International Federation of Red Cross and Red Cresent Societies - 12 July 2004
Tapiwa Gomo in Harare

This comes at a time when the International Federation is looking into ways of participating in the global initiative to get millions onto anti-retroviral (ARV) treatment through National Red Cross and Red Crescent Societies.

Shamiso Ndonya, 31, is one of the many people living with HIV/AIDS whose hopes could be revived with the introduction of treatment. There are several reasons why she does not have access to treatment, not the least of which is poverty.

Shamiso, a mother of four, lives in a single room with her husband in Chitungwiza, about 30km southeast of Harare. It's more than three years now since she tested positive for HIV following the death of her first husband, the father of her three children.

"My husband passed away after a very long illness - he suffered from abdominal pains and diarrhoea. This forced me to go for a test as I suspected that he could have died of AIDS," explained Shamiso.

Going for a test was not an easy decision, given the stigma and discrimination that is so prevalent in her community, but she finally resolved to do it thanks to the counselling she got from Zimbabwe Red Cross home-based care facilitators and the other support groups that operate in her area.

Although Shamiso found comfort in knowing her status and the material support from the Red Cross, she remembers very well the days when her health deteriorated so much that she couldn't do anything to help the family.

"I felt very weak. I felt pains in my stomach and sometimes all over my body. I was worried because my children were still young and there was nobody to look after them," she recalls.

"The care facilitators were always there for me, as my neighbours and relatives shunned me."

As her health deteriorated, Shamiso could not continue selling vegetables at the market - her only source of income.

"We survived by begging. Sometimes we slept without having eaten food," she recalled.

Two of her children were taken away by their grandparents. "They thought I was not going to survive, so they took the children away," Shamiso explained. Now she lives with two young children.

Any hope of recovery was undermined by worsening health and a lack of food. "I was bed-ridden for several weeks. There was never any food in the house and my children stopped going to school because I could not raise the fees. But I always prayed I would again be able to work for my children."

Shamiso's community is among the poorest in Zimbabwe. Not only do people here survive on informal subsistence trading, they have for the past two years been hit by drought, which has left them with little to depend on.

Neighbours and relatives had nothing to spare for Shamiso and her children. "I was advised by doctors to stop breastfeeding my youngest baby, to reduce the risk of passing on HIV through my milk, but because there was no food in the house I could not do that."

The introduction of a food aid programme by the Zimbabwe Red Cross came as a surprise relief to Shamiso. Her health was further boosted by the introduction of treatment by a local AIDS organization.

She is now on a drug used to treat opportunistic infections and other ailments that emerge as a result of a weak immune system.

"When I started receiving food, counselling, school fees and clothes for my children from the Red Cross, plus the treatment, my health improved a lot," explained a smiling Shamiso.

"I have resumed my trade of selling vegetables to supplement what I am getting from Red Cross. I can now work for my children which is what I have always wished for since I knew my status."

Shamiso is supposed to receive the pills on a regular basis, but due to limited funds, sometimes the pills are not available for more than a month. This has seen Shamiso's health fluctuating.

"We need a consistent and reliable supply of treatment for all HIV-positive people so that we can continue working for our children - that's the only possible solution available. Even this mere treatment of opportunistic infections has brought a lot of hope to many of us, and many people are no longer afraid to go for a test as they are aware that they can have access to treatment. Some are even disclosing their status, yet there is not enough medicine," Shamiso said.

She is hoping for the day when she will be able to access ARVs for both her last daughter and her second husband who also tested positive.

"All we need is treatment so that we can live longer and work for our children. I think this would also be a relief to my relatives who are looking after my children."

Shamiso had words of advice to those living with HIV and AIDS; "No matter how difficult life can be, people living with HIV/AIDS should continue looking after their children. Treatment will certainly give us more hope."

She also applauded the psychosocial support being given by the Zimbabwe Red Cross to people living with HIV and AIDS (PLWHA).

"The support, care and treatment that I am getting from Zimbabwe Red Cross' home-based care programme has really changed my life. The care facilitators always find time to visit us just to see how we are coping. We feel we are loved and are part of a family and community."

One of those ZRCS home-based carers, Elizabeth Honyerwa, could not hide her joy at seeing her client brimming with hope and life in such a short period of time.

"The case of Shamiso gives us and other clients a lot of hope given the severity of this problem in our area. The sudden change in her health was dramatic. It is now easy for us to convince people to go for a test as they are now assured of support from Red Cross," she explained.

"We work in cooperation with the health authorities in the area who refer clients to our home-based care programme and to whom we also refer our clients. We only hope that when the ARVs become available, the lives of our clients will become even better," Elizabeth said, explaining that the care facilitators will continue giving HIV prevention education, support and counselling, as well as encouraging people to go for testing.

However, Bongai Mundeta, the International Federation's regional HIV/AIDS coordinator indicated that the Red Cross/Crescent will become involved in ARV treatment only in collaboration with government ministries of health, which, given their technical competence, administer the laboratory and clinical aspects.

"The National Societies will play an active role in our areas of competence such as community mobilization, treatment literacy, promoting home-level nursing and adherence to ART, provision of nutritional support through home-based care programmes, education of clients, family members and communities on the prevention of the spread of HIV etc," Mundeta explained.

The Zimbabwe Red Cross Society has been implementing home-based care programmes throughout the country in 23 project sites and is one of six National Societies in Africa that have been selected to pilot a Red Cross/Red Crescent project to increase access to ARVs to poor communities.

Complementing home-base care with ARV treatment will provide PLWHA with a continuum of care.

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