Wednesday, 1 December 2010

An AIDS story: Mayibuye iAfrica

Today is World Aids Day: a day to remember the 25 million people who have died of AIDS so far and the 33 million currently infected with HIV/AIDS.

Yesterday at an event to mark the day at a friend’s house in London, I had the privilege of meeting some people who are making serious inroads in the struggle against the spread of this disease in Africa. They are three thoroughly nice, humble, and very impressive  professionals who live in Cape Town where they run an organisation called mothers2mothers.

Mitch Besser (above) is an American gynaecologist, who joined the Obstetrics & Gynaecology department at Cape Town’s Groote Schuur Hospital in 2000. There he was confronted with the impossibility of providing effective care for huge numbers of pregnant HIV positive women in the face of serious social and political obstacles.

Graves of AIDS victims in Port Elizabeth, South Africa. Source:

These are the problems:

•    22 million of the 33 million people currently infected with HIV/Aids live in 

•    90% of all HIV positive women in the world are in Africa.

•    In resource-rich countries, the rate of transmission of HIV/Aids from mother
     to child is around 2%.  In Africa, the rate of mother to child transmission is 
     40%. This means that every day in Africa 1000 HIV infected babies are born.

•    The continent of Africa has precisely 3% of the world’s doctors and nurses.

These are the obstacles:
  • For effective prevention of mother-to-child transmission of the disease, rolling out medication is not enough. In fact, the necessary drugs are increasingly available to women in Africa (including South Africa in recent years).  The challenge is fear, ignorance and stigma, which drastically reduce the chances of adherence to treatment.
  • In Africa, where the need is greatest, health systems are the most stretched and have absolutely no chance of providing the support and education necessary to deal with these hurdles.
Image source:

Mitch devised a simple scheme aimed at addressing both problems simultaneously. He enlisted the help of the people who were in the best position to provide it: mothers in the community who were themselves HIV positive, who were counselled and trained to work as mentors to other women, newly pregnant and identified as HIV positive. 

A key feature of his approach was to avoid using mentor mothers as volunteers: these women, many previously in desperate circumstances through being stigmatised by their communities, are paid a decent wage and work within existing healthcare structures, alongside clinical staff, thus both ensuring a high standard of professional service and giving them a respected status in the community. Their salaries go directly into the local economies.

Image source:

The model is both incredibly simple and incredibly effective: its root strength comes from the women who serve it and the women whom it serves. Its culture comes from the field staff, in response to their clients. It empowers women to take control of their social, reproductive and economic lives.

Site Coordinator Babalwa Mbono:
I came to mothers2mothers thinking my life was worth nothing. I had AIDS [and] a baby on the way, my husband beat me, and there was no hope for the future. Now I can give to others —people in the township come to me for help and advice. I [became] a leader. I have been beaten and abused but I will never be beaten and abused again. I have learned that women have value; we can make a better world for our children. Now I have a life.

From Mitch’s  small, local start in a Cape Town township, mothers2mothers has expanded to seven African countries (South Africa, Lesotho, Swaziland, Malawi, Zambia, Rwanda and Kenya) where it reaches 300 000 women. In the Western Cape province of South Africa, where m2m reaches 70 – 80% of pregnant HIV positive women, the rate of mother-to-child transmission has dropped to only 5% - virtually the same as in developed countries.

Image source:

There are stories of hope, after all. In the jaded, cynical northern continent of plenty, these are the kinds closest to my heart.

If this interests you, I urge you to watch this:

and go to and consider making a donation. £35 ($55, ZAR 384) will see a mother through diagnosis, support and having an HIV free child.

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