Journeying from HIV patient to life-saving case manager
Scholastica works for KP-STAR (Key Populations Strengthening Technical Assistance Response), a US government-funded project that provides health and other crucial services in Namibia to people who are at risk of contracting HIV.In 2007, Scholastica tested HIV positive and started taking drugs and drinking alcohol. When doctors put her on HIV treatment, she did not take her medication regularly and soon her immune system started to weaken.
“My HIV-positive diagnosis was the most difficult news at the time due to limited information, stigma, and discrimination associated with the disease. I feared dying and started abusing alcohol and drugs. My body was weak, and I was also diagnosed with tuberculosis. In 2010, I weighed merely 27 kg,” Scholastica recalls.
Whenever Scholastica defaulted on taking her medication, she would change to a different health facility and pretend to be a first-time client – after which she was put on HIV treatment again. She did this to avoid the stigma and discrimination that patients fear when defaulting. “My struggle to adhere to the treatment continued. I moved from one clinic to another and always registered myself as a newly diagnosed HIV patient,” she explains.
This continued until Scholastica received the opportunity to become a Peer Educator on the condition that she improves. A Peer Educator is a person who reaches out to other community members who live with or are affected by HIV to convince them to receive professional care and treatment.
Contemplation
She narrates that it took her several weeks to contemplate whether she wanted to continue being who she was or honestly change her life and start afresh. “In the end I decided to change. It had to change not only to help my peers to take up HIV services, but also to help myself and gain control of my own life,” Scholastica recalls.
Scholastica’s steadfastness paid off and she was finally even recruited as a Case Manager in Gobabis under the KP-STAR project. Today, her role is to ensure that clients who test HIV positive are receiving antiretroviral treatment (ART), becoming virally suppressed, and staying on their treatment. This means that a blood test does not detect HIV anymore, and the person can no longer transmit HIV to someone else.
Scholastica also ensures that clients who test HIV negative and are at high risk of acquiring HIV are getting Pre-Exposure Prophylaxis (PrEP) medication. PrEP reduces the risk of HIV infection significantly. She also provides other health and social support services to those in need.
Life-changing
Being a Case Manager has been a life changer for Scholastica.
“Considering my own defaulting history, I first had to evaluate myself. I took a very important step in my journey when I requested to be transferred from Katutura Health Centre in Windhoek to Epako Clinic in Gobabis. At that time, my viral load was very high. But with the support of the Epako Clinic staff and USAID’s KP-STAR project I became a model HIV patient. I am now virally suppressed and proud that I cannot transmit the virus to anyone.”
Scholastica has become a role model for many people living with HIV and an advocate for the project’s Undetectable = Untransmissible (U=U) campaign. With the help of lunchbox-sized transparent containers filled with red and black beads, she demonstrates the positive effect that HIV medication has on the viral load of a patient’s blood.
As a Case Manager, Scholastica is committed to helping anyone, including people who may feel marginalised, such as female sex workers living with HIV, to lead a happy, healthy, safe, and fulfilled life. She currently manages 139 clients on ART and 51 on PrEP.
“I enjoy my work a lot. Knowing that I have helped many people and made a difference in their lives is very satisfying,” she concludes.
Making things easier
Fayonce Van Wyk, Omaheke Regional Coordinator for IntraHealth Namibia, asserts that Scholastica’s openness about her HIV status makes it easier for her to carry out her work.
“Scholastica has received case management training from IntraHealth Namibia, and she is also a certified HIV Rapid Tester. She knows all her clients as well as their file numbers by heart which shows a high level of commitment towards her work,” Fayonce says.
Scholastica is a living testimony of how a single person can impact others to fully benefit from services provided by the Ministry of Health and Social Services in collaboration with projects such as KP-STAR. She is also a good example of how to remain healthy and live positively with HIV.
KP-STAR is funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) and implemented by Intrahealth Namibia.