Mothers to Mothers

Yesterday we had the opportunity to travel to the Matsenjeni clinic in southern Swaziland to participate in the mothers2mothers (m2m) program.  M2M helps prevent transmission of HIV from mothers to babies, provides access to medical care for the mothers, and counsels mothers with HIV to overcome social stigma and live positive and productive lives.  Mothers2mothers trains HIV+ women to become “mentor mothers” to other mothers living with HIV offering not only support but also education on ARVs and how to prevent transmission to their child.  Since 2001, this incredible organization has expanded to seven different sub-Saharan African countries with a total of 405 sites.  The m2m program has been highly effective in decreasing the rate of HIV+ babies as well as helping mothers cope with and effectively treat their HIV.

We traveled in a small van through RFM’s Wellness Centre Outreach Program to the Matsenjeni clinic about 2.5 hours away. The Wellness Centre is a clinic through RFM that provides confidential care to healthcare workers and their families for conditions such as HIV/AIDS and tuberculosis.  This week’s topic was disclosure of HIV status to loved ones.  Disclosure is a very important part of living with HIV in that it allows for a support system among loved ones.  M2M encourages the mothers that they should be the only ones who can disclose this information.  However, as you can imagine, this can be incredibly difficult.  Many women are ashamed; frightened by the stigma that will be put on them, or scared that their partners may leave them to care for their children alone. 

One woman in particular shared her struggles in how to inform her child that she had HIV.  She asked the child, “What would you do if you met someone who had HIV?” to which the child responded “I would run away and throw away anything they touched.”  This was very difficult for the mother as she first felt she needed to educate the child and rid him of his ideals before she revealed her status and he thought of her as a “monster.” 

Many problems can come from misleading others about HIV status.  Some people will go as far as hiding their ARV therapy outside, at work, or even at the neighbors to keep loved ones from knowing.  Unknown to the patient, this is more detrimental to them since the medications should be stored in a cool dry environment.  Children in the home especially should not be lied to.   One example was brought up that a mother claimed her ARVs were for headache leading the child to start taking her medication every time he had a headache causing serious complications and adverse effects.   

Another difficultly these mothers are faced with is how to tell an HIV+ child about their infection.  In school, most children are only taught that HIV can be transmitted sexually and that using a condom will completely prevent transmission.  Many children do not understand that they can be born with HIV and cannot grasp why they have this condition when they did nothing “wrong.”  Education and disclosure to a child at a young age is very important before they become sexually active and begin spreading HIV to others.  In instances when HIV status is disclosed to a child in their later years, many become incredibly angry or depressed.  A child who has not grown up being aware of and learning to cope with their condition may have already developed false and difficult to break stigmas.  In very severe cases, it is not unheard of for a child to run away and live on the streets or even commit suicide rather than face their peers. 

The importance of this outreach program is to educate patients and their loved ones and move away from the social stigma that has been placed on HIV/AIDS.  It does not only provide access to care, but also counseling and a strong support system.  M2M has approximately 712 mentor mothers across Africa.  There are currently 57 sites in Swaziland in which 82 mentor mothers work.  M2M pays for transportation of the mentor mothers to different clinics in Swaziland and is able to reach approximately 75% of HIV+ women who are attending prenatal and postnatal clinics throughout the country.  We found this organization to be extremely eye-opening and learned to not judge a book by its cover.  These women brought up many important struggles that we had not even thought of before.  We were very fortunate to be able to hear their stories and were incredibly inspired by their strength.