Helping Health Workers Go the Extra Mile
By early 2000, an estimated 160,000 children were living with HIV in Zimbabwe and only 1-in-16 had access to life-prolonging antiretroviral drugs. In order to provide better access to health interventions in rural areas, organizations like Seke Rural Home Based Care (Seke) were established. Initially, home-based care programs only focused on adults, and children were left out of HIV and AIDS interventions. It was a challenging time for field workers like Stella Paraziva, who was one of Seke’s first staff members.
Over the next decade, Stella conducted home visits to patients with HIV and AIDS. Due to limited resources, she traveled to patients’ homes on foot, walking up to fifteen miles a day with a bag of medicine on her back, and only two rolls of bread to sustain her throughout the day. By the time she reached the village, Stella had precious little time to treat those that were suffering, and even less time and resources available to help children who needed HIV and AIDS care and support.
In response, Bantwana’s Children First program began working with field workers like Stella, nurses, and local clinics to provide treatment to children who were excluded from critical health care services. Together, they established the Integrated Management Pediatric AIDS Care and Treatment (IMPACT) program.
Under the IMPACT model, Bantwana and Seke trained community home-based caregivers to identify HIV-positive children and encourage them to go for HIV testing, CD4 counts, antiretroviral therapy, and psychosocial support. These caregivers are trained volunteers who live in the communities and provide routine visits to patients, relieving field workers of some of their workload. To better serve children in remote communities, Bantwana also donated motorbikes to Seke, which enable caregivers and field workers like Stella to travel up to 100 miles a day, thus reaching more children with critical HIV and AIDS services.
“Many of these children did not have anyone to talk to, to comfort them and offer them security,” Stella explains. “Now, even if they have enlarged lymph nodes or a skin disease, they won’t feel inferior. They will know that there is someone who cares, someone who asks if they are adhering to their medication, someone who checks up on them.”
Bantwana’s IMPACT program has succeeded in refocusing health care on the children who were left out of home-based HIV and AIDS services. Thanks to IMPACT, Seke now has more than 400 caregivers who support field workers like Stella Paraziva in placing over 170 children on life-saving antiretroviral therapy, in addition to offering psychosocial support to hundreds of others. With the provision of the motorbikes and the additional trained community home-based caregivers, Seke can now effectively collect CD4 counts and better reach patients for counseling and ART adherence monitoring, thus improving the lives of orphans and vulnerable children in rural Zimbabwe.
“Our children are our future, our tomorrow,” says Stella. “We cannot replace their parents, but we can continue to help and protect them until they grow up.”