14 September 2012

Zimbabwe: Innocent Victims of HIV

Mbuya Lucy is over 75 and has been on ART for the last eight years.

She lost her husband a long time ago before the advent of the HIV/Aids pandemic and has not remarried neither has she had a sexual relationship.

"I have been ill for some years and it was only in 2004 that my daughter who works as a nurse at Mutare General Hospital took me for some tests at her workplace. She asked me to take an HIV test since I had been looking after one of my daughters who unfortunately passed away," said Mbuya Lucy.

Mbuya Lucy did not have the know-how on care and handling of a sick person back then.

In fact, there was little awareness and care giving was not supported from institutions for those who had patients at home.

It was during the 90s and the early 2000 that many succumbed to the Aids pandemic.

With many patients referred home because there was not much that could be done by hospitals, caregivers did not even have basics like gloves and sanitary pads that they bathed patients with open wounds using bare hands. This could have been the source of infection for Mbuya Lucy.

Today the environment has improved as caregivers are now recognised and offered support.

Paida Magaya, the Public Relations Officer for the Zimbabwe National Network of People living with HIV (ZNNP+), says her organisation recognised the importance of caregivers and offered them their support.

"As an organisation we value the great work that caregivers do at home. We offer our support in the form of gloves, sanitisers and pads. We give a basic home toolkit and this kit has a plastic sheet in case one soils bedding," said Magaya.

Magaya said they strive to make live comfortable for patients referred home and try where possible to assist the caregivers since this is a 24-hour job.

"Caregiving is a 24-hour job and at times the caregiver gets tired so we believe working in groups helps under such circumstances," she said.

Mostly caregivers are relatives and are not paid. They usually do not afford the kits needed in taking care of a sick person. It is working without protective material that some people have ended up getting infected with HIV. Data on ageing with HIV is largely restricted to the developed world and very little is known about older Africans living with virus, despite the high case load in this region.

A July 2012 supplement of the medical journal, Aids, noted that an estimated three million people in sub-Saharan Africa aged 50 and older are HIV-positive and 14 percent of all infected are adults.

Most demographic and health surveys use 49 years as their end point for data collection.

Policymakers can no longer afford to neglect this older age group as the advent of ARVs has seen people living beyond 49 years now.

Why is it that data shows statistics to end at 49? Do people over that age not have any sex life? Sex does not end at 49 and the earlier the data captures the true picture the better. Is it that when one reaches 49 and has been living positively they suddenly die?

So why the myopic and narrow mindedness in statistics one would ask?

A case in point is of our neighbours down south who have included men over 50 years as one of the most at-risk populations. This shows that their statistics have gone over the 49-age limit.

"This age cap assumption is wrong and the earlier it is noted and corrective measures are taken the better," said Tendayi Westerhof an HIV and Aids activist.

"Women over 50 are still able to engage sexually so are men. I know many that are over that age and are active so why not capture that age group? In fact, statistics must not have an age cap, HIV has no age restriction," she said.

The healthcare providers do not make it any easier for women over that age.

They look at you with a questioning eye as if it's a crime to be HIV positive when one is over 60 years and HIV positive said a woman from Mufakose, who requested anonymity.

"When I go to the clinic and am not feeling well the first thing I do is to disclose my HIV status. The healthcare personnel look at each other before giving me any help, it is like a crime to be HIV positive and over 60 years old," she said.

"Older people are not targeted in safe sex campaigns and I wonder why they do that," queried the woman.

It is a fact that as one gets older one's health gets a host of knocks from other ailments associated with old age. Older people living with HIV are more prone to getting hypertension. This could be due to depression or just the idea that society considers them not to be HIV positive which is stigmatising. Locally lack of enough food, loneliness and being isolated leads to a high risk of older HIV positive people getting hypertension.

The Bill for the Aged seems to be taking too long and if this is not put in place, those in their 40s should know that the 40s is a transitional age. Today you are beginning life celebrating the forties, a decade and a half later you are a pensioner, old and with no security and in need of the Bill.

Society generally regards old age as a burden resulting in little or no attention to the needs of the aged.

Before the advent of ARVs most people did not make it over 49, but today with over 25 drugs to suppress the HIV virus one's lifespan has been given a lifeline of 30 to 50 years from day of diagnosis.

The cost, which is usually seen as little by most, is beyond reach for many old people.

Mbuya Stella of Chitakatira, in Mutare who lives positively said she finds it difficult to get US$1 for bus fare to Rowa Clinic to get her supplies.

"It is a distance that one cannot cover on foot. I need US$1 for bus fare to and fro, which I fail to raise. I end up sending neighbours to collect some medication on my behalf," she said.

Sending a friend or neighbour to collect medication is a measure of last resort, which is not urged.

A nurse working at the Opportunistic Infections Clinic at Harare Hospital said they had no choice but to dispense medicines to messengers.

"It is advisable that one gets to be checked by a health personnel in every three months but we get situations where one is not able to come and ends up sending a wife due to work commitments. We cannot deny that patient medication so we dispense but would be comfortable if everyone presented in person at health centres as we not only dispense medicines but need to check on the patient," he said.

"We would be comfortable seeing each patient as we would be in a position to assess their health. We understand the cashflow constraints and work commitments so we end up giving whoever is sent with the cards the supposed supply for the duration," he said.

A medical journal admits that getting old and being HIV positive is not an easy road.

"It's hard enough dealing with the aches and pains that usually come with getting older, but when you are HIV positive, getting old brings more chronic illnesses and even more medication, many health systems are not ready to cope with this relatively new phenomenon," said PlusNews.

Zimbabwe is also caught in this web where the aged people's needs are not well catered for.

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