BroadReach
Providing Hope and Tough Conversation
by Jacqueline Novogratz
BroadReach partners with private practitioners to run one of the largest HIV/AIDS programs for the poor in South Africa.
February 2006: Until BroadReach began its program in Hammersdale, a small suburb of Durban in South Africa, the people who live in the ticky-tacky houses on the hillsides had to find their way into town for treatment, and many did not. Hammarsdale is estimated to have HIV rates at 33 percent, although BroadReach’s doctor there believes that it is closer to 50 percent among women.
We are here for the beginning of a three-day training that happens before patients are enrolled with their official BroadReach general practitioner. Already, about twenty people are seated in a circle in the small local church building, waiting for the training to begin. They are young and old – from about three to nearly sixty. They are men and women, though the latter outnumber the former. All sit quietly, usually with hands folded. All have learned recently that they are HIV-positive and are waiting to do the training so that they can start their regimen of anti-retrovirals and, hopefully, begin living healthier lives.
Zaneli, the main trainer here, is a powerhouse, with an infectious smile and braids to her shoulders. She starts the training with a song to break the ice, and then doesn’t waste time in getting into the important questions. “How long will you take ARVs?” she asks the group. Quiet at first.
She asks again. A woman answers shyly, “Until your viral count is below 50.” Another says, “Until your CD4 count is above 200.” Finally, an older woman in a green beret answers correctly: “Forever.” Forever. It is a different word for the sixty year-old than for the fifteen year-old girl.
We watch BroadReach’s training video that explains the process. The main spokesperson on the video, herself an HIV patient, talks about how she feels better than she has in a long time and how she intends to take good care of herself and live a healthy life. Everyone is glued to the TV.
First comes training; then the doctor visits; third, visits from support people; and fourth, the regular taking of medicines. Each person is given a membership card and told where and when to pick up medicines.
Zaneli asks the group again what the stages of treatment are, stressing the importance
of finding a friend who you trust. She asks the group, “Who is the first person you know who has taken this step of admitting the disease and getting help. A young woman in her twenties with a green crocheted hat hits her chest and says, “I am the first person I know who has done this.”