The backbone of NAYO is the group of field workers who each visit up to 30 clients suffering from HIV or AIDS normally twice a month. They are essentially social workers; each designated a catchment area of normally 2 villages to supervise. This is done with the help of local volunteers who are their ears on the ground, they report to the field worker if something is wrong with a client or if there are any other HIV sufferers that need to be enrolled as clients. It’s an impressive structure which encourages community responsibility and acts as a safety net for those that are really helpless.
One of the biggest challenges NAYO field workers face is the stigma of AIDS and HIV among people in the village where it can be linked to witchcraft. There is a pervading tradition that men with HIV should sleep with young virgins to cure themselves of the disease. People are often fearful to get tested for HIV as they don’t want to face the discrimination that comes with it from their neighbours.
One such victim of this stigma is Enifa a girl of nineteen years old with HIV whose mother died when she was little. She lives with an aunt and her family who do not look after he well and refuse to take her to the hospital when she needs to go. Enifa came to NAYO’s nutrition support handout but was too weak to carry the 50kg bag of maize back to her house. NAYO called her aunt to help who laughed at Enifa’s weakness. On visiting this girl at her home it is easy to see she is not being cared for properly. She is emaciated and shivering in the hot mid-morning sun, without a blanket she uses her chitenge for warmth, as she tries to eat a cold, congealed bowl of porridge. NAYO’s nurse and field workers are working on an intervention to educate the aunt on HIV and encourage her to care for her better.
At a different village, field worker Crispin visits another young woman suffering with HIV whose husband refused to accept this. He refuses to use contraception even though she is not well enough to have any more children. She looks about 18 years old and is already a mother of 3 year old twins and a newborn baby, more children would most probably kill her. His thinking is ‘you are my wife, why should I use contraception?’ He had only recently consented to have an HIV test himself, which was fortunately negative.
When we arrived the husband was out at work. We sat on stools in the house, the baby lying on a blanket on the floor and the toddler curled up protectively over his mother’s lap as she leaned helplessly against the wall. She was very thin and looked weak.
Crispin asked her questions to understand the full story. At one point the mother breast fed her baby, her breast was small, shriveled and lifeless. Crispin held his head in his hands, saying, “Look she can’t even feed her baby milk. She hasn’t enough food. This is so pathetic.” And it was heartbreaking to see this young mother not able to eat enough food herself yet alone nourish her three children, and yet she was being forced to be this baby-making machine.
Crispin set up another meeting where the husband could be present so he could counsel them together on family planning. He planned to also talk to the husband separately to try and instill the seriousness of his wife’s health. There is not much question of the wife leaving the husband. Divorce is rare and a taboo in rural life, especially a female instigated divorce. Most of the time, the woman and children are so dependent on the husband that it would just be inconceivable to leave him.
NAYO’s social work is simple, with little funding but effective at giving those most vulnerable people in the community – women, children, those with HIV-fundamental support and care. The field workers reliable presence, hard work and compassion among for with HIV or AIDS also help to break down the stigma attached to the disease.