Zambia: Measures against HIV/AIDS “Don’t worry alone” AAR encourages HIV/AIDS patients to take medicine by cooperating with volunteers

AAR has been making comprehensive efforts to prevent HIV/AIDS infection since 2000 in Zambia by spreading proper knowledge, supporting children whose parents died of AIDS to go to school and providing care for HIV/AIDS patients. AAR reports about the ART (antiretroviral therapy) support, which we implement in the suburb of the capital city of Lusaka.

We wish more patients could live longer
Zambia, where more than 200 people die due to AIDS every day, is working on measures to combat HIV/AIDS. Recently, the treatment using “ARV”, the medicine for HIV, which slows down the progression of the disease, if taken properly everyday for the rest of patient’s life, has become common. However, among HIV/AIDS patients, many stop taking the drug due to various reasons. Some are afraid that their neighbors will know their status and thus hesitate to receive the drug in a clinic, while others procrastinate to visit a clinic, thinking “I am fine now.”

In response, AAR started training local volunteers who support patients to take ARV drugs since January 2013. 21 people were chosen from the area around a clinic, and received training for 23 days. The volunteers learned counseling skills such as how to make a friendly atmosphere that patients feel comfortable to talk, along with the basic knowledge of HIV/AIDS and ARV drugs.

The volunteers during the training. Their bright smiles and careful counseling support the patients. (April 10th, 2013)
Two centers where patients can receive medical check-ups in a privacy-protected environment have been constructed in clinics in Lusaka since May. Nangongwe clinic under construction. (September 18th, 2013)

Advice after listening to each patient carefully 
After completing the training, the volunteers visit the houses of HIV positive patients who did not have a medical check-up based on the clinic’s patients list. The volunteers ask each patient if they are taking the medicine properly, check their health condition and encourage them to go to clinic. Quite a few patients start asking questions and talking about their worries, which they did not discuss with anybody until the volunteers asked. The volunteers carefully listen to patients’ issues regarding their home environment and current living situation, and give advice to improve the condition. There was a patient who got too weak due to AIDS progression and was stuck at home when one of the volunteers found him. He was carried to the District Hospital by car. To prevent the delay of support, AAR provides volunteers with bicycles and asks them to visit the patients as often as possible.

At a bicycle donation ceremony, the volunteers learned how to repair minor malfunctions. (August 13th, 2013)
Belita, one of our volunteers, said, “I gave advice, while taking the mother-daughter relationship into consideration”
Christine (Right) and Belita, a volunteer (May, 31st, 2013)

I visited Christine (false name, 15 years old), who is HIV positive and had not visited a clinic for a while, to check if she was taking the drugs regularly. When I was talking with her, she seemed to be worried and confused about the fact that she got infected, asking “Why did I get infected?” Her mother told me secretly, “I am afraid my daughter will condemn me for the infection. I can`t disclose that she was possibly infected due to maternal-fetal transmission.” Her mother is HIV positive as well and taking ARV drugs.
I thought the help of an experienced expert was necessary for Christine to be convinced without damaging their mother-daughter relationship, and recommended that Christine and her mother receive socio-psychological counseling. After the counseling, Christine accepted her circumstances and now takes ARV drugs regularly.
We, the volunteers, have experienced loss of important people such as family members and friends owing to AIDS and some of us are HIV positive ourselves. I think this is why people with HIV/AIDS and their families trust us and ask for advice.
 “Health Talk” in waiting room.
Moreover, the volunteers hold lectures, called “Health Talk”, for patients once a week in a clinic. The lecture is held between 8 to 9 am every Tuesday in Mt. Makulu Clinic, which is a 40 minute drive from Lusaka urban area, when patients who are taking ARV drugs visit the clinic and wait for their medical check-ups. Steven, who is a volunteer, gave a lecture about the importance of drug compliance and how to store drugs at home to 18 patients at Health Talk on September 17th. All participants seemed to be listening eagerly and asked various questions such as “Why do I have to continue to take drugs?”, and “Even after knowing I am HIV positive, do I need to use condoms?” The lecturer, Steven himself, is HIV positive and continues to take drugs. At the end of the lecture, Steven told patients “if we continue to take the drugs, we can live longer and watch our grandchildren grow up. Please don’t be pessimistic.”

A volunteer, Steven, who is a health talk lecturer (front).  He changes the contents of the talk according to patients’ questions. (September 17th, 2013)
The cooperation of patients’ family and partners is crucial for drug compliance. AAR staff and the volunteers ask the family whether the patient takes drugs regularly or not, and if not, we ask the family to encourage the patient to visit a clinic. We will continue supporting the people to take ARV drugs for their treatment by cooperating with the volunteers, the family and local people.

Moeko NAGAI, AAR Japan Zambia office
After graduating from university, she worked at a pediatric department at a hospital as a nurse.
Following her career at the hospital and study abroad in the United States, she worked for a nursery school as a nurse. She joined AAR Japan and worked for emergency aid project for the Great East Japan Earthquake. She has been working in AAR Japan Zambia office since May 2012.