Not angels, but the next best thing

Connecting with and supporting health workers living with HIV, doctors, nurses, community health workers (CHWs), and others in clinical settings, was a significant pillar of the Boresha project (Kenya and Tanzania, 2010–2013, part‑funded by the European Union). Historically, this group had been overlooked in HIV programmes.

Nyanza Provincial Hospital, Kisumu

Kenya:Grace Abong’o, a nurse and chair of the Kiwoso Support Group for HIV‑positive health workers at Nyanza Provincial Hospital, led a peer network that met monthly for group therapy and to share personal and professional experiences. Members worked across the hospital, in the labour ward, casualty, counselling, and administration, and all were HIV‑positive. One member, Bernard Okombo, lectured at the Kisumu branch of the Kenya Medical Training College.

“It was assumed for so long that health workers had knowledge at their fingertips about HIV - it was not so,” Grace said. “Health workers had a raw deal for a long time. There was a sense of: ‘I am the one taking care of people, how can I be seen to have HIV?’ HIV had been stereotyped. Health workers did not fit that stereotype and so they were left behind.”

The group grew from six members to ten, and then to 35. Mildmay International trained many in home‑based care (HBC). Nurse Jane Oyombra reflected: “The biggest challenge was coming for the first time, and that was then behind me.”

“We tried to let health workers living with HIV know that they had a family,” Grace added. “For people living in silence or isolation, we tried to reach out to them. We cherished the support group and wanted it to continue.” She noted the impact of training: “Our members were able to talk publicly as a result of Mildmay’s training—what to say, when to say it, and where. The stigma most of the time was within yourself. Once the stigma had gone, there was no longer discrimination—and you were a free person.”

Reaching doctors remained challenging. “You couldn’t say we had made a breakthrough,” said Grace. “The most senior cadre of health workers—that was the real challenge. We were aware that senior people were HIV‑positive but they would not come to this group. At the time we were losing them to HIV and we shouldn’t have been losing them.”

The hospital administration acknowledged that the group had changed how staff viewed HIV. Such was the success of Kiwoso that members began mentoring staff in other health facilities to establish similar support groups. As part of Boresha in Tanzania, efforts were also made to connect with health workers living with HIV.

Peer solidarity and reduced stigma

Members expressed pride and parity with colleagues: “A person who was negative walked like me; the way they went somewhere was the same way I went somewhere,” one member said. “In our support group, we all stood up proudly if we were HIV‑positive. Because we were trained, it was easy for us to train clients. Because of education, stigma and transmission went down.”