Trip out for the Mobile ART Clinic and Community Meeting

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.

Awaiting

Greetings from a dry dusty and roasting Mwandi as we await the rains at the end of the month, we hope. Duncan and Ina, our daughter Kirsten’s in-laws have been collecting pre-school equipment being disposed of in Edinburgh and taking it through to Kildrum to be stored until a container is organized. Our thanks go to Kildrum for putting their dunnie at our disposal. We are so pleased to have been given those wonderful toys and look forward to their being used here.

We are well but kept busy with duties at the school and hospital. The latest good news is that US$40 000 has been pledged by a US Foundation to build a classroom block at Sikuzu. This will save children a 10 mile round trip to school.

We are about to leave on Saturday for Mongu to the Western Presbytery Meeting where the new Bishop will be elected. Before the Covenanter in you chokes on your coffee, a Bishop here is in effect more of a Moderator than the priestly prelate of Presbyterian prejudice! The United Church of Zambia is actually an amazing and working mixture of Presbyterians, Congregationalists, Methodists, some Baptists and French Protestants; so there are several forms of baptism, child and adult believer, sprinkling and immersion depending on your 'tradition' and three forms of communion: the Scottish- passed around, the Methodist- on your knees at the front or the French - a series of horse-shoes around the Communion Table. Services too can be very liturgical, others are more like ours from the Common Order. Some services are more traditional and rather staid while others are quite charismatic. It is wonderful how all these manage to be accepted and welcomed by all. There is a lesson here for the Scottish Church(es).

The new Minister for Mwandi will also be elected there. Presbytery is followed by a 4- day Church Camp Retreat on an island in the Zambezi. So we have packed our camping equipment with our tents and sleeping-bags.

We will be using the inaptly named M10. Some of you, Scots of a certain age, will remember in 1970s and 80s, the A96 Aberdeen to Inverness road being referred to as the ‘goat-track’; well the M10 takes that place here in Western Province. Mongu is only 400km away but the tar runs out at Sesheke and it is sand dust and dirt to the pontoon ferry at Sitoti. After crossing the Zambezi, a dreadful drive ensues across the floodplain to Senanga., another pitted and pot-holed causeway with washed out culverts. At Senanga we enjoy tar again for the last hour to Mongu. There are only tarred roads in Western Province. We’ll leave at 0700h and get to Mongu at around 1600h

Unfinished building work

Finally, Nick has asked us if we would make urgent enquiries to try and find an individual or a small team of builders who could come now or in the near future to work on the roof of the Church of Scotland house. He is desperately needing assistance to get the roof put on before the advent of the rains and before he goes on leave at the end of November.

If any of you know of anyone who might be able to help, please let us know and get them to contact us as soon as possible. This really is a pressing need.