Resspeace Mgawe talks about his work as a counsellor with AMREF's HIV/AIDS project in Tanzania and how mobile voluntary counselling and testing is making a difference.
My name is Resspeace Mgawe and I am the senior counsellor for AMREF’s HIV/AIDS project in Magu district, north-west Tanzania. Local people call the project ‘Angaza’ - Swahili for ‘bringing light to dark places’. We were given this name because we provide mobile voluntary counselling and testing (VCT) for HIV/AIDS.
We move from place to place pitching our tents in the village centres, making sure we reach the most remote areas and that people notice us. It is all part of the battle to stop people feeling ashamed about having HIV and to help them to understand the importance of being tested.
Each mobile unit is made up of five khaki-coloured tents, with a piece of tarpaulin spread between them to give shade to the waiting patients. The service is available to anyone in the village or surrounding area who has chosen to find out their HIV status.
We counsel 750 people each month. In the 26 months we have been working, we have tested almost 20,000 people. The average HIV infection rate in Magu is approximately 15% of those we test, so every day we have to tell four or five people that they have HIV. It is hard work.
The service operates in three phases. First, the person is assessed for the risk of having contracted HIV. We ask them questions about their number of sexual partners, whether they used protection and how well they know their partners’ sexual behaviour. This opens the patients’ eyes to what results might come.
At this stage, we also educate people about HIV/AIDS and how it is transmitted because, in Africa, there are many misconceptions about how people get the disease. A few weeks ago, I counselled a young man named Michael who wanted to know his status. He believed that HIV was a punishment from God for being evil.
After the initial counselling, a nurse takes a blood sample from each individual and the test is performed in the laboratory tent. The new ‘rapid’ HIV tests supplied by AMREF give a definitive, reliable answer in under fifteen minutes.
Finally, when the test result is ready, the patient goes to another counselling tent and their HIV status is disclosed to them. If their test is negative, the counselling focuses on avoiding infection. If it is positive, we try to help them come to terms with having the virus. We tell them about anti-retroviral medication (ARVs), the dangers of infecting other people and family planning issues.
Telling young people that they are HIV positive is most difficult because they have ambitions and dreams. When I tell them there is no cure, their dreams are broken. Many people cry with regret when they find that they are HIV positive but it is better to know.
Nowadays, ARVs can keep people with HIV alive for many years and are provided free by the Tanzanian government. This has brought about a real change in attitudes towards getting an HIV test. Before ARVs were available, a positive result was bad news. While this is still true, there is now hope. AMREF helps people to know, and knowing means that people can now prolong their life with this medication.
Click here to read more about the Angaza project.