An HIV patient is being assisted by a care-giver at a clinic in Morogoro, Tanzania - a town with some 206,000 residents, and the capital of the like-named region. She is being taught how to cope better with her chronic illness, something she is still learning about every day. The care-giver helps explain the condition to the patient’s parents, advises that her partner get tested, and works with her to set up an anti-retroviral therapy regimen to which she can stick. He relieves some of the stigma, and helps put her mind at ease during this troubling time in her life. He knows all too well how she feels. After all, he himself has HIV.
Empowerment is an important theme at the 2012 Geneva Health Forum, and a pilot project on HIV peer patients at 14 healthcare facilities in Morogoro is an example of front-line efforts. The project is presented by Josephy Kundy and his colleagues at the University Research Company, a for-profit health services consulting company based in Bethesda, MD. In an effort lead by the Morogoro Regional Health Management Team and funded by USAID, the project is challenging traditional care-delivery models by employing ‘expert patients’: volunteering HIV patients who have been selected and trained to act as peer mentors for other patients.
Peer mentors provide assistance to the clinical staff, and - as carriers already quite familiar with how to cope with the disease themselves - work with patients. By disclosing their condition, peer mentors are able to gain the trust of patients. In doing so they not only alleviate some of the operational pressure on an already strained medical system, but are also able to better communicate how to deal with daily life and HIV as a chronic disease. They discuss the illness with patients, and help overcome feelings of shame that society instills, leading to the eventual goal of a relatively normal life. Peer mentors have also helped with the patient-provider relationship, making a more comfortable environment for patients to talk. Most notably, they are able to keep patients on their strict anti-retroviral therapy schedule, and - in the long-term - improve self-management skills.
The peer-mentor approach has been so successful at Morogoro that plans are now being made to expand the system to other chronic diseases. With self-management on the rise for HIV patients, efforts can now be moved to address other chronic diseases, such as hypertension and diabetes. Through better awareness of the lifestyle habits that lead to chronic diseases, one hopes that some day none of these measures will be necessary. In the meantime, these volunteering ‘expert patients’ are an integral part of clinics, and provide invaluable services in a resources- and financially-stricken environment.
(Photo © Ministry of Health and Social Welfare, Tanzania)
(HP Photo © Worldwide Crusades 2012)