UNITE FOR CHILDREN UNITE AGAINST AIDS

November 19, 2007

Challenges faced by People Living with HIV and AIDS around Silele Clinic

In my September blog, I spoke about UNICEF's activities in promoting the Prevention-of-Mother-to-Child-Transmission of HIV at the Silele Clinic, in Swaziland's Shiselweni Region. The Silele clinic recently introduced counseling and testing for HIV as part of its expanded services to the community. However, beyond counseling and testing, the clinic lacks expertise in the administration of Anti-Retroviral treatment (ARTs). UNICEF has pledged to assist the government with staff training and equipment needs.

Today, I have come back to Silele to gather more information on how the people are coping with the challenges of HIV and AIDS, particularly those living with HIV and I'll attend their bi-monthly support group meeting for people living with HIV.

The support group was established in 2002 by two women who named it Nkhosi Sikelela Africa Support Group - which loosely translated, means "God Have Mercy on Africa". The group's main objectives are to share information by supporting each other and promoting positive living; to conduct home visits for their members and to coordinate all their activities. They also ensure that members have access to the ARV drugs.

A member of the group Lomasontfo Dlamini says the membership has grown over the years to 104 people---all living with HIV; 26 are males, 78 are females and 61% of the total number is already on ARVs. “Of those on treatments, 17% are children” says Lomasontfo, adding “the group is awaiting the results on three children to determine if they have reached the stage where they can begin taking ARVs”. Most of these children suffer from infections. What is most disheartening to me regarding the children is that the clinic does not offer free treatment, thus orphaned and vulnerable children from poor households in the community do not have access to treatment. UNICEF's impending support should soon ease the burden of disease afflicting the people of Silele.

Like the rest of Swaziland, Silele is also affected by the prevailing drought, which is described as the worst in 15 years and that's having a big impact on children, especially those who are HIV-positive and on treatment. Many barely have access to food even though it's an essential requirement for patients on ARV. UNICEF in collaboration with the Swazi government has introduced therapeutic feeding at the country's major hospitals of which Silele Clinic is not a beneficiary. Malnourished children can only benefit when they go to the main hospitals. UNICEF is nursing the hope that with donor support and adequate resources, it would be possible to train more health workers and procure more therapeutic food to expand the services to all health facilities in the country.

In the meantime Nkhosi Sikelela Africa Support Group voluntarily collects ARVs for its members at the nearest hospital in Hlatikhulu at least eight times a month at a rate of $15 per trip. It's a challenging arrangement, as the group is always cash-strapped. I noted though that despite the challenges, the group has recorded a decrease in the death of HIV-positive people as the drop-out rate for ARV treatment is now very low. Only two members of the support group died this year.

I'm very impressed to learn about all the voluntary work that is carried out by this Support Group. Among others, they are given an opportunity to talk to communities about HIV and AIDS and the community leadership supports them. Sixty members of the group have been trained and educated on HIV treatment adherence and are operating in four chiefdoms. The support group has also encouraged members to plant back-yard gardens and also to plough some useful herbs to fight infections.

But despite their successes, the group is still faced with major challenges that threaten their survival: the collection of ARV drugs for group members is becoming very expensive due to the increases in transport fees. Moreover, there is no transport available for the health personnel of Silele clinic for home visits.

At the end of the day, I head back to the office to meet the Health team. I've been thinking on how to help the support group carry out its important work. During our meeting, I'm assured that UNICEF is already working with the government to ensure that a needs assessment of Silele Clinic is carried out promptly and staff is trained on ART administration. Immediately after that, drugs and supplies will reach Silele Clinic and this will help sustain the Support Group as the vital ARV drugs will then be available closer to the community.