Zimbabwe

Insights: Home visits

Visiting patients with our social worker

Some of our patients live in the most difficult of circumstances, making it scarcely possible for them to keep strictly to their HIV treatment. Our social worker Melania Mugamu visits them in their homes to find out how we can support them better. Having her own HIV/Aids story to tell also helps.

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1/6: Newlands Clinic social worker Melania Mugamu regularly makes home visits to see patients who need particular support. Here she is calling in on two HIV-positive orphans (on the left and in the middle), who are living with their elderly grandparents.

2/6: When making visits, Melania Mugamu also has to address very private issues such as poverty, abuse and violence. She finds the strength for this difficult job in her own story: Melania herself is HIV positive and lost her husband to Aids.

3/6: Here one of Newlands Clinic’s patients is receiving a new wheelchair, without which he would be unable to make his way to the clinic to continue with his HIV treatment.

4/6: Here our social worker is visiting Memory, a 15-year-old girl who lives with her great-aunt having lost her parents. Integration in the family is very important particularly in the care of young people.

5/6: Our patient Christine faces a struggle as a single mother of four children. Depending on what Melania finds when she visits patients at home, she can apply for them to receive nutritional support, for example, or to have them enrolled in group therapy.

6/6: Back in her office, Melania Mugamu enters all the new information in the clinic software. The clinic’s pyschosocial and medical teams work together closely to improve the situation of our patients.
(Photos: Patrick Rohr)

Catching Melania Mugamu in her small office at Newlands Clinic is no easy task. Aged in her early sixties, and always ready with a warm, welcoming smile, she spends most of her time on the go. In her job as social worker, she runs group therapy sessions for patients at risk of treatment failure, counsels people currently in a particularly difficult situation, and makes home visits to patients who need special support.

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An understanding ear for patients’ troubles

Melania drives around the poor districts of Harare, visiting children who have lost their parents to Aids and live with their elderly grandparents, as well as young mothers scarcely able to provide for their babies and young people who see no prospects for the future. The primary objective of such home visits is to prevent people from breaking off treatment. “Sometimes it turns out that the reason for appointments being missed is the long journey to the clinic. In other cases, the patient’s psychological condition is so bad that they can barely motivate themselves to continue the treatment,” she says. Melania often also has to address very private issues such as poverty, abuse and violence. She makes no secret of the fact that she can have great difficulty with certain situations – for example when a small orphaned girl is passed from one relative to the next and therefore has to stop treatment at Newlands Clinic.

HIV positive herself

In tackling her difficult job, Melania can call on her own story for support and motivation: she herself is HIV positive and lost her husband to Aids in 2000. Back then there were no drugs to treat the virus in Zimbabwe. She was more fortunate, however, and although gravely ill she was able to start treatment three years later. “I had already begun to prepare myself for death,” she says. But just a few weeks into the therapy she already felt much better, and half a year later was well enough to take part in her daughter’s wedding.

Breaking the dangerous silence

Having been given the gift of a second life, she wants to use it to bring hope to people with HIV, and to fight against stigmatisation. “I’m fortunate in being able to break the dangerous silence about HIV as part of my work,” she says. It is a long battle, one that she fights together with the team at Newlands Clinic, but Melania does not doubt for a single second that it is worthwhile. And the greatest reward she can receive for her work is when a young patient starts to take their life back into their own hands, or when a child is strong enough to go back to school.

Insights: Maize farmer Augustine

Back to life

The HIV/Aids epidemic has taken a heavy toll on Augustine’s family, but with the help of Newlands Clinic they should be able to get back on their feet again soon.

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1/7: Maize farmer Augustine lost his first wife to Aids. He, his daughter Gracious and his son Talent are all HIV positive and receiving treatment at Newlands Clinic.

2/7: Augustine provides for his patchwork family. From left to right: Augustine, his second wife Constance, his daughters Gracious and Theresa from his first marriage, his young son Trevor, Constance’s daughter Beyoncé and Augustine’s son Talent.

3/7: To feed his family, Augustine grows maize, sweet potatoes and beans. Using the knowledge he learned at the maize farming project run by Newlands Clinic, he sows the seeds far enough apart to make sure the plants grow properly. His first grandchild watches on.

