‘Ba­sotho no longer afraid of Aids’

Lesotho Times - - Big Interview -

LE­SOTHO joins the rest of the global com­mu­nity in com­mem­o­rat­ing World Aids Day on 1 De­cem­ber. World Aids Day — one of eight of­fi­cial global pub­lic health cam­paigns marked by the United Na­tions World Health Or­gan­i­sa­tion (WHO) along­side World Health Day, World Blood Donor Day, World Im­mu­ni­sa­tion Week, World Tu­ber­cu­lo­sis Day, World No To­bacco Day, World Malaria Day and World Hep­ati­tis Day — raises aware­ness about the epi­demic, which is caused by the spread of the Hu­man Im­mun­od­e­fi­ciency Virus (HIV).

Gov­ern­ment and health of­fi­cials, non-gov­ern­men­tal or­gan­i­sa­tions and in­di­vid­u­als around the world ob­serve the Day, of­ten with ed­u­ca­tion on preven­tion and con­trol.

The first World Aids Day com­mem­o­ra­tion was held on 1 De­cem­ber 1988 and each sub­se­quent cam­paign has fo­cused on a spe­cific theme.

How­ever, since 2011 the global theme has been “Get­ting to Zero: Zero new HIV in­fec­tions. Zero deaths from Aids-re­lated ill­ness. Zero dis­crim­i­na­tion”.

HIV causes the Ac­quired Im­mun­od­e­fi­ciency Syn­drome (Aids) which has no med­i­cal cure, and con­tin­ues to ravage com­mu­ni­ties un­abated.

The Min­istry of Health will lead Le­sotho’s 2014 World Aids Day com­mem­o­ra­tion in Thaba-bo­siu on 1 De­cem­ber and in this widerang­ing in­ter­view, Dis­ease Con­trol Depart­ment Psy­chol­o­gist, ’Moelo Sehlabaka-ramahlele, tells Le­sotho Times (LT) re­porter Lekhetho Nt­sukun­yane how the coun­try has fared in the fight against HIV and Aids and what is ex­pected to take place next Mon­day.

LT: World Aids Day is a som­bre oc­ca­sion for the global com­mu­nity as it re­minds us of the killer among us. How is Le­sotho go­ing to com­mem­o­rate the Day and where?

Sehlabaka-ramahlele: World Aids Day in Le­sotho will of­fi­cially be com­mem­o­rated on 1 De­cem­ber in Thaba-bo­siu. To be ex­act, the com­mem­o­ra­tion will be at the Le­sotho Evan­gel­i­cal Church grounds.

How­ever, as part of the com­mem­o­ra­tion, we had al­ready started the jour­ney by en­gag­ing on know-yoursta­tus cam­paigns through­out the coun­try ahead of the big­ger event on Mon­day next week.

World Aids Day is com­mem­o­rated an­nu­ally world­wide on this day, and Le­sotho is no ex­cep­tion.

The main ac­tiv­i­ties planned for this com­mem­o­ra­tion in­clude scal­ing-up na­tional Hiv-test­ing and coun­sel­ing ser­vices in all the 10 dis­tricts of the coun­try, and this be­gan early this month.

Mon­day’s com­mem­o­ra­tion will also ac­knowl­edge and hon­our some of the he­roes and hero­ines of our time who con­tinue to live with HIV and have a pos­i­tive in­flu­ence in our com­mu­ni­ties on the com­mem­o­ra­tion day.

The hon­our will be ex­tended even to the he­roes and hero­ines who have since passed away were brave enough to dis­close, to the pub­lic, how they lived with HIV and Aids. Our coun­try theme for the Day is: “HIV Test­ing for All; Get­ting to Zero”.

LT: How do you con­duct th­ese cam­paigns?

Sehlabaka-ramahlele: As the cam­paigns were launched of­fi­cially on 20 Novem­ber this year, our ap- peal to all the lead­ers, be it in gov­ern­ment, churches, area chiefs, work­places and oth­ers, is to show support for pro­cesses that en­sure peo­ple are tested and know their HIV sta­tus so that, if nec­es­sary, they re­ceive proper treat­ment on time.

On 1 De­cem­ber, there will be re­ports from all the 10 dis­tricts of the coun­try con­cern­ing the out­come of anti-hiv/aids cam­paigns.

Each of th­ese dis­tricts was given a tar­get re­gard­ing how many peo­ple should be tested, so they will be pre­sent­ing their re­ports show­ing how far they have gone in reach­ing the tar­get.

The com­mem­o­ra­tion of World Aids Day should not be re­garded as a brain­child of the Min­istry of Health; it is a na­tional is­sue, hence all sec­tors in so­ci­ety should be in­volved. We are invit­ing ev­ery Mosotho to be part of this.

