How can We Reach More Families Living with HIV in South Africa?

kgerstman

I had heard that South Africans were warm and friendly, but imagine being hugged by 15 grannies!  In South Africa, strong interventions are needed to reach out to children who are not currently accessing HIV treatment services.   Since HIV is clustered in families, grannies who reach out to grannies may help children get the care they need. 

I had heard that South Africans were warm and friendly, but imagine being hugged by 15 grannies!  This was one of the highlights of my recent trip to South Africa for the Population Council.

 In South Africa, nearly one in five people is living with HIV and AIDS, including an estimated 280,000 children under 14.  I was visiting the Population Council’s South Africa office for a week and had just flown to East London, a small city in the Eastern Cape Province.  Thandi Mini, a program officer for the Population Council, was my guide for the day.  In the car, she explained to me that I would be seeing some health clinics, the Cecilia Makiwane Hospital, and a government site where South Africans receive grants to assist in caring for their families.  

 

Thandi drove us to a very poor township on the outskirts of East London.  The hills were covered with tin shacks.  Thandi explained that each shack contained an entire family – 5-7 people, which was hard for me to fathom.  I really couldn’t count how many people were living in this community…certainly thousands.  In this community there are high rates of child sexual abuse identified by health workers and some of these children tested as HIV positive.  Near this settlement we drove to a government grants disbursement site surrounded by armed guards and barbed wire.  This is where people went to enroll for government grants. 

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When we arrived, we were surrounded by a group of 15 or so older women (called “gogos”, meaning “grannies”) wearing Population Council caps and t-shirts.  Each one came over to me, introduced herself and gave me a big hug!  I was immediately taken by their warmth and enthusiasm.  These grannies, who are part of the Caregiver Project, funded by the President’s Emergency Plan for AIDS Relief and the American people through the U.S. Agency for International Development , are responsible for approaching older women who are coming to enroll for grants to help care for their grandchildren.  Many of the grandchildren had parents who had died from AIDS or were no longer present in the children’s lives.  The grannies educate the women about HIV in children and encourage them to have their grandchildren tested.  We were unable to stay long because we had an appointment at the local hospital.  We told the grannies that we would come back later to hear more about their work.

 

Next, Thandi took me to visit two health clinics and the public hospital.  The facilities were packed with people who were there to get health services.  The waiting rooms were filled, and people were standing along the hallways waiting for services.  The surroundings were uncomfortable, and the patients were so patient!  Residents are travelling long distances to get health services, and the facilities themselves are clearly overextended.  We met with quite a few staff members, some involved with pediatric care and others involved in maternal care.  The staff told me that many children were only being treated for HIV and AIDS when they showed up with serious symptoms and were quite sick.  In this environment, children, who have such a strong chance of positive health outcomes when treated early for HIV, were not getting attention soon enough.  Most children living with HIV reside in households where another family member is HIV-positive, so we need to find better ways to reach these families about getting their children tested and treated early. 

 

At the East London facilities, I met data collectors who were approaching patients seeking HIV treatment and asking them for more information about their entire families.  Using this family centered approach, also funded by the President’s Emergency Plan for AIDS Relief and the American people through the U.S. Agency for International Development, they would encourage these patients to have their children tested for HIV.  I could see that with these masses of people the data collectors definitely had their work cut out for them.   I spoke with one of the data collectors, and she said that her work was very satisfying because she has had success in advising mothers to have their children tested for HIV.  After each interview, she gives them a referral card which can be used to access services.  The hospital and clinics have seen many people show up with her referrals. 

 

Thandi and I decided that it was time to go back and visit the grannies.  The grannies were expecting us and were already seated in a circle when we arrived.  One of the grannies had written down some remarks to share with me.  She said that they have all had very intimate conversations with people and have gotten involved in the lives of the women they have met.  These elderly caregivers face incredible hardships trying to take care of their grandchildren.  Some have been afraid to get these children tested for HIV.  However, the caregivers who do go for HIV testing are extremely glad they did this – whether the children are HIV positive or not.  Many of them come and report back to the grannies about the test results and their future plans.  It was clear that the grannies truly loved their work.   I could see that they were feeling empowered in helping their community in this way. 

 

In South Africa, strong interventions are needed to reach out to children who are not currently accessing HIV treatment services.   Since HIV is clustered in families, innovative methods that target this family link may help people get the care they need.  Just as grannies reach out to more grannies, we need to be committed to finding new ways to reach some of the most vulnerable populations in South Africa.

 The contents of this blog are the responsibility of the Population Council and do not necessarily reflect the views of USAID or the United States Government. 

