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Running errands of mercy in the age of AIDS
Ignatius Banda, Inter Press Service (IPS)
July 19, 2007

http://allafrica.com/stories/200707190269.html

Priscilla Ndlovu feels like she has seen it all. She works as a member of one of myriad community home-based care groups, the prevalence of which shows the extent of HIV/AIDS in Zimbabwe, highlighting the country's struggle to control the pandemic.

"The way things are going and the poverty that people are living with here, it is sad that the list of patients seeking our services keeps on increasing," Ndlovu (43) told IPS. Families that were previously reluctant to have strangers in their homes tending to an ailing relative are increasingly asking for these services.

"There is still reluctance by some people to come out in the open. We have not seen much change in behaviour as we are tending to people as young as 15 years," Ndlovu said.

She is one of many women in Bulawayo, Zimbabwe's second largest city, who have become community heroines as they struggle against the country's worst ever social and health crisis.

They run errands of mercy at a time when the government is hard-pressed for resources and hundreds of health professionals leave the country to seek employment overseas.

When nurses and doctors go on strike, Ndlovu and her group of home-based caregivers are the ones who for years now have stepped into the breach. The Joint United Nations Programme on HIV/AIDS (UNAIDS) said last year that it was making the improvement of the quality of home-based care and counselling for people living with HIV one of its priorities.

According to UNAIDS estimates, there are around 1,3 million children in Zimbabwe who have been orphaned by AIDS.

These figures are emerging at a time when there are growing concerns that sub-Saharan African countries such as neighbouring Botswana and South Africa will not reduce HIV prevalence in line with Millennium Development Goal six, which is also aimed at reducing the incidence of malaria and tuberculosis by
2015.

Bulawayo's home-based caregivers help people in desperate situations. The growing economic crisis has eroded incomes, with the media reporting a growing sex trade in the country's border towns and major cities.

Local non-governmental organisations (NGOs) fear certain towns and cities have become a breeding ground for HIV/AIDS.

Gifford Hlatshwayo, a peer educator with the National Aids Council, says the continued hardships have forced especially young girls into early sexual activity as a means to earn a living.

"We are living in difficult times. It is sad that they are being introduced to this at a time when there are so many risks involved. We are seeing a growing number of people who come here saying they want to end their lives because they discovered they are positive."

In rural Plumtree, a few kilometres from the Botswana border, young women can be seen at night openly propositioning clients believed to be carrying the much coveted and stronger Botswana currency, the pula, which has traded at one pula to 10,000 Zimbabwean dollars on the parallel market.

In Bulawayo's government-owned Mpilo Hospital, relatives bringing ill family members on wheelbarrows are not an unusual sight. As fuel shortages continue, there are no ambulances to ferry the sick.

HIV/AIDS NGOs are concerned about the accuracy of government statistics. Zimbabwe's crumbling health sector, health workers say, has made it difficult to track new infections.

A doctor working with Doctors Without Borders at Mpilo hospital told IPS on condition of anonymity that it has become virtually impossible to track new infections.

"At the opportunistic infections clinic we do get a few people who want to be on the list for people receiving anti-retroviral drugs but my experience here is that these numbers do not reflect the extent of the infections in the city.

"Many patients are still in the closet and die anonymously. So it is extremely difficult to see if this fight is being won at all," the doctor said.

However, Joshua Chigodora of the Southern Africa HIV/AIDS Information Dissemination Service (SAfAIDS) points out that Zimbabwe "is one of the few countries in Africa that have seen a decrease in the prevalence rate of HIV". Antenatal clinic data shows that prevalence among pregnant women dropped from 30-32 percent in the early 2000s to 24 percent by 2004, according to UNAIDS.

Overall, according to UNAIDS, the figure has dropped to about 20 percent among adults in 2006.

Meanwhile, the Bulawayo City Council says it is running out of burial space because of the high number of deaths due to AIDS-related causes.

A council spokesperson says it has become difficult for the local authority to document HIV infections because surveillance is being compromised by lack of resources.

"The work being done by home-based caregivers reflects the extent of the pandemic. Council has always said we do not know how government makes its calculations but our experience here is that the numbers are not going down," the spokesperson told IPS.

Bulawayo is one of the country's major local authorities which are under the control of the opposition political party, the Movement for Democratic Change. It has clashed with the ZANU-PF-controlled central government after reporting in its regular analysis of the food situation in the city that there had been some deaths in the city due to hunger.

US President George W Bush last month excluded Zimbabwe from an African HIV/AIDS funding package, a move which is likely to further constrain efforts to meet the MDGs on HIV/AIDS.

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