One of the greatest challenges that HIV/AIDS patients face, especially in remote areas, is the lack of food, since the antiretroviral treatment is heavy and requires them to eat properly.

Poor nutrition, combined with stigma and discrimination, has contributed to some patients dropping out of treatment, leading to physical weakness and making recovery difficult.

Recently, the National Council for the Fight against AIDS (CNCS) launched a study that points out that about 500 thousand people have abandoned antiretroviral treatment in Mozambique.

According to the same CNCS study, two million people receive antiretroviral treatment in the country, and twenty-five percent have abandoned it.

This situation worries not only the government, but also the associations that work with this social group.

This is the case of the Tionane Tense Association, a non-profit organization dedicated to home care for people with HIV/AIDS, Tuberculosis, Malaria, with a focus on the key population (female sex workers). After the assistance in the communities, the association’s mission is to advice the patients to resort to the health unit so that they can continue the treatment with dignity.

Located in the Liberdade neighborhood, in Moatize, in the central province of Tete, with 25 members, the Tionane Tense Association is currently assisting about 150 patients. In an interview with the Citizen Observatory for Health (OCS), Suzana Chikuna, a member of the organization, lamented the fact that daily they come across patients who, because they don’t eat properly, can’t bear the medication, and end up abandoning the treatment and consequently losing their lives.

Suzana Chikuna, activist

According to Suzana Chikuna, from last year to this part, three patients who were assisted by the Tionane Tense Association died for lack of support, and one left children.

“Despite frequent visits, the patients do not have someone who can help them with feeding.”

“It constitutes, for the association, a shocking situation, since its work is to achieve the full recovery of the patients it assists”, she pointed out.

Before the loss of this patient, Suzana explained that the members of the association even sought support from the district AIDS nucleus, but were recommended to resort to Social Action. The association, in turn, said they should turn to the nearest Health Unit, allegedly because there is a social action office there.

The association is sometimes faced with some patients abandoning the treatment, apparently because they think they are free form the disease. But after some time, the virus comes back with more aggressiveness and the person becomes debilitated.

“sFor these cases, we have to raise awareness again and take the patients to the hospital”, the activist said.

Contrary to this scenario, it has been a great joy, not only for her, but for the Association in general, when she manages to recover a patient who was already debilitated.

“It is known that when a person stops taking medication the virus comes back very strongly and it is hard work for this person to recover from the relapse. I can say that the moments that impress me most positively are these, when we manage to rehabilitate the patients”, he stressed.

“Since I started working at the Association, we have already helped to recover several patients who were debilitated because of HIV/AIDS.

Suzana Chikuna, who has been working as a health activist since 2005, explained that people in the community, when they get sick, do not usually present themselves to the health unit. Therefore, it is the association’s role to encourage them to seek help at the hospital.

“We make the person understand that the virus is not death. If they follow the treatment properly, they can live for many long years”, she said.

Lack of Transportation as a Barrier

Regarding the difficulties that the association faces, in the scope of carrying out its activities, the source pointed out, as the main one, the lack of means of transportation to visit the communities. Even so, however, the association has been able to “fulfill with the missions.”

“Besides the lack of transportation, we sometimes find ourselves with patients without food so they can follow up with their medication, and some are also struggling with tuberculosis and they are taking antiretroviral drugs”, he says.

Although resources are scarce, the association has made efforts to help the patients, gathering cornmeal, oil, and other basic products to offer to the patients.

In addition to offering some basic products, the members of the association have dedicated themselves to nutritional education, advising patients to use local and easily accessible foods, such as “matapa” and moringa, as well as “malimbe” and peanuts.

To continue the work in the communities, helping to rehabilitate seriously ill patients, the association is asking for support from people or organizations of good faith.

“We would also like to have some kind of report to record our work. Although the government acknowledges that we are working, there is no record of our work”, the source said.

About the health services, according to Chikuna, the sector has registered significant advances, but even so there is a need to increasingly improve attendance.

It should be noted that the OCS conducted a study in 2021 on Budgetary Dynamics of the Health Sector in Mozambique: with a Focus on Funding for Sexual & Reproductive Health and HIV/AIDS Programs. The research indicates that from 2018 to 2020, spending on HIV/AIDS actions increased at the central level by about 59.7%. However, at the provincial level, it decreased by about 42%, contrary to the decentralization process in place in the country.

In per capita terms, health sector spending has tended to reduce since 2013, dropping from $28.69 to $15.41 in 2020. The 2020 amount represents a quarter of what would be needed, according to the World Health Organization (WHO) (US$60.00) and corresponds to only 6% of what is needed to achieve the Sustainable Development Goals by 2030 (US$271.00).

The same amount (US$ 15.41) is also below the average for Africa (US$ 32.00 per capita). This means that health spending is not keeping up with the trend of population growth, which may compromise the improved delivery of Sexual Reproductive Health and HIV/AIDS goods and services, for example.

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