Tafadzwa: Transforming the life of a young woman
“The Zvandiri program has helped me to realize how l should live as l am. l am now ready to go into the community in order to help other children, adolescents, and young people to adhere well to antiretroviral treatment and fight all forms of stigma and discrimination,“ said Tafadzwa.
Tafadzwa is a 22-year-old, double-orphaned young woman who was born with HIV. She stays with her grandmother in Mount Darwin, in Mashonaland Central province.
In 2004, she was bedridden as a result of continuous illness.
Tafadzwa stayed at Karanda Hospital for so long that it was declared as her second home. Her grandmother decided to tell her about her HIV-positive status while Tafadzwa was hospitalized. While this helped Tafadzwa to understand her persistent illnesses, she lacked the necessary information, counseling, and support she needed. She struggled to come to terms with her diagnosis and to adhere to her new ARV medication. At the same time, she faced stigma and discrimination from her peers and in her community.
In October 2016, Africaid scaled up its Zvandiri model of differentiated service delivery for children and adolescents in Mount Darwin district with financial and technical support from PEPFAR through USAID and Management Sciences for Health (MSH). This is when Tafadzwa’s life was transformed. She was selected by Chitse Health Facility in Mount Darwin to be trained as a Community Adolescent Treatment Supporter (CATS). In November 2016, she participated in the week-long CATS training, together with 28 other adolescents and young people living with HIV. However, Tafadzwa did not participate in this training on her own initiative. She became involved in the program to fulfill the wishes of her caregiver.
On the first day of training, Tafadzwa did not interact with anyone, even with other new CATS, who she already knew from her health facility. She spent most of her time crying, without disclosing why she was so upset. Africaid staff members attempted to engage her, but Tafadzwa would only say that no one cared about her and that the solution to her current situation was death.
During the training, Tafadzwa engaged in a participatory exercise in which the CATS share their life experiences. She found the process of reflecting and sharing painful memories and experiences to be extremely difficult, and was unable to speak without bursting in tears. Her struggle was apparent in everything that she did—how she reacted, how she carried herself, and the way she isolated herself from others. Her distress was so intense that she was unable to eat during the first two days of the CATS training.
During the training sessions, Tafadzwa slowly began to listen to and benefit from the life experiences of other CATS. She identified with their stories and emotions shared through role plays and meaningful and honest discussions, and began to engage in counseling with the training facilitators. As the training progressed, the training facilitators observed a dramatic change in Tafadzwa’s overall behavior. She began actively participating in all sessions, speaking openly about past events in her life, leading group presentations, and reflecting on her own experiences to develop coping strategies with other CATS. Tafadzwa became an active, strong member of the new Mount Darwin CATS team. She explained that she now realizes that she is not alone and that she is loved and valued. She is no longer just waiting for death.
As a CATS, Tafadzwa is now complementing Zimbabwe’s national efforts to achieve its 90-90-90 targets by accelerating the initiation of children, adolescents, and young people with HIV on ART, as well as providing subsequent support for those on treatment. Under the PEPFAR-funded Game Changer program, she currently supports a cohort of 120 children and adolescents on ART in their health facilities and communities with adherence monitoring, counseling, and support. She identifies adherence challenges, traces patients lost to follow up., and proactively identifies and refers children and adolescents in need of further investigation for possible opportunistic infections, treatment failure, child protection issues, and their psychosocial support, sexual, and reproductive health needs.
Tafadzwa is now ready to work within her team to collaboratively reach 1,600 children, adolescents, and young people with HIV to be linked to and supported by CATS in Mount Darwin.
*Name changed to protect identity