ZAMBIA: Community benefits from free ARVs
[This report does not necessarily reflect the views of the United Nations]
LUSAKA, 13 September (PLUSNEWS) - The sleepy railway town of Kapiri Mposhi, north of Zambian capital, Lusaka, comes alive every Thursday evening when the Tanzania-Zambia Railways Authority (TAZARA) passenger train pulls in to disgorge its weekly load of business travellers, tourists and drifters from Dar-es-Salaam, capital of Tanzania.
Kapiri Mposhi lies in the transport corridor that links Zambia to the port of Dar-es-Salaam in the northeast, the Democratic Republic of Congo to the northwest and Zimbabwe to the south.
Long-distance truckdrivers also stop over in the town, and towards the end of each week the shoppers and fun seekers arrive.
"It is like this every Thursday," said Lizzy Mbwili, coordinator of the Street Kids, Orphans and Widows Association (SKOWA), a local NGO. "The whole province awaits the TAZARA and then converges to cash in on the increased activity. For many people, this is the only source of livelihood."
Many of the district's inhabitants used to work at the country's only glass manufacturing plant until it shut down six years ago; reduced production on the Copperbelt, and the post-apartheid re-emergence of South African ports as viable routes to the sea have all contributed to reduced economic activity in the town.
"Not surprisingly, the loss of conventional employment opportunities has seen a marked increase in commercial sex work. Inevitably, that has seen an increase in the rate of HIV/AIDS infection," said Mbwili.
A treatment programme run by Medecines Sans Frontieres (MSF) and the Zambian government kicked off in July 2004, when the Kawama clinic became one of the first health facilities to begin distributing antiretroviral (ARV) medication free of charge. Kapiri Mposhi is one of the worst-affected areas in the country.
Masautso Mwanza, a middle-aged father of four, is one of 450 people receiving ARVs at the clinic. Before taking the drugs he constantly suffered opportunistic infections and could not walk without being supported; seven months ago he lay on a bench at the clinic waiting to die. Now a healthy-looking Mwanza is looking forward to going back to work as a truckdriver.
Another patient at the clinic, Rodger Banda, 36, said, "I have seen many people getting better, and I have hope that with this medication I will get to live much longer. Before I came for treatment I could not walk for long distances without having breathing complications, but now I can even go jogging - I am very fit," he said, flexing his muscles.
Kawama clinic is known by the community as the ARV clinic, and HIV-positive people queuing for their medication are no longer concerned about discriminatory attitudes they might encounter.
"People's attitudes are changing. I used to see many people that I knew, waiting for the [HIV/AIDS] services but as soon as I approached them, they told me they were waiting for someone. They now freely tell me that they have come to check their CD4 count whenever I see them here," noted Anna Taveres, the MSF field coordinator in Kapiri Mposhi.
According to Ruth Lubambula, the HIV/AIDS coordinator at the centre, more people were visiting the voluntary counselling and testing (VCT) centre - as many as 474 in July this year.
Dr Kanyanta Sunkutu, an advisor to the World Health Organisation (WHO) in Zambia, acknowledged the effect of the medication. "These drugs slow down HIV replication to such an extent that the viral load in the blood is reduced to very low and even undetectable levels, allowing CD4 counts to recover."
He called on the government to adopt more flexible testing policy, including making HIV tests routinely available at public health facilities to encourage more people to do so.
In Kapiri Mposhi, Mwanza reflected that "HIV and AIDS is like a train that is moving forward ... you get on it and move forward [by getting treatment] or you get left behind."
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