4/7: A severe drought caused problems for many of Newlands Clinic’s patients in 2016. The water level at the well Augustine uses to water his plants is also very low.

5/7: Augustine’s second wife Constance is HIV negative. The couple received comprehensive information at the clinic on how HIV is transmitted. If the virus is successfully suppressed by medication, infection can be virtually ruled out.

6/7: While Augustine’s son from his first marriage Talent (pictured here on the left) was infected with HIV at birth, his young son Trevor from his second marriage was born healthy. His first grandchild also came into the world HIV negative thanks to the treatment.

7/7: The family returns from their small fruit garden where they grow avocados, guavas and peaches. They are on the right track for a future free from HIV.
Photos: Patrick Rohr

Fields as far as the eye can see, the silence broken only by the occasional bark of a dog: in Chishawasha, a settlement near Harare, you could be forgiven for thinking you were in the middle of the countryside. This is where Augustine lives with his patchwork family. HIV has turned their lives upside down: Augustine’s first wife died of Aids, and he and two of their children are HIV positive and are receiving treatment at Newlands Clinic.

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Providing for the family with maize farming

Augustine has now re-married and has a son. To feed his extended family, he grows maize, sweet potatoes and beans, but the harvest is often not enough – because it either rains much too much or hardly at all. To help address this, Newlands Clinic is running a maize farming project that provides support to 150 patients who own some land. Here Augustine has learned how to make compost, how to prepare the soil properly, and how to make sure the seeds are spread far enough apart when sowing. The first crop was only modest because of the drought, but the efficient farming technique seems to be paying off, and he should soon be able to provide for his wife and children.

The goal: an HIV-free generation

Things finally seem to be taking a turn for the better for Augustine and his family. His son Trevor is healthy, and his daughter Gracious also gave birth to an HIV negative boy thanks to the treatment. And this first grandchild will also benefit from Newlands Clinic’s support: Gracious is attending a self-help group for young mothers, where she is learning how to take better care of her son. Augustine’s family is on the right path to an HIV-free future.

Insights: Magret und Rosaline

Fashioning a better future 

There was a time when Magret and Rosaline had nothing to do. Then they were able to set up a small company thanks to the vocational skills training programme for young people run by Newlands Clinic. «Unlimited Fashions» makes home textiles – and has opened up a whole new range of prospects for the young women.

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1/5: Magret (on the left) and Rosaline took part in the vocational skills training programme, and set up their own company together with a young man.

2/5: They cannot afford to pay rent, so their company is based for the time being in Magret's grandmother's living room.

3/5: The sewing machine was provided to the young patients as basic equipment. Their only problem is the frequent power cuts, but this should soon be solved with a solar panel.

4/5: "Unlimited Fashions" sells bedding, cushion covers and home textiles at local markets and to order.

5/5: Magret (on the left with her small daughter) and Rosaline (on the right) receive regular visits from their mentor, Tonderai, who supports them in dealing with problems.
(Photos: Patrick Rohr)

Magret and Rosaline meet us in Mbare, a high-density suburb of Harare. They want to show us their company "Unlimited Fashions", which they set up with a young man, Enoch. All three are patients at Newlands Clinic, but there is nothing apparent to suggest that they are HIV-positive and require life-long treatment.

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Magret, Rosaline and Enoch attended the vocational skills training programme aimed at helping young patients to support themselves. This is desperately needed because young people with HIV not only suffer from stigmatisation, they also have scarcely any career prospects given the dreadful state of the economy. «We just used to sit around all day,» says Magret. Many become depressed because of the difficult situation; young women often marry young and have children, even though they are unable to look after them.

The dream of running a shop

Both Magret and Rosaline already have a child, but they are fortunate in having a support network around them – and with Unlimited Fashions they now also have a small source of income. Competition is tough, but with the help of their mentor they are sticking at it. In the living room, cushion covers and bedding lie ready to be sold at the local market. Enoch is out buying material, Magret busy at the sewing machine, and Rosaline is getting the fabric ready. Their small children sleep in the next room.

«We would like to open a shop,» the young women tell us. There may be a lot of work still ahead, but they are clearly making the most of the opportunity that has presented itself.