Mkoba 1 Polyclinic Review Day
October 14 2015

Mkoba 1 Polyclinic Review Day

Mkoba 1 Polyclinic is one of four that ALERT supports close to Antelope Park in Gweru, Zimbabwe. We are privileged to join AFRICAID to assist them in review days that take place at the Clinic every two months.  Review days are for children with HIV/AIDS to give them a full check-up and to make sure that they are keeping up with their medication.  HIV/AIDS remains a source of social stigmatism within the community, as well as in Zimbabwe as a whole.  Statistics show that 15% of Zimbabweans (12% male, 18% female) are living HIV/AIDS.

Antelope Park volunteers attend review days to interact with the children and bring some fun to a day that would otherwise be a reminder of a negative condition that would make even adults hide away.  The volunteers planned a day of activities including face painting and various games that kept the children happy and occupied throughout the day. The regular participation of the volunteers has contributed to making review days fun, which positively encourages the children of Mkoba to attend.

Mkoba 1

During a recent review day 74 children - 30 males and 44 females aged between 4 years and 16 years - living with HIV / AIDS attended for their check-up and to receive their medication for the next two months.

Simba Munyonho, Africaid Zvandiri Provincial Mentor for Midlands Province has this to say about our involvement with review days:

You successfully organized volunteers and they were always present during review days. This went a long way in addressing some psychosocial issues faced by these kids. The time these volunteers spent with the kids was very important. Apart from the clinical attention these children receive from their respective health facilities, this quality time they spent with volunteers was/is equally important as it produces some psychosocial outcomes. The days have become attractive to children and they always look forward to the next review day; full of fun and interaction with the volunteers, thereby promoting adherence. We have realized that through these interactions children have become more responsible for their own care as they are now also present for the collection of their medication. In the past caregivers used to collect medication for their children with the children remaining home. But with your volunteers present no kid wants to remain home and this has promoted ownership and meaningful involvement in their own care. We as AFRICAID, Gweru City Health and the children we also greatly appreciate your support.

ALERT and Antelope Park are proud to assist AFRICAID in this work. AFRICAID is a non-governmental organisation which was established in Zimbabwe in 2004 in response to the growing psychosocial support needs of children and adolescents living with HIV. It started as one support group of children and adolescents living with HIV and now it have grown to be a network of support groups, community outreach services, training and advocacy. A total of 8000 children and adolescents living with HIV are currently being reached throughout Zimbabwe with psychosocial support services. The programme is called “Zvandiri”, meaning ‘accept me for who I am’.

Mkoba 2

Although increasing access to antiretroviral therapy (ART) is radically improving survival for children and adolescents with HIV in Zimbabwe, they remain highly vulnerable due to overwhelming physical, psychological and social stressors. Their childhoods are characterized by frequent illness, hospitalization and the need to adhere to daily medication. Adherence to ART presents challenges for all age groups but particularly for children and adolescents. In a recent study by AFRICAID in Zimbabwe 229 (74%) of HIV positive adolescents reported sub-optimal adherence to their antiretroviral drugs (ARVs) with 20% reporting only 50% adherence. The study also found that poor mental health among adolescents living with HIV was related to less medication adherence. Effective adherence strategies are a vital component of any supportive environment for children and adolescents with HIV if they are to be protected from treatment failure, opportunistic infections and mortality. AFRICAID has pioneered adolescent-led adherence counselling and support in Zimbabwe through its Community Adolescent Treatment Support (CATS) programme and learnt that this approach is a highly effective, sustainable strategy for supporting children and adolescents on ART.

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Children and adolescents with HIV also face problems of orphaning, caring for sick relatives, recurrent change of household and HIV-related disclosure. Yet they commonly lack resources to cope with these issues. AFRICAID is providing counselling services to these children and adolescents especially on issues of disclosure and this is making a significant change in their lives and families,  helping them  to understand and cope with events in their lives, to look forward to a meaningful life ahead and to feel accepted, valued and loved.

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Another considerable challenge for HIV positive children and adolescents which AFRICAID work with is widespread stigma in the home, schools and community resulting in profound psychological distress. Stigma results in verbal, physical and emotional abuse towards children and adolescents with HIV, and in schools this results in dropping out from school and resorting to the streets. AFRICAID is working hard in implementing some strategies which aims at creating safe, secure environments in the home, school and community. This is going a long way in addressing the causes of stigma towards children and adolescents with HIV and also equipping them with the skills to cope with the impact of stigma.

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The issues faced by HIV positive children and adolescents as described above all combine to create feelings of isolation, shame and powerlessness within their sense of self, fears for the future and lack of hope, lack of confidence, self-esteem, self-worth and motivation. The work of AFRICAID in providing the much needed psychosocial support to these children has gone a long way to rekindling hope in these children and adolescents as well building a sense of self-worth and high self-esteem.

Simba Munyonho of AFRICAID says:

The provision of psychosocial support to children in Gweru Urban, living with HIV, could not have been successful without the support of Antelope Park Volunteers. AFRICAID started to operate in the City of Gweru Clinics in 2013. Through the City Health Department, mostly with the assistance of the Senior Nursing Officer, AFRICAID successfully advocated for the introduction of review days for children and adolescents during weekends. In search for support during these review days, communication channels were opened with Antelope Park / ALERT and the volunteers began to come during review days for the children. The presence of volunteers during review days made the days very attractive to children and this went a long way in motivating children to adhere well to their medication. No child would want to miss the review day given the playful activities which were provided by volunteers. This promoted ownership to their medication unlike in the past when parents and guardians used to collect medication for children with the children remaining home. This sense of ownership thus means children were/are now involved in their own care.  Improved adherence has been witnessed among children and adolescents from City of Gweru Clinics since the introduction of separate review days for children and the participation of Antelope Park volunteers during these events. Most of these kids experienced love through such interactions with the volunteers which they never experience in their lives and this went a long way in building a sense of self worth. Some of the kids also came to realise the potential and strengths in them through the games and various activities provided by the volunteers, thereby building confidence in these children. One child at Mkoba 1 clinic at one of these review days was heard saying, “Regai timbofarawo nekuti kumba hatiwani mukana wakadai”, (Let us enjoy ourselves because we don’t get this opportunity at home). All this points to positive psychosocial outputs which the volunteers brought about to the lives of these children. AFRICAID greatly appreciates the support from Antelope Park / ALERT and wishes for the continuation of such a good relationship as it is evident that it goes a long way in benefitting children.”

About Mkoba 1 Polyclinic

Right on the door step of our Gweru project site at Antelope Park is the high density area of Mkoba. This is where the majority of Gweru’s population live, most of whom do not have access to private healthcare facilities and are therefore totally dependent on the under staffed and poorly resourced local clinics.  These service providers are currently heavily dependent on the goodwill and support of donor agencies to service its community.

Mkoba 1 Polyclinic caters for a catchment population of almost 35,000.  Services provided include: clinics for Opportunistic Infections (HIV & TB), outpatients departments for adults and children, Extended Program of Immunization for children 6 weeks – 5 years of age, family planning, antenatal & post-natal care, PMTCT - Prevention of Mother to Child Transmission for HIV affected mothers, and voluntary counselling and HIV testing.  

We provide both manpower and material support to these clinics.  Personnel are provided to assist the qualified clinic staff in many of the routine tasks, freeing them to concentrate on frontline healthcare. This project operates under a Memorandum of Understanding with the local healthcare authority.

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