Casestudy: Clementine Mumba

it will take all of us to stand up and speak one word

Clementine is a single parent with one child and four dependents. She is HIV positive having found out about her status in 1998. She had contracted TB in that year and, as those who have TB are also suspected to be HIV positive (TB is known to be a co-infection or opportunistic infection of HIV), a friend encouraged her to have a test for the virus. At that time, there was no VCT as counselling was not available. Nonetheless she went for a test. When she learned she was positive, Clementine was devastated and could not sleep for two days but soon realised that if she continued in that way she would not survive for long. Since then she has lived positively.

As Clementine had been stigmatised by her office supervisor over the TB, she decided not to inform anyone of her HIV positive status but her boss called meetings which excluded her.They discussed how to deal with Clementine as they thought she would infect them all, however fortunately for her, the rest of the staff were very supportive. When she was tested for TB, she was told that it was non-infectious, so she continued working. Her boss did not believe that she was not infectious, and arranged for everyone in the office to go for TB screening. Nobody went for this screening except her boss. But Clementine was psychologically affected by all of this.

Her boss then asked the Administrator to tell Clementine not to touch any of the office tea cups, plates or spoons in the staff room. Despite this action, Clementine felt relieved because she thought she was going to lose her job. But Clementine now has a new boss, and things have improved greatly.

Clementine is very open about her status but thinks people do not believe her some times because of how healthy she looks. Despite the cost, Clementine began taking ARVs in 2000 having bought them from Botswana as ARVs were more expensive at that time in Zambia. However, she could still not afford to continue with the treatment as they still proved to be expensive. And so, Clementine only took the ARVs for three months, but later with the help of friends she resumed medication.

As time passed, subsidised ARVs were made available in public institutions though there was still bureaucracy to access them. Clementine realised that some doctors did not inform patients that they were subsidised ARVs and continued buying from Drug Stores at a full cost. In 2005, the Late President, Levy Patrick Mwanawasa, SC. announced that ARVs should be provided for free to all those who required them.

The side affects of ARVs are challenging, having to take the drugs every day for life, Clementine has lost fats in her face, her stomach has grown big and her legs become small (like sticks).

But the greatest challenge arises from the attitude of friends who, once they hear of her status, disappear from her life. This, she comments, makes you wonder whether you should tell people or not. You can get very lonely, but you don't have anyone close to you. Once she opens up, she feels better.

Clementine feels that people have become complacent because of the introduction of ARVs and insists that the emphasis needs to firmly remain on prevention and on sensitising people about HIV, speaking about what is happening ‘on the ground'. ‘We need to use role models more because some people still dont think the virus is real. If the public can see how others have living a positive and productive lives , it will help remove stigma and will also help reduce discrimination. There are many who cannot read or write, especially in English, it would also help if information was simplified and also made available in at least the seven main local languages'.

Clementine insists that leadership is key in the fight against HIV and AIDS. She would like to see the President taking a key role say, for example, going for VCT - leaders are supposed to lead by example.

She believes that it will also take a few brave women going into the communities, encouraging other women to stand up and speak. ‘Women have to learn to stand up and defend ourselves because no one will do that for us. You have to stand up and be assertive because there are very few women who will stand up and say no. Women need to tell men enough is enough, but this will take time – it will take all of us to stand up and speak one word, otherwise we are going have a big battle to win. Not many people are taking the lead especially leaders'.

Losing people to HIV related illnesses has made Clementine strong. She lost two young sisters. It has given her a vision of where she needs to go in life, what she needs to do. It has affected her in that she cares for the dependents of her loved ones, two of whom are HIV positive; one of the children has cerebral palsy, and needs a lot of care as she cannot do most of the things on her own. ‘Most households in Zambia have a number of orphans and it takes a lot to care for them, feeding them, clothing them, taking them to school, helping them have a normal life. You have to provide for everything, not just shelter'.