 

News Politics

Progressives Notch Wins, Anti-Choice Republican Gets the Boot in State Primaries

Ally Boguhn

U.S. Rep. Tim Huelskamp (R-KS), whip of the congressional Pro-Life Caucus, was defeated after losing the support of business groups and the agricultural lobby in Kansas.

State primary elections brought major victories for progressive candidates on Tuesday and saw incumbent Rep. U.S. Rep. Tim Huelskamp (R-KS)—an anti-choice member of the extreme House Freedom Caucus—lose his seat to his primary challenger.

In Washington state, progressive candidate state Sen. Pramila Jayapal advanced to the general election in November in her bid to replace retiring Rep. Jim McDermott (D) in Washington’s 7th Congressional District.

The candidate has “been a champion for access to healthcare, and commonsense gun safety and civic engagement as well as for women, workers, students, communities of color, low-income communities, immigrants and refugees,” according to Jayapal’s website. That work earned her the endorsement of Sen. Bernie Sanders (I-VT), who solicited donations for her campaign telling supporters in an email that Jayapal is “not afraid to take on powerful special interests” and is “running her campaign with our political revolution.”

Sanders lauded Jayapal’s win Wednesday in a statement circulated by press release. “Pramila just proved that candidates can run a strong progressive campaign funded by small-dollar donors and win big,” Sanders said. “The people-powered movement that propelled our campaign to victory in states around the country is already changing how campaigns are run up and down the ticket.”

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Liberal and progressive groups praised Jayapal as news of her primary win broke.

“Pramila Jayapal winning this primary is huge for progressives,” Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, said in a statement on the night’s election results. “She is a bold progressive game changer whose strong performance shows that voters are hungry for bold progressive ideas like expanding Social Security benefits, debt-free college, and a $15 minimum wage. With Pramila’s record as an accomplished activist and state senator, we are confident Pramila will be one of the strongest partners progressives have ever had in Congress and one of the strongest representatives Washington has ever had.”

Stephanie Schriock, president of EMILY’s List, called Jayapal a “a progressive leader and a tireless advocate for women and families” in a Wednesday statement. “She understands the importance of increasing economic opportunities and protecting women’s access to health care. EMILY’s List is proud to continue supporting Pramila in her historic bid to be the first Indian American woman elected to Congress.”

Elsewhere in the state, fellow progressive candidate Darcy Burner finished among the top two candidates in her race for the state’s 5th District House seat. The state’s primary system allows the top two candidates to advance to the November election regardless of party affiliation.

In Kansas, the incumbent Huelskamp lost his primary race to challenger Roger Marshall. The three-term congressman has represented the state’s 1st Congressional District since 2011, where he has carved out a place for himself among the extremist House Freedom Caucus (HFC), which has pushed ultra-conservative and anti-choice policies in Congress. Huelskamp was one of a dozen politicians backed by the HFC’s unofficial PAC, the House Freedom Fund, as Rewire reported.  

Huelskamp championed anti-choice efforts prior to being elected into office and was “active in assisting women in crisis pregnancies” during graduate school, according to his website. He continued that legacy in Congress, where he serves as the Pro-Life Caucus whip.  

Huelskamp in 2012 notoriously delivered a speech on the House floor comparing abortion care to slavery and accusing both Planned Parenthood and the Obama administration of being racist. He again used race to push his anti-choice position in 2015, tweeting that those who accepted awards from Planned Parenthood supported a “racist” agenda.

According to the New York Times, Huelskamp’s challenger Roger Marshall “won with the support of business groups and the agriculture lobby, which had turned its back on Mr. Huelskamp after Speaker John A. Boehner had him removed from the Agriculture Committee in 2012, a crucial position for a legislator from a farm state.”

During the primary race, Huelskamp released an ad questioning whether Marshall, an OB-GYN, was truly pro-life and claimed he “supports pro-abortion groups that back Planned Parenthood and Hillary Clinton.” The accusation reportedly refers to a donation from the American Congress of OB-GYNs PAC to Marshall, and a previous donation he made to the group.

Marshall’s campaign website prominently displays the Republican candidate’s “pro-life” position and touts a recommendation of his from the anti-choice American Association of Pro-Life Physicians and Gynecologists. 

Brent Robertson, Marshall’s campaign spokesperson, however, defended the candidate’s anti-choice position in a statement to the Topeka-Capitol Journal in January.

Roundups Politics

Campaign Week in Review: ‘If You Don’t Vote … You Are Trifling’

Ally Boguhn

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party's convention.

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party’s convention.

DNC Chair Marcia Fudge: “If You Don’t Vote, You Are Ungrateful, You Are Lazy, and You Are Trifling”

The chair of the 2016 Democratic National Convention, Rep. Marcia Fudge (D-OH), criticized those who choose to sit out the election while speaking on the final day of the convention.

