With U.S. government support, Development Aid from People to People (DAPP) is saving lives in Namibia by testing, counseling and caring for people living with HIV/AIDS. DAPP provides vital health services in five of the most affected regions of Namibia with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC). DAPP works in close collaboration with the Ministry of Health and Social Services in serving rural communities.
Maria Makuni Mandondo, DAPP Total Epidemic Control (TCE) Field Officer, lives and works in Musese, a village about 85 km west of Rundu, Kavango West Region. The Kavango Region is one of the regions most affected by HIV in Namibia; with an HIV prevalence rate of 24.5% amongst HIV pregnant women in in Rundu. Maria works daily within her communities, making a difference in the lives of those around her by offering HIV counselling and testing, providing referral services between the community and health facilities, and promoting voluntary medical male circumcision to protect against HIV, and services to prevent mother-to-child transmission of HIV, and to promote adherence to HIV treatment medications.
Maria hosts a weekly HIV/AIDS youth group at a local school where she is able to directly engage with youth, the future generation of her village. She meets with in-school and out-of-school youth and discusses difficult subjects such as condom use, safe sex, gender-based violence, teen pregnancy and poverty alleviation. The Life Skills teacher, Vilho Shikukumwa, at Olavi Combined School explains, “Because Maria is young and friendly, the students are more likely to be open with her and talk about these difficult issues. The students prefer to talk to Maria, whom they see as their peer, over a teacher.”
Maria travels weekly on a “mokoro”, a wooden canoe, across a runway of the Okavango River to work with a community support group of people living with HIV/AIDS and vulnerable children affected by AIDS. This group, of more than 28 people, works in a garden on the lush river’s edge and grows nutritious foods that are vital for the health of those taking anti-retroviral medication. The group sows tomatoes, cabbage, carrots, onions and mutete (type of dried spinach), which are shared among support group members. This food keeps the group healthy and gives them strength to live normal lives, despite their HIV status. Maria meets with the group weekly, making sure that they take their medication regularly, that they eat well, and that they do not compromise their treatment by drinking alcohol.
As a trained DAPP TCE Field Officer, Maria has the necessary skills and expertise to work in her community supporting those who require her services. She is confident to address the challenges of working in her community on HIV/AIDS issues including HIV testing and counselling, a flagship DAPP program. These trainings are financially supported by the United States government through the PEPFAR program and are organized regionally by DAPP.
The DAPP TCEs are recognizable in their red shirts and have become popular and well-respected in rural communities where it is difficult for residents to travel to clinics, sometimes more than 50 kilometers away. It has become Maria’s daily activity to go door-to-door to provide HIV testing, counseling, referral services, and follow up support.
When conducting couples HIV testing and counselling during home visits, Maria focuses on providing clear information to couples to prepare them for the test results. HIV results could be negative, positive or discordant. She discusses the meaning of the results, the importance of couples supporting each other and the importance of prevention, treatment and care depending on the outcome of the test results.
The special aspect of the DAPP program is that people like Maria are able to provide individualized follow-up care and support in the homes of people who are less likely to seek care or get tested at a public health facility which might be several kilometers away.
Maria stays in regular communication with HIV positive men, women and children in her community and encourages them to adhere to their HIV treatment regimes. She also counsels those people who are HIV negative about ways to protect themselves from becoming infected with HIV. Maria explains that she will continue to provide assistance to pregnant women to ensure that babies in her community are born HIV-free.
Home-based HIV testing with DAPP field officers is a unique service, one that values privacy, confidentiality, easy access, quality testing, and face-to-face life-saving conversations. Maria is working around the clock to save lives in her community and her efforts are contributing to an AIDS-Free generation in Namibia.