By: Lunga Memela (HST Communications Engagement Lead)
Meet Nhlakanipho Dlamini. He is one of the Health Systems Trust's (HST) unsung heroes: a warm-hearted Driver Mobiliser, entrusted with the important task of taking much-needed health services, including HIV and TB screening, deep into under-served communities in uMgungundlovu District, in South Africa's KwaZulu-Natal (KZN) Province.
About HST Driver Mobilisers
The Driver Mobilisers are employed by HST's flagship 'South Africa Sustainable Response to HIV/AIDS and TB' Project (SA SURE PRO) which is funded by the U.S. President's Emergency Fund for AIDS Relief (PEPFAR) programme through the Centers for Disease Control and Prevention (CDC) for sustaining HIV/TB epidemic control. The project engages at the provincial, district, facility and community levels of the South African health system to support Department of Health (DoH) facilities in four PEPFAR focus districts in KZN: eThekwini, uMgungundlovu, uThukela and Zululand.
HST's SA SURE PRO Operations Manager, Felicity Basson, notes that Driver Mobilisers play a key role in encouraging local community members to access health services, linking them to care, promoting health, and supporting the DoH to achieve the UNAIDS 95-95-95 targets for epidemic control. "Mr Dlamini is one such custodian," she said. "He is passionate about his role as a Driver Mobiliser, which aligns with HST's vision and mission, and the added advantage of being able to market services such as HIV testing, treatment and care, condom distribution, pre-exposure prophylaxis (PrEP), voluntary medical male circumcision (VMMC), and screening for sexually transmitted infections (STIs) and tuberculosis (TB), specifically to men. He can converse with them as peers about health-seeking behaviours, even if they are feeling well."
In the local setting, having limited access to health services is exacerbated by a number of barriers highlighted in a February 2021 blog article titled: How nurse-led pick-up points are boosting community HIV service delivery in uMgungundlovu. The barriers include high rates of poverty, youth unemployment, child-headed households, grandparents raising orphaned grandchildren, migrant labour, and poor transport systems that hinder commuting to and from the villages to community care centres timeously.
Dlamini is passionate about making a difference in uMgungundlovu District
Dlamini joined HST as a Driver in 2015, and in 2016 he was trained as Lay Counsellor to enhance his role by reaching more men through pre- and post-test HIV counselling and offering them the opportunity to be tested in the comfort of their homes or the mobile clinic. Dlamini says that his skills as a Lay Counsellor are rewarding as he is able to link men for services in the communities. He operates in Frans (near Imbali unit 15), Unit 13, Unit 14 and Unit BB, that feed into Impilwenhle Clinic in Imbali Township.
Dlamini loves his job because he gets to help people: "Previously, we didn't have the opportunity to help our families in the communities as we do now," says Dlamini. "Services were not available back then, so we lost a lot of family members and friends."
Dlamini embraces the challenges that come with his job, because he often gets to meet many couples who are wary of starting HIV treatment. "This gives me an opportunity to learn more about their background, counsel them, and give them health education regarding the benefits of HIV medication, and this often leads to the couple accepting their status and volunteering to start the treatment. I am privileged to engage couples, to do family counselling, and to play an active role in tracking and tracing of partners and children of HIV-positive patients through index contact testing services.
A custodian for men's health
Typically, there is resistance among men to seek medical help from the local clinics. This may be related to the stigma associated with HIV, and not wanting to be treated by female nurses at the clinic. This gives Dlamini the opportunity to interact directly with men of all ages through initiatives such as the MINA Men's Health Campaign, the Isibaya Samadoda movement, and the Amajita programme which targets young boys and adolescent and adult men, in collaboration with community partners in uMgungundlovu.
HST Driver Mobilisers are wide-spread across KZN districts. In 2022, a broader cohort was trained to conduct HIV Testing Services (HTS). The World Health Organization explains that HTS covers the full range of services that should be provided together with HIV testing, comprising: counselling (pre-test information and post-test counselling); linkage to appropriate HIV prevention, treatment and care services, and other clinical and support services; and co-ordination with laboratory services to support quality assurance and the delivery of correct test results.
Forging ahead
The next time you see an HST Driver Mobiliser, relax and know that you are in good hands. They work with dedicated and well-trained teams of healthcare professionals.