By Victor Akuma
In the year 2000, Dejah Osman contracted the Human Immunodeficiency Virus, HIV, shortly after her marriage to Kabir. The 42-year old, whose name has been changed for fear of stigma, works as a cleaner in a tertiary institution in Minna, Niger state. Her greatest fear was telling her husband about her status since she knows how troubled and emotional he can be. When she finally did, her fears became real as her husband developed high Blood Pressure (BP), which eventually led to his death in 2007.
Apparently, he had contracted the virus before he died but Ms Osman insists it was anxiety that killed him and not the virus. “His anxiety which gave rise to High Blood Pressure led to his death because he became too afraid of what people would say when they got to know. He was afraid that we might be asked to vacate the house we rented. He was just afraid of so many things.
“Because of this, he started seeing a herbalist in Gwagwalada that used to give us ‘Abalake’ (a native drug said to cure HIV/AIDS). He also visited other communities across Niger state, in search of solutions. There was also a juju man that took so much money from us then and promised to cure us but nothing happened,” she told DAILY NIGERIAN.
Before her husband’s demise, Ms Osman took in and gave birth to Mahmud, who is now 17 years old. Sadly, Mahmud also has the virus.
Shortly after Mr Osman’s death, she started seeking help at General Hospital Minna, as her condition continued to deteriorate and no member of her family offered help. She later joined a local HIV/AIDS support group at a local hospital in Dutsen-Kura Gwari and this proved to be a watershed moment in her quest for support.
“That was the very first counseling class I attended after knowing my status since 2000 and that was probably all my husband needed to be alive. If he had the opportunity to attend one of those classes, I doubt if he would have died.
“The day I went for the meeting; I saw many others like me. That gave me some relief and I said ah, it’s not only me but by that time, my husband had already gone,” she said.
Speaking about the stigma, Ms Osman said she didn’t divulge information about her status to her mother until years later after contracting the disease. “Before then, we really do not live close to my mother, neither do we visit each other frequently. When I told her, I personally didn’t feel I was stigmatized. The only thing that happened was that she slumped on hearing the news. She didn’t regain consciousness until after three days. She also became hypertensive but she is still alive till date.
“Aside her and close family relations and those who counsel us, no other member of the public is aware and I have not felt stigmatized in anyway. I still go to my work place and I am living like every other normal human being now. Even my neighbours are not aware because before the death of my husband, he gave me strict instructions not to tell anyone my status,” she said.
She said her encounter with the support group established by a not-for-profit organisation, Friends of the Poor foundation in Africa, FOTP, helped her wriggle out of many challenges as a HIV patient.
Ms Osman has gone ahead to re-marry, and her three children –Safiya 11, Adama 5 and Umar –have tested negative to the virus.
The Psycho-Social Support Initiative by FOTP
Psycho-social support approach for people living with HIV (PLHIV) is geared towards understanding the influence the social environment has on their physical and mental wellness and their ability to function. It helps to meet a person’s emotional, physical, mental and spiritual needs, all of which are essential elements of positive human development.
Emotional needs include the need for love, security, encouragement, confidence, motivation and self-esteem. Other important needs include a sense of affiliation or belongingness, community ties, acceptance from peers, provisions of food, shelter, education and basic health care.
To this end, FOTP, established a Psychosocial Support Initiative, PSI, to cater for the needs of persons living with HIV/AIDs. The organisation was founded by Rev. Fr. Chiedozie Ezeribe, a priest with the Catholic Diocese of Minna, Niger state. The clergy stated the organisation access PLHIV largely through the state’s General Hospital in Minna during periodical visits to offer interventions. At other times, when the General hospital is flooded, they refer some of the patience to Divine Mercy Hospital, an organisation that also works closely with FOTP. At the hospital, FOTP will take up the responsibility of counseling the patients and other activities in its psycho-social initiative.
In a complete departure from what is often obtainable in the management of the disease in Nigeria, the methodologies employed by the organisation is quite unique. As part of a well-thought process, FOTP quickly dismantle the barriers of self-pity, and stigma that most infected persons are confronted with by encouraging victims of the virus, who have overcome the shame of the virus and its stigma, to counsel new patients. These experienced patients are already well developed psychologically and making waves in their career pursuits.
