A few weeks ago the Aids Relief staff came back from a settlement 90km away from here saying that they had had a very difficult clinic. A mentally-deranged women had set fire to the thatched roof of the New Apostolic Church, so they only had had one room for the clinic. The choir was also rehearsing where we usually met and patients did not want to collect their medicine from the back of the vehicle in case they were seen. One member of the Team felt that we should move the neighbouring clinic further south - more convenient for us, but further to travel for most of the patients. We discussed the problem at our monthly meeting but the staff was divided. As chairperson I came in and said that this was not our decision but the decision of the affected community. Our Adherence Counselor took the message back that they should hold a meeting and then we would come to meet the Community and hear of their decision.
Yesterday we set off late at 0930h in the pouring rain, for the two hour trip. The road is usually sandy but today it was just muddy porridge. The trucks picking up maize that had been sold to the Government had churned it up making it very treacherous. We arrived at 1130h with the sun beginning to peep through the overcast clouds. Today, we were given two rooms at the New Apostolic Church, a typical pole and dagga building. Four clients were already waiting for us, three as appointed and one who should have been the week before.
As we began the clinic more clients arrived. One lady came for her CD4 results. She was found to be positive when she delivered her baby recently. I began to fill out the forms with her for enrolling her. She gave her treatment supporter as her husband. When we reached the part that asked who she had disclosed her status to she answered no-one. We stopped and went back to the Treatment Supporter. No, her husband did not know and he would divorce her if she told him. Could she not persuade him to come for testing? No, he is difficult, was the reply.
I called the Adherence Counselor and together the three of us decided that when we come for the next clinic the VCT team would do Door-to-Door VCT in her village and hope to test all the family, including the husband, and also re-test the client so that they hear the results together as a couple.
It was now time for the meeting, the Community were sitting outside; people of all ages and the Headman seated in the middle. We greeted one another and went through the formalities. The Headman then explained that as a community they had held a meeting earlier and this is what they had decided.
The clinic would no longer continue in the New Apostolic Church but that they would build a new clinic. They had already started. Those who could, had donated a bucket of maize which was sold to the Government Agents who are purchasing relief maize. With this they had bought eight roofing sheets. The Headman explained that they had cleared the land and begun cutting poles. They felt that four rooms would be good but that that would take 20 roofing sheets in total. He explained that a few more people had donated but it is a difficult time of year as last year’s maize is finishing and they are all trying to purchase seeds and plant again now that the rains are here.
I thanked them for their efforts but explained that the Aids Relief program was unable to help. I said that I could not promise but I might find some help towards the roof but meanwhile they should keep on trying to raise the money. I also said that I was sorry that not only the church roof had been burnt but also the community school’s roof by the same woman.
From there we moved on to discuss stigma in the community. Why were people afraid to be seen receiving medicines? (A drunk man answered that he did not have a problem.) I said that this was a issue that they as a community should try and address and instead of hiding from each other they should be caring for each other and their needs. I then went on to suggest that they should be thinking of some form of Income Generating Program to help support the Community Health Workers and the clinic. They should also be considering beginning home-based Care.
We ended the meeting and waded through the mud across the road to look at the site that had been cleared for the clinic.
We have a lot to thank God for!
Wishing you all the best for Christmas and a Happy New Year
Glossary
ART: Anti-retroviral therapy, drugs used to suppress HIV virus
VCT: Voluntary Counselling and Testing (for HIV)
CD4 Count: the level of unaffected white cells in the blood.
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