HIV Education & Counselling
Overview of HIV / AIDS
HIV / AIDS is a complex subject.
The following link provides more information about the medical elements of HIV / AIDS
But HIV / AIDS is not just a medical issue. The fact that it has killed a very significant number of the 18 – 40 year old generation has had massive repercussions on society that will take a generation, possibly longer to recover from. Care for the remaining offspring falls jointly to the remaining members of the 18 – 40 year olds who are increasingly stretched as they shoulder responsibility for nieces / nephews and children of late friends and neighbours.
Older sisters are often taken out school to care for these extra children. Grandparents are also called upon to care for grandchildren. All of these carers are stretched beyond belief. Consequently, they are unable to work and their exposure to poverty increases. Transactional Sex suddenly becomes one of very few ways to generate an income for more hungry mouths. It also increases exposure to HIV / AIDS.
Children are often left to fend for themselves without parental guidance and they become increasingly vulnerable to social pressures. Teenagers are particularly easy to influence and without guidance are often attracted to vices such as alcohol, smoking, drugs, crime etc.
Children that have lost one or both parents have to endure very traumatic circumstances that have long lasting repercussions. So too do adults that have witnessed their brothers, sisters, neighbours, friends and their own children die a horrible and slow death.
Everyone is affected. Many are affected and infected. Everyone knows someone that has died as a result of HIV / AIDS. Sadly, openly admitting that HIV / AIDS killed your friend / relative is not acceptable in most of society. Stigma & Discrimination are so incredibly powerful that it forces many people to deny their status for fear of being shunned into a corner of society.
Pre-test Education and Counselling
In an effort to address "a lack of education and behaviour change towards HIV / AIDS" as a root cause of many social ills, we have recruited and trained a team from the local community to conduct house to house education in people's houses.
They follow a series of 13 lessons that explain the different elements of HIV / AIDS ranging from the basic facts to PMTCT (Prevention of Mother to Child Transmission).
Each household is plotted on a map using "Google Earth" and a record of the lessons taught to each person at each household is logged. Each household has a sticker on their door so that our team knows where to find the records that have been kept.
The overall objective is to ensure that members of the community have the information presented to them to make a decision about whether to get HIV tested. We have the capacity to guide them through this difficult, emotionally challenging and potentially life-changing process.
HIV testing is managed by a government department called "Tebelopele" (meaning "New Dawn").
We have worked with them and TOP Banana has become one of a small few non-Tebelopele run HIV testing centres. We have had 4 members of our HIV team trained as HIV Testers and they are able to work closely with members of the community from the very first point of contact, through the education and counselling process to getting tested and beyond.
We believe that this more intimate approach encourages members of the community to get tested and to know their status. We also believe that by being tested by individuals that have been through the process and have decided to be open about their status to the community, the members of the community that we work with will also be encouraged to be open about their own status.
People living with HIV / AIDS need the care and support of the community in which they live. Unfortunately, many myths and misconceptions about HIV / AIDS have discouraged openness about the virus and many people live with HIV / AIDS as a closely guarded secret. Knocking down this obstacle is a massive part of what TOP Banana is trying to achieve.
"Stigma, discrimination and ostracism are the real killers."Nelson Mandela X1V International AIDS Conference 2002
Overview of Positive Living
Getting tested for HIV is not the end of the journey and, we believe, it is actually the point that people start to need the most help, especially if they are HIV Positive.
What makes us somewhat unique is the fact that we have a series of tangible ways for people to follow "Positive Living".
HIV is a virus that weakens the immune system. "Positive Living" is a way to help people boost their immune system as high as possible and for as long as possible.
There are 4 ways in which this can be done;
• Balanced diet
• Regular exercise
• Positive Mental Attitude
• ARV Adherence
A nutritious balanced diet keeps the immune system strong.
With funding from the Lady Khama Charitable Trust, we have been able to set up a drip irrigated vegetable garden for members of the community. It is covered with shade netting to protect the crops from the intense heat.
Members of the community are free to use this and are responsible for planting and growing crops and for tending their plots.
Regular exercise boosts the immune system.
We have a gym instructor on site who manages the gym that we have constructed. He also organises various sports activities for the community and for children to promote the importance of regular exercise.
Positive Mental Attitude
A Positive Mental Attitude boosts the immune system.
People with worries tend to be more stressed and often these worries and stresses grow in the mind if they are not shared.
We have a series of individual and group counselling sessions led by trained counsellors who try to ease the worries of people in the community.
Group Counselling sessions are held in small groups of peers. They can be organised sessions or simply spontaneous at random locations. The important point is that the community knows that they are available.
ARVs (Anti Retro-Virus drugs) are given to people when they have AIDS or are close to having AIDS.
They are drugs that need to be taken at specific times each day and once started, have to be taken forever.
Part of the problem is ARV drugs work very well. People with AIDS are very often very thin, almost skeletal. What commonly happens is that they start to take the ARVs and get better (and "fatter"). People often stop taking the ARVs because;
• They believe that they are better forever.
• Society stigmatises and discriminates against them. If people see that they are taking drugs at the same time each day, it doesn't take long before people realise that they are taking ARVs and that they are HIV positive.
• The drugs cause side effects that people prefer not to encounter. These can include liver damage, strokes, heart failure and similar.
They stay well for a period of time (months or years) but eventually start to get sick again as the immune system weakens.
Unfortunately, the medical science of ARV drugs is in its infancy (relatively) and the first "cocktail" of drugs that have been taken and then stopped cannot be re-started. So a second batch of ARVs is taken. The process of getting better, social pressures and side-effects (this time much worse) means that some people stop taking the ARVs again. The third batch is the last chance. The side effects are much more severe again and people die.
We plan to train our HIV / AIDS team to intervene in this process and become ARV Adherence Counsellors to encourage people to persevere with the first batch of ARVs and to pre-empt the latter parts of the process. We are seeking funding for training in this area.
For now, we are concentrating on our measures to promote "Positive Living" to boost the immune system and prevent the need for people to take ARVs in the first place.