The world is celebrating World AIDS Day, with the theme “Getting to Zero”. This refers to the vision of UNAIDS: Zero new HIV Infections. Zero discrimination. Zero AIDS related deaths. This is a challenging vision. When one considers the available reports and statistics for South Africa and particularly the province of kwaZulu-Natal one can easily come to the conclusion that the vision is not attainable. However that would be looking at it from the distance; like a fish eagle circling above and looking down on the African landscape below.
The same applies to the Mpopomeni town in the Umngeni Municipality of this province. It is located in the district with the highest antenatal HIV prevalence in South Africa – 37%. The general HIV prevalence in the province is close to 17%, compared to 12.2%. nationally. The HIV incidence rates are still high. If one narrows the focus of the statistics according to factors like age and gender the picture gets even worse.
Now consider the Ethembeni HIV/AIDS and TB team supported by the AIDS Foundation of South Africa. Going from house to house, knocking on every door. The door of house is opened to them, and they met a lady by the name of Sophia. She is alone at home. A conversation begins, and a new relationship is formed. They share information around HIV and AIDS and encourage her to do HIV counselling and testing. The result unfortunately was a positive test. She was pregnant at the time, and so was screened for PMTCT (Preventing Mother to Child Transmission). The local clinic continued with the testing, and she was found to have a very low CD4 count. She attended Anti-Retroviral Treatment classes, and started on treatment.
The team continued the relationship with Sophia. She began attending antenatal classes provided by the Maternal health Ethembeni team. The Prevention team helped to make sure she attended the clinic every month. Over time as the relationship grew the team discussed how she can encourage her partner to do HIV counselling and testing. His initial reaction was fear and unwillingness. He lived in another area of the town. She was willing to tell the team where he lived.
When the team was in his area going from house to house they looked him up. He was at home, and another conversation began. They discussed the transmission of HIV, and the importance of supporting his partner. He was still very afraid to be tested. They encouraged him to consider it carefully, and went on to knock on more doors.
The visits and counselling continued with both of them. Their baby was born healthy (and HIV-negative), and they continued to encourage her on how to make sure that both she and the baby could stay well. It then transpired that her partner did eventually go for HIV counselling and testing. The team did not just leave it at that. Again they went to visit and encourage him. This time they talked about the value of “medical male circumcision” in HIV prevention. And so he got circumcised. The couple accepts each other’s status and enjoys raising their child.
This is a good enough ending but yet the story continues. Sophia is taking part in community dialogues arranged by the team. She encourages people to do HIV counselling and testing, and so contributes to the impact of these dialogues. For us this is a sure indication of growing wholeness in a person, when they get involved with people whose story they share and help to change their story too.
So we see something quite different when we look at the lives of individuals impacted by the work of Ethembeni and many others. In this case, we have a pregnant female in a very high-risk group being helped to avoid death by AIDS by getting on ARV treatment and being helped to adhere to it. The partner overcame his fear of HIV. The same couple is now raising a healthy HIV-negative baby. The couple knows and accepts each other’s status, and has the knowledge around HIV. The lady is using her story and knowledge to impact others. It began with journeying with one person in relationship.
Now we see zero AIDS-related deaths becoming a reality, because she has avoided certain death. We can see zero new HIV infections, because she and her partner has been equipped. We see zero discrimination, as they accept each other’s status and openly encouraging others with her story.
Yes it is possible to get to zero! But it happens one person at a time. This requires the willingness and commitment of people to journey with those infected and affected by HIV and AIDS in relationship. It is a journey in relationship; not once-off brief contacts with individuals to “download” knowledge. It requires the involvement and commitment of many different people and organisations. The Ethembeni team, the government clinic, partners like the AIDS Foundation of South Africa (AFSA), and most importantly the person concerned. AFSA is very much part of the story – supporting the teams, providing good transport, and in many other ways. Yet again we affirm this is a shared journey of people who choose to enter into relationships of trust and care.
We celebrate together on this World AIDS day that we are getting to zero – one person at a time.