By 2007, increasing numbers of HIV positive children and adolescents in Zimbabwe were being treated with anti-retrovirals and consequently were living with HIV rather than dying. It quickly became apparent however that these children had major psychosocial support needs if drug treatment was to be effective and their lives were to be worth living.
Dr. Monica Glenshaw who was then the DMO at Murambinda made the decision that Buhera district would pioneer such support and after a number of meetings of district stakeholders to discuss the issues, it was decided to establish a Resource Centre at MMH to offer complementary psychosocial support to children and young people on ART.
So CARC began in 2008, in a time of hunger and difficulty but with great enthusiasm. It was based initially in an old hut in the Hospital grounds and was staffed by volunteers – a Play Therapist from UK, nurses from the Hospital, counsellors from MSF, Newstart and New Life, and a head teacher and pastors form the local community.
CARC quickly outgrew the old hut and a new building housing playrooms and an office was built thanks to the generosity of SVMH, the Dutch Friends of Murambinda Hospital, and was then followed by a big new play hall. A programme of regular sessions was developed which including
- Health education
- Social activities
- Cultural activities
- Spiritual support and education.
All activities were delivered using play.
In July 2009 Mrs Evelyn Natale was appointed as full-time Coordinator of CARC. As a former District Nursing Officer she brought a large range of skills, experience and local contacts to the post and CARC has thrived and developed greatly under her leadership. This is thanks also to a Danish organisation, SUG, who have secured funding from the Danish Government for a sustained programme over 5 years.
CARC activities have been extended to include group and individual counselling, empowerment of children through active participation in expressive arts and leadership training. CARC has built a partnership with Africaid, based in Harare, who have trained adolescents elected by their peers at CARC to become Community Adolescent Treatment Supporters (CATS), leading psychosocial support sessions, offering individual counselling and conducting home visits to support antiretroviral treatment adherence among their peers.
CARC also established a Caregivers Support Group, to help caregivers to care confidently for HIV positive children. Topics covered include:
- Basic information on HIV and AIDS
- Opportunistic infections
- Antiretroviral Therapy
- Positive living and positive prevention
- Nutrition and HIV and AIDS
- Stress management
The caregivers also help each other by discussing challenges they face and trying to solve them. Disclosure for example is a very difficult subject for the caregivers, who find it very difficult and painful to tell a child that he/she is HIV positive. Sessions are held to empower them to disclose and these include discussions, lectures and a puppet show.
Sometimes caregivers also give each other material support, and SUG is currently supporting the development of nutrition gardens to help alleviate the effects of poverty. Educational support (payment of school fees) has also been provided for selected beneficiaries.
Initially confined to Murambinda Mission Hospital (MMH), CARC has now expanded to three Rural Health Centres in Buhera District (Munyanyi, Nerutanga and Betera) through the Danish partnership, and further extension is planned.