Masoyi Home Based Care March Report

Recent Events

Current Focus

- HIV Counselling and Testing (HCT)
- Door to door campaigns with information regarding HIV and TB screening 
- Referrals to the primary health centers for those who have tested HIV positive or have signs and symptoms of TB, or any of our patients who might need to be referred
- To check patients medication 
- To encourage patients to adhere to their medication 
- Follow-up on patients, and counselling 
- Giving emotional, physical and spiritual support to patients  

Home Visits

During March we did 609 home visits to all seven areas of the Masoyi community, giving DOT support to those on TB treatment and TB screening to family members. 12 new TB and HIV clients were registered in the program. 21 people were counselled, screened and tested for HIV, only 2 tested positive and so were also referred to the clinic for CD4 count test. 51 family members were screened for signs and symptoms of TB, 15 referred to the clinic for clinical assessment. We had 2 clients die and 10 recovered.  

HIV Counselling and Testing (HCT)

With the strong relationship that we have with the local clinics, we recently had an HCT campaign held at Masoyi Home Based Care Centre doing TB screening, pap smear, immunization, BP and haemogluco tests. The attendance was good and people came in large numbers. There is therefore a great need for more campaigns to be done because people come in large numbers and we ran out of testing kits while people were still coming. The Department of Health conducted or hosted the HIV/TB campaigns at Masoyi Centre. 

Support Groups

We have managed to conduct adherence support groups for 63 clients in their places during home visits and also one big support group meeting was conducted at Masoyi HBC Centre. We also do them in the care worker's garage.

The small adherence support groups were conducted in all seven areas. The topics were about correcting misconceptions, treatment literacy and treatment adherence. General evaluation was conducted after each lesson delivered. The attendance was good and the support group was conducted in the homes and at the Centre. Clients were so excited that the support group was out from the health facility because they were able to be open enough to say whatever is in their hearts and share their stories with the group. 

Personal Stories

Mpangane family

The Mpangane family lives in Mthimba area. There are seven people living in this three roomed house. These include the grandchildren. On the first day of our visits we found the situation very bad.  The client was in pain. She complained of her right hip and both feet. She tested HIV positive in December 2015.  

She is doing well with the treatment now even though they are facing a big challenge of not having enough food. There is no income in this family. They survive with the social grant of two grandchildren but it's not enough for this big family. The problem is she can't walk properly because of the pain.  She also tested for TB but the result came back negative.  We suspect TB of the bone. We referred her to ASM for further observation.  We thank BHW and all the people that are helping with food parcels and the money for transport to the clinic, as we do not have money for this.  

Female client at Phola

This lady is 80 years old and the photo shows her together with her care worker during a home visit to monitor her medication and also checking the clinic card for next return date because she is old and stays alone in this two roomed shack. She tested HIV positive and is already on treatment. 

She had two children but they are not taking care of their mum. Her son is abusing her and took all the money for social grant and left her with nothing. She went to the social worker to report the case and even to the police but she couldn't get any help. There is no food and she is not adhering to her treatment because of an empty stomach. We have managed to provide her with a food parcel and refer the case to a social worker. 

Soweto Manganyu

Soweto Manganyu was visited in Jerusalem by one of our community care workers and her friend. She stays alone in this two roomed house and is originally from Mozambique.  She tested HIV positive in 2012.  

We are happy because she doesn't need us to visit her continuously as she is able to take her treatment on her own.  However, on our first visit the condition was bad. She was bedridden for three months. She has a hip problem because her husband used to beat her with a wooden stick. She no longer stays with him. We tried to refer the case to a social worker but failed because she doesn't even have an ID or passport. She was not taking her medication well and was not eating properly. By monitoring her medication, providing food and visiting her twice a month, MHBC saved her life.  

It's difficult to apply for a social grant or other help. The local councillor built this house. With the food parcel that was provided it brings a good impact and it enables our patient to adhere to their treatment.  

Family in Manzini

We visited a family in Manzini. There were five people living there in this four roomed house which is still under construction. Three of them are patients on ARV's.  Loveness, the mother, was not home. She is doing piece meal work. The care worker said she visited her on Friday and she was not well. She is on ARV's, as well as her mother, Josephine, and her baby.

