Photo: Pablo Garrigos/MSF
A consultation with an HIV-positive patient, the first day of the full re-opening of MSF’s HIV programme within the Munhava health centre after Cyclone Idai struck Beira.
When Cyclone Idai struck the port city of Beira in Mozambique on 15 March, in which damaged or destroyed buildings along with infrastructure along with ripped the roofs off most health centres, rendering many completely unusable.
Leaving countless patients with nowhere to go might be a major public health concern anywhere within the entire world, although the tree-lined streets of Beira hide an added vulnerability; This particular city of more than half a million will be the capital of a province where one in six adults lives with HIV.
“We cannot abandon them”
Stigmatised communities such as sex workers, who may be relatively modest in number although who statistically have an extremely high risk of being infected with HIV, are particularly vulnerable.
MSF was running an HIV program in Beira before the cyclone struck. Teodora Tongouche will be a sex worker who understands the challenges well. She will be also one of MSF’s peer educators.
“Some of these people [who lost their homes] are ashamed,” she explains. “They are right now living with ten some other people within the same space, along with they don’t want their HIV status to be known. although in which has been difficult to contact them because the phone along with internet have not been working well.”
As the post-cyclone humanitarian response phases out, her role working with MSF to educate some other sex workers on the management of HIV will be more important than ever.
Filipe Francisco Luis will be a male sex worker along with also a member of the MSF peer educator team. As an HIV-positive person himself, Filipe knows how crucial in which will be to ensure people can continue their HIV treatment within the wake of Cyclone Idai’s devastation:
“in which will be very important to find these people right right now, along with remind them of the importance of taking their pills. Because taking their medicines will be not their biggest worry – they are worried about finding shelter, where to sleep, what to eat. We cannot abandon them, because if they go untreated their viral load will increase.”
Like hundreds of thousands of some other people, Filipe too lost nearly everything during the cyclone along with subsequent massive flooding. “I practically only have my clothes along which has a mattress,” he says. “Cyclone Idai did not leave anyone well.”
Paula (not her real name) will be a sex worker along with one of MSF’s HIV patients. She spoke about some of the some other impacts the cyclone has wrought on both her income along with professional safety as a sex worker.
“My work will be more risky right now,” she says. “Many of the places I used to meet clients have been destroyed by Cyclone Idai. I end up going to more dangerous places. Recently, when I left one of those places, I was approached by three armed men. I had to give them everything.”
“I have fewer clients since the cyclone,” she continues. “I think they cannot afford the same amount as they paid before. Everyone was affected by the storm.”
Since 2014, MSF’s HIV program in Beira has focused on assisting particularly high risk communities – sex workers along with men who have sex with men. Additionally, in Beira’s main hospital emergency care will be given to patients with advanced HIV along with life-threatening associated infections such as tuberculosis.
within the aftermath of the cyclone, MSF’s response in Beira initially focused on the most visible consequences of the storm damage including the lack of clean water along with the outbreak of cholera.
via the first days, the less visible HIV needs became part of the response. However, in which took almost a month before MSF’s full HIV program – including night clinics in brothels along with some other sex worker hotspots – was up along with running again.
“In one of our HIV clinics in Beira, we saw an average of 125 HIV patients each day before the cyclone hit,” says Dr Antonio Flores, an MSF infectious diseases specialist. “Then the roof of the centre was ripped off, along with the out-patient activities more or less closed for ten days. Our team of peer educators started off hearing about patients, including some sex workers, who had been unable to refill their prescriptions. in which was a big concern – because some sex workers were taking the medicine as a way of keeping them safe via catching HIV, some to keep the level of their virus low enough to not be a risk for their health along with to make sure they cannot transmit the virus to their sexual partners.”
The financial impact of the cyclone may also be exacerbating the spread of HIV. “After natural disasters, extreme hardship often forces people to look for alternative, last resort, ways to make money to survive,” says Dr Flores. “We have heard multiple reports suggesting in which transactional – or survival – sex may have increased, including people who had never engaged in sex work before. We have to put HIV as an increasingly urgent priority within the post-disaster response. The HIV epidemic was claiming lives long before the cyclone along with, if we overlook This particular medical emergency, the long-term consequences could be devastating.”
MSF in Beira: MSF has run an HIV program in Beira since 2014. The team provides sexual along with reproductive health services, including HIV testing along with treatment for vulnerable along with stigmatised groups, such as sex workers along with men who have sex with men (MSM), as part of MSF’s transnational ‘corridor’ project along transport routes between Malawi along with Mozambique. More recently, since 2018, the team has been working within the emergency room of Beira Central Hospital to reduce sickness along with mortality in patients with advanced HIV by improving diagnosis, treatment along with continuity of care, along with supporting the laboratory along with pharmacy. As the cyclone emergency response starts to scale down, This particular team will remain to continue supporting the Ministry of Health with This particular vital HIV program.