Involving PLHIV in service delivery

As I take photographs during a clinic day in TASO Tororo, a lady's voice behind me laughingly says, 

"That was not a very good one. They are all looking at you instead of paying attention to the health talk facilitator"

It turns out that the voice belongs to Judith Apai, a Community ART Support Agent (CASA) at one of the TASO Tororo Community Drug Distribution Points (CDDP). She has come to the Center for cervical cancer screening but she also has pain down her right side. She tells me about how women her age (she is 52 years old) and older feel that they should not go for cervical cancer screening because they are not sexually active. Yet Judith knows that the health workers told them that the HPV virus can remain alive in the cervix for a while before the cancer manifests. So she feels that after some years, she should come back for another check up and so should others. 

After telling me why she has come to the Center, she then tells me about her life. Judith lost her husband in 1999. She was bedridden and yet at the same time she was expecting. She thought that the stress of expecting plus loosing her husband had affected her because she lost a lot of weight and she had a rash in addition to having no appetite. When her baby was born, he too got a rash. One of her sisters who had gone to see the baby, suggested that both Judith and her baby go for an HIV test. Judith's results were positive and so she tried to sneak into TASO while covering herself so that she could not be identified. 

With counseling and continuous treatment, the rash got cured and Judith became more confident. She was now able to walk into TASO without hiding. Luckily, her son was HIV negative (this was even before the PMTCT programme was rolled out in TASO Tororo). 

Today, Judith is a CASA in TASO Tororo at a CDDP with 75 clients under her care. She also carries out continuous client education in her community. When I told her that some clients in TASO Tororo are reported to have their CD4 count go down, she was ready to find out more about the causes and to encourage them to ensure that they take good care of themselves. 

Judith says she is so much happier now that she is open about her sero status and is able to help other people in the community regardless of their HIV status.

Thanks to Judith for sharing her story and for the work she does in the community.