Tackling HIV and malnutrition in Swaziland

12 April 2010 - Keira Lowther, a nurse from London, has swapped her busy East London wards for Swaziland, where she is working as Head of Projects for Action Against Hunger.

"Left a bit, right a bit. Right, left, right. You need to be in first gear to get up that hill. Here! Straddle that pothole! Back down to first. Swerve left to avoid that one" (relieved round of applause to finish).

Sounds a bit like a rally driver’s commentary, no? That is, in fact, the commentary for the five minute drive from my new home to my new office. The roads in town are MUCH worse than I remember, but the mountains are just beautiful and the sun even a little warmer.

I arrived in January to take up my new position as Head of Projects for Action Against Hunger’s HIV & Nutritional education programme in Swaziland. There is so much to do: my day begins at 7am, and ends 12 hours later.

One lady we met in a local clinic was HIV positive and had three children, with her youngest still a baby. She was very weak, and found it difficult to take ownership of the nutritional advice we were giving her so she could support her children. Women in Swaziland rely on men so much, not only to provide for them, but also to make decisions The worrying question is who is going to look after her children if she doesn’t come back to us for proper treatment? This is the challenge for us, as Community Nutritionist Health Workers, to keep on being creative, and thinking how to solve the problems we come across.

We coordinate with the Ministry of Agriculture, Nutrition Council, Infant feeding NGOs and people who work in the community, to produce educational nutritional information for those with limited literacy. We use pictures, stories, role plays and other creative things.

Last week, we held a drama role play on the importance of good nutritional practices, focusing on women with HIV, and it was a huge success! We even had our own private media circus and made it into the paper!

It was great to be heavily involved in the community, and get to know our partners. Sister Diane and Sister Barbara, from the Cabrini Mission, talked of a staff member who had lost five close family members in the past year. She now finds herself responsible for the rest of the family. How can she cope with this massive grief, and make sure her family are safe and healthy? She is only 22 years old.

I hear similar stories everyday. Today our cook/cleaner/fantastic helper has the day off, because she has to pick up her granddaughter from her maternal grandparents house. They cannot take care of the child, as the mother has left and the son died. So, now she takes care of her, and pays for all her school fees. She also has another dependent: her 8 year old half-sister. Having already brought up her own children, she now has limited resources to bring up the rest of her extended family.

Many of the women in Swaziland who are taking care of so many children are very old. They have already raised families of 9, 10, 11 children and asked for no help the first time. Now they are arthritic and tired, and yet their responsibilities continue. One of our partners asked: "Would you expect your Granny to do manual labour in order to feed 15 of her grandchildren as her children have all died?"

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