David Othomile spent all his days between the drivers’ seat and the toilet seat. In September 2009, while working as a driver and messenger at Scania Botswana, David, 28, started having experiencing a continuous runny stomach. “I took it lightly and thought it would get better, but it didn’t.”
Instead, he started getting throbbing head-aches and mouth sores so painful he was unable to eat or drink. He went to see a doctor at Princess Marina Hospital, the state-owned facility in the capital Gaborone. He was diagnosed him with Pneumonia and put on treatment for the illness. “The pills they gave me did not change my condition. So I went back to the hospital. The nurses took some x-rays and the results showed that I also had Tuberculosis,” he recalls.
David was advised to start the treatment for TB, but because he was in “denial” he did not heed the advice until two more weeks had passed. With his condition worsening he went for an HIV test at one of the Tebelopele HIV testing centers, the government-supported and donor-driven facility set up to encourage everyone to know their status. The test revealed that he carried the Human Immuno-deficiency Virus (HIV). “I didn’t think much about it because I didn’t believe the Tebelopele counselor when she told me I had HIV,” he says.
As time and months went by David realized that he was drastically losing a lot of weight. He went to a clinic where the nurse noticed from his patient medical card that he was meant to have long started TB treatment. “They gave me the treatment and told me to come back in six months after completing it. After which I would be enrolled into the Antiretroviral (ARV) Therapy.”
In August 2010, David was admitted to Princess Marina Hospital. He was a “health risk” due to his failure to adhere to the TB treatment. At this point David’s CD4 count was critically low at 33. “I couldn’t walk, I could barely talk, I couldn’t see clearly. My eyesight was weak. I think I nearly died. The time I wasted while in denial took its toll on my body. The disease really affected me,” he recalls.
David says he was disillusioned most of the time. “I wasn’t thinking clearly; laughing for no reason all the time. I couldn’t even bath myself. They dripped water into my body on a daily basis and I had taken on a darker shade of my usual skin tone.” He was hospitalized for four months. When he was discharged, he was still on TB treatment. The nurses did home visits to ensure that he completed treatment. “I no longer have TB. Soon after this I started on ARVs and have been on the same treatment line since.”
David says ARV therapy has a potent effect on the body. When he first enrolled on the program, the tablets had a “terrible” negative effect on him. “They made me weak and put me into a drunk-like state. I would usually sleep immediately after taking them. There were times I used to wonder why I was taking these pills that seemed to be killing me. I was scared. I used to wonder if I would live. I thought about death a lot during this time.”
David recalls conversations that he used to have with his mother and his girlfriend instructing them to give his only child all his belongings if he happened to die. “I was impatient and didn’t see the point in living. Luckily I never gave up and continued taking treatment until I started getting better. Now taking ARVs is like chewing gum.”
Whenever his condition improved, David would go back to work (Scania Botswana) and his colleagues would tell him he needed more time to heal. “I used to think I had lost my job; that they were saying this only so that I would go away and leave them alone. I really want to thank my colleagues, especially my manager Freddie who gave me lots of advice and Caroline and all my other colleagues who also helped me by taking me for hospital visits and checking on me while I was hospitalized.
I also want to thank most importantly Scania Botswana, the company for standing by me and not firing me or letting me off while I was off work for many months. They gave me time to heal and recuperate while they paid my full salary. I also receive nutritional support from the company and counseling when I need it. I don’t know where I would be if it wasn’t for this compassion and support I got at work.”
Caroline Tlhankane, 40, is a Customs Clearing Agent at Scania Botswana, as well as being an ‘HIV/AIDS workplace peer educator’ or WPE. Workplace peer education is a concept born out of the acknowledgement that a good percentage of people living with HIV are workers and that they spend most of the day at the workplace. As the current statistics reveal that one in two women aged 30 ÔÇô 34 in Botswana are HIV positive, it indicates that this is a largely working class age group. The numbers also reveal that 44% of men aged 40 ÔÇô 44 are HIV positive, another reflection on the working class group, hence the focus on WPE.
Caroline explains that Scania Botswana provided her with formal training on how to be a WPE in 2010. “To volunteer to be a WPE, one has to have passion for helping other people; you need to be able to put yourself in their shoes,” she says. Both David and Caroline work in the sales department and it was Caroline that David first revealed his health worries to. Caroline observes that, “since it is not easy for co-workers to come forth and seek advice about HIV or any other health matters, it helps to have people in the workplace that are visible and known such as WPEs; that makes it easier for someone to approach.”
She clarifies that WPE are not doctors or nurses, but they only act as mediators who refer the affected person to the relevant expert or professional. “I would pick and drop off David for his hospital visits, and book him his counseling sessions.” David had chosen to list Caroline as one of his guardians on his hospital cards. “When he started absconding on his treatment they would call me to find out what was happening. It would be my responsibility to follow up on him and make sure he ate well and took his meds.”
While David was in denial about his HIV positive status it was Caroline who had to constantly remind him that he was not “bewitched” that he did not need to consult the traditional doctors but to rather seek the professional medical route and to stick to the advice being offered. “At some point I was giving up on David. After everything we had gone through he would turn around and tell me that he was going to consult a traditional healer. This decision always interfered with the treatment he was taking at the time. I would always feel like I failed him as a WPE.”
Caroline observes that someone infected with HIV does not always want to believe it is true. “They would rather create another illness to avoid dealing with it. The denial state leads to wanting to go to a traditional doctor with an illness they know can be cured.” She says there is still a lot of HIV-related stigma. “People living with HIV are still scared about what people will think of their status. It is even more difficult for them when family is not supportive. It’s a pity because there are people who still don’t have the right attitude towards those living with HIV.”
Caroline explains that being a WPE goes further than just the workplace. She intends to start using this skill in her community, with the football team. “I would like to reach out to them because there is probably a need, especially to spread the message about safe male circumcision. I also intend to see how I can incorporate this role at church, sensitive as it might be.” Caroline highlights that she would not have been able to play her WPE role if Scania Botswana was not an enabling and supportive environment. “Don’t forget that I was helping David during working hours.”
David emphasises the importance of counseling during and after discovering one’s positive status. He says he went through a stage of self stigmatization after finding out he was HIV positive. “I was reserved, keeping to myself, and I lost a lot of friends. But after counseling I was able to mend some of my lost friendships. Counseling comforts your emotions and also helps you to face people. It helps you to deal with the question of what will people say.”
Deciding to disclose his status at work was not easy. “No one forced me but I knew it would make my life more practical if I disclosed. It was difficult but I don’t regret it as I am now free and it feels good to be living openly and positively. When I first started taking ARV treatment I used to hide the pills so no one at work would see me. Now I am able to take my treatment freely. People tend to be more respectful when you disclose your status.”
David says he knows that companies or people are scared to have or hire people living with HIV and he thinks it is because they think they will never get better. “HIV does get better. People living with it can work well with you. Don’t be afraid of them or uncomfortable.” To someone living with HIV in the workplace David shares that, “When you do things right, don’t drink or smoke, follow the doctors’ orders your life goes back to what it used to be and sometimes better. My CD4 count is now 400. I am back a work and will be going for my regular check-up next month to see how it’s going.”
