Lay counselors are an intergral part of MSF's TB and HIV programs in Lesotho, and each has a story to tell.
The Doctors Without Borders/Médecins Sans Frontières (MSF) HIV/AIDS program in Lesotho relies on lay counselors to ensure its effectiveness. Lay counselors are committed community members, and often HIV or TB/HIV co-infected patients, trained to undertake non-medical tasks usually done by a nurse or a doctor. Devoted to helping fellow patients in their villages, they are an integral part of the program, as they provide guidance and encouragement when it comes to following treatment regimens. But each one of the counselors has their own story to tell:
Mahlomola, 33, arrives at the rural Masemouse mountain clinic after a brisk 15-minute walk from his grandmother’s house, where he lives. Holding his chest x-ray and yellow medical booklet in his right hand, he joins the queue. Mahlomola has been visiting the clinic regularly since he tested HIV positive in 2006. In 2007, Mahlomola completed a course to become one of 46 lay counselors trained by MSF to provide HIV testing and counseling to patients experiencing the same difficulties he had faced.
“I want to help other people to know their HIV and TB status before they become weak, ill, and face deteriorating health conditions due to HIV and opportunistic infections–just like what my grandmother did for me,” Mahlomola says.
Four years ago, he was constantly weak and suffering from chronic fever and illness. Seeing his condition, his grandmother, Mantsotso Panyane, convinced Mahlomola to address his HIV status and begin treatment before it was too late—unlike his mother, who is suspected to have died due to HIV and TB a few years earlier.
In 2009, Mahlomola was diagnosed with TB. He has to undergo additional intensive treatment for at least six months, which complicates his HIV treatment. “My grandmother ensures that I have a ration of HIV and TB pills and that I follow exactly what my nurse instructs me to do,” he says. “She is my inspiration and guarantees I always do my best in providing assistance to others who are in the same situation I am.”
Facing up to the reality is not always easy, however. Despite heightened awareness about HIV and TB, stigmatization persists; patients are often ostracized from village life as gossip spreads. Mahlomola says he has learned to tolerate the snide comments and sidelong glances: “It still hurts, and I feel like I am different from other people because of my condition. It is distressing to hear neighbors, and other people in the village gossiping about me, saying that I will die soon. So, I decided to isolate myself from them. I stay in the house mostly, and I talk to no one, but my co-patients.”
He continues: “It is my grandmother who gives me the strength. She made me realize that I am not the only person in the world who is co-infected with HIV and TB, and that I can help others like me. When I realized this, I became more motivated to be healthier and stronger, and to fight to survive.”
In accepting his condition, seeking treatment and reaching out to others, Mahlomola has also found the love of a woman in his village who is also HIV positive. “She and my grandmother are my inspiration," he says. "They give me more reason to continue helping other HIV and TB positive patients, because I know from my own experience that patients need support more than they know.”