LT: Why do you have to put so much ef­fort into en­cour­ag­ing peo­ple to test for HIV?

Sehlabaka-ramahlele: It is very im­por­tant for peo­ple to know their HIV sta­tus. Liv­ing with HIV and Aids does not mean the end of your life.

The gov­ern­ment has em­barked on a va­ri­ety of ef­forts to as­sist peo­ple liv­ing with HIV and Aids. It is only through know­ing your sta­tus that the gov­ern­ment can be able to as­sist you.

This is why, for the first time ever, we are go­ing to hon­our those peo­ple who showed the courage to say to the pub­lic they were liv­ing with HIV and Aids, giv­ing peo­ple hope that there is still life after in­fec­tion.

Peo­ple just need to take care of them­selves. The gov­ern­ment has en­sured that after know­ing that you are HIV pos­i­tive, there is im­me­di­ate treat­ment de­pend­ing on the sever­ity of your con­di­tion.

The gov­ern­ment went fur­ther, mov­ing from only pro­vid­ing for the treat­ment to pre­vent­ing in­fec­tion from an Hiv-pos­i­tive mother to her baby.

That has been a mile­stone achieve­ment as we suc­ceeded, in most cases, in en­sur­ing that the baby is not in­fected even dur­ing labour.

The min­istry fur­ther re­cently in­tro­duced the VMMC (Vol­un­tary Male Med­i­cal Cir­cum­ci­sion) cam­paign, also in a bid to re­duce chances of HIV in­fec­tion on males by 60 per­cent.

On 1 De­cem­ber, there will be re­ports from all the 10 dis­tricts of the coun­try con­cern­ing the out­come of anti-hiv/ Aids cam­paigns. Each of th­ese dis­tricts was given a tar­get re­gard­ing how many peo­ple should be tested, so they will be pre­sent­ing their re­ports show­ing how far they have gone in reach­ing the tar­get

LT: What are the other ac­tiv­i­ties sched­uled for World Aids Day com­mem­o­ra­tion?

Sehlabaka-ramahlele: Be­fore com­mem­o­ra­tion be­gins at 9 am, we will first lead a march start­ing at 7 am from Li­haseng to the church’s premises.

This will be to en­sure peo­ple liv­ing around that area feel that this oc­ca­sion be­longs to them.

Per­haps I should men­tion that from yes­ter­day (Mon­day this week), a team from the min­istry here was as­signed to go and start ed­u­cat­ing vil­lagers in Thaba-bo­siu about the im­por­tance of this event.

Again, this Fri­day, our other part­ner in the fight against HIV and Aids, PSI (Pop­u­la­tion Ser­vice In­ter­na­tional) Le­sotho, will host a gi­ant pup­pet-show which also pro- vides ed­u­ca­tion on HIV and Aids is­sues.

Other en­ter­tain­ment ac­tiv­i­ties, in­clud­ing mu­sic and po­etry, will be show­cased dur­ing the main event on Mon­day. Re­mem­ber there are tar­gets for each of the 10 dis­tricts.

We are try­ing to in­crease the num­ber of peo­ple test­ing for HIV. We have or­gan­ised that peo­ple should be tested ei­ther at health fa­cil­i­ties by way of PITC (Provider Ini­ti­ated Test­ing and Coun­sel­ing).

This is whereby the of­fi­cer at the fa­cil­ity will en­cour­age or rec­om­mend that any pa­tient com­ing for ser­vice at the cen­tre un­der­goes test­ing.

It is the op­po­site of in­stances where peo­ple vol­un­teer to test. We also visit com­mu­ni­ties and go doorto-door to en­cour­age peo­ple to test. We do not en­force it.

The re­ports from the dis­tricts are go­ing to be pre­sented at the com­mem­o­ra­tion.

LT: What are th­ese tar­gets?

Sehlabaka-ramahlele: The tar­gets dif­fer per dis­trict based on preva­lence. For in­stance, it is 2 610 for Butha-buthe, Berea 6 075, Leribe 7 020, Mafeteng 4 545, Maseru 11 295, Mo­hale’s Hoek 4 050, Mokhot­long 2 115, Qacha’s Nek 1 575 and Quthing 2 835.

We have many other part­ners, in­clud­ing UNAIDS, as­sist­ing us to meet th­ese tar­gets. We are ap­peal­ing to the com­mu­ni­ties to co­op­er­ate.

LT: How is Le­sotho cur­rently rated in terms of HIV preva­lence in the world?

Sehlabaka-ramahlele: At present, Le­sotho is rated sec­ond (at 23 per­cent HIV preva­lence) in the world after Swazi­land.

And the World UNAIDS 2014 re­port adds that in 2013 alone, there were 26 000 new HIV in­fec­tions.

