WINDHOEK –HIV positive residents of the Mix informal settlement which is located some 20 kilometers north of Windhoek say the lack of transport fare to travel to Windhoek is one of the reasons some fail to collect their anti-retroviral (ARVs) drugs, thus compromising their health. 

Speaking to New Era over the weekend, a health extension worker at Mix, Samuel Paulus said nine HIV positive people defaulted on their ARVs last year. 

“Those are only the ones who are free to talk to us about their HIV status. What about those who are hiding? Nine people are a lot because it means that their health is compromised,” explained Paulus. 

The reason they give is that there is no transport money to go and collect their medications, explained Paulus. 
“But we encourage them to do everything in their power to go and collect their medications because if they don’t take their medications regularly and as prescribed, their viral load will increase,” said Paulus. 

Also, HIV positive patients who default on their medications risk being put on second line ARV regimen due to resistance, explained Paulus. 

“Patients who default on their ARVs are at higher risk of getting Tuberculosis because their immune system is weak.”  New Era also spoke to an HIV positive couple at the Mix settlement who refused to give their name for fear of “victimisation”. Seblon * and Victoria* were diagnosed with HIV in 2006 and 2011 respectively. *Seblon who according to Paulus (and also written in the health passport) has a high viral load at the moment says there was not a day that he forgot that he should take his medications. 

“My partner is always there to remind me to take my medications. The problem is that transport money to travel to Windhoek is not easy to get, especially because I am unemployed at the moment. It costs N$64 for one person to go and collect medications in Windhoek,” he added. 

Seblon said it is not always easy to ask money from the neighbours because they “also don’t have”. 
The couple survives on selling wood in the Mix informal settlement for N$20. 

“We use that money to buy food or pay for the children’s transport fee to Windhoek. If I have to choose between collecting my ARVs and sending my children to school, I prioritise my children because they are future leaders. That does not mean I don’t care about myself, it just means that the little I get, the children get first priority and what is remaining from that money, we buy food,” explained Seblon. 

Seblon has two children from a previous relationship and his partner, Victoria has three children from a previous relationship. “We had one child together but the child passed on,” said Seblon. 
Victoria has never skipped her medications since being initiated. In fact, her health passport has stars, indicating that she has been adhering to her medications and her viral load is suppressed. 

“I never miss collecting my medication. Even if I don’t have money I go to the neighbours and struggle,” added Victoria. Her partner Seblon wants the two of them to be given the same dates of collecting their medications. 
“That way if one does not have money, the other can collect both our medications.” 

But Paulus explained that there is an initiative in the pipeline, similar to community-based ART services, which was launched in June 2017 by the U.S Ambassador to Namibia, Thomas Daughton in northern Namibia, where the burden of HIV is high. 

Through this initiative, ARV services were decentralised to support groups within communities to ensure that people living with HIV, who are on treatment have access to their medications regardless of challenges. 

Through this initiative where support groups and ARV clinics work hand in hand to ensure that HIV positive people who qualify (those with low viral loads and those who are not pregnant or lactating among others) only one person collects ARVs on behalf of the community. 

Seblon says that initiative would be good for Mix residents who are HIV positive and are open about their statuses. 
“If a group of 20 or 30 people agree to contribute an amount less than N$64 towards the transport of that one person who will collect the medications for us, it would be much better,” said Paulus.

 Apart from selling wood to buy food and transport for their children, the couple relies on food donations to survive. 
*Not their real names