"Knowing your status is the first step to planning your future"

By Janie Telling Some statistics report that around 70% of HIV positive people live in sub-Saharan Africa. This shocking statistic is echoed in Malawi - UNAIDS and UNICEF report that one in seven people between the ages of 15 and 49 are HIV positive. The SOS Medical Centre in Lilongwe is providing services to assist the local community in the face of such worrying evidence on the prevalence of HIV/AIDS infection and the opportunistic infections that arise from a lowered immune system. The four care counsellors from the left, Foster, Jean, Charity and Mildred - Photo: J. Telling Services available Direct HIV/AIDS related services offered at the medical centre include counselling, free testing and information provision about subjects related to HIV/AIDS. Medical care for secondary infections is also available through the existing clinic facilities. Counselling is important At the SOS Medical Centre, HIV/AIDS counselling takes place in a private location. All four of the "care counsellors" who conduct counselling at the medical centre are fully trained. Their course lasts for six weeks and comprises both practical and theoretical aspects of counselling. The clients are welcomed to make sure that they feel free to participate in the session. The session starts off with a question to the client as to why they have come for counselling. This helps the counsellor to know how to start to counsel the client. The emphasis is on allowing the client to talk rather than the counsellor. There is no lecturing of the client. The counsellor enquires about the client's knowledge of HIV and will then give information if required. All of the clients concerns will be addressed during the ongoing sessions. The main issues that people bring up during counselling are their worries about their partner's behaviour and sometimes, the partner's denial of a positive HIV status. Also, clients want information about their illnesses and how they affect them. Some want to know their HIV status so that they can prepare for their future. They want to be able to make decisions about marriage, having children and continuing relationships. Enock, a lab technician uses an HIV quick test to ascertain a persons HIV status - Photo: J. Telling Free testing Kathy Bowler, the project director for the medical centre, explains the procedure that clients are guided along: "The counselling and the testing is done free of charge. Some clients come to the clinic just to have access to the counselling and testing. For these clients there is no charge. Others are referred for pre test counselling by the clinicians at the SOS Medical Centre. These patients will pay a fee for the medical consultation and treatment but will not pay for the counselling or the testing. The testing is done on a voluntary basis. If a consultant sends a client for pre-test counselling the first step is to explain about the testing process and to ask the client whether they wish to have the testing done. Any questions the client has will be answered. However if they choose not to be tested there is no pressure to change their mind. We do however give them a brochure about why testing is a good idea. They can read that brochure at their leisure and if they change their mind they will be welcome to come back for testing. The test which we use is a rapid test which takes about 15 minutes to do." Since the Medical Centre was able to offer free testing, in July, 34 clients have undergone pre-test counselling and of those. 20 clients have actually been tested. Treatment for secondary infections The existing clinic facilities continue to be used by many from the local community. Some of the clients attending will be suffering from secondary infections due to their lowered resistance to illness because of the HIV virus. Often this means that they will need to see a doctor more frequently than a person who is HIV negative. The lower cost of a visit to the SOS Medical Centre than the private or government clinics enables those who are HIV positive to seek medical treatment when otherwise they would not be able to afford to. *** Janie Telling is SOS Children's Villages co-worker in southern Africa.