TB/HIV Care Hero: Nontobeko Makhosonke – the strength to refuse

Nontobeko Makhosonke works at a new facility that was opened in 2014. Because a lot of staff are new, the HAST Counsellors in the facility have found that they receive many different orders from many different directions which can be challenging. Nontobeko’s line manager, Jessica Mvelase, commends her for having the strength to politely refuse an order Nontobeko felt was not in the best interests of her client.

Nontobeko tested a client whose rapid test came back positive. The normal protocol is for a confirmatory test to be performed, but none were available at the facility. Blood was drawn for ELISA testing to check the result, but when the client returned to receive the results only the CD4 count was available. The ELISA result had gone astray.

A doctor ordered Nontobeko to perform the first ARV counselling session for the client. Since the client’s HIV status had not been confirmed, Nontobeko refused, stating she needed to have the client’s status confirmed. This was brave, but according to protocol. If the client was in fact HIV negative and during the counselling Nontobeko had incorrectly informed them that they were positive, it could have had severe consequences for the client’s life.

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