MOHALE’S HOEK — HIV-positive Basotho living in Qhalasi constituency in Mohale’s Hoek are enjoying the benefits of subscribing to Community ART Groups (CAGs) as a way of combating the challenges related to replenishing their medication.
Mohale’s Hoek is Lesotho’s leading district on HIV-prevalence at 29.3-percent as noted by the Lesotho Population-Based HIV Impact Assessment (LePHIA) report of 2017.
CAGs are HIV-positive residents on antiretroviral drugs (ARVs) who live in the same community and take turns to collect their ARVs at the health-centre and then distribute the medication among fellow group members.
These groups are better known in Qhalasi as Nkukele (loosely translating to carry on my behalf).
Thabang Chobokoane from Majapereng village in Qhalasi, told the MNN Centre for Investigative Journalism his group originally comprised of five members but two of them had since passed on from incidents unrelated to HIV.
Chobokoane says they help each other collect their ARVs from Liphiring Health Centre. “We rotate on a monthly basis. It means if it’s my turn to collect the medication, I carry along other members’ health booklets to get their medication as well as they will all be having one refill date.”
He, however, said it still remained the responsibility of each group member to visit the health-centre for their CD4 count tests and other health issues.
“Nonetheless, we no longer visit the health-centre frequently as we would do while collecting our medication individually,” Chobokoane assured the Centre.
Chobokoane tested HIV-positive in 2009 and has since been on ARVs together with his wife, who started taking treatment two years later.
He said before the Nkukele programme was introduced at Liphiring Health Centre in 2015, the couple would miss duties and other important family matters to go and pick-up their refills.
Ten years down the line, Chobokoane and his wife still lead healthy lives and adhere to treatment.
On the other hand, Nekewe Ndabeni from Ha Keke village in the same Qhalasi constituency, collects her medication individually. Ndabeni has to travel around 10 kilometres to Liphiring every month to collect the medicine.
Although she enjoyed being a member of Nkukele, Ndabeni said she quit the group in 2017 as she left to work in Cape Town, South Africa. She had been part of the group for the whole of 2016.
“While I was still in Cape Town, my daughter would go to the health-centre with my booklet to get my refill and medication would be given to people going to neighbouring places in South Africa. I never defaulted,” she stressed.
Back home now, Ndabeni remains healthy but has not re-joined Nkukele. She said although the programme remained a good initiative, the main hurdle was securing taxi-fare for members who were supposed to go to Liphiring for the medication.
“Liphiring is far and we are forced to raise funds for transport. Every member was supposed to contribute M5 every month as a fundraising strategy for a member who would be collecting the monthly medication,” she said.
“The problem arose when a member could not afford this amount. Others would not be happy to collect that particular member’s medication as they would not have contributed to the taxi-fare.”
Ndabeni started taking ARVs in October 2014.
“I was not sick but I was losing weight in an abnormal manner. Upon consulting a doctor, it was diagnosed that my CD4 count was very low and I was very adamant to start treatment because I was aware that neighbours on ARVs were very healthy.”
Apart from collecting ARVs, the Lesotho Network of AIDs Services Organizations focal person in Mohale’s Hoek district, Mangope Mangope, said Nkukele members also manage their own health and share experiences about living positively with HIV.
He also said Liphiring Health Centre had set-up a protection committee comprising villagers on lifetime treatment, including those who are HIV-positive.
“The committee’s duties include monitoring CAGs, providing counselling to CAG members, dealing with cases of abuse and removing stigma between partners of different HIV status to battle default cases,” he said.
“That said, even those who default are easily identifiable and traceable from CAGs.”
Mangope further said when CAG members get employment out of their current communities, they simply get their medication from alternative health-centres near their new workplaces. “CAGs are first to know of such and working together with the patient, they approach the former centre to get a transfer letter,” he said.
“This is important especially when it is done early so that the migrating patient’s specific medication can be ordered and made part of that particular centre’s monthly list.”
According to Mangope, the committee does its work by visiting CAGs in their villages from time to time.