Coping with HIV in Zambia

Chanda Fikansa runs a home-based care programme for people living with HIV/AIDS in the copperbelt region of Zambia. [CAFOD]

When a doctor from Zambia discovered that his hard-earned medical training was not enough to help relieve the suffering of people living with HIV/AIDS, it changed the course of his life

Chanda Fikansa saw the hospital where he worked crumbling because they did not have the staff to care for the number of AIDS patients in their wards.

His boss regularly asked him to discharge patients who were still sick and desperately in need of care, because they needed the bed space.

Turning point

Then, in 1994, two years after he had qualified as a doctor, Chanda’s elder brother, fell sick with AIDS.

"My family looked up to me because I was the only one who understood medicine. Unfortunately I was helpless because my limited training did not provide me with the skills I needed to help my brother.

"I felt a great stress because I could not help him and my family expected a lot from me. When he died I realised my training was inadequate to respond to HIV issues. I felt I could have done more.”

Chanda had planned to become a surgeon, but after his brother’s death, changed direction and took a course specialising in sexual health and sexually transmitted diseases.

Hospitals not up to the job

In 1996, Chanda started running a home-based care project for people living with HIV/AIDS, which was supported by CAFOD.

"I had found that hospitals were not adequately able to look after people with HIV/AIDS," Chanda explains. "Zambian hospitals are poorly funded because of the poor economy."

"In the African setting, HIV brought a very different dimension to hospitals. People with AIDS need to depend on the healthcare system for a long time and that wasn’t possible.

"So it was important to come up with different approaches. One was to work in the communities – getting people involved in helping to look after sick people.

"This idea is not a new phenomenon in Zambia. People have always gone to visit sick neighbours or relatives, taking them food or helping them in the house."

Home-based care

Working with the CAFOD-supported Catholic Diocese of Ndola, Chanda helped train community members about HIV/AIDS, to reduce stigma and raise awareness about how to prevent its transmission.

They offer home-based care in the desperately poor shanty towns in the industrialised Copperbelt region of Zambia.

"Through the programme, we were able to buy drugs to treat opportunistic infections, to provide psychological care and to bring a spiritual aspect by praying with patients," Chanda explains.

In 1998 Chanda gave up formal medicine and was employed as a full time programme manager. His medical background enables him to train volunteers on how to make basic diagnoses and distribute medicines.

The programme also caters for orphans who have been left with no family members to care for them.

"We did not encourage the building of orphanages," said Chanda. "We wanted orphans to be taken into families because the most important thing that anyone needs is love. We support those families who take children in, many of whom are very poor. For example, we pay for the children's education."

In November, Chanda was invited to the wedding of one of the orphans who the programme had supported for six years.

"She has graduated as a teacher now and got married. She made a speech and said that without our programme she wouldn’t be where she was today. That was very moving for me. I really felt we had made a difference."

Coping with tragedy

When another brother and a sister died of AIDS, Chanda was personally much better prepared to help them through difficult times.

"I could explain what was happening to my family. I could also counsel my siblings and help them psychologically when they lost all their hope – that was so important.

"I don't regret that I am not a surgeon," he says. "My friend [a surgeon] spends eight hours a day in an operating theatre without seeing the sunshine. I spend my days outside, in the communities, talking to the women, dancing and singing. That, I really enjoy."

Hunger the number one problem

The number of new infections in Zambia has fallen since the 90s and Chanda sees this as encouraging.

However demand for care is rising because people who became infected ten years ago are now getting sick. One of the main problems is lack of food.

"If we ask people living with HIV to rank their needs – even when they are very sick – they will always think of their children and say that they need food. Food is always number one.

"Supplying food is very expensive and most partners do not think it’s sustainable so they don’t want to do it. But if people are very sick they cannot work and they cannot provide food for themselves."

Fight AIDS by fighting poverty

Chanda had a clear message to CAFOD supporters in the UK.

"It has been proven that there is a direct connection between poverty and HIV/AIDS. So I want to ask you to help us fight poverty - that way we can fight the disease."

"On our own we in Zambia have a feeble voice. Please speak on our behalf and lobby your leaders about fighting poverty."

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