Marseille 2007
Marseille 2007
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Abstract #181  -  PLWA - From invisibility to becoming recognised partners of health services
Session:
  43.8: Access and models of care (Parallel) on Tuesday @ 16.30-18.30 in CP Chaired by Joseph Okone, Martha Nthenge
Authors:
  Presenting Author:   Dr Marga Kowalewski - GFA/GTZ-PSS, Guinea
 
  Additional Authors:  Dr Flavien T Ndonko, Dr Daman Keita, Dr Aboubacar Keita, Dr Helga Piechulek,  
Aim:
The issue: The HIV/AIDS project (PEC) in Mamou region is part of the GTZ health programme in Guinea. Amongst others, PEC supports the development of a PLWA association. Within one year PLWA became recognised and appreciated partners of health services. Understanding and respect of transparent procedures in self-organisation were powerful tools for motivating the group.
 
Method / Issue:
The PEC project supports the regional health administration in implementing a set of comprehensive interventions to fight against HIV/AIDS. Starting in 2003 with diagnostic HIV tests at the regional hospital, Mamou was the first site outside the capital city to provide ART treatment in 2004. Since 2005 VCT and PMTCT were added to the scope of services, and another 8 VCT sites are now operational in the region. But it was not until September 2005 before a small group of persons under ART treatment could be motivated to meet regularly in the sense of a self help group. First attempts to regroup PLWA showed a sad picture: people were shy and dared not to speak even with their peers. Most HIV+ persons in Mamou region were middle-aged illiterate housewives not used to speak out. In view of extreme stigmatisation of HIV/AIDS, health workers and PLWA were at a loss how to promote a self-help group. A KAP study run 2004 in the same region, reported 55% of interviewees consenting with immediate removal of PLWA from their community, 7% opted even for killing PLWA. PEC supported the PLWA by organising several meetings aiming at: - Living positive accepting and understanding to live with HIV - Treatment compliance anticipating and beating obstacles - Associative live Principles of self-organisation and citizens rights
 
Results / Comments:
The series of meetings boosted courage and self esteem in PLWA, especially in women. By August 2006 about 65 persons had participated in this meetings and as one result the first association of PLWA in Mamou region was created. The Mamou group is the first Guinean association of PLWA led by a female president and sporting a board exclusively of PLWA. Unlike other associations in Guinea that centre on income generating activities, the Mamou group has defined self help and care for PLWA as their main objectives. The association is now a recognised partner of the health administration. Annually renewable conventions got signed with the regional hospital and a health centre. The association assures the respect of patients rights (gratuity of tests and medications). Their members assist regularly in pre and post test counselling, and guide and counsel PLWA under ART treatment. Other members are engaged in home visits and promotion of HIV prevention in their community.
 
Discussion:
Lessons learned: A set of workshops explaining citizens rights and associative work were the cornerstones in changing PLWA from patients into active partners. The previously shy and reserved PLWA became active collaborators of health services. Before, no one could imagine even two PLWA talking to each other about their status. Since the creation of the association the members meet regularly, go visit each other and provide mutual assistance within the community.
 
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