I can’t believe that we’re half-way through our time here in Zimbabwe. Time is definitely flying by for Team Regina! We have had a varied week, running our programmes in schools, conducting support group visits and facilitating workshops on Paediatric ART. However the main thing that has stood out for me personally is our work in the hospital. Having studied Immunology of Infectious Diseases, the pandemic of HIV and AIDS in Zimbabwe is something that intrigues me deeply.
We attend morning devotions every Monday at the hospital, which is an example of how religion is integral to everyday life here. Phillip is the lab technician at the Regina Coeli Mission Hospital and my interest in all things medical prompted me to approach him to get an idea of how an educated health professional views the pandemic and issues surrounding it.
Phillip explained to me that although they test for HIV at the hospital, they don’t have the technology for CD4 testing (the type of immune cell infected by HIV) or viral load counts. These tests are essential to assess the progression from HIV infection to AIDS and to test if the patient is complying with drug treatment. The lack of adherence can lead to the development of resistant HIV strains which are harder to treat; causing the progression to AIDS. To complete the tests, the samples are transported to Nyanga District Hospital. This is expensive and for those that are not eligible for free testing, it may not be an option. After hearing that some people are not able to receive the basic testing that is so important to their treatment, I can’t help but think of how lucky we are to have such a valuable health system back in the UK.
I asked Phillip about his experience in dealing with the pandemic here in Zimbabwe. We have spent a lot of time with support group members so it’s interesting to gain another perspective. It seems that one of the major problems is disclosure. Many people do not tell their partners they are positive and some parents don’t tell their children they were born with the virus. This results in infections and re-infections without knowledge, heightening the spread of the disease.
The use of condoms is subject to massive debate. There is a lot of stigmatization, the main argument being that they encourage promiscuous behaviour. This directly links with religious practices and expectations of abstinence as the main form of prevention. I was pleased to hear that Philip believes in prevention through the use of condoms and that education should take priority. He has seen too many young people infected in his lifetime. I find it hard to believe that such simple, affordable prevention methods are not being advocated for nationwide, however there are many complex religious, cultural and political issues affecting this.
Something that affected me personally is that many people who are positive are unaware of the full details of the condition that impacts their lives so greatly. Despite information being readily available in more urban areas, those in rural communities struggle to access it. It disturbs me that in the Nyanga district, it is clear that without the presence of the Diocese of Mutare Community Care Programme (DOMCCP) and the mission hospital, not only would people not know their status; the population would most probably be halved. Support group members alike, are testimony to the incredible work DOMCCP is doing. Nothing prepared me for the magnitude and competence of the organisation, and the immense impact it has on the Manicaland province. One of the methods used are workshops in which support group members and DOMCCP volunteers are educated on a number of topics relating to their condition.
I was provided with a platform to speak to support group members in a Paediatric ART workshop with Nurse Necheronga. I chose to focus on the choice parents have in preventing the next generation becoming infected. Globally 90% of positive children live in sub-Saharan Africa and mother-to-child transmission is preventable. With correct medication during maternal stages, the risk of transmission is reduced from 30% to 2%. The vast majority of the support group members are parents; they made it clear they did not want their children to endure the same hardships that they have. If all parents across Zimbabwe are made aware of these facts and adhere to the medication, there could be a new generation born, HIV free.
It has become apparent to me during my studies and here on the ground in Zimbabwe that the impact of HIV goes beyond the individual. It affects the community, it devastates the health system and it’s a strain on the economy. I can only hope that organisations such as DOMCCP carry on providing their essential support to communities and continue in assisting the countries effort to end the pandemic.
By ICS volunteer Yvonne Muigua
Photo: Volunteers Yvonne and Charlee talking about HIV in the classroom