Thursday, August 5, 2010

Home based care and HIV


On Tuesday we met with the Flying Mission (FM) team to find out more about their outreach work in Botswana, as well as ways that we can become involved in their projects here. FM is committed to preventing the spread of HIV/AIDS by training local grassroots organizations to be effective and partnering with caregivers to provide home-based care (HBC). FM was founded to provide medical transport services and reach communities that are difficult to access via roads, but has since expanded its work to encompass care for orphans and vulnerable children, homebound individuals, and HIV outreach education. In order to help support their non-profit work and show their commitment to sustainability, FM also has a for-profit wing that uses their planes for private safaris and excursions.

Relationship-building is extremely important in Botswana, and as such, FM has spent much time and effort to cultivate their relationships with the community. Before meeting with villagers or doing any health assessments in the surrounding areas, it is expected that visitors meet with the village chief at the kgotla. Traditionally, the kgotla is the focal point of the village and a place where the chief (or kgosi) and villagers meet to discuss important issues. Today it remains an important place for visitors to pay their respects to the chief and receive his endorsement to be in the village. FM has established relationships with the villages in which they provide HBC, which will enable us to meet key leaders and bridge the cultural divide. We will be able to learn from their health care workers about providing medications and education in a rural area.

FM’s HBC program hires and trains volunteers to be caregivers in the communities. These caregivers visit client’s homes as frequently as they can, depending on the need of the residents. In some communities, the caregivers also help create home gardens to increase the residents’ access to fresh produce. Due to the nursing shortage in Botswana, the caregivers are the main providers of HBC.

Home care and feeding programs are vital in Botswana due to the country’s high HIV/AIDS prevalence. There is some controversy over the correct HIV prevalence rate in Botswana: UNICEF cites the HIV rate at 23.9% for 15-49 year olds (2007), WHO cited the HIV 35.5-39.1% (2003), and Botswana’s own data shows that the rate is 17.1% (2003). Despite the discrepancy between data sources, the impact of HIV without doubt reverberates throughout the community. During our meetings with FM and others we learned about the attitudes and behaviors surrounding the epidemic. A conversation with Dr. Sheila Shaibu from the University of Botswana leads us to believe that one reason for the discrepancy regarding prevalence is lack of testing and knowledge of one’s own HIV status due to stigma and fear. Botswana has tried to combat this by holding annual Mr. and Miss Stigma pageants and anecdotally it seems that younger generations have better understanding of the risks associated with unsafe sexual practices.

As we begin our journey into the community we have much to learn, and we are very grateful to FM for helping us to start the work!


Posted by Danielle Altares, Trudy Kao, & Erin Schelar

3 comments:

  1. Seniors having an infectious disease are not advised to enter into adult day care centers.

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  2. Quality medical care should be available to everyone from birth to hospice services. We should all do our part to achieve this goal.

    ReplyDelete
  3. I totally agree with Shantel with this issue. They should be a separate healthcare centers for seniors who has an infectious disease instead of mixing them to seniors who are healthy. If they will not do this they will cause health problems and adult day care centers will look like a hospital keeping sick seniors around.

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    ReplyDelete