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Page last updated at 12:10 GMT, Wednesday, 6 May 2009 13:10 UK

Lesotho Aids diary: Counselling co-ordinator

The BBC, in conjunction with Medecins Sans Frontieres, is following the lives of seven people from the community of St Rodrigue, in Lesotho, who will share their hopes and fears as they each struggle to live with and work through the country's HIV/Aids crisis.


Mececilia Makhetha Leche | MSF counselling co-ordinator | Morija

MSF Counselling coordinator Mececilia
Mececilia counsels patients on multi-drug resistant TB

In the future, once so many people stop dying from HIV, MSF will have to leave Lesotho completely and help people in other countries.

Of course the lay counsellors worry about that.

They know that if MSF leaves the government will have to take responsibility for paying them.

We all hope that the government will recognise the important work that they are doing it and value it.

People have to cross rivers to get to the clinic, so when it is rainy attendance is not so good

Normally, to keep motivation high, we have monthly meetings with the counsellors.

We talk about the challenges they face and come up with ideas to solve them.

Every meeting we have, we have a TLC (Treatment Literacy and Counselling) team and a medical team.

Highly motivated

We find that a lot of the challenges our lay counsellors face are medical.

MSF counselling co-ordinator
Age: 26
Lives: Morija
Occupation: Counselling co-ordinator
Wishes

If this is about magic wishes then I want to live forever. Of course, I know that one day I will die. In reality, I believe that if someone dies, then someone else is born.
I also wish that all Basotho would get tested for HIV - not that the test was compulsory, but that education about the disease would reach everyone.
Finally, my third wish is for my family. I wish we could have a great life - maybe with a good house and a car - and able to go on holidays.

Sometimes we find that a lot of people from a certain village are defaulting on their medication - not taking them regularly which is vital, or even stopping completely.

So we, together with the lay counsellors from that clinic, plan a community gathering, usually a health talk or education session.

It involves everyone in the village, starting with the chief - but men and women, children and grandparents are all there. They get together in one place and we provide the talk or education.

Another example of a problem can be when clinics run out of drugs.

We decided that the lay counsellors would tell MSF if drugs were running low long before the stock completely depleted.

Then MSF could help back up the stock while the clinic waited for the government to deliver new supplies.

The government in Lesotho provides anti-retrovirals (ARVs) needed for treating HIV but does not supply drugs for the infections that people with HIV can get, which are called opportunistic infections.

HIV weakens the body's ability to fight disease and infections which are rarely seen in those with normal immune systems can be lethal for those with HIV.

Thus, it is so important that our clinics have drugs to fight these infections. MSF provides those drugs.

Tough journeys

A specific problem to St Rodrigue is that people come to the clinic from villages that are very far away.

They have to cross rivers to get to the clinic, so when it is rainy attendance is not so good.

For this problem there really is no sustainable solution except for planning infrastructure development by the government.

Being a counselling co-ordinator, I have learnt so much about teamwork and management. As a lay counsellor also, I have learnt that patients need patience and lots of time to spend with the counsellors.

If you provide them with time, they are free to tell whatever they want and you can find a solution before a problem arises. I have learnt so much in this role, helping others with HIV, supporting the counsellors.

I still want to go to nursing college. I want to upgrade my subjects and become a nurse. Then my plan is to work with MSF again in the future as a nurse to help more people through medicine.





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