Asides this, findings showed that the organisation offers free psychological therapy classes for PLHIVs, through the assistance of professionals, to get their minds off suicidal thoughts, which Ms Osman confessed of having given a trial. The FOTP also provides recommended drugs for these patients free of charge and settle other medical needs, whilst providing food items to many who cannot not fend for their families.
In her words, Ms Osman said that: “The PSI takes care of the mental, physical and spiritual wellbeing of patients. They took care of our drugs and every other thing that pertains to our health. Other times, they prayed with and for us regardless of the faith we profess.
“During my time, we were like 80 to 100, if not more. Each time we have a class, you can literally see everyone happy and hopeful. Some of us who had thoughts of suicide, were able to overcome it. Now, I really don’t care what those who know my status say or think about me anymore, because the class made me courageous,” Ms Osman said exuding in confidence.
According to her, FOTP’s strategy of meeting the needs of the PLHIVs have largely worked, especially for her. She believes that having persons with the virus, who have nipped their fears in the bud, have helped her live above her situation, especially knowing she is not alone in her plight.
Going beyond counseling to providing personal needs to these patients have worked as well. Mr Ezeribe noted that without some of the things the organisation included in the psycho-social activity, like provision of food items and taking care of the cost of some of their drugs and other things, many of them would have given up coming for the classes at some point.
A review of these persons are done periodically and contact made to ascertain their welfare. According to Fr. Ezeribe, the psycho-social support initiative, have largely been successful and should be adopted especially in the management of patients with HIV/AIDS.
HIV continues to pose huge health threat to world’s population
HIV is a viral infection that attacks the immune system. If not treated, it can lead to Acquired Immunodeficiency Syndrome, AIDS, a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.
Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype. With routine access to health care and good response to modern Antiretroviral Treatments, ARTS, there is no exact number of years one can live. Hence, a 20-year-old who starts on ARTs early enough, might eventually live up to 67.
Globally, the disease continue to be a major global public health issue killing 40.1 million people. The World Health Organisation, WHO, reported that there were an estimated 38.4 million people living with HIV at the end of 2021, two thirds of whom (25.6 million) are in the WHO African Region. However, women account for the highest number of affected patients in this region, at 58 per cent.
The Nigeria HIV/AIDS Indicator and Impact Survey, NAIIS, of the National Agency for the Control of AIDS, NACA, indicates that about 1.9 million Nigerians are currently living with the disease.
According to Victoria Matthew, HIV consultant and member North Central Civil Society of HIV/AIDS, “The essence of introducing the psycho-social support initiative for people living with HIV/AIDS is to give life back to these patients who have lost confidence in themselves because they feel once you test positive to HIV/AIDS, your world has come to an end. The initiative helps them to have confidence in themselves and that they can still make it in life.”
Adenike Jimoh is an experienced Health Information Officer with Association of Reproductive and Family Health, ARFH, an indigenous non-profit Organization committed to improving quality of life of under-served and vulnerable communities in Nigeria. She said, “the best way to care for someone confirmed HIV/AIDS positive is to give close attention and care to the person. It is also important to counsel the care givers, so they know the right time to give drugs to the patients.”
“HIV patients who religiously take their drugs, have reduced viral load. It reduces it to less than 20 to 1000. At the range of 20 to 1000 viral load, a HIV patient is believed to have a suppressed viral load, while from 1000 to 1,000,000, it means the patient is at high risk and the viral load unsuppressed.
“Viral load means the amount of virus domiciled in the body of a HIV patient. Taking adequate drugs regularly, help suppress them and lack of drugs help them grow rapidly,” she told DAILY NIGERIAN.
She clarified further on the prospect of an infected person marrying an uninfected person.
“A HIV positive patient can marry a non-positive individual without the risk of transmission if the former has a suppressed viral load. HIV nursing mothers are equally advised after two months of pregnancy, to go for the viral load test to determine the risk level of breast feeding her child,” she said.
Ms Jimoh also advised that the baby should be breastfeed for only six months since the child is expected to start producing tooth by then. This also helps to avoid the risk of biting the mother while suckling, which could expose him or her to the virus as well.
“When positive mothers fail to go for the viral load test earlier, Nevirapine should be given to the baby at early stage (72 hours per week, for six weeks). After which, Early Infant Diagnosis, EID, test would be carried out to ascertain if the child is positive or negative of the virus,” Ms Jimoh said, adding that with proper management and support, the likes of Osman can live a well fulfilled life.
