THREE times a month, 18-year-old Grace Mutungambera walks more than 14 kilometres from her home, to the nearest clinic. With her baby strapped to her back and in the extreme heat, the walk takes her about four hours, each way. She lives in the rural, tobacco growing region of Hurungwe, in Zimbabwe.
"Sometimes my feet get painful, sometimes I have backache and headaches because of the sun. But I have no choice, I have to be strong and make the effort, because I need the clinic's services." - Grace Mutungambera When she was just 10 years old, Grace found out that she was HIV positive. She has been taking medication for most of her life. Her determination to get to the clinic is fueled by her desire to ensure that her baby does not become infected. So she adheres to her own medication and she makes sure she gives the little one her medicine on time, every day.
But Grace was not always particularly consistent with taking her medication. She describes a tumultuous time of her life, when she was briefly married to the father of her child:
"I left Hurungwe for a while and I eloped with my husband. At that time, I left my medication here and my mom actually followed with the medication. I then continued taking my medication, and I started gaining weight.
"Then my husband said, 'you are now healthy and you have gained weight, so you should stop taking your medication'. But I argued and said I cannot stop taking my medication because this is what is keeping me alive for the rest of my life. Sometimes when it was my clinic appointment dates he would say, 'you are not going there' and I actually threatened him and said if it is like that, then I will actually go and report the matter to the police, and as time went on I came back home. I can now take my medication again and attend my clinic appointments and am free to attend support groups because I don't have any problems or obstacles."
A turning point for Grace was her encounter with the Young Mentor Mothers Community Initiative. This is a programme by the Zimbabwean Health Ministry, which is implemented by NGO Africaid Zvandiri and supported by UNICEF.
In terms of the programme, adolescent girls and young women are trained to fulfil a peer support role to young mothers who are living with HIV. The mentor mothers are parents themselves, who are also living with HIV. The initiative provides a safe space for moms to make friends and gain support, for themselves and their HIV exposed babies.
In Zimbabwe, 1.3. million people are living with HIV. The HIV prevalence rate among women is at 16.7 per cent. This is significantly higher than the prevalence rate among men, which is 10.5 per cent. At the Young Mentor Mothers Community Initiative support groups, women are encouraged to talk about the issues that contribute to infection. They discuss sexual and reproductive health, including topics like the negotiation of condom use in a patriarchal society.
Dr Angela Mushavi is the National PMTCT and paediatric HIV Care and Treatment Coordinator in Zimbabwe's Ministry of Health. She says the mother-to-mother peer programme addressed a crucial issue in the healthcare system, by providing a unique approach to adolescent and young women in clinics. Dr Mushavi says this particular group sometimes found it difficult to ask healthcare workers for information regarding their sexual and reproductive health.
"One of our challenges, in preparation for elimination of mother-to-child transmission of HIV and Syphilis plan, was a recognition that we were not doing a favour to the young adolescent moms and the youth moms. When we saw them in anti-natal care we managed them just like any other pregnant women and that was identified as a weakness. Therefore, when we were looking at strategies moving forward, we really thought we should address the needs of the pregnant adolescent. We felt that they needed to speak to one of their own so that they can really understand what we are talking about, whether they are HIV positive or negative. So we looked at a situation where you could have a peer support mechanism."
Chiara Pierotti is the chief of UNICEF's HIV/AIDS programme in Zimbabwe. She adolescent girls are often ill-equipped to deal with their new role as a wife and mother, and the programme plays an important role by giving them important information about their own bodies, as well as steps they can take to protect themselves and their children.
Evelyne Mtetwa from implementing partner, Africaid Zvandiri, works with young people living with HIV in several communities across Zimbabwe. She says not only does the programme benefit the young moms, but it is also a massive boost for the mentor mothers, as the training they receive makes them more employable in the future. One of the biggest issues she tries to tackle in the course of her work, is the stigma that still revolves around a positive status.
Tonde Murimwa, an HIV specialist at UNICEF in Zimbabwe, says it is time for all age groups to start speaking openly about HIV, so that stigma can become a thing of the past.
"The older generations, particularly in the rural areas, are still not open to discussing issues to do with HIV. The information that we have given both the young people and the old people, should start stimulating discussions. It might not be easy discussions, but it allows for people to talk about the condition, it's no longer a death sentence, we have life-saving treatment so really there is no reason why people shouldn't talk about this."
These discussions would certainly make life just a little bit easier for people like Grace, who dream of a future free of discrimination.
The Young Mentor Mothers Initiative was made possible by the Government of Zimbabwe, Africaid Zvandiri, UNICEF and the joint UN Together for Sexual and Reproductive Health and Rights Programme, with funding from the Swedish government.