“It is Possible to Dream”
“Today, it is possible to dream—when we thought that life was over,” says Teresa Joaquim Mbalane, a 50-year-old mother of four living with HIV in Mozambique. “Now I try to pass my experience on to others.”
As a subsistence farmer, Teresa depends entirely on farming and seasonal work for income. In 2003, she began battling an illness, making it impossible to work. Every time Teresa went to the health facility, she was treated for the symptoms she was presenting at the time, but she was never able to get completely well. When Teresa was diagnosed with tuberculosis—one of the diseases associated with HIV—she was referred for HIV counseling and testing. The test result was positive.
At that time, only four health facilities provided HIV treatment in her province, Gaza—which is 27,000 square miles and has a population of 1.3 million. Teresa remembers that there was a long waiting list to receive HIV treatment. Once she made it to the top of the list, medical care remained difficult to access because Teresa lived in Macia, nearly 40 miles from the health unit in Xai Xai, the provincial capital and the closest health facility with HIV treatment services at that time. Barely able to move because of illness and being financially strapped, Teresa had difficulty traveling for routine health consultations and medicine.
That’s largely because, in 2004, the Centers for Disease Control and Prevention in Mozambique received funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Through a PEPFAR grant via CDC, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) expanded access to antiretroviral therapy (ART), which reached Teresa. Since then, the health system continued to strengthen—ART access has continued to expand, and HIV care and treatment and prevention of mother-to-child transmission of HIV is now available at 124 health facilities in Gaza.
Teresa is also a member of a community adherence and support group, which EGPAF established with PEPFAR funding at health facilities throughout the province. In each group, stable and adherent patients encourage each other to remain on ART and return for services. Taking turns once a month, each member travels to the health facility to collect antiretroviral medication for themselves and for the other members of the group. This system promotes retention of patients on treatment and reduces travel costs and time spent at the health facility. It also reduced the number of patients who need to be at the health facility, alleviating the workload for nurses and leaving more time to attend to each patient.
After more than a decade on HIV treatment, Teresa now feels healthy and strong. She inspires and mobilizes people living with HIV and their families to live positively by sharing her story.
“When I realize that a family member or neighbor is suffering from an undiagnosed disease, I advise them to go to the hospital,” says Teresa. “They don’t have to share the results with me. They don’t have to tell me what the outcome is. They should know that it is all about seeking care and taking care of themselves."
Teresa pays special attention to other mothers in her community.
“No child should be born or die of a preventable and treatable disease,” she says.
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