PALAPYE: A dispelling fallacy about HIV/AIDS is an ongoing challenge health organisations deal with. Palapye/Serowe sub-district health workers have come across episodes where HIV/AIDS has been treated under the banner of boswagadi (a condition a widow or widower is perceived to have after their spouse has passed on) thus requiring cleansing by traditional healers. This has negatively affected patients’ adherence to ARVs.
“There still is insufficient knowledge and skills of preventing HIV/AIDS in the community,” says Mokgadi Mantswe, the sub-district’s AIDS coordinator. “And as a result we have placed great emphasis on community mobilisation programmes.”
Kediretswe PMTCT support group based at the Palapye Infectious Disease Care Clinic (IDCC) is made up of individual participants in the Preventing Mother To Child Transmission (PMTCT) treatment and those having family members infected with HIV.
They teach and assist mothers in infant feeding, and growing their young children with the least possibility of HIV infection.
The group also gives talks on variant topics related to HIV at Palapye IDCC on Tuesdays, and have held drama competitions to sensitise community members.
Staff at the IDCC acknowledge Kediretswe support group for the decrease of the fear of stigmatisation by IDCC patients because they now collect their ARVs without shame and HIV positive mothers who are on the PMTCT programme collect powdered infants milk without qualms.
However, since the redeeming Preventing Mother To Child Transmission (PMTCT) treatment has been available, health workers Mantswe reports that they have since been confronted with a significant number of repeat pregnancies by HIV positive mothers.
Serowe/Palapye’s AIDS Coordinator Mantswe says: “The women argue that if they can give birth to HIV negative children, there is no reason for them not to fall pregnant.”
Shortage of doctors
This does not make the job of the 6 doctors who serve the Serowe/Palapye sub districts, which has a population of 167 000, any easier. “The shortage of health staff is a national issue, and is certainly not ideal,” Mantswe said.
The Sex Industry
Among the volunteer projects that address the many challenges that affect Serowe/Palapye is the Tsholofelo ÔÇô Hope Humana People to People project sponsored by the African Comprehensive HIV AIDS Partnership (ACHAP) that deals directly with sex workers who service the trucking pit stops along the A1 road from Gaborone to Francistown.
Given the fact that though the sex trade is not clearly defined as illegal, and thus no hard-line charge reprimanding sex workers exists. They are instead slapped with loitering and public nuisance charges. The larger community views the practice as offensive and Mantswe says the Tsholofelo – Hope project, which was founded in 2005, consequently is their most controversial.
Says Mantswe, “The project is eyed with disapproval by some. Our stance however is that because of the fact that the sex trade is an HIV/AIDS factor and very evident at the Palapye, Serule and Sherwood pits tops, we address issues as they come.
“The chances of sex workers being infected and/or infecting their clients with HIV is increased; we intervene by providing them with adequate information about HIV/AIDS and provide them with condoms.”
Baboloki Moyangwa, an outreach officer working for the project, revealed to journalists touring Tsholofelo – Hope premises, that initial contact with sex workers and truck drivers (who are of varied nationalities) is often unpleasant because of assumptions that outreach officers are out to stigmatise.
Once rapport has been established, the outreach officers find out what the sex workers and truckers know about HIV and AIDS and fill the gaps. The officers eventually forge better ties with both sex workers and truck drivers, encouraging them to test for HIV.
Their acquaintance is challenged by the fact that truck drivers are mobile. The Tsholofelo ÔÇô Hope outreach officers have, however, managed to mobilise 14 truck drivers, having them discuss HIV issues with their colleagues. The least cooperative are the white truck drivers, who also purchase sexual services at the pit stops.
In the first three quarters of the year The Tsholofelo ÔÇô Hope team have at the three pit stops talked to 365 sex workers aged between 25 and 34 years, and 48 of those aged below 24 years.
The biggest challenge, the outreach officers say, is decreasing the rate of prostitution because the issue is complex. It involves behavioural change and economy, we cannot force the sex workers to stop because it’s a source of income for them, Monica Kaisa the project leader says. She says though some report that they have no alternative while some augment their salaries in the sex trade.
Tsholofelo ÔÇô Hope also managed to reach 23 villages in the Serowe/Palapye sub-district through door-to-door campaigns, rallies and talk shows.