STATE of HIV disclosure in rural areas is more open as compared to urban areas. Disclosure in rural communities is better managed on a community level of well knit people who live in the same geographical area.
People hailing from the same village know who suffers from diabetes mellitus, hypertension and chronic back ache or asthma. So for such a community, disclosing an HIV status is not a big deal as they usually talk of their health concerns at the water point (well or borehole) when drinking beer at the shops or when herding cattle.
Urban folks are not that open about their health status in comparison to folks above. It could be due to individual state maintained in towns.
In some cases a family living in the same neighbourhood is not acquainted with the neighbours and vice-versa.
When taking urban settlers staying in apartments, the state of being individual or rather minding your own business is even pronounced.
A person in Block 1A does not know the name of a neighbour in Block 1B. They do not even greet each other, let alone talk of health issues is far-fetched.
We find that rural folks are enlightened in HIV issues since stigma and discrimination barriers were long dissolved.
Taking for example my rural community in Kakora, Chiweshe, Mashonaland Central, people with HIV meet under the Baobab tree monthly for updates and support.
They help new people into the group with integration.
Speaking to Shepherd Yashanu who is one of the few men in the group was mind opening.
“As a community in Kakora we are beyond diagnosis. We help each other manage our health. We have a livelihoods project where we pool resources and buy an individual chickens or goats. We find that people prefer to work on their own time and framework, so we provide the money and know-how in the group. When we meet, we do not talk of health only we also tackle economic issues.
A good economy builds a healthy family,” said Yashanu. Yashanu stressed time management in project management. He pointed out that they came up with a timetable for medication collection.
“We find people from the same neighbourhood in queues at hospitals and clinics, yet they are healthy and only need refills. One sees a nurse when ill or on routine at the requested time by the hospital. We therefore have formed club refill groups,” said Yashanu.
Yashanu said in a refill group, the members take turns to visit the clinic on behalf of the group.
“In our refill group one person collects the medication for the rest of the members.
We have 15 people in a group. We have several groups.
When back from clinic we meet under the Baobab tree for collection and moral support. We also discuss family issues, adherence and check if any member has a problem. We are one big family, “ he said.
Yashanu said in some families where three or more people are on medication, they form a family ART group refill.
“We have some people preferring to be in a family ART group rather than community one. It is still recommended and also engage them since we are a community,” he said.
Yashanu pointed out that children on ART are not excluded from groups since they need moral support.
“We have children in our groups and cater for children’s special needs. Children are growing up and need to be seen at the hospital.
The minors need to have medication adjusted since they are growing up. What they take changes as they grow so the visiting member to the clinic may take the child along or rather have the parent of the child collect on behalf of the group,” he added.
Children have a paediatric follow-up schedule where ART is adjusted accordingly as they grow. At the clinic a nurse fills out the patient care and treatment booklet for each member.
These booklets are then recorded in the main ART book and register.
With communities now managing time effectively and reducing congestion at clinics we find that ART refill groups are a novel way to be recommended to other communities living in the hard to reach areas.
Stigma has no place in a community with active refill groups.
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