Doctors Without Borders (MSF) HIV/AIDS programme SELIBENG SA TŠEPO in Lesotho also relies on lay counsellors to ensure its effectiveness. Lay counsellors are committed community members and most often co-infected or HIV patients, who are trained to undertake non-medical tasks and responsibilities usually done by a nurse or a doctor and are devoted to helping fellow patients in their villages. They are an integral part of the programme and ensure patients adhere to treatment through regular counselling and by providing step-by-step guidance on taking the life-saving medication. But each one of the counsellors has their own story to tell.

Mahlomola arrives at the rural Masemouse mountain clinic, holding his chest x-ray and yellow medical booklet in his right hand when he joins the queue after a brisk 15 minutes of walk from his grandmother’s house where he lives. Mahlomola has been visiting the clinic regularly since 2006 when he tested HIV positive. In 2007, confronted with the challenges he faced because of his HIV status, Mahlomola completed a training course to become one of the 46 lay counsellors trained by MSF to provide HIV testing and counselling support at clinic level to patients experiencing the same difficulties he had faced after diagnosis.

 
“I want to help other people to know their HIV and TB status before they become weak, ill, and face deteriorating health conditions due to HIV and opportunistic infections – just like what my grandmother did for me,” Mahlomola says.
Four years ago, weak and suffering from chronic fever and illness, it was his grandmother, Mantsotso Panyane, who convinced Mahlomola to be brave enough to deal with his HIV status and treatment before it was too late, unlike what had happened to his mother who is suspected to have died due to HIV and TB a few years before. 
 
In 2009 Mahlomola was diagnosed with TB. He has to undergo additional intensive treatment lasting at least six months which complicates his HIV treatment. “My grandmother ensures that I have a ration of HIV and TB pills and that I follow exactly what my nurse instructs me to do. She is my inspiration and guarantees I always do my best in providing assistance to others who are in the same situation I am,” he says.
But, facing up to the reality is not always easy for Mahlomola. Despite the heightened awareness about HIV and TB, stigmatisation persists and patients often are ostracised from village life as gossip spreads. Mahlomola says he has learned to tolerate the snide comments and sidelong glances people give him.
“It still hurts, and I feel like I am different from other people because of my condition. It is distressing to hear neighbours, and other people in the village gossiping about me; saying that I will die soon. So, I decided to isolate myself from them. I stay in the house mostly, and I talk to no one, but my co-patients. 

Mahlomola and his grandmother. Photo: Zethu Mlobeli/MSF

“It is my grandmother who gives me the strength. She made me realise that I am not the only person in the world who is co-infected with HIV and TB, and that I can help others like me. When I realised this, I became more motivated to be healthier and stronger, and to fight to survive,” he says.

In accepting his condition, seeking treatment and reaching out to others Mahlomola has also found the love of a woman in his village who is also HIV positive. “She and my grandmother are my inspiration. They give me more reason continue helping other HIV and TB positive patients, because I know from my own experience that patients need support more than they know.”