ADHERENCE TO TREATMENT AND DOMESTIC VIOLENCE

The Center used to be a home based care and counseling center where people received counseling and testing for HIV. I regret to say that I have only been on two home based care visits due the fact that we can’t fuel our vehicle to make home visits (excuses, excuses). We visited a female client who defaulted from her HIV treatment and was too thin and sick too walk. She had a bed pan and little in a hut that was half way thatched. She did receive food baskets provided by the government but since there is a lot of corruption with food baskets, I speculate that her food was stolen by family members. The other was another defaulter who was in the early stages of the disease.

I respect Botswana’s efforts in providing free TB and HIV treatment to its citizens but without proper adherence these people will develop drug resistance strains. You can’t just throw free drugs to people! A lot of people here in the bush take their drugs at the clinic and once they get home they throw the drugs away due to side effects, lack of food, and lack of understanding on the importance to adherence. Also people can spread drug resistant strains of HIV which is really scary. Care and treatment is not on the priority list of donors which is causing a lot of organizations like ours to close their program due to funding. This is maddening because Botswana has the second highest rate of HIV infection.

A lot of people ask why the rate is so high and the reasons that come to mind are decreased mortality death rates due to life saving free drugs combined with increasing risky sexual behaviors. In ten years Botswana will experience an alarming death toll when the drugs can not extend their lives any further. This is a country with a small population of 1.7 million people and 36% HIV prevalence.

There is a lot of domestic violence in Botswana for reasons that not many people can explain other than it’s just an old practice excepted by the uneducated families. The Bakalanga tribe in my region has the highest rates of domestic violence, also known as “Passion Killing.” Most of the Passion Killings are related to HIV brought on my infidelity. I highly recommend a South African movie called “Yesterday”. It’s a beautiful film and depicts the reality of many families in affected by AIDS in Africa.