Democratic Republic of the Congo
Phelicite Shimuna is a 40-year-old seamstress from Kikwit in Bandundu Province in the Democratic Republic of Congo. Kikwit, a town of one million inhabitants 600 kilometers from the DRC capital of Kinshasa, is a town without electricity or indoor plumbing. Residents line up to fill their buckets with water from taps that are turned on to sell water during certain hours of the day.
Phelicite discovered she was HIV-positive in 2000. Since then, she has taken a long and visible journey – rejecting fear and shame, disclosing her status to those in her family and community, and along the way helping many other HIV-positive people in Kikwit find the courage and strength to, as she says, “live positively.”
A seamstress by trade, she says that there aren’t many people ordering clothing these days, and so she’s also started farming to support her family. Her husband, who is unemployed, helps her on the farm. (Popular estimates place the unemployment rate in DRC around 85%.)
Phelicite lives with her husband and their eight children. Three of the children are from her husband’s previous marriage; at the time they met, both Phelicite and her husband had lost spouses. Since getting married, they’ve added five children to their family, and Phelicite is pregnant with their next. By the time Phelicite learned about her HIV status in 2000, she already had given birth to two children. Unfortunately, her eldest daughter, now seven, was born before Phelicite knew PMTCT services were available in Bandundu, and she is HIV-positive.
Luckily, Phelicite and her family live close to the Kikwit II Health Center, one of the only health centers in the entire province of Bandundu that offers PMTCT services and antiretroviral therapy. PMTCT services first became available in Bandundu seven years ago, when the EGPAF-supported KSPH program expanded to four sites in the Province. Since then, Phelicite has returned regularly to the sites offering the lifesavings prevention services to keep her children healthy. Phelicite, her husband, and her eldest daughter are all on antiretroviral treatment.
On the breezy summer day when we met with Phelicite, she’d come in to the facility to access EGPAF-supported PMTCT services. Currently five months pregnant, Phelicite tells us she is certain her daughter will be born healthy and the ARVs she takes will prevent transmission of the virus to her newborn.
Phelicite has started several support groups for people living with HIV in Kikwit. She says she initially gained the courage to disclose her status because she wanted to help other people. She wants to encourage people not to be afraid. She says in the days when she was hiding her status, she was always self-conscious. She felt guilty, and was suspicious that anyone talking was talking about her.
Since going public with her status, Phelicite has gained a sense of calm. Sometimes she even wears a T-shirt that says “HIV positive.” If people point at Phelicite and intone that she has HIV, she just responds, “Yes, I do.”
Luckily for Phelicite, her due date is in October, and when she returns to the health center to give birth, PMTCT services will be available for her. For the last seven years, EGPAF has used private funding from generous donors to support PMTCT services at four sites in Bandundu. Due to the lingering effects of the global economic turndown, EGPAF has struggled to continue supporting this privately financed program. Current funding for the program ends in December, and if the program were to close entirely there would be absolutely no PMTCT services available anywhere in Bandundu. Bandundu is one of the most underserved provinces in DRC, rural, inaccessible, and far from the conflict in the East - and few donors have made it a priority. In fact, the EGPAF-supported KSPH program is the only PMTCT partner in the entire province. Phelicite plans to return to the health center for subsequent pregnancies, but without critical donor support the next time she comes she may be told that services are no longer available.
In ending our conversation, Phelicite says the advice she’d like to give other people is to get rid of their fear, their shame, and their anxiety. “HIV is a disease just like malaria,” she says. “When you take your medicine, you can live well, you can live long.” Hopefully for Phelicite, private donors open their hearts so that medicine to prevent the transmission of HIV from mother to child continues to be available.