Next big challenge: Ending HIV stigma

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Tanya Raisi (10) in front of her family house in Epworth. Pic: Rachel Corner/De Beeldunie, Medecins San Frontieres.

Tanya Raisi is a 10-year-old girl who, like any other little girl, should envy playing outdoor games with her friends in the high-density suburb of Epworth, located on the south-eastern outskirts of the city of Harare, but she cannot.

By Wongai Zhangazha

Everyday she comes face-to-face with the reality of her condition Tanya was diagnosed with HIV at birth and tuberculosis at six months in 2005. To make matters worse, she is also disabled. She uses a wheelchair to get around. She lost her mother to Aids when she was five years old. She lives with her father, who is also living with HIV.

“When the other kids are playing outside my home, I try and use my crutches to keep up, but they don’t slow down for me because I can’t walk as fast. When it happens, and they run away from me, it hurts me a lot. I start calling out to them. If they don’t come back, I go inside my home,” Tanya says.

“When they run away, it’s very painful to me, I can even feel the pain deep down in my heart and that’s why I end up sleeping and I will then wish for my daddy to come home and be with me.”

Tanya’s father, Life Raisi, said at six months she started having fits and she was admitted to the Médecins Sans Frontières (MSF) Therapeutic Feeding Centre in Epworth, a clinic that was opened by international aid group Doctors Without Borders (MSF) in 2006 in partnership with the Ministry of Health and Child Care.

She also has dreams like any child.Tanya wants to be a teacher, but the journey is proving not to be easy.

While Zimbabwe has over the last five years doubled its efforts to reduce the prevalence, another battle fought from a different front is far from over. Discrimination and stigmatisation remain a challenge in fighting HIV/Aids.

Official statistics from UNAids show that as at 2015, Zimbabwe, at 15%, had the fifth highest HIV prevalence in sub Saharan Africa. The figures show that 1,4 million people are living with HIV, including 77 000 children.

“Before she started her HIV treatment, – you would not imagine she would be the young girl she is now. She was underweight, she was not developing properly, her hair had not grown. Once she started treatment, her health began to improve. However, I am not employed so I can’t raise enough money to take her to a special school,” Raisi says.

Raisi says they discovered that Tanya was disabled and unable to walk in 2008.

Florence Chipunza (their neighbour and her mother’s friend) looks after her. She is the one who brings her anti-retroviral treatment and takes care of her.

“I don’t remember much about my mum except that she was put in a coffin and she was buried. The people who take care of me now are my father, my neighbour Florence and my brother,” Tanya says.

“When I grow up, I want to be a teacher, because I want to teach people and help them read, even though I don’t know how to read, I want to teach them that they should read.”

Chipunza (40) is a mother of four and is the first patient to be treated at the Epworth HIV Clinic 10 years ago.

She tested positive for both HIV and tuberculosis in 2005 shortly after giving birth to her third child.

After testing positive to HIV she went on the HIV Prevention of Mother to Child Transmission programme and is happy that her fourth child tested negative to the virus.

“Being diagnosed with HIV doesn’t affect me anymore, although initially it upset me. Now that I have accepted the situation it hasn’t changed the course of my life,” Chipunza, who works as a seasonal worker at a government institution which specialises in tobacco research, says.

Tanya and Chipunza’s stories tell of how a condition, which was once viewed as a death sentence, has become manageable.

MSF Intersectional Communications Officer Gloria Ganyani said over the past 10 years, more than 30 000 patients in the country have received free medical care at the Epworth clinic.

“Along with providing general health care, the clinic focuses on the treatment of thousands of HIV patients living in and around the community, ensuring they have access to high quality and free medical care,” Ganyani said.

“In the decade since the HIV programme started, HIV prevalence in Zimbabwe has reduced from over 30% at its peak in 2000, to 15%, and today over 1 000 HIV positive patients have formed support groups in the community.”

While there has been no known cure to treat HIV and Aids, the advent of anti-retroviral therapy has helped in the fight. A UNAids-initiated programme, “Get on the Fast Track — A Life-Cycle Approach to HIV”, finds solutions for people to address the complexities of HIV, especially among children.

This approach aims to ensure that all children start their lives free of HIV and that treatment becomes more accessible so that everyone stays Aids-free by 2030.

Last week, Zimbabwe joined the rest of the world in commemorating World Aids Day whose theme was ‘Closing the gap of new HIV Infections’.

According to UNAids this theme calls for strengthening of HIV prevention strategies which include HIV testing and counselling, voluntary medical male circumcision, prevention of mother to child transmission, HIV treatment, zero discrimination, no violence and condom use, among others.

The theme comes against a background of HIV infections that continued to be recorded.

According to UNAids, 78 million people have been infected with HIV and 35 million died from Aids-related illnesses since the first cases of HIV were reported in the 1980s.

Vice-President Emmerson Mnangagwa told delegates attending the World Aids Day commemorations in Kwekwe that the country was steadily recording a decrease in new infections in the 15 to 49 year age group.

HIV prevalence in 15-49-year-olds is now 14% from 14,8% meaning that 14 in every 1 000 adults are currently HIV infected.

He said according to the Zimbabwe Population-based HIV Impact Assessment (Zimphia) and Zimbabwe Demographic Health Survey (ZDHS), Zimbabwe was making great strides in the fight against HIV and Aids.

Mnangagwa said HIV-related deaths have declined by 77% in the country since 2006.

He said five per 1 000 Aids-related deaths were recorded in 2016 against 50 per 1 000 which was recorded at the height of the pandemic in 1994.

UNAids executive director Michel Sidibé in a statement said the world has committed to end the Aids epidemic by 2030 as part of the Sustainable Development Goals.

“We are seeing that countries are getting on the Fast-Track — more than 18 million people are on life-saving HIV treatment and country after country is on track to virtually eliminate HIV transmission from mother to child,” Sidibé said.

“We are winning against the Aids epidemic, but we are not seeing progress everywhere. The number of new HIV infections is not declining among adults, with young women particularly at risk of becoming infected with HIV.”

He said young women in sub-Saharan Africa are facing a triple threat: a high risk of HIV infection, low rates of HIV testing and poor adherence to HIV treatment.

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