Not angels, but the next best thing

Connecting with and supporting HIV-positive health workers – doctors, nurses, community health workers, all those working in health settings – is a significant pillar of the Boresha project. The people who care selflessly for others, with a variety of illnesses and conditions, for a variety of reasons, have been overlooked in HIV programmes in the past.

Today, thanks to the work of Mildmay International real efforts are being made to finally involve this key group in the HIV response in a meaningful way.

NYANZA PROVINCIAL HOSPITAL

‘I am the one taking care of people, how can I be seen to have HIV.’

Grace Abong’o is nurse and the inspiring chair of the Kiwoso Support Group for HIV-positive health workers, based at Nyanza Provincial Hospital in Kisumu, Kenya.

“It was assumed for so long that health workers have knowledge at their fingertips about HIV – it is not so.  HIV being as dynamic a disease as it is, it is not easy for health workers to keep up.

“Health workers had a raw deal for a long time. There was a sense of: ‘I am the one taking care of people, how can I be a victim, how can I be seen to have HIV’.

“HIV has been stereotyped. The health workers did not fit that stereotype and so they were left behind.

All the members of the Kiwoso Support Group, work in and around Nyanza District Hospital. Some are nurses, working on the labour ward or in casualty, there are some counsellors and even clerks. One member, Bernard Okombo, is a lecturer at the Kisumu branch of the Kenya Medical Training College. All the members are HIV-positive.

The group meets once a month in a very small room at the hospital for group therapy sessions and to share their personal and professional experiences.

Nurse Jane Oyombra is a member of the group: “The biggest challenge was coming for the first time, and that is now behind me.”

‘We try to reach out to people living in silence or isolation’

Grace, who found she was positive in 1992, added: “I’m happy to be among other people who are living with HIV. We are strong by being together and we have begun to reach out to our colleagues. They are not yet where we are. They have still a long way to go.

“We try to let the health workers living with HIV know that they have a family. We tell them that the group exists. For people who are living in silence or isolation we try to reach out to them.

“We cherish [the support group] and would like it to continue. It’s important that we don’t have a stagnant population.”

The Kiwoso group had six original members, then there were10, now there are 35. Mildmay International has trained many of them in home-based care.

Grace Abong’o said: “Our members are now able to talk publicly and that is a result of training from Mildmay. We are now able to know what to say when you say it and where to say it. The stigma most of the time is within yourself. Once the stigma has gone there is no longer discrimination – and you are a free person.”

Reaching doctors remains a challenge

But challenges remain. Particularly when reaching HIV-positive doctors.

Grace Abong’o: “You can’t say we have made a breakthrough. The most senior cadre of HWs – that is the real challenge. We are aware that senior people are HIV-positive but they would not come to this group. We don’t want to leave them behind. We feel we can reach them. At the moment we are losing them to HIV and we shouldn’t be losing them.”

View from the top

Grace Abong’o: “The administration of the hospital has acknowledged that the group has made a difference to the way HIV is viewed by staff.”

Such has been the success of the Kiwoso group that they have begun mentoring staff in other health facilities to establish similar support groups.

As part of the Boresha project in Tanzania, efforts are also being made to connect with positive health workers.