A New Approach to Fighting HIV/AIDS in Swaziland

Magiyagiya Zwane, a MSF Community Expert Patient, explains his experience. “It’s very simple for me to encourage a person testing for HIV. I always tell the people to look at me; I’m healthy, I’m living okay, so it is very easy to convince them. Once a person has tested, I always refer them to the clinic for their next steps.
Yasuhiko Okuno
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MSF is working with the Swazi Ministry of Health on a new project called PMTCT B+ for HIV-positive pregnant and breastfeeding women.

In Swaziland, 26 per cent of the population aged between 15 and 49 is HIV-positive. In 2007, Swaziland approached Médecins Sans Frontières (MSF) to ask for help in the fight against HIV and Tuberculosis and MSF started a project with the Ministry of Health (MoH). In February 2013 in Swaziland, MSF started rolling out an innovative approach called PMTCT B+ with HIV-positive pregnant and breastfeeding women.
MSF
Gift Mumanga, Senior Nurse at Tfokotani Clinic, talks to a patient. “It’s not easy to have people tested. When the result is positive, they think ‘Oh, now people will push me aside.’ Taking a treatment for the rest of their lives is another fear for the patients.”
Yasuhiko Okuno
Johannes Zwane, Community Leader, says, “We are really encouraging men, especially young ones, to support their HIV-positive partners. Also I encourage them to come forward to get tested. I believe that once they have all the knowledge about HIV/AIDS, it is going to be easier for them to support their partners.”
Yasuhiko Okuno
Ephriem Dube, traditional healer, is HIV-positive and on treatment. He says, “I treat all illnesses except for HIV/AIDS. It is true that I still meet people who have misconceptions about HIV/AIDS, mostly because they are in denial. Even if you try to convince them, they still believe in the traditional medicines. It can be quite a challenge but I make an example of myself, I am a living testimony, I live with HIV.”
Yasuhiko Okuno
Magiyagiya Zwane, a MSF Community Expert Patient, explains his experience. “It’s very simple for me to encourage a person testing for HIV. I always tell the people to look at me; I’m healthy, I’m living okay, so it is very easy to convince them. Once a person has tested, I always refer them to the clinic for their next steps.
Yasuhiko Okuno
Nomcebo Dlamini, a MSF Clinic Expert Patient at Tfokotani Clinic, is giving a health education talk to the patients. “We talk to patients so they can understand why testing is important. We also tell the patient how we ourselves have benefitted from taking antiretroviral treatment and how can it help them.”
Yasuhiko Okuno
A MSF Community Testing Counsellor explains what is HIV, how it is transmitted, and how it is prevented. Patient Support, Education and Counselling teams and Psychosocial Assistants often visit the communities, especially in meeting areas such as farms and churches.
Yasuhiko Okuno
A HIV-positive pregnant patient says, “Now that I am on treatment, I can see a brighter future for me and my family because I will give birth to a HIV-free baby and I will take my older child and my husband for testing. I realise that the treatment I have started is a very important step in my life.”
Yasuhiko Okuno
A HIV-positive breastfeeding patient is at home with her second and third children who do not have the virus. She talks about the support from her husband who is also HIV-positive and on treatment. “I always encourage people to take action in the sense that taking antiretroviral treatment is not the end of life, you can still live a happy life. ”
Yasuhiko Okuno
Médecins Sans Frontières works in close partnership with the Ministry of Health to show that this new approach is effective, accepted by pregnant women and health workers and that it can be rolled out nationwide. The signboard shows the collaboration between Ministry of Health and MSF.
Sam Taylor/MSF
Hon. Benedict N. Xaba, Minister of Health, explains that main challenges are how Swazi people will respond to this initiative and the cost implications of the approach. “We hope this initiative will not only help Swaziland but also become a successful example for other countries.” Elias Pavlopoulos, MSF Head of Mission, continues, “We are here to be a catalyst for change, so that when we are out, essential antiretroviral treatment will be continued.”
Yasuhiko Okuno
“We talk to everyone because you are either infected or affected. Everyone must stand up and support each other,” says Dolly Zikalaka, MSF Psychosocial Assistant. Over the next four years, more than 2,000 pregnant and breastfeeding women are expected to start life-long antiretroviral treatment in Nhlangano. PMTCT B+ is a first step to envision a HIV-free Swaziland.
Yasuhiko Okuno