No lone ranger in this fight

HIV and non-communicable diseases such as cancers are among the major health concerns worldwide.
Fortunately, it is not all gloom.
Integrated approaches in addressing HIV infection and NCDs have been developing in the country and beyond.
“We need to appreciate current interventions in fighting HIV and NCDs, the Government in partnership with various non-governmental organisations are doing so much to ease the burden,” said Tadiwa Pfupa, communications officer for Zimbabwe’s National Aids Council.

When prevalence figures start dropping as is the case with HIV right now, rest assured that you are using a winning formula.
The Global Aids Progress Report recently revealed that Zimbabwe’s HIV prevalence rate declined from 15,7 percent in 2011 to 13,8 percent in 2015.

The incidence rate has also been on a downward spiral for the past decade.
Prevalence is a measurement of all individuals affected by the disease at a particular time, whereas incidence is a measurement of the number of new individuals who contract a disease during a particular period.

So what exactly could be causing both the prevalence and incidence rates to decline in the county?
We set out to find the answer to this question and more.

As it turns out, this is a war that has transcended age, tribe, political orientation or geographical location as various stakeholders have joined hands.

Taking information to the people
Rashy Shuga is just one of the many volunteers working under the banner of Family Aids Caring Trust (Fact) in Kadoma, Mashonaland West.

The NGO is conducting door-to-door campaigns aimed at disseminating information on several issues that include HIV counseling and testing, cervical cancer screening and domestic violence, among others.

“They call me Tapi-tapi,” she declares with a smile as she introduces herself to a family that had been randomly selected to receive information on any one of the 31 topics she can tackle.

Tapi-tapi goes on to deliver a flawless interactive dialogue in which the family picks a topic for discussion and she educates them on that, pausing to listen to questions here and there and addressing them with so much eloquence.

At the end of the session, armed with very vital information on cervical cancer, all the three members of the family vow to go for cervical cancer as well as HIV testing at their earliest convenience.

Shuga has made it clear that in fighting HIV and cancer, knowledge is power.

Give them a rod, not the fish
In Makonde, Mashonaland West province, a soft-spoken woman – Mrs Hluphekhile Mujuruki – is touching many hearts, both young and old.

She is the co-director of Musoro Muchena Skills for Life, an NGO that is giving hope to rural youth who are economically vulnerable and those whose parents are living with HIV through vocational and entrepreneurship development.

“We are doing our country a disservice by not teaching our youth composite entrepreneurship skills,” she declares as she explains the thrust of her organisation’s vocational training programme.

The aim of the one-year programme is to ensure young people are equipped with skills that can mould them into good entrepreneurs such that they can create employment for others.

Under the mentorship of Musoro Muchena, Joseph Guruve has been turned into a master of fine art, Kelvin Garawasvika is now a renowned tailor in the town of Chinhoyi, and Isabelle Mushunje is now a crème-de-la-crème chef who specialises in traditional foods.

Demystifying the MSU demon
With a student population of around 23 000 students, there are bound to be some good and bad apples, all in one basket.
Peer educators at Midlands State University are working flat out through influencing behavior change to ensure that the bad apples are saved.

The university’s acting director of health services says several initiatives are being implemented at campuses to reduce the HIV burden.

“We are conducting male circumcision, peer education, edutainment through theatre, and there is access to ARTs for those living with HIV and the provision of condoms.

“We preach the gospel of abstinence but statistics show that young people are indulging in sex. What more at such an institution where we have a mixed bag of age groups, we also have to encourage those who are indulging to condomise. Our thrust is to make sure that condoms are available where they are needed,” he explained.

A whooping 5 000 condoms are distributed every month at the university.
Probably because of these interventions, Mr Shoko said only four percent of the MSU students who were tested for HIV in 2010 where found positive while the figure dropped in 2015 to two percent.

HIV testing at your doorstep
According to a recent hot-spot mapping survey, Kwekwe has the second highest incidence rate in the Midlands province coming after Gweru.

Yet there seems to be just too much going on for the pre-dominantly gold-panning population to find time to visit distant health facilities for HIV testing.

NAC has found a way around the busy schedules. For years now, they have been taking the services to the people.
Every quarter, the council’s mobile clinic visits busy places and conducts voluntary HIV testing and counseling, cervical cancer screening and male circumcision.

“A normal clinic can record less than 400 people a day who will walk in for HIV testing but when we do these outreach programmes, we test an average of 400 people per day,” said Ellison Kombora, NAC’s Kwekwe district aids co-ordinator.

Experience is the best teacher
Meanwhile, as people get HIV counseling and testing, in Kwekwe’s CBD, Estina Sikweila – a sex worker – takes the microphone and shouts at the top of her voice, encouraging passers-by and her colleagues to get tested and live responsibly.

Long winding queues soon emerge. That is the beauty of peer education.
Estina has been a sex worker for decades now and established that she is HIV positive 16 years ago.

She narrates that she was forced into prostitution due to poverty after the death of her husband.
“I raised my three children through prostitution, the eldest of them is now married and the youngest is 13-years-old. However, I realise the need for behaviour change. These girls need to condomise so that we can beat HIV.”

She vows that if she comes across other means of survival, she will not hesitate to quit prostitution.
“Ini handitsvagi kuzadza vamwe nechirwere asi mabhinya haashaikwi. Plus basa racho harina mari yakawanda, ukawana mbozha anogona kukusiira US$20,” she said.

Beating cancer
Cervical cancer accounts for one-third of all cancer cases in Zimbabwe and is the leading cause of cancer deaths among Zimbabwean women.

This high disease burden has been heavily influenced by the HIV epidemic.
Cervical cancer infects the mouth of the womb but it can spread to other parts of the body. It is caused by a virus called Human Papillomavirus (HPV), which is mainly sexually transmitted.

Deep in Silobela, Midlands province, Sister Mary Chin’ono, the sister-in-charge at Nyoni clinic is an angel sent to deliver rural women from the jaws of cancer.

Sr Chin’ono explained that there is rampant early onset of sexual activities in the area due to early marriages and this is causing high prevalence of cervical cancer.

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