Taming stigma with a smile in Mash central

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Mount Darwin– Chenai Mukapa is a village role model of ‘unsung heroes and heroines’ taming HIV and AIDS stigma with a broad smile among rural folks in Mount Darwin in thd rural outskirts within Mashonaland Central province.

She is among Community Linkages Facilitators (CLFs) whose role is to facilitate dialogue among HIV positive clients here.

“It is our role to interconnect with HIV positive clients so that they understand why defaulting medication is not good for their health. It is a life-long commitment,” she says jokingly punctuating our interview with uncontrolled laughter.

“We need to laugh it out and beat stress at all costs,” she says.

Her face was beaming with confidence of how she has helped several HIV positive patients to be accepted in families and communities, she adds that ‘You lose nothing after smiling but you remain healthy’

Mukapa is married to an artisanal miner and the couple has three children aged between seven and eighteen years.

Being HIV positive, she revealed her status to her family members and villagers around here making a personal sacrifice for building confidence and fighting stigma.

Mukapa is a member of a program that started in 2016 under International Training Centre for Education, (Itech) getting funding from United States of America, bankrolled by President’s Emergency Plan for Aids Relief (PEPFAR).

It has made positive strides among communities here.

In Mount Darwin district, Itech is operating at Chitse clinic, among other 20 outlying sites.

Situated about 163 kilometres north-east of Harare, the clinic is within Mashonaland Central province.

It has made positive strides in addressing stigma associated with HIV and AIDS here.

Garikai Stewart Bepura, Itech official based in the district is happy that CFLs are making life easier for Ministry of Health staff partners to implement programs for testing and accessing Anti-Retroviral Therapy, (ART).

He said:

“We trained 15 CFLs in the district covering 21 sites including Chitse clinic. Their roles include facilitating and strengthening community activities, prepare clients testing among others things. This is done through community dialogue for positive change on health matters especially on HIV and AIDS as well as fighting stigma.”

Defaulter tracking

Bepura adds that CFLs are well accepted in communities.

“They are part of the society and have been helpful to assist in HIV advocacy where villagers are accepting to be tested. We work within the Ministry of Health guidelines for counselling, testing and availing ART,”he adds.

As part of their work, CFLs also help in defaulter tracking.

Mukapa  said the reason why it was easier for her to track defaulters was that she had long standing relationships with most community members so they are open to her.

 “We track our clients and as part of the community we are open to each other on side effects of defaulting that may result in deaths. We do not want to lose anyone due to HIV and AIDS in the era.”

Driving point home

Young Women Christian Association national secretary general Muchanyara Cynthia Mukamuri admits that besides recent advances in HIV care, mitigation and support stigma remains a barrier to ending HIV and AIDS by 2030,

She says community facilitators like Mukapa play a critical role fighting stigma.

“These are cadres who stay in communities and help with information and HIV knowledge. They take advantage of ward or village meetings to share information even through drama and song to drive the point home,” says Mukamuri an HIV and AIDS advocate.  

Mukamuri says technically they offer support to health officials around the district including Chitse clinic.

“This is meant for professional approach in counselling, testing, social and psychological support. It has paid off for the community and health personnel,” she adds.

Mukamuri says, through community-based facilitators who are cadres, coverage of ART and treatment has widened.

“Among the CLF some have been on ART and make follow ups monitoring. It reduces defaulting by ART patients as community-based facilitators are close in the communities,” explains Mukamuri.

He explains that that they formed Community ART Refill Groups (CArgs) as part of fighting stigma.

“We have 33 CARgs with 10 members each to collect ART drugs when they run out. This reduces stigma and HIV patients open to each other,’”he explains.

Equipping health officials

Itech assisted in training health personnel staff for technical ‘back up support’ on HIV and AIDS, he adds.

Chitse clinic Sister in charge Sithembile Bunga admits that the program has been helpful.

There is a staff compliment of six trained nurses, two primary counsellors, nurse aide, data entry clerk and environment health technician.

She says that Itech have been assisting with human resources.

“Itech trained cadres to help in counselling, testing, make follow ups on defaulting clients and consolidating data. Training community cadres equipped with knowledge ease burden for communities,’”says Bunga during a recent media tour facilitated by National Aids Council.

Testing kits inadequate

District Aids Coordinator officer, Veronica Nyamudoka-Katsande pleaded for more partners to help implement HIV programs around the district.

Nyamudoka-Katsande says testing kits are in short supply and inadequate to cover vast areas including communal, resettlement farms and mining areas.

However, artisanal mining is the backbone and source of employment here, complicating matters for stigma around communities.

“We face testing kits challenges for our clients. We call upon others partners to come on board for HIV and AIDS programs here,”says Nyamudoka.

Mount Darwin has estimated population of 202 000 where 13 000 people including children are on ART.

The population targets in the district are artisanal miners along Mukaradzi river that is one of hotspots areas.

Gateway for early treatment

Bepura says operating in a rural based set up the intervention program is a ‘gateway’ for earlier treatment.

‘ART coverage widened as we have viral load monitoring machines that help us track our patients. This is a timely responsive and intervention method for HIV and AIDS patients here,’ he adds.

For majority of CFLs, as rural health care unsung heroes, it is a matter of time before achieving goals facilitating dialogue and taming stigma for HIV positive clients around here and the country at large.   

Mukamuri concludes that CLFs share information on positive health and dignity prevention within communities they live in.

“Organisations that deal with People Living with HIV and AIDS should ensure that they train more of these and ensure sustainability,”she says.

For Mukapa and several others, Itech facilitated their roles in communities to fight stigma here.

With everlasting hearty smile, Mukapa hopes that the national program will add value in fight against stigma.

‘‘After all is been done, a smile will add to fight stigma,’ she concludes.

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