Occupational and nutritional therapy for people living with HIV and AIDS

HealthNutrition

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Lesotho, formerly called Basutoland, is a mountainous country with staggering natural splendour and a breathtaking landscape. It is bordered on all sides by South Africa and has a population of about two million. It has the world’s highest HIV prevalence at 27.7%, though, because the population is small, in absolute numbers only about half a million are infected with HIV. That has resulted in the average life expectancy of Lesotho being very low – 37 years. Breadwinners, especially men, often go to work in South African mines and return home with HIV. Those unable to obtain treatment die, leaving behind widows and children. As a result, there are many households headed by children.

It is good to report that people are now able to seek medical treatment and get antiretroviral therapy, or ART. Treatment and drugs are free and HIV-positive people are now able to live longer and healthier lives. However, people living with the disease, especially widows and children, often suffer the dual pain of HIV infection and poverty. Resources are scarce and jobs are hard to come by. In order to help each other, People Living With AIDS, or PLWHAs, usually form support groups to tackle common problems.

The Heso Organic and Integrated Therapeutic Centre is one such support group. It aims to empower families and communities by using a holistic and practical community-based approach to care and support. The Centre is located in the middle of the Thuathe Plateau in Berea District, which faces the beautiful Lesotho landscape and Maluti Mountains. According to the founder Malitlallo J. Majara, the centre has grown to be self-sufficient and caters not only to the needs of HIV-impoverished people, but also the nutritional and occupational needs of nearby communities. It offers a wide range of alternative and complementary therapies to vulnerable groups (HIV-positive or not), including massage, meditation, fitness exercises and open-air garden walks.

This script is a mini-drama based on an actual interview with the founder and participants of the Heso Organic and Integrated Therapeutic Centre in October 2010. Informal interviews also took place between the author and two German interns who had volunteered at the Centre for about six months. You could use this script as inspiration to research and write a script on a similar topic in your area. Or you might choose to produce this script on your station, using voice actors to represent the speakers. If so, please make sure to tell your audience at the beginning of the program that the voices are those of actors, not the original people involved in the interviews.

Script

Characters

Mphana: 30-year-old widow and mother of three
Ngopokin: 8 years old, first child and son of Mphana, orphaned by death of father
Mphor: 6 years old, second child and daughter of Mphana
Mateboho: 4 years old, daughter of Mphana and last child
Mputsoe: teacher and active member, HIV support group, Maseru
Modise: an elderly participant in the seminar on income generation and people new to HIV drugs
Moshoeshoe: administrative officer of the support group which Mphana joins.

Presenter:
Hello and welcome to our radio show, Everyday People. I am your regular presenter, Malepekola Sejane. The following is a mini-drama; I will start by giving you a short summary of this true-to-life drama. This is the story of Mphana. Mphana is a widowed mother of three who recently lost her husband to an AIDS-related illness. She later tested positive for HIV at a government clinic. She began antiretroviral therapy and has been doing well health-wise. Luckily, her three children tested negative. Her major challenge has been her joblessness and her daily struggle to feed and pay the school fees of her three children. Then one day, things took a dramatic turn for the better when her son was brought home by his teacher for unpaid school tuition. This marked the introduction of Mphana to a network of people living positively with HIV and AIDS.

Signature tune. Fade and hold under presenter.

Presenter:
On today’s episode of Everyday People, we will be taking a look at a very sensitive issue that affects women in society. Let me get the ball rolling by asking you a question. (Pause) How would you feel if you were an HIV-positive and jobless woman, and the breadwinner of your family passed away? Give me your thoughts. I will be back in a moment with the story of Mphana and her colleagues. We will hear how they were able to weather the storm. I remain your anchor on radio, Malepekola Sejane.

Signature tune up and out

Presenter:
Back to my question. What would you do if you were an HIV-positive woman, had no job, and your husband passed away, leaving behind three children? How would you cope? Well, that is the dilemma of Mphana, a housewife with three children whose husband died of an illness related to AIDS. Let’s take a peep into Mphana’s life. Let’s see how she has been coping with life two years after her husband’s demise.

Sound of woman singing a local tune, poking wood in the fire

Mateboho:
(Yawning) Mummy, I am hungry!

Mphana:
(Exasperated, trying to assert her authority) Will you shut up, Mateboho, and wait for the food to get ready? Can’t you see how the fire is burning my hands? Take this cob of maize. Eat it and drink a lot of water. Take this second and give it to your elder sister Mphor. Make sure you don’t eat her piece! Then we wait until God provides. Wait till I return from the farm.

Mateboho:
But what if God refuses to give us anything?

Mphana:
(Reassuringly) God who made the mouths – that includes yours, Mateboho’s, Ngopokin’s, Mphor’s and mine – will definitely feed them all, my gal. Smile for mummy, will you? That’s my gal.

