20 March 2003
Tserayi Machinda is at the centre of the HIV/AIDS epidemic in Africa. In his native Zimbabwe, he combats the disease throughout Manicaland -- a province of 1.5 million people bordering Mozambique. With more than 100,000 orphans and 15,000 known cases of full-blown AIDS in the province, he says he has his hands full.
"We have approximately 4,000 Zimbabweans dying of AIDS each week. That's a whole [administrative] ward being wiped out," he notes.
Tserayi is a national United Nations Volunteer working with Zimbabwe's National AIDS Council (NAC). He, along with the provincial coordinator of NAC, is responsible for visiting home-based care workers, evaluating and monitoring HIV/AIDS prevention, mitigation, care and research activities, promoting education campaigns and fighting stigma.
Statistics released in December 2002 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) paint a grim picture for Zimbabwe. The national adult HIV infection rate is 33.7 per cent, the second highest in Africa only topped by Botswana at 38.8 per cent.
Many countries in Africa are facing a breakdown of social services. The educated and most productive segment of society is being wiped out, and the younger generation is unable to compensate. For the past decade, more than 160 UN Volunteers have served under 36 projects and programmes to fight the epidemic and care for those affected by HIV/AIDS. Currently, more than 260 UN Volunteers, many of whom are HIV-positive, are engaged in prevention campaigns, policy development, health care, skill-building and income-generating activities to curb the epidemic at local, regional and national levels. UN Volunteers contribute to the effectiveness of HIV/AIDS programmes by ensuring that the knowledge and expertise of those infected and most directly affected are considered.
Three hundred kilometers southwest of Manicaland in Masvingo province, national UN Volunteer Fungai Mhlanga spends the majority of his days traversing the province and meeting with Zimbabweans, HIV-infected people and non-governmental organizations (NGOs). On his journeys, he hears alarming stories.
"In Munorevesa village, a father hanged himself following the death of four of his children due to AIDS," he says. "In our custom, parents look forward to being cared for by their offspring in old age and not the other way around."
Culture is an important aspect of understanding the epidemic in Zimbabwe. It is something both cope with everyday. Tserayi often visits patients who have open sores and blisters, so he must take all necessary precautions to protect himself.
"When making home visits to check on [patients], it's difficult to be sensitive to the needs of the people while protecting one's own health and well-being," says Tserayi. "I often wear protective gloves and culturally it's like, 'Why should you use gloves with me?' We try to educate the people and make them understand why protection is necessary."
Getting Zimbabweans to take heed of education and awareness campaigns is now the major focus of NAC and many NGOs in Zimbabwe. Fighting stigma is also a challenge. Most difficult is dealing with false 'remedies' that circulate in some villages, such as that an infected person can get rid of the disease by sleeping with a virgin.
To combat stigma, Tserayi organized a number of workshops with leaders to urge them to promote safe sex techniques and discourage unsafe traditional sex practices. He says the influence of village chiefs and community leaders is extremely important as they have the power to change behaviour.
Both UN Volunteers are quite active in promoting volunteerism in their work, but acknowledge that spreading the spirit of voluntary action is difficult at a time of crisis.
"The major problem I have experienced in promoting volunteerism is the serious hunger, poverty and unemployment in the community," says Fungai. "People see projects such as HIV/AIDS as a possible source of employment or income and usually there is [a] low willingness to work on charity. Even those people who join our voluntary positions...complain about the economic hardships and the need for some form of remuneration."
He adds family members and friends often take responsibility over orphaned children or the sick. This concept is not new to Zimbabweans, he notes, but what makes today's situation different is the need.
"People are no longer able to cope with the epidemic," he says. "Many express the opinion that most people dying now due to AIDS could have lived longer if they had access to good nutrition and antiretrovirals."
Unfortunately, access to medication and treatment is not an option for the majority of the infected.
"When they see you coming in the UN vehicle, they expect assistance immediately," says Tserayi. "We don't have the funds to help them all the time. All we can do is offer some nutritious food, some counselling and a prayer."
But thankfully, not everything is negative. There are positive signs that their work is making a difference in combating HIV/AIDS.
Tserayi is working with students to incorporate HIV/AIDS awareness into drama productions and sexuality workshops.
Fungai is also active with several support groups of people living with HIV/AIDS. Through the various district AIDS committees, he assists in distributing food, clothing and medical and home-based care kits to the infected.
Another project he is involved in provides funding to HIV-infected persons who are capable of working. They sustain themselves by making and selling honey, soap and clothing. Fungai stresses the importance of keeping HIV-infected persons integrated in society.
"For there to be meaningful gains towards controlling the epidemic we should put people living with the disease at the centre of all interventions, be it prevention, care and support and mitigation," he says. "Our major effort at the moment is to forge strong partnerships with them as they are a valuable resource in terms of stigma reduction, advocacy on HIV/AIDS and encouraging positive living for those infected and affected by HIV/AIDS."
The UN Volunteers agree that the social and political climate is slowly changing in Zimbabwe, as people realize the severity of the disease and the urgency for an immediate response.
Fungai says Zimbabweans are depending on the government and the international community to take action because without a concerted effort the lives of millions are at stake. "AIDS is a serious disaster, a catastrophe and a tragedy that needs to be confronted with all the might and power that the world can offer if we are to save millions of lives trapped by HIV/AIDS in Zimbabwe."