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Millions of men and women around the world volunteer their time to help people living with HIV in their communities. But despite their valuable contribution, community health workers and volunteers often remain invisible, unacknowledged and under-utilised. As world leaders and HIV experts gather in Melbourne, Australia for the upcoming 2014 International AIDS Conference, the delegation from the International Federation of Red Cross and Red Crescent Societies (IFRC) is urging governments to ensure community health workers and volunteers are given the respect and support they need to play a critical role in the global fight against HIV. What more can be done to support these unsung heroes?
The role of the community – be it local professionals, volunteers, civil society, friends or neighbours – is often taken for granted in discussions about HIV. But the neverending flow of inspiring stories should serve as a reminder of how valuable an asset community-led healthcare really is.
Laxmi, a former sex worker from Nepal, considers herself lucky. In 2009, when she was still working in the sex trade, a Nepal Red Cross Society volunteer alerted her to the use of condoms and persuaded her to go for an HIV test in Pokhara, the third largest city in Nepal. Laxmi tested negative but the experience completely changed her outlook on life. In a bid to help others at risk, she started a support group for sex workers in her district. Her group ‘Goreto Nepal’, which is registered with the local branch of the Red Cross has expanded rapidly – initially helping 12 local sex workers and is now reaching out to over 200.
In Viet Nam, another inspirational lady, Nguyen Thi Hang, who is HIV positive, leads a group of 12 Viet nam Red Cross counsellors that work throughout the province. Since discovering she was HIV positive in 2002, when her newborn child was diagnosed with HIV, Hang has been determined to channel her grief into something positive for the many others at risk in her community.
In Africa, we hear more inspirational stories. Jessie is an HIV positive woman and member of the Kataila Aids Support Group and which is run from a humble mud brick church in central Malawi. Kataila was initially set up by four people living with HIV and now boasts 52 members. With support from the Malawi Red Cross Society the group has ventured into income generation activities, gardening and micro enterprise projects. The members of the group support each other to take their medication and provide outreach services in the community to encourage people to get tested and seek treatment.
What do all these people have in common?
Laxmi, Jessie and Hang have all experienced humiliation, stigma and discrimination and have been denied HIV prevention, testing and care services. They were not aware of their HIV status for a very long time. All of them, however, have taken action to change the way HIV is affecting their communities.
Globally, only about half of people like Laxmi knows their status and half the people who test HIV-positive in places such Malawi and Mozambique are lost to follow-up before they can be assessed for treatment eligibility.
But Laxmi, Jessie and Hang are equally determined to not be treated as passive victims but as peer supporters, volunteers, activists and service providers, people that can actively contribute to ending AIDS.
Around the world, volunteers such as Laxmi, Jessie and Hang are quietly having a powerful impact on achieving the HIV targets. But if we are to rely on these volunteers to help do what governments and market forces cannot, what are we going to do to support and protect this vast, community health workforce? And if the communities’ efforts are so important, why is their contribution not even counted in most national measures of economic productivity and development?
Bringing HIV services to the communities
The IFRC is speaking with one voice at the International AIDS conference and making the case that a community approach to health service delivery does work, including in fragile situations where health professionals are scarce. Bringing HIV treatment and testing services, combined with other health services, closer to where people live, and shifting certain tasks to a new generation of community health workers, volunteers and people living with HIV.
From the 20 to the 25 July 2014, the Red Cross Red Crescent is participating in the 20th International AIDS Conference in Melbourne, Australia to reinforce the importance of engaging communities and volunteers in all stages of the treatment continuum, including in fragile states. See more at www.ifrc.org/AIDS2014