Mphor:
Mummy, have you taken your medications? I didn’t see you swallow the pills this morning.

Mphana:
(Giving her daughter a big hug, shedding tears) My guardian angel, what would I do in this world without you? I was busy trying to cook something for you and almost forgot them. Please, go inside the bedroom and bring me the container of pills. Thank you.

Mphana:
(Summoning her guardian angel) Fetch me some water too, Mphor!

Sound of water gurgling into a cup, then sound of footsteps as Mphor hands over the cup to her mum

Mphana:
(Swallowing hard) Thank you. Now I can face my (cut short) … Who’s that coming home with Ngopokin? Is he not supposed to be in class?

Mphor:
(Grunting) Oh oh! This doesn’t look good. I think he is with his class teacher.

Presenter:
So what happened next to this hardworking mother of three? Please stay tuned. I’ll be back after a short commercial time out.

Music/advert fades up, then down and out

Presenter:
Welcome back to Everyday People, your educating and entertaining program. Before the break, we witnessed Mphana, the widowed mother of three, face some challenges. Let us join her as she receives an unexpected visitor.

Sound of footsteps approaching

Mputsoe:
(Coming on mic) Lumela meh (Editor’s note: pronounced “Du-me-la meh,” which means “Good morning, madam”). How do you do?

Mphana:
E-e! I am doing well. And you? (Editor’s note: E-e! is a verbal mannerism common in the Basotho culture. It is a respectful way of acknowledging a greeting, a way of saying “um hmm” or “yes.”

Mputsoe:
So-so, but we thank God. Are you Ngopokin’s mother, please?

Mphana:
E-e! Yes, I am. Is there any problem with my boy?

Mputsoe:
Not really. I am his teacher. Mputsoe is my name. I must say your child is brilliant in class. (Turning sharply) Hey, Ngopokin, will you stop making faces at your siblings? But that is not what I came here to talk to you about. I was sent on behalf of the school to tell you that he has unpaid school fees for the second and third term. You now owe the school 350 Lesothan Loti. The school feels he should remain at home until all his fees are paid. I am sorry; I’m only a messenger.

Mphana:
(Pause) Well, thank you. I know he owes that much. You see, I tried to make a vegetable garden to make some money. Unfortunately, we ate up most of it. I used the little I could sell to purchase his new sandals and the exercise books you see him carrying.

Mputsoe:
I am so sorry about your late husband. Your son told me about your predicament. Permit me to say I can see we have something else in common.

Mphana:
(Perplexed and anxious) What would that be apart from womanhood (burst of nervous laughter)?

Mputsoe:
Well yeah, that’s right. Excuse me if I am intruding on your privacy. Those drug containers in your hands – they look exactly like mine. I am also HIV-positive. I have been on ARVs for five years now. I’m not doing badly, am I?

Mphana:
That is interesting. Good to hear that. I have been on them barely two years.

Mputsoe:
I think we have met at the right time. I am the leader of an HIV support group in the next village. A number of us widows have the same kind of problem, namely, feeding our children, clothing ourselves, paying school fees. My sister, the burden is too much.

Mphana:
My sister, you have scratched me where it itches me most. I thought I was the only one suffering in silence. All my in-laws and relatives have abandoned me and the kids to our fate.

Mputsoe:
You are not alone. We have actually started forming a larger support group involving our two villages and five neighbouring villages, all around the Maluti Mountains. We have recruited over 40 widows and 20 married women, all living positively with HIV and AIDS. We are involved in farming. We have a co-operative society that gives loans to assist our members. Do you want to join us this afternoon at the Heso Centre near King Moshoeshoe the Great’s Cemetery?

Mphana:
E-e!With all pleasure! I will be there for the meeting even before you get there.

Fade in local musical instruments, then fade out

Presenter:
In the concluding part of this program, we will hear how Mphana joined this network of women. We will also hear how the support group has improved the socio-economic status and well-being of not only those living with HIVand AIDS, but the neighbouring communities as well. Please, don’t go away.
Fade in local musical instrument playing, then fade out

Mputsoe:
Ah, my sister Mphana. You beat me to the meeting! You are welcome. Let’s get inside. I want you to meet the administrative officer who will register you. It’s free. Then later, we meet the other participants.

Mphana:
E-e! Ke leboha! (Editor’s note: Thank you).

Moshoeshoe:
Please have a seat. To register, I need a record of your family history: name, marital status, number of children, your educational history, and so on. I will also need your medical history in brief. This will be kept confidential. If you can later get us a medical report from your hospital, it would be easier.

Mphana:
That is okay by me. Problem is … (shyly) I have no money to pay for the medical report.

Moshoshoe:
Never mind. I will give you some money from our funds to cover transport and the medical report. Meanwhile, you can choose which area of our activities you want to start on. You can choose to work in the orchard or the piggery or the restaurant or the organic farm. Or maybe you could help in facilitating workshops, or even assist in the administration of the office or the rentals.