Those are only new in­fec­tions recorded in 2013. At the mo­ment, the DHS (De­mo­graphic Health Survey) is still be­ing con­ducted and a com­pre­hen­sive re­port will be is­sued next year.

Based on the last DHS re­port is­sued in 2009, Le­sotho has a to­tal 281 000 peo­ple liv­ing with HIV and Aids. And re­mem­ber there are still a lot of Ba­sotho who do not know about their HIV and Aids sta­tus. They have not tested.

This is why now the UNAIDS says “we should close the gap.”

What they mean is that by 2020, at least 90 per­cent of Ba­sotho should have been tested and be­come aware of their HIV sta­tus.

It is use­less to keep say­ing we have such and such a num­ber of peo­ple liv­ing with HIV and Aids, yet we still have a lot of other Ba­sotho who do not know about their sta­tus, and who could still be liv­ing with the dis­ease.

This is why we have this PITC pro­gramme. As we speak, we have about 50 per­cent Ba­sotho who have tested and know their sta­tus. And the World UNAIDS re­port fur­ther shows that in 2013 only, we had 13 000 deaths re­lated to HIV and Aids.

This shows that even with the ef­forts we are try­ing to make, we still have to do more.

What we re­alise with th­ese big fig­ures is that Ba­sotho, even though they be­lieve they know much about HIV and Aids, still have a long way to go in terms chang­ing their be­hav­iour.

Ac­tu­ally, Ba­sotho still lack knowl­edge and re­main ig­no­rant even after so many years of be­ing pro­vided with in­for­ma­tion re­gard­ing the dis­ease.

LT: Are there any other fac­tors in­creas­ing the spread of HIV and Aids in Le­sotho?

Sehlabaka-ramahlele: What has also ac­cel­er­ated the spread of HIV and Aids in re­cent times is the fact that peo­ple liv­ing with the dis­ease are no longer eas­ily seen to be ill be­cause of the im­proved treat­ment they get.

It is no longer like in the old days when they would quickly de­velop symp­toms.

And also there is no longer that stigma at­tached to peo­ple with HIV and Aids.

And that also says peo­ple are no longer afraid of the dis­ease and are not chang­ing their be­hav­iour.

They en­gage in a lot in un­pro­tected sex. The 2009 DHS re­port showed that although Ba­sotho had some knowl­edge about the dis­ease, they were just not will­ing to im­ple­ment change in their lives be­cause of var­i­ous tra­di­tional prac­tices they are at­tached to.

We are more con­cerned about the youth. Re­search shows that the spread of the dis­ease among peo­ple be­tween the ages of 15 and 24 years is faster.

They do not want to test. They are dy­ing in large num­bers. They fall in love and have un­pro­tected sex with adults who are way older than them.

Older peo­ple, on the other hand, pre­fer th­ese young boys and girls and they call them ‘ Ben-10s.” It is also called in­ter­gen­er­a­tional sex.

And all th­ese ac­cel­er­ate the spread of HIV and Aids.

LT: Based on the re­ports you have just men­tioned, what do you think is go­ing to hap­pen next with Le­sotho in terms of HIV and Aids?

Sehlabaka-ramahlele: It is ob­vi­ous that next year’s DHS re­port will come with big num­bers of more in­fec­tions.

Le­sotho could soon be rated num­ber one in terms of HIV preva­lence. With the cur­rent rate of new in­fec­tions, we are def­i­nitely go­ing to over­take Swazi­land.

This says we still have a mam­moth task to do some­thing about this sit­u­a­tion.

You know the study fur­ther shows that each Mosotho adult only uses nine con­doms a month.

That shows that adults are not keen to use con­doms as the main pro­tec­tion against in­fec­tions.

LT: What could be done to change this mind­set?

Sehlabaka-ramahlele: The Global Aids Progress re­port has iden­ti­fied 12 groups of peo­ple with clear rea­sons why each group is left be­hind in the HIV and Aids ed­u­ca­tion, ac­cel­er­at­ing the spread.

Th­ese groups are peo­ple liv­ing with HIV, ado­les­cent girls and young women, pris­on­ers, mi­grants, peo­ple who in­ject them­selves with nar­cotic drugs, sex work­ers, gay men and other men who have sex with oth­ers, trans­gen­der women and men, chil­dren and preg­nant women liv­ing with HIV, dis­placed per­sons, peo­ple with dis­abil­i­ties and peo­ple aged 50 years and above.

What we should do is ap­ply rec­om­men­da­tions which also ap­pear in this re­port and close the gaps as this year’s theme for the World Aids Day com­mem­o­ra­tion stip­u­lates.

Dis­ease Con­trol Depart­ment Psy­chol­o­gist ’Moelo sehlabaka-ramahlele.

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