Zimbabwe has scored a first in health interventions by becoming one of the few countries in the world to implement a mainstream HIV and AIDS peer counseling training programme for people with disabilities that is running from January 2014 to December 2016.
The three-year ground-breaking programme, funded by Global Fund, which began in earnest in June with a survey to determine the informational and service provision requirements of people with disabilities relating to HIV and AIDS, has already seen the National Association of Societies for the Care of the Handicapped (NASCOH), under the auspices of the National Aids Council (NAC), training 393 people with disabilities as HIV and AIDS peer counselors in 16 districts of the country. The trained peer counselors have been integrated into local NAC structures, including District Aids Action Committees, and are already working in collaboration with other civil sector organisations involved in HIV and AIDS interventions and national institutions. These include Family Aids Caring Trust (FACT), Zimbabwe National Network of People living Positively with Aids (ZNNP+), Zimbabwe Community Health Intervention Research Project (ZICHIRE), Zimbabwe National Family Planning Council and Ministry of Health and Child Care (MoHCC).
People with disabilities are enthusiastic about the training programme, which will see 1 500 people with disabilities trained as HIV and AIDS peer counselors by the end of the three-year programme, which is being piloted in 24 districts in Manicaland, Masvingo, Matabeleland South and North, Midland, Mashonaland, East, West and Central provinces. NASCOH is implementing the programme in conjunction with four of its member organisations: Zimbabwe National League of the Blind (ZNLB), Council for the Blind (CFB), Zimbabwe Association of the Visually Handicapped (ZAVH) and Zimbabwe National Association of the Deaf (ZIMNAD).
One of the trained participants, Bothwell Makumbe who is visually impaired and who was elected as the focal person for people with disabilities in Marondera District, said: “This training programme is God sent. At long last, we are now being included in national HIV and AIDS interventions and we will now be able to play a meaningful role in curbing the AIDS epidemic among people with disabilities and the society at large”.
The Executive Director of NASCOH, Fambaineni Innocent Magweva, sees the programme as a gateway to holistic inclusion of people with disabilities in HIV and AIDS interventions: “ We are grateful that disability has at last been recognized by NAC as a critical gap in the management of prevention, care, treatment and support of HIV and AIDS interventions in the country. People with disabilities have now managed to get a foothold into HIV and AIDS interventions but what we would like to see is holistic inclusion of disability and people with disabilities across the whole spectrum of HIV and AIDS interventions”.
The Executive Director emphasised that, in order to ensure holistic inclusion of PWDs, there was need for review of all current HIV and AIDS programmes to ensure that PWDs have access to all programmes and services offered to the community; disability mainstreaming workshops with disability stakeholders to establish partnerships, integrate PWD needs in HIV and AIDS policies, strategies, programs, training, statistics and publications , and establish indicators and benchmarks; inclusion of disability in HIV and AIDS policy; mainstreaming of disability in District Strategic Plans and Health Facility work plans; concerted awareness raising and behavioural change education; establishing linkages and networking between government, HIV and AIDS organization and disability organizations; inculcation of disability needs in in-service HIV and AIDS training for current providers and in pre-service training offered in medical, nursing, midwifery, public health programmes, and; training of a cadre of sign language interpreters in HIV and AIDS issues
A major success story and immediate benefit from the 16 trainings conducted in the second half of the year was the appointment of focal persons with disabilities in the districts in the 8 provinces in which training workshops were conducted has immense implications for integration of PWDs into the entire rubric of HIV and AIDS interventions in Zimbabwe. Already, benefits are beginning to be noticed from this development. It is heartening that trained counsellors with disabilities are already developing synergies with other stakeholders in the HIV and AIDS arena in order to ensure the mainstreaming of disability in health issues in the country.
A Disability and HIV and AIDS situation analysis commissioned by NASCOH in 2003 revealed that people with disabilities are particularly vulnerable to AIDS due to their low literacy levels, little access to health care, high vulnerability to sexual abuse, lack of information on AIDS especially for the visually impaired and hearing impaired, and consequent lack of inclusion in AIDS intervention programmes. Stigma, fear and ignorance results in the majority of PWDs refraining from accessing available services such as VTC, Antiretroviral therapy, home based care and counselling. Such is the impact of stigma, discrimination and social exclusion among people with disabilities that those who contract HIV go to extra lengths to hide their status, for fear of compounding this stigma, discrimination and social exclusion. The peculiar situation of people with disabilities calls for urgent, target-specific interventions aimed at mitigating the impact of AIDS in the disability sector.