By Derrick Silimina
Initially, Naomi thought health care delivery at her local clinic in Lusaka in Zambia seemed well organized, but later she realized how challenging access to antiretroviral therapy was due to the stigma associated with HIV/AIDS, even in the health facility setting.
Naomi, who didn't want her last name used, discovered that she was HIV-positive five years ago but resisted telling anyone, fearing the stigma and having clinic workers disclose her status to others. Then the 35-year-old developed tuberculosis, and then AIDS two years later. On the brink of death, she sought refuge at Our Lady's Health Centre — a Catholic sisters-run health facility in Kalingalinga township, east of Lusaka about 3 miles (about 5 kilometers) — where she was put on antiretroviral drugs.
"Had it not been for this medical facility's unique initiative on access to antiretroviral drugs in our community, I would be dead by now!" she told Global Sisters Report. "Today, despite my HIV status, I live a healthy and happy life."
According to the Zambia Population‐based HIV/AIDS Impact Assessment (ZAMPHIA 2021) Report, HIV was markedly higher among women than men in each age group from ages 20-24 through ages 35-39 and among those ages 45-49.
According to a recent study, "Zambia has yet to meet global testing and treatment targets among adolescent girls and young women living with HIV," particularly due to stigma in health facility settings. Stigma about the virus and the disease is perpetuated by friends and relatives, who often shun those who are HIV-positive or have AIDS. Getting antiretroviral drugs at a public health clinic, where identities are easily exposed and there are concerns about health care workers disclosing information, compounds the challenges patients face.
However, Catholic sisters are at the forefront of addressing health challenges that include stigmatization, and are strategically placed to be key players and problem solvers. For this reason, Sisters of the Holy Cross, a Roman Catholic congregation of women religious based at the Archdiocese of Lusaka, manages Our Lady's Health Centre to address the inequalities which are holding back progress in ending HIV/AIDS.
Nestled in Kalingalinga, one of the densely populated slums near Lusaka, Our Lady's Health Centre was established in 2001 in a bid to provide quality health care and equalize access to essential HIV services, particularly for key populations among the marginalized people in society.
Kalingalinga is one of the poorest areas in the region, and due to high poverty levels, the slum overflows with terminally ill patients, most of whom can't afford better medical attention. In this context, the religious sisters' health center is strategically located to provide quality health care to these patients, especially those in need of antiretroviral therapy.
"When I first came here, I discovered that most of our people in this community living with HIV/AIDS used to avoid coming to collect ARVs due to stigma," Sr. Adelina Adao, assistant administrator for the center, told Global Sisters Report. "We found out that only patients from other towns came to get ARVs and that's why we came up with a strategy to establish three 'community posts' within local markets where our staff could easily engage and attract clients back to our ART [antiretroviral therapy] services."
"Our initiative works out in such a way that since our community posts are situated amidst shops, salons and market stands, people would think that someone is just going to a market while they are just coming to collect their medicines. When you see the number of people on ART therapy, the response is now overwhelming," Adao said.
Adao noted that each community post is staffed by a clinician and a counselor who attend to their clients in confidence. That helps eliminate the stigma for those with HIV, while being accessible in a market environment for easy access.
Before it transitioned last year from being a hospice center to a health center, the facility also attracted patients from outside the area. Previously, the Oblates of Mary Immaculate was one of the four religious congregations involved in building and managing the medical facility to help provide palliative, end-of-life care for patients with HIV/AIDS and other ailments.
Now, Adao said, the medical facility's health delivery concept in Kalingalinga township has also attracted people living with HIV from outside Lusaka to access ARVs with ease, which is more conducive to their treatment.
With its slogan dubbed, "holistic health care for all," Our Lady's Health Centre offers a broad range of health care specialties. In addition to the antiretroviral therapy, it has a general clinic, ultrasound, obstetrics, gynecology, dental and other services.
Currently, with 25 medical staff, Adao is assisted by a fellow sister who belongs to the Religious Sisters of the Holy Spirit. Demand for the center's services has been strong but she could not offer an estimate of the number of people treated each month. For COVID-19, the center provided testing. Those who were positive with severe symptoms were treated and quarantined at the center, while those with mild cases were urged to quarantine at home. Vaccinations were done at government health facilities.
Their faith in Jesus Christ drives their dedication to serve, Adao said, as she and others work tirelessly to treat and support those with HIV/AIDS. Yet the conditions in which they work can cause them to feel burned out at times.
"I recall during my first days here, I was so traumatized and emotional to see how patients, especially those with HIV/AIDS, were suffering since it was my first time to work in such kind of a health facility," said Adao, who was trained as a teacher. "But after fellow sisters strengthened me, I got attached to each patient and whenever they get better, I usually get fulfilled," she added.
Other patients getting treatment for other conditions are enthusiastic about the center. "I am so thankful to the midwives at this clinic where I had a successful operation," said Belinda Ngoma, a mother of two. "My second-born child is now 4, but each time I think of how traumatizing it is to give birth via a caesarean operation, I am grateful to the staff at Our Lady Health Centre for their dedication to duty."
A Lusaka-based teacher lamented how she recently survived a protracted urinary infection, and had it not been for the swift intervention she got from urologists at Our Lady Health Centre, her health would have been severely affected.
"The health staff are simply the best we can ever have in our community because my condition might have worsened had it not been for the quality health care treatment I got here," she said.
She has since been recommending anyone with any illness to seek medical attention from the Our Lady's clinic, and says those she has referred have reported progressive results.
Following its revolutionized health care system that it offers to HIV-positive clients and other patients to keep their hope of recovery alive, Our Lady's Health Centre is certainly saving lives, according to Clement Tembo, a teacher in Chipata in eastern Zambia. He travelled to Lusaka for treatment of his chronic headache and said it was worth the trip, about an eight-hour drive.
A bus driver based in Kabwe, central Zambia, is also impressed with quality medical attention from the health centre for his backache, which almost rendered him jobless.
"Due to the long-distance driving, I used to have a constant backache," Bruce Mwenda said. "This affected my work, until a colleague advised me to seek medical attention at Our Lady Health Centre and I have now recovered."
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