adminCatherine Murombedzi HIV
IT can be difficult to explain to a young child why they have to take medication for the rest of their lives.
If a child is diabetic the parent or guardian explains why the child needs to control the sugar levels and the need to take medication always. Usually with the help of a health personnel or a doctor a parent can explain and have a child understand the need for daily medication.
The problem comes when one has to tell an HIV positive child that s/he has to take medication daily. It is easier to tell a child to take medication everyday when ill but the child will ask why should s/he continue to take tablets when they are feeling well.
I find that a child’s age plays a part because at times telling an eight-year-old why the take ARVs is rather difficult but necessary. It is easier to tell a child in teens as they have read and have been taught about the HIV virus. I feel it is better to explain first before the child finds out on its own as that would build anger and resentment. Children who have found out on their own feel betrayed.
Our sister paper, The Herald last year carried a very sad story of a Beitbridge 12-year-old boy who died in a mishap due to a misunderstanding concerning ARVs. The boy who was an orphan lived with his 26-year-old brother since the death of their parents. The 26-year-old brother being the guardian was concerned that his sibling who was born Code 1 (HIV+) take his medication as prescribed by the doctors but the young boy did not understand why he had to take tablets every day.
I can imagine the day to day living of an unemployed 26-year-old relying on subsistent farming having to look after his minor brother an uphill task.
The 12-year-old is said to have refused on many instances to take his medication. I can imagine the minor asking why he has to take the tablets when the brother was not. The minor could have even argued that why would he continue taking medication when he was not ill.
He could have started medication at a time he was ill and then there could have been no challenges because the minor understood that he had to get well. Now that he was feeling well why did he have to continue taking the medicine when he was not ill at all. That could have been difficult for the elder brother to explain.
Children under 16 are commenced on ART with the consent of a parent or guardian. In the above case the 26-year-old is the one that consented to his sibling being put on the life saving medication.
Anti-retroviral drugs do not cure one of the HIV virus. ARVs help to restore the destroyed immunity hence they have to be taken for life. The purpose of ARVs is that they suppress the viral load thereby restoring one to health. A weakened immune system is a host to many infectious diseases like tuberculosis, pneumonia, skin disorders, meningitis and mouth thrash. A person on ARVs can therefore fall ill like their HIV negative counter-part and when this happens they have to be treated for that particular ailment but bearing in mind that they also take ART. It is always important for an ART client to notify medical personnel that they are on ART when they fall ill and have other drugs prescribed.
In the scenario of the Beitbridge minor as stated by the brother that he flatly refused to take his medication, the two ought to have gone back to the clinic for further counselling.
The 12-year-old refused to take his ARVs and the elder brother got a switch and raced after him as he tried to force the minor to take his ARVs. The minor fell down and hit his head on a stone. He was rushed to hospital where was pronounced dead on arrival.
Sad indeed, the elder brother loved his sibling and was just trying to see that he lives long. He was arrested and would soon appear in court facing murder charges.
I know of a 15-year-old girl who was born HIV positive, the guardian brought her to my house because she kept asking him why God made her HIV positive when the other siblings were not. So starting children on ART can be a nightmare because they see injustice applied on them and ask why them.
The child warmed up after I told her that I take medication just like her. She remarked that I was healthy and I told her that she too could be even better than me and can achieve whatever she wants if she accepts her condition and moves on. By the end of day when she was picked up, the uncle found a changed happy teen and today she is doing well at school. She has kept in touch through the phone and now appears happy.
In such circumstances where a minors ask why is it only them and not the rest of their classmates, counselling at the clinic alone may not be enough. They need to meet peers who they can identify with hence the importance of support groups. Support groups in communities are mainly made up of old people who are parents but in these groups they have seen the need to have children’s needs met.
In Mufakose there is a support group of children that meets on Saturdays. It was the brain child of Mr January and fellow support group members that they set-up a support group for children.
In this group children affected and infected meet, talk of their challenges and hear how other children who had met similar obstacles overcame them. There is a counsellor, and Mr January usually attends the sessions during the last 15 minutes.
“The children have to meet on their own as this helps them in opening up, so there are times they need the space to themselves with no adults around hence the Saturday sessions at the council hall help them just achieve that. An adult, usually someone living positively then joins them in the dying minutes of their session to see if there are any issues that need parental guidance, but usually I have found out that they have been finding their own feet which is commendable,” said Mr January.
In a base line survey taken in 2010 by Rozaria Memorial Trust in ten districts of Murehwa they found out that children on ART did not understand why they had to take medication. The adults in the care of these children too did not fully grasp the importance of taking ARVs as prescribed. The answers ranged from ‘I do not know’ ‘I just have to take the tablets’ which revealed the glaring gap in information.
The founder of Rozaria Memorial Trust, Nyaradzayi Gumbonzvanda, said she saw the need and requirements of children that were not met and hence founding the organisation in memory of her mother the late mbuya Rozaria Marumisa Dhizha (1923-2006).
“As an organisation we specifically cater for children in Murehwa and work from schools on ART literacy. We plan to cover more schools in Murehwa as the need still exists so funding permitting we will roll out to more schools,” said Gumbonzvanda.
AFRICAID Zvandiri + an organisation that caters for children born HIV positive also has gone national. The organisation has peers and these children have weathered the storm as they have accepted their HIV status. It is therefore easy for a child to be told be a child their age and listen to why they have to take medication. As children speaking on the same page peer educators from the organisation speak in schools and communities empowering positive living.
If a parent or guardian finds it difficult to talk to minors introduce them to peer educators in support groups or organisations dealing specifically with children. One can ask at their local clinics where these groups are found.
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