is a hot afternoon in Makohliso village, 300 kilometres south
of Zimbabwe’s capital, Harare. The land is green but
the crops are wilting in a persistent dry, hot spell. It should
be the rainy season in this poor country in southern Africa,
where everyone hopes the rains will bring good harvests, a
source of survival for many people. In Zimbabwe, a difficult
climate is not the only struggle.
Three kilometres off the main road, along a narrow and meandering
path, is Isaac Masvanike’s homestead. Six graves lie
at the entrance to the house. For Isaac, this is a reminder
of what the AIDS pandemic can do.
Isaac, a mine worker who had to retire after 22 years because
of illness, tested positive for HIV in 2005 after he was admitted
to hospital. “I felt sick. The doctor asked my family
to pray as he thought I had less than 24 hours to live,”
he said. “The doctor was very quick to advise me to
go for an HIV test and be prepared to accept my status.”
That was the turning point in Isaac’s life as he was
immediately put on antiretroviral treatment to slow the progression
of the virus.
Only about 8 per cent of Zimbabwe’s estimated 1.5 million
people with HIV take anti-retroviral treatment. Isaac’s
nephew pays about ZW$ 5,000 (US$ 21) a month to get the medicines
for Isaac from a private medical centre. Today Isaac is a
strong man, fit enough to work for his four children and send
them to school. Isaac is living example of how knowledge can
change lives, says Priscilla Makambe, 36, a Zimbabwe Red Cross
Society volunteer care facilitator who visits Isaac every
“When I look at Isaac, I see a miracle,” says
Priscilla. “I was coming here when he was bedridden.
I always shed tears when I looked at his children. Isaac had
lost weight, but his ability to face reality and accept his
status helped a lot to manage his condition. It was really
a touching story.”
Priscilla (pictured right with another client) gives some
of the credit for the turnaround in Isaac’s life to
an innovative course she took for community volunteers, called
HIV Prevention, Care and Support, which is designed to give
power back to people living with HIV, their families and caregivers.
Launched in 2006, the course was developed by the International
Federation, the World Health Organization and the Southern
Africa HIV and AIDS Information and Dissemination Service,
in consultation with networks of people living with HIV. Zimbabwe’s
Ministry of Health and Child Welfare, the National AIDS Council,
CONNECT (a welfare organization), the Centre (an HIV project)
and the Kenya and Zimbabwe Red Cross Societies field-tested
The course materials are now being translated into 16 languages
and the programme will be introduced in nine other southern
African countries and around the world.
Priscilla says the course increased her understanding of
the needs of people taking anti-retroviral medication, which
is supplied by governments, aid organizations or private businesses.
“Although we were already encouraging the families to
practise proper hygiene and making sure that clients had a
balanced diet before we attended the training programme, we
realized they need to have adequate food before they take
their medicine,” she says.
“Even more important is ensuring your clients enjoy
peace of mind and letting them know there is more to be gained
by being open about their condition with family members so
they get the care and support they deserve.”
Because of pressure on Zimbabwe’s public services,
people with HIV must rely on their families and neighbours.
But this requires people to be frank about their HIV status.
Isaac says the programme helped him be more open with his
wife. “It is helpful for the two of us since she is
HIV-negative and I am positive. We use condoms without any
problems as we now understand our situation. People used to
think that condoms were only used by sex workers,” he
He adds that it is important for couples to get tested together
or at least disclose their status so they can help each other
to avoid risk and stay healthy. “When I am very sick
it’s my wife who cares for me and this was going to
be a problem if she didn’t know the cause of my condition,”
Isaac also says taking his anti-retroviral medication regularly
was important to minimize infections and add to his quality
of life. “Our Red Cross care facilitator emphasized
sticking to the timetable for taking the drugs. Some people
were just taking the medicine randomly, while others used
to share the drugs with their friends. My wife is very helpful
as she always reminds me to take my medicine on time,”
says Isaac, adding that this has kept him strong enough to
work. “I hope I can live long enough to see my children
through their education.”
Priscilla says an eight-part course handbook with information
on topics such as treatment, palliative care, care for carers,
counselling, nutrition and positive living helps volunteers
respond more quickly.
“The package acts as a reference. Whenever we need
some questions answered we consult the package instead of
waiting for officers from the head offices,” she says.
Evelyn Isaac of the World Health Organization says the training
package is unique because it is centred on people living with
HIV and their communities, and it links with health services,
community programmes and organizations working on HIV.
“It also falls in line with the principle of universal
access to prevention, care and treatment as defined in the
Millennium Development Goals which will eventually change
the dynamics of the epidemic in all countries across the world,”
she says. International Federation Southern Africa regional
delegation head Françoise Le Goff says the package
will complement the increased availability of anti-retroviral
“The availability of anti-retroviral therapy is changing
the shape of home-based care programmes from helping people
to die with dignity to positive living,” she explains.
“This package couldn’t have come at a better time
as it empowers people living with HIV, caregivers and family
members who provide care and support and improves backup for
their humanitarian work.”
Near to Isaac lives Tendai, 32, a mother-of-two who fell
ill in 2003. She tested positive for tuberculosis in 2004.
She lives with her parents and ten orphans left by four brothers
or sisters who have died. Life has been a struggle for Tendai
and her mother, who is 70, who had to sell some of the family’s
draught animals to buy food, thus reducing the household’s
income from farming.
In the past, Tendai only took her medication when she felt
sick. But Tendai’s Red Cross care facilitator told her
she needed to continue taking her drugs regularly.
Today she has returned to the market, strong enough to sell
mangoes to help support her family.