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TB/HIV Care Hero: Sibusiso Masoko

Sibusiso is a HIV/AIDS, TB and STI (HAST) Counsellor at Green Point Clinic in Cape Town. Recently her commitment to providing a service instead of judging her clients meant she was able to assist someone and prevent him from defaulting on his ARV treatment.

Her HAST Area Co-ordinator, Jessica Mvelase, relates the story:

“Sibusiso Masoko in Green Point CHC was able to assist a patient who was released from prison and had started ARV treatment there. When his ARVs were about to finish, the patient went from clinic to clinic begging to be accepted to continue his lifelong treatment. He was scared to attend a clinic in his own community as he had committed a crime there that landed him in prison and now was not accepted by community members and facilities where he went looking for help. He was refused when he told them that he had started his treatment in prison.

Sibusiso said that she left the patient’s criminal record for the law to deal with, and that she was there to provide a health service and not to judge.”

As the nurses could not provide the patient with his ARV medication that day, Sibusiso ensured that the nurses provided him with enough ARV pills to cover his requirements until he could come back to the facility to collect the rest of his medication.

Well done to Sibusiso for recognising that as health care workers our role is to provide health services in a nonjudgemental, friendly manner.

Doubling TB case-finding among inmates – the success of partnership in Pollsmoor

On the 30th March, TB/HIV Care and the Department of Correctional Services (DCS) held an event to highlight and share the successes achieved in the TB/HIV programme in Pollsmoor. The honourable Western Cape Minister of Health, Nomafrench Mbombo, participated in the event; helping to cut the ribbon on a brand new digital X-Ray machine which will assist in finding new cases of TB in prison

Other screening techniques, including the GeneXpert machine which was launched two years ago and can diagnose TB within two hours, have already borne fruit. TB case-finding in Pollsmoor doubled in one year; from 190 diagnosed in 2012 to 405 diagnosed in 2013.

Since then, 68 152 inmates have been screened for TB, 9922 have been tested with the GeneXpert tests and 701 started on TB treatment of whom 28 were started on multidrug resistant TB treatment. If one TB patient infects 20 others, then the rapid diagnosis and treatment of 701 cases of TB may have prevented 14 020 other TB infections in Pollsmoor.

This is of particular importance in the prison setting, where TB prevalence and the risk of transmission is high. Inmates are therefore one of the groups of people South Africa’s National Strategic Plan for HIV, STIs and TB 2012-2016 proposes targeting with interventions. Other groups include people whose immune system is compromised and people who live or work in areas where they are exposed to TB such as inmates and officials in correctional facilities, miners and those living within mining communities. The theme for World TB Day this year in South Africa is ‘Ending South Africa’s TB epidemic: accelerating our response in key populations’. The sub theme is “Find, treat and cure TB in hard-to-reach communities”.

The main aim of Monday’s event was to show how civil society can work in partnership with government to fight the spread of TB in correctional facilities. Through funding from the Global Fund to Fight AIDS, TB and Malaria (Global Fund), the Department of Correctional Services (DCS) and the Department of Health (DOH) in partnership with the National Health Laboratory Service (NHLS) and nongovernmental organisations such as TB/HIV Care Association (TB/HIV Care), Right to Care and the Aurum Institute have implemented a TB screening service in correctional facilities throughout the country.

TB/HIV Care is responsible for supporting 91 correctional facilities throughout the Western Cape, Eastern Cape and in two management areas of KwaZulu-Natal.

World AIDS Day: the numbers and the networks

Activists often say, “Every day is World AIDS Day for me.” This may be the case for TB/HIV Care too, but World AIDS Day does provide us with an opportunity to focus on and scale up HIV counselling and testing (HCT) service delivery. This year TB/HIV Care participated in 44 events (in both a hosting and supporting capacity) in the four provinces in which we operate (Western Cape, Eastern Cape, KwaZulu-­‐Natal and Northern Cape). At these events, 8 119 people accessed HIV/TB/sexually-­‐transmitted infections (STIs) behaviour change interventions, 4217 were provided with HIV counselling and testing (HCT) (44 of whom tested positive for HIV), and 4196 with TB screening1. Over 69 065 condoms were distributed.

Partnerships
TB/HIV Care has always worked in partnership with other organisations and structures of government. World AIDS Day this year was no exception and saw the organisation develop and foster new relationships with municipalities, city officials and organisations. The Health Festival in Samora Machel, Cape Town saw a total of13 other organisations support TB/HIV Care in providing a holistic wellness experience for the community – enabling access to vital health services, and health and social information. Organisations present included Childline/Lifeline, The Heart and Stroke Foundation, Rape Crisis, Treatment Action Campaign, Sonke Gender Justice, SAHEP, Mosaic, The Parent Centre as well as both the Weltevreden Valley and Inzame –Zabantu clinics. The Department of Social Development and Department of Sport and Recreation also provided services. On top of this, various relationships were built with corporations through donations, including Capitec, Illovo, Parmalat, Conde Nast, Golden Harvest, and Aquelle. This allowed us to pack 1000 ‘goodie bags’ for attendees. The trend in relationship building extended to other parts of Cape Town, in the form of the Grassroots soccer tournament TB/HIV Care supported on the same weekend. TB/HIV Care has been working with Grassroots for two years, a fruitful relationship which has yielded media exposure for TB/HIV Care. Activity in Mthatha included the Mthatha team working with municipalities in various areas to provide HCT services, and with the Department of Social Development, SAPS and Home Affairs for one particular event. Pietermaritzburg partnered with with I Teach, Community Media Trust, municipalities, CCG, Department of Health and USAID. TB/HIV Care participated in the Nelson Mandela Bay district World AIDS Day in Port Elizabeth, along with the District AIDS Council, the District Department of Health, Khahlamba Project, SASSA, the Department of Social Development, the Department of Public works, and the Department of Home Affairs.

Zero Stigma and Zero Discrimination
The national theme for this year’s World AIDS Day was ‘zero stigma, zero discrimination.’ Work on stigma and discrimination is evident in much of our work. TB/HIV Care’s key populations programme deals directly with parts of the population who are most often discriminated against. Nine of this year’s World AIDS Day event were focused on key populations (inmates, sex workers and people who inject drugs (PWID)). Events in Cacadu and St Albans correctional facilities explicitly focused on zero stigma and zero discrimination. The Eastern Cape World AIDS day event in East London was supported by key populations staff, wearing t-­‐shirts with the slogan “You can’t change an HIV status but you can change your attitude.” Both Durban and Pietermaritzburg offices held events commemorating World AIDS Day for sex workers and PWID.

Youth
Girls aged 15-­‐24 are one of the groups at highest risk of HIV infection. As such youth is one of our programme focuses. Many of our World AIDS Day events targeted the 15 – 24 age bracket and youth in general. The event in Malmesbury combined MMC and HCT, focusing on youth. 14 MMCs were done at the event. At the Grassroots event, out of the total 172 that tested, 81 were in the 14 – 25 group, 64 of these female. This focus on youth is set to continue due to the partnership TB/HIV Care teams have with Grassroots Soccer. The Health Festival in Samora Machel had a large youth contingent attending. Entertainment was provided by Come and Play (Department of Sport and Recreation), LoveLife, Future Champs (boxing demonstrations), and DJs. Events at the Appelsbosch Hall in Pietermaritzburg included donations of clothes to orphans and vulnerable children and attendance was high from primary and high school learners who performed songs and poetry. In Pietermaritzburg, 1 225 people aged 15-­‐24 accessed TB/STI/HIV behaviour change interventions and 125 of this group accessed HCT.