19 January 2007
The Mozambican Red Cross will begin training hundreds of volunteer workers to manage antiretroviral therapy (ART) for people in their care living with HIV/AIDS.
"This training is extremely important and will improve the work of our carers," Paula Macava, the Red Cross Mozambique coordinator of the HIV/AIDS programme, told IRIN. "We have now finalised an eight-module training package on antiretroviral therapy management, specifically designed for carers."
The three-week training package for volunteers, who should have at least basic reading and writing skills, includes information on how to judge the preparedness of a client to start antiretroviral (ARV) medication, ensure that those using the drugs stick to their regimen, and the importance of eating nutritious food when taking anti-AIDS medicines.
A handful of NGOs have started ARV management training for carers but their reach is limited, whereas the Red Cross has a nationwide network of 600 carers in its home-based care (HBC) programme, which operates in 9 of the country's 11 provinces.
The national HIV/AIDS prevalence rate for adults is 16.2 percent but rises to 19 percent in Manica and 26 percent in Sofala - the provinces bordering Zimbabwe. According to UNAIDS, Mozambique's HIV prevalence rate is the 10th highest in the world, and nearly 80 percent of the country's about 20 million people live on US$2 or less a day.
According to the health ministry, the government, with the support of partner organisations, provides ARV treatment to 34,000 people and aims to have 50,000 on ARVs by the end of 2007. The ministry estimates that 250,000 people may require ARV treatment.
Managing ARV treatment in Mozambique presents a huge challenge, especially in the sparsely populated rural areas where infrastructure is poor.
Red Cross carer Angela Mondlane conceded she was being overwhelmed by the demands of the HIV/AIDS pandemic in her hometown of Moamba, 60km northeast of the capital, Maputo. The HIV/AIDS prevalence rate for adults in Maputo Province rose from 13.5 percent in 2000 to 20.7 percent in 2004, according to health ministry figures.
Mondlane, 42, a mother of three, walks to visit five chronically sick people at least three times a week because her bicycle is broken. Some of them are on ART, but she admits that her knowledge of ARVs is rudimentary, saying, "I need to understand the ARV drugs better."
Her ignorance of administering ARVs showed during a house call on HIV-positive Bata (not her real name), 21, who lives with her aunt and six other orphaned nieces and nephews.
Bata has apparently just started second-line ARV treatment, but neither she nor Mondlane know what these drugs are, or even if they are ARVs. Her aunt is also not sure exactly what the medication is, but thinks it must be ARVs because "she [Bata] is always hungry".
"I know I must take these tablets twice a day. They are different from the other ones - the first lot of tablets made me very sick," said Bata, who has never received any formal education.
Like all carers, Mondlane participated in the health ministry's two-week training course, which teaches basic medical knowledge such as first aid and counselling, but does not include training in administering ARVs. "I am looking forward to the training on ARVs, so I can care for my clients better," she said.