The baby also has TB. She is one years old and losing weight. When we saw the baby she was being cared for by her granny, Josephine. Josephine was involved in an accident approximately 15 years ago and it left her mentally challenged. Apparently she has attempted suicide. The baby has not been given her medications properly and is very lethargic. I have never seen a baby so sick. Her eyes were drooping and she had a discharge from them, as well as from her nose and ears.  She weighed approximately 6.5 kgs, down from her weight in October.  

At first we discussed sending the baby to ASM (African School of Mission clinic), but the support team decided to bring her to the Manzini clinic immediately. The clinic then sent her by ambulance to Themba Hospital. Had the Masoyi Home Based Care team not been there today, this baby would certainly have died.  Food was left at the house and the care worker counselled Josephine on giving proper medication to the baby. She felt the baby was not given the TB medication properly and was not eating well.  

Katiego

Katiego is a 15 year old boy who is in a wheelchair. There are four in his family. He has two siblings and his mum. His mum left him several years ago because she said it was very difficult for her to care for him due to his condition. Social Services took him for about a year and his aunt was caring for him. The mother begged to have him back and they returned him to her.  She says she loves him very much and appears to take good care of him. However, she refuses to send him to the special school available for handicapped children. She claims they do not take good care of him. We tried to convince her to send him to school. We prayed for him and his mother and left a Bible and food.

She is not working therefore it is difficult for her to provide for her children. The social grant for Katiego was stopped because the aunt had been receiving it but now he is back with his mum. We encouraged her to apply for the social grant. Masoyi Home Based Care gives the family hope and direction on how she can improve her life and the lives of her children.  We also provide food. During the visit we faced the challenges and helped the family as above and therefore it was successful.

Gift

Gift is an 11 year old boy who lives with his granny. He tested HIV positive. He contracted the virus from his mother, who has passed away. Gift and his granny live in a wooden shack in the community of Mahushu. Granny used to drink and Gift was not regularly attending school.  We counselled granny and she also removed her Sangoma bracelets and said she would give only proper medication to Gift.  She had failed to take care of him previously. The neighbor and the Masoyi community care-giver were assisting Gift with his ARV medication. Gift was also given a uniform and encouraged to attend school. Granny picks up the food parcel here at the MHBC office (see photo). There is no income. She is eligible for a social grant but her ID has the wrong birthdate.

We are happy to report that Gift is doing well and is now attending school, thanks to the influence and help of Masoyi Home Based Care and BHW.  

Challenges Faced This Month

- Some of our clients are still mixing alcohol with treatment. 
- 20 care workers under Global funding will be affected because the contract for 2014 just ended early this year of 2016.  
- Some of our clients are sharing treatment with their partner. 
- Some of our clients are not taking their treatment well because they are not working and do not have enough food to eat and they are victim of TB (MDR). 

Successes This Month 

- We plan to do an adherence support group to OVC children that are on ARV treatment.  
- Clients attended the support group and they were all participating. They were not afraid to ask questions, clients were friendly towards themselves; they also enjoyed the meal that was prepared for them. 
- They appreciate the topic especially when we talk about the opportunistic infection symptoms of TB and the way of getting it. 
- We learned more from our clients and they also learn more from us. 
- 5 clients were referred to African School of Mission clinic (ASM) for clinical observation and also provided with transport money. 
- 5 families that are mostly in need of food were provided with food parcels helped by Bright Hope World
- Some of our clients are not afraid to get tested, especially woman.  
- HBC clients, a mother and her daughter were both tested HIV and TB positive. During our first visit they were both bedridden and we referred them to a clinic, where the daughter was admitted to Themba hospital for two weeks. On our second visit their condition was better and they are now able to care for each other. We provided them with food parcels because there is no income. 
- A 24 year old HBC client who lives in a three roomed house tested HIV positive but she was afraid to go to the clinic. The 58 year old woman was the one who encouraged her to go to the clinic and also took the initiative to take her there. Now she is already on treatment and is also doing quite well.