Mphana:
Did you say facilitating workshops? No, not me. I cannot stand before a sea of eyes and talk! God knows, my vocal cords would fail me. (Laughter) I would rather give the pig farming a try. I just have a primary school certificate.

Moshoeshoe:
That’s good. We will give you a soft loan. You will run the animal farm here on our premises. You can use all our equipment free of charge. You will then remit to the organization on a pay-as-you-earn basis. When you pay back the whole loan, the pigs are all yours.

Mphana:
Just like that?

Moshoeshoe:
Just like that! That is one of the ways we generate income here. We are self-sufficient. We receive no help from external sources. Of course, if you later wish to change your area of specialization, you can still do that. You can work in the rental unit where you can rent out the accommodation and the conference hall for an affordable fee. You can also choose to join our group of farmers and do farming, or market the farm produce.

Mphana:
How about working in the restaurant? I pride myself on being an excellent cook. I will definitely win over new customers.

Moshoeshoe:
(Smacking his lips, perceiving the imaginary aroma of a delicious meal) Uhmmmmnnnn! I can’t wait to taste your food! Do I take it you want a change from piggery to the restaurant?

Mphana:
(Warm heartedly) Oh no! Piggery is definitely more profitable. I rear them, sell some of them, and make some money to pay you guys back your loan. Then I have some pigs of my own. What more can I ask for?

Music interlude fades to women singing in local dialect, sound of hoeing in the background, grunts of pigs

Mputsoe:
Mphana, could you help me with that pail? No, that one with the corn husks. Yes! Thank you. How many pigs have you fed?

Mphana:
E-e!I have fed 15. Those piglets in pen 12 are still breastfeeding. When they are done, I will feed their mother. Meanwhile, I want to go to the organic farm. I’ve got some potatoes and pumpkins to harvest. I need some for those hungry monsters called my children (laughing).

Mputsoe:
Thank God I’m not alone. Don’t forget the principle of a balanced diet. Get them some pork from the abattoir. We can always deduct it from your salary at the end of the month.

Mphana:
E-e! Ke leboha!(Editor’s note: pronounced “Kia-le bo-ha” which means Thank you!)

Women singing a boisterous song in Sesotho. Fade and hold under speakers.

Modise:
Hey, Teacher Mputsoe, we twenty two participants have just finished the counselling course for those new to their medication, and the income-generating training for village men and women. Can we walk in the garden now, just to relax our nerves and breathe in more fresh air?

A participant:
Ntate Modise, I have not been in a classroom since my high school. My brain’s got rusty for classroom brouhaha! I could use some more oxygen (Editor’s note:Ntate is a polite Sesotho word for Mister).

Mputsoe:
(Laughing) I guess you lousy bunch should go for your stress-alleviating and depression-lifting walk around the orchard! The members of the second group from Leribe and Mohale villages are waiting to start their session. Could you please vacate the hall? Can I get an “E-e!” in the house?

Chorus:
E-e-e-e-e!

Signature tune up, then fade and hold in the background

Presenter:
The Heso Centre’s occupational therapy program has created jobs for over 200 people in five villages. Families have made positive changes to their diet, increased their earning capacity, managed their stress better, and adopted farming as an occupational therapy. In fact, the Centre has built its own conference hall with local materials. It also has five-bed lodging with modern furnishing, a home-based care facility with units for maternal and child health care, a piggery with capacity for 50 animals, organic farms, an orchard, a nutrition centre and more than 10 hectares of farmland. For more enquiries, please contact the centre at +266-58752797.

Fade up signature tune for two seconds, then under presenter

Presenter:
This wraps up today’s edition. I hope you have been inspired by the stories of the people you have heard. Stay tuned for the next episode of Everyday People on this same station, same time. Have a pleasant evening. I remain your presenter, Malepekola Sejane.

Fade up signature tune, hold, then fade out

Acknowledgements

  • Contributed by: Lawrence Wakdet, pharmacist/public health practitioner, Institute of Human Virology, Kano, Nigeria
  • Reviewed by: Lynn Van Lith, Johns Hopkins Bloomberg School of Public Health Center for Communication Programs

Information sources

  • The Heso Organic and Integrated Therapeutic Centre, Makujoe, Berea District, Lesotho, brochure, 2010.
  • Lesotho Mountain Kingdom Tourist booklet, Lesotho Tourism Development Corporation, Maseru: www.ltdc.org.ls
  • Interview with Malitlallo J. Majara, founder, The Heso Organic and Integrated Therapeutic Centre, Makujoe, Berea District, Lesotho took place in October, 2010.
  • Interview with two German interns at the Centre in October 2010.
  • Informal chats with the Administrative Officer of Heso Organic and Integrated Therapeutic Centre, October 2010.
  • Informal chats with a participant who cooks at the kitchen/restaurant, October 2010.