Comprehensive Care Under One Blue Roof
This morning we headed to the Blue Roof Wellness Centre, in the Wentworth area of Durban, where the HIV infection rate has been estimated to be as high as 40%. A former nightclub-turned-clinic in one of the most violent areas of the city, the Blue Roof was created in 2006 by Keep a Child Alive South Africa. The building kept its name and its signature cover, but was transformed into a comprehensive care centre for people living with HIV and AIDS. The Blue Roof’s goal: to provide free comprehensive HIV care to all who seek it, and to restore the sense of community in an area that has been badly marred by violence and crime.
After a warm welcome from the staff, Rhona, the Blue Roof’s director, gave us a tour of the centre. It is a brightly coloured, open and inviting space.
The building was bustling with activity. The Blue Roof has more than 1,000 patients on antiretroviral drugs, as well as 30 children – an astonishing feat, given that the clinic has only been open for a few years. In order to cope with the numbers of clients who pass through the centre on a daily basis, the centre has a full-time doctor and a full-time pharmacist on staff, in addition to a host of nurses, counsellors and home-based care workers. Clients waited to pick up their drugs, attend counselling sessions, and see the doctor. Outside the VCT (voluntary counselling and testing) and blood test offices, people waited for HIV tests and to receive their CD4 counts. (A CD4 count is a measure of cells that help protect the body from infection. When people are living with HIV, the virus attacks the immune system, drastically reducing the ability of the body to fight back against infection. In South Africa, people with CD4 counts of 200 and below are eligible to receive antiretroviral treatment).
We passed a classroom filled with adults who were learning about how to take and adhere to antiretroviral drugs. Every person on treatment at the centre participates in the class, so that they can learn about how and when to take the drugs, side effects and proper nutrition.
Everyone who comes to the centre also receives a hot meal – a different dish each day of the week. Edna, the centre’s cook, makes the meals at her home each morning and brings them to the centre to distribute throughout the day. Stephen, Aissatou and I each had a bowl of today’s offering – it was a delicious stew that tasted similar to beef and barley soup. It’s an amazing thing: few, if any, other organizations offer free meals to all clients who come to the clinic for counselling, testing and medication. It is part of the Blue Roof’s incredible commitment to a holistic approach – everything is under one roof, including a space for clients to come and share a meal together.
A number of clients had gathered to tell us their stories. The group was diverse, but the common thread was that the Blue Roof had been there to provide essential services and care for people who needed it most. As we moved around the circle, one man spoke of coming back to health after having a CD4 count of only 28; a refugee from Zimbabwe described how the Blue Roof was the only place that would provide health care and drugs for her after she came to South Africa. All of the people telling their story spoke of the care and attention that the Blue Roof staff gives to each and every person who comes to the centre for assistance.
We later headed out into the community for a home-based care visit with Patricia, a home-based care worker, and Nonhlanla, a home-based care volunteer, to the home of one of Blue Roof’s new clients in a neighbouring township. We visited with a 40-year-old man who had only recently started taking antiretroviral drugs. Patricia and Nonhlanla were there to change, wash and bathe him, and to ensure that everything was going smoothly with treatment. Thulani, the Blue Roof’s driver, is also a part-time home-based care worker. He often steps in and helps out with the clients, particularly when caring for men in the community.
Patricia and Nonhlanla lifted the man out of bed and undressed him. They cleaned his body and changed his clothes, and gently rubbed lotion onto his frail frame. Wiping his mouth and tongue with a cotton swab dipped in saltwater, Patricia explained that she was trying to treat oral thrush (a common ailment for people living with HIV) and prevent it from spreading to his throat, which can make swallowing extremely difficult.
Watching the care and the respect with which the women handled his body was an extremely moving experience. They spoke softly to him as they moved him, and reassured him as he winced when they touched his swollen feet. As she tended to him, Patricia told him about how she had also been sick and bedridden at one time, and how she had been cared for at home and in a hospice. Although he was weak and swollen from the drugs, she told him, things would soon improve. “I’ve been positive for 15 years now,” she said. “I’ve been there, done that, bought the t-shirt. Look at me now – I’m healthy and beautiful!”
Patricia, Nonhlanla and Thulani are just three examples of incredible, dedicated caregivers who devote their time and energy to tending to the sick in their community. I asked them why they do this work, particularly since many of them volunteer their time. “We’ve been there,” explained Thulani. “We’ve been sick and we needed home-based care.”
“When I was sick, I didn’t have any family around,” said Patricia. “My friends cared for me, and home-based care workers. I had a CD4 count of 59, and I was close to death. I want to do the same thing to give back and contribute to my community.”