They meet under a tree

Community members living with HIV have come together to form support groups under the Community Adherence Refill Group (CRAG) which is funded by the US government through the President's Emergency Plan for Aids Relief (Pepfar). USAID, along with the health ministry implemented Tonata PLHIV, the organisation of numerous support groups such as the Gwaanaka Support Group which is located in northern Namibia in the Onyaanya district. Tonata PLHIV, which means “open your eyes” in Oshiwambo, is the main network organisation of people affected by, or living with, HIV. Also known as the community-based antiretroviral therapy (CBART), CRAG is designed to bring anti-retroviral delivery closer to the community and provide the much-needed and appropriate support to encourage long-term retention of patients, as HIV/Aids still remains the number-one killer in Namibia, claiming lives of 3 900 people per year, according to Pepfar. According to Loide Nakumbwala, sister in charge at Onyaanya Health Centre in the Oshikoto Region, contributing factors why most patients living with HIV die sooner than expected is because of the lack of commitment to taking their treatment and those living far from health facilities fail to pick up their medicines on a regular basis and adhere to their treatment regime. “HIV still involves a lot of stigma. Most of the patients on treatment are not willing to take their medication for a fear of judgement and the distance between the homes and the nearest health facility where they can access their treatment is far. Thus most patients are negatively affected,” she said. To address many of these challenges, community–based medicine distribution models such as the CBART where implemented to help remove the economic and social barriers that make it difficult for people living with HIV to access treatment. In addition, support groups like that of Gwaanaka, which was established in April 2006, have made the lives of many infected people much easier as the treatment comes to them.Relieving the burdenGwaanaka's group leader, Elli Ndhikwa, has made the collection of medication for her group much easier. Every three months, she travels to the Onaanya Clinic to collect ARV medication for each group member. They hand over their health passports to Ndhikwa and she takes them to the clinic's health pharmacists, who then process their medication accordingly.Nakumbwala explained to Namibian Sun that refill groups have reduced staff work load in the clinic. Long waiting times at health facilities caused by the sheer number of patients, was further reduced for patients. This has increased the productivity of the work flow, making it more efficient to attend to patients quickly. “In the past, we would have to tend to a lot of patients to make sure each of them have received their medication, but those days are long gone,” she explained. This system suits the group best, as Ndhikwa is excused from joining long queues which were common at the Onyaanya clinic. In the past the group would come as early as 07:00 in the morning and only receive service later in the day.According to Nakumbwala, on each visit the clinic is well aware of the group's arrival. “Their health passports are thoroughly examined to ensure each patient has received the correct dose of medicine and it is correctly labelled, as some experience allergic reactions to certain medicine.” She also added that a follow-up is done and discussed with the group leader to make certain each patient has taken their treatment and if any problems have been experienced over the span of three months. However there are certain requirements to joining a support group and to receiving assistance. “Since the support group was established to help people take their treatment, we want to work with people who are committed. They should have a stable health history, their viral load has to be suppressed - which means they at least need to be on treatment for more than a year and should not use alcohol and drugs.” After signing off the dispensed medication, Ndhikwa travels back to Onanjamba village and gathers under a tree located close to the main road. It is under this tree where the main purpose of the support group is executed. Each member is called by Ndhikwa to receive his or her treatment and signs it off to acknowledge they have receive it. Although this tree is exposed to the harsh weather conditions, members of Gwaanaka are enthusiastic. Happy chatter is picked up around the group as they wait, while others keep busy with making handmade jewellery. The jewellery is sold for N$50 or more at a local market. Profit from the proceeds are used to support the some of the group members – either pay for transport used to collect the medicine or help to buy food for members who sometimes may have fallen ill. A change for the betterHilma Prastus, who joined the Gwaanaka support group in 2014 has been living with HIV for the past 13 years. “Upon joining Gwaanaka, I have realised that I do not have to go through this alone. When I come here, I feel at home. We are like one family, because we all go through the same struggles, but the only difference is, we are prepared to overcome those struggles together,” says Prastus, 55. After going through numerous experiences of being discriminated against for having the virus, Prastus was prepared to throw in the towel. “I would go to the hospital and I would hear people make rude remarks like 'she is not going to live past 40 years' and 'she is a dead woman walking'. This really discouraged me and I lived with a lot of fear,” said Prastus softly, after being questioned about how her life was before she joined the support group. Fast forward three years later, Prastus is now motivated to live a positive life and making sure others do not have to give up on their life. “The help is here, and I have made a lot friends that have accepted me with opened arms.” Last man standingAs the first group in the Oshikoto Region to start a community-based refill group, Gwaanaka has made a great impact in the lives of many, including Ben Uugwanga, who is the only surviving man in the group after seven passed on. A former chef that worked at a farm in southern Namibia during the 1960s, Uugwanga and his wife are both on ARV treatment and adhere to healthy living with the help of the support group. “Being the only man in this support group is a good and bad thing. It is a good thing, because I want to encourage other men infected with HIV to come forward and live a positive life. It is also a bad thing, because I have no companion and someone I can talk to when all the women engage in their activities,” said the 69-year-old. Uugwanga also told Namibian Sun that among the seven men that have passed on, he established close friendships with some of them and misses them dearly. “When we received this area from the headman to conduct our meeting, we also received a fence and my close friend that passed away and I worked together to set it up,” says the father of five. He also expressed that men are not willing to get tested and find out where they stand. He is however hopeful that more men will see the good in joining a support group and getting assistance where necessary. He feels he can serve as a good example for other men to open about their status by joining support groups.A total network of 574 refill groups have so far been established in Namibia - serving the Ohangwena, Oshikoto, Oshana and Omusati regions. According to statistics by Tonata, out of 16 845 members, only 3 444 are male while 13 401 are female. Uugwanga and many others share the same sentiments that life has improved since the refill groups has been established. They have learned about positive living, gained help with adhering to treatment, and participated in community funding structures to generate income. TUNOHOLE MUNGOBA

They meet under a tree

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Namibian Sun 2025-07-07

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They meet under a tree

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Namibian Sun 2025-07-07

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