing, said Moroasui.
“Trained caregivers and counselors who are community-based have also proved to be a great resource when they conduct testing services either during community gatherings or when doing door-to-door testing, which helps bypass the risk of being exposed to stigma in public places,” said Moroasui.
Communities need test kits
Community-based church agencies need test kits to help encourage on-site testing and to support clinics that are overwhelmed with patients.
“We have had all the OVCs in our programme tested at local clinics, and those who are found to be positive we enroll at a clinic for treatment. If the clinic is far, we give the children transport money to go and collect ARVs monthly. It is incumbent upon the clinics to provide us with documentation so that we know who, amongst our children, needs support with adherence,” Rakhetsi said.
“Lack of adherence to medication is our biggest challenge. Over the last six months, four of our children died due to complications caused by defaulting on treatment.”
Moroasui, of the MCSA, is concerned that FBOs and their work are not taken seriously. “Health departments are missing out on good opportunities of partnerships by not taking FBOs —who are trusted institutions in most communities through their history in welfare services —seriously.
In southern Africa, most of the patient care is provided by volunteers, some of whom are HIV-positive themselves. There is little financial support given to the trained community-based caregivers, and some of them become demotivated and unwilling to provide a much-needed service.
Several adherence treatment clubs have been established around South Africa, but there has been very poor communication by the government to ensure full understanding by all stakeholders of the varying roles they should be playing.
Equipping FBOs to do their job
FBOs believe that there is a need to return to the model of training parish nurses who carry out testing and treatment.
Rakhetsi thinks this is critical, since most people do not have correct information. “We need more HIV prevention education that speaks to both children and their parents because most people have stopped taking it seriously, and there is too much half-baked information and misinformation that is being spread,” said Rakhetsi.
The treatment adherence clubs are vital for people who are stable in their treatment but cannot spend days on end in queues for medication. Clubs have established medication pick-up points managed by caregivers and nurses. Clients get weighed as well and the data are forwarded to the local clinic.
Nutrition support is another driver of treatment adherence. Most clients abandon their treatment when they find it difficult to take medicines on empty stomachs, which cause considerable stomach pain as the drugs are strong and potentially corrosive to the stomach lining. FBOs mobilize food parcels and supplements for those who need food. The only condition is that each household receiving a food parcel should start a vegetable garden within a specified period for further nutrition support, an approach that has produced positive results in adherence as well as self-support for households in poor communities.
The 21st International AIDS Conference will be held in Durban, South Africa, 18-22 July 2016. An Interfaith Pre-Conference, “Faith on the Fast Track: Reducing stigma and discrimination; increasing access; and defending human rights now!” will be held 16-17 July. An Ecumenical Media Team will be covering faith-based participation at the conference. For more information see www.iacfaith.orgor contact Sara Speicher at [email protected].
Also See:
Faith community issues call to action to end AIDS by 2030
Registration opens for July interfaith pre-conference on AIDS
More information on the WCC-Ecumenical Advocacy Alliance Live the Promise HIV Campaign
More information on the WCC-Ecumenical HIV and AIDS Initiatives and Advocacy
