Casestudy: Misheck Akatumwa

Once people know their status, then they can know how they need to live.

Born into a family of five boys and two girls, Misheck is a counsellor by profession and started working with ARHA while he was in school. This experience encouraged him to continue and to study counselling. He began work in Lewanika General Hospital in Mongu, where he delivered VCT services. He then began doing home-based care after completing his studies. He enjoyed this work because he met and supported a lot of different people, some negative, some positive. He also found it hard because he found it difficult to give people the results when they tested positive.

But with time, he got used to this and now enjoys the relationships he is able to build with his clients. He says that after counselling, the relationship with the client does not end there. He makes follow up calls to find out how people are doing, if they are having any difficulties in terms of medication or any other challenges such as stigma or discrimination. He developed his interest for this work after attending a workshop on behaviour change. He admired the work people were doing and first wanted to work as a nurse or a doctor, but that did not work out. He knew he wanted to help people, so he decided on counselling.

Misheck argues that HIV and AIDS are definitely spreading among young people. If someone has a girlfriend, that girl may have another boyfriend also, sometimes an older man. The pandemic is spreading because people lack access to effective and appropriate information. Even those educating on the issue often do not have accurate information. Sometimes, Misheck argues, those very HIV and AIDS educators leading workshops go in search of girls after they finish and, as a result, people lose trust in them because of their behaviour.

Misheck feels he has achieved a lot with those he has helped. Before they were tested, they were very sick, some could not even walk, but now that they are on medication and have been supported they can walk again. They are much healthier and some are working with other support groups. Around 20 support groups have been set up for about 200 young people living with HIV and AIDS in Mongu. Previously, they were living with stigma and discrimination but this is now beginning to change.

Misheck goes for VCT frequently, every 3 months. People think the only way to become infected is by having unprotected sex but this is not true. On one occasion, while doing home-based care, he was splattered with blood from a person who is HIV positive. He waited 3 months to do a test, but it came out negative. He was quite scared when this happened, so now he goes every 3 months to be tested. Misheck's girlfriend is also a counsellor and works at the Lewanika General Hospital in Mongu. They go for VCT together.

He lives in the same community as Kahilu (an ex-sex worker). She knew him as a counsellor but did not approach him to seek help until very sick. He encouraged her, by counselling her on HIV and AIDS (he carries out door-to-door education in the community). After that, she went for VCT with her friend and they both got tested and were found to be positive. After being hospitalised for over a month, Kahilu began taking ARVs.

Misheck has worked with a number of sex-workers, helping them to get tested and to access ARVs if necessary. Misheck has supported sex workers in becoming peer educators to get different work and cease selling themselves for sex.

It is difficult to support people like Kahilu now because there is not enough funding anymore to discourage them from going into town. If there is no support, they will most probably go back to sex work. Misheck feels like he has failed when things like this happen, because he has not been able to help them as much as he should.

People need to know their status. Sexual intercourse is not the only way you can become infected, there are many ways. Once people know their status, then they can know how they need to live.

Misheck argues that the government needs to be more serious about rural people. Urban areas have a lot of information, but the information does not spread effectively. Some people don't even know about condoms or do not have access to them. More education is needed and Zambian leaders need to be role models.