Dr. Avnish Jolly:b) Self-help groups: – Another key element of the community mobilization strategy is the formation of self-help groups of PLWHA or Networks of Positive People. The self-help group can provide a context for PLWHA, to share local knowledge and support each other, to solve problems and look after themselves in a better way. It will help to respond to a shortage of adequate health services in the community.
It will help encourage people to use their own resources to meet the needs that may not be met by existing health and social services provided by the Govt. or the NGO’s. Self-help groups can be formed as clubs also and can serve many purposes for e.g.:
1. Health services access: – The club may be a good way for local public health centre to provide services to PLWHA. These services could be offered at convenient frequency (as twice a month) and could consist of physical check up in addition to counselling on care and health diet.
2. Social and economic support: – The main reason that why a HIV infected/AIDS patient shall join this kind of club is to seek out economic support when they are unable to work due to their illness. Through the self-help group, they may be able to get vocational training appropriate to their health status for e.g. knitting, handicrafts, stitching etc. The clubs can raise fund to provide personal health insurance for patients in the community, and can obtain any available free treatment from public health offices and hospitals and also seek financial assistance from both public and private sectors.
3. Recreational activities: – The club can go a long way in providing release to the stressed PLWHA by organizing various activities like music and dance concerts, games, picnics, yoga and meditation classes etc.
c) Religious groups (FBOs): – To cope with crisis PLWHA can seek support and coordinate the effort of various religious organizations. It may be very helpful if religious persons, such as priests, can conduct activities in the club related to spiritual care. They can also provide counselling and visits those patients who are having family problems. Such individual or
groups can provide moral support; encourage the family members and community to feel more at ease and help with the care and support of PLWHA. Such groups need not include the word "AIDS", they can be called "HELPING HANDS" project – not only to avoid reference to the disease itself, but also more importantly to emphasis the healthy, positive vision of this compassionate and helping initiative. This will allow PLWHA to meet others who are suffering from similar kinds of difficulties, discuss and share experiences and talk about their problems and failures.
B) Formal Agencies: –
a) Health Sector: – Providing anonymous testing and counselling is an important way for the health sector to reach out to those people in the community who may be infected with HIV. Drop-in clinics can offer clients, counselling and general information on AIDS/STIs and general
health. The clients can be helped to understand more about HIV/AIDS and learn how to modify their risk behaviour so that they avoid contracting disease and prevent the spread of HIV/AIDS. The clinic staffs needs to provide counselling, comfort and guidance to HIV/AIDS patients and their families during the crisis. In addition the health centre or the clinic may be restricted to providing same medicine to treat symptoms, diarrhoea, headache, fever etc. If need be the clinics can refer PLWHA to Govt. Hospitals for specialized services. Barriers such as lack of food, clean water, adequately trained health workers and infrastructure, and the stigma and discrimination which surrounds HIV/AIDS, all hinder poor people’s access to care and treatment. While working towards solving these problems, the priority must be to prolong life and improve
its quality by whatever means are immediately available, accessible, affordable and safe. Health care systems and home care need to be strengthened as a basis for improving access. Existing tuberculosis(TB) services using Directly Observed Treatments, Short course (DOTS) can be
an entry point for the provision of care to PLWHA.
b) Hospice Care: – In this system patients are provided care and support giving an ideal situation for the patients for living a life free from discrimination and hatred. For providing care and support to the AIDS patients. The Missionary of Charity has already opened a centre.
Hospice care can serve as a place to counter the negative responses. It can serve as an intermediary between hospital, home and community based care system. It can be managed as part of an integrated cost effective care system. As more HIV infected persons develop into
full-blown AIDS, there will be a need to develop more hospices and community based care centres.