Community togetherness for health benefits

Catherine Mwauyakufa, CNS Correspondent, Zimbabwe
[First published in Manica Post]
The state of HIV disclosure in rural areas is more open as compared to urban areas. Disclosure in rural communities is better managed at a community level, through well knit people living in the same geographical area. People hailing from the same village know who suffers from diabetes mellitus, hypertension and chronic backache or asthma.

So, for such a community, disclosing their HIV status is not a big deal as they usually talk of their health concerns at the water point (well or borehole), or while drinking beer at the shops, or when herding cattle. Urban folks are not that open about their health status. It could be due to a more individualistic living 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 more 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. I have found that rural folks are more enlightened about HIV issues, since stigma and discrimination barriers were long dissolved. Take for example my rural community in Kakora, Chiweshe, Mashonaland Central, where people living with HIV (PLHIV) meet under the Baobab tree every month 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 in their own time and framework, so we provide the money and know-how to them.  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 upon time 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 only when ill or on routine at the requested time by the hospital. We therefore have formed club refill groups. In a refill group, the members take turns to visit the clinic on behalf of the group, with one person collecting the medication for the rest of the 15 odd members. 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,” beamed a proud Yashanu.

Yashanu informed that in some families where 3 or more people are on medication, they form a family ART (anti retroviral treatment) refill group, rather than a community one. However, he feels that engaging at community level is always better. 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. Children have a paediatric follow-up schedule where ART is adjusted accordingly 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. 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.

Catherine Mwauyakufa, Citizen News Service - CNS
June 1, 2017

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