“If you want a decent education for your children, you had better vote,” Fudge told the party’s women’s caucus, which had convened to discuss what is at stake for women and reproductive health and rights this election season.

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“If you want to make sure that hungry children are fed, you had better vote,” said Fudge. “If you want to be sure that all the women who survive solely on Social Security will not go into poverty immediately, you had better vote.”

“And if you don’t vote, let me tell you something, there is no excuse for you. If you don’t vote, you don’t count,” she said.

“So as I leave, I’m just going to say this to you. You tell them I said it, and I’m not hesitant about it. If you don’t vote, you are ungrateful, you are lazy, and you are trifling.”

The congresswoman’s website notes that she represents a state where some legislators have “attempted to suppress voting by certain populations” by pushing voting restrictions that “hit vulnerable communities the hardest.”

Ohio has recently made headlines for enacting changes that would make it harder to vote, including rolling back the state’s early voting period and purging its voter rolls of those who have not voted for six years.

Fudge, however, has worked to expand access to voting by co-sponsoring the federal Voting Rights Amendment Act, which would restore the protections of the Voting Rights Act that were stripped by the Supreme Court in Shelby County v. Holder.

“Mothers of the Movement” Take the National Spotlight

In July 2015, the Waller County Sheriff’s Office released a statement that 28-year-old Sandra Bland had been found dead in her jail cell that morning due to “what appears to be self-asphyxiation.” Though police attempted to paint the death a suicide, Bland’s family has denied that she would have ended her own life given that she had just secured a new job and had not displayed any suicidal tendencies.

Bland’s death sparked national outcry from activists who demanded an investigation, and inspired the hashtag #SayHerName to draw attention to the deaths of Black women who died at the hands of police.

Tuesday night at the DNC, Bland’s mother, Geneva Reed-Veal, and a group of other Black women who have lost children to gun violence, in police custody, or at the hands of police—the “Mothers of the Movement”—told the country why the deaths of their children should matter to voters. They offered their support to Democratic nominee Hillary Clinton during a speech at the convention.

“One year ago yesterday, I lived the worst nightmare anyone could imagine. I watched as my daughter was lowered into the ground in a coffin,” said Geneva Reed-Veal.

“Six other women have died in custody that same month: Kindra Chapman, Alexis McGovern, Sarah Lee Circle Bear, Raynette Turner, Ralkina Jones, and Joyce Curnell. So many of our children are gone, but they are not forgotten,” she continued. 

“You don’t stop being a mom when your child dies,” said Lucia McBath, the mother of Jordan Davis. “His life ended the day that he was shot and killed for playing loud music. But my job as his mother didn’t.” 

McBath said that though she had lost her son, she continued to work to protect his legacy. “We’re going to keep telling our children’s stories and we’re urging you to say their names,” she said. “And we’re also going to keep using our voices and our votes to support leaders, like Hillary Clinton, who will help us protect one another so that this club of heartbroken mothers stops growing.” 

Sybrina Fulton, the mother of Trayvon Martin, called herself “an unwilling participant in this movement,” noting that she “would not have signed up for this, [nor would] any other mother that’s standing here with me today.” 

“But I am here today for my son, Trayvon Martin, who is in heaven, and … his brother, Jahvaris Fulton, who is still here on Earth,” Fulton said. “I did not want this spotlight. But I will do everything I can to focus some of this light on the pain of a path out of the darkness.”

What Else We’re Reading

Renee Bracey Sherman explained in Glamour why Democratic vice presidential nominee Tim Kaine’s position on abortion scares her.

NARAL’s Ilyse Hogue told Cosmopolitan why she shared her abortion story on stage at the DNC.

Lilly Workneh, the Huffington Post’s Black Voices senior editor, explained how the DNC was “powered by a bevy of remarkable black women.”

Rebecca Traister wrote about how Clinton’s historic nomination puts the Democratic nominee “one step closer to making the impossible possible.”

Rewire attended a Democrats for Life of America event while in Philadelphia for the convention and fact-checked the group’s executive director.

A woman may have finally clinched the nomination for a major political party, but Judith Warner in Politico Magazine took on whether the “glass ceiling” has really been cracked for women in politics.

With Clinton’s nomination, “Dozens of other women across the country, in interviews at their offices or alongside their children, also said they felt on the cusp of a major, collective step forward,” reported Jodi Kantor for the New York Times.

According to Philly.com, Philadelphia’s Maternity Care Coalition staffed “eight curtained breast-feeding stalls on site [at the DNC], complete with comfy chairs, side tables, and electrical outlets.” Republicans reportedly offered similar accommodations at their convention the week before.

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