Annah, 29, and her beautiful baby boy, Sandile (not their real names) have been with the Witkoppen postnatal program for 6 months. The program, a FRESH Start – “A Future Realized through Education, Support and Healthcare”, funded by The Gift of Hope, is a fully comprehensive postnatal clinic service for 18 months for women and babies, including expanded HIV testing, care and support. They have never missed a scheduled visit. Like many patients, however, their time at the clinic has not been without ups and downs. A native Zimbabwean, Annah moved to the Johannesburg informal settlement, Diepsloot, in 2010 with the hope of finding work. She began selling vegetables from her garden, and in 2012 was finally able to find a job as a housekeeper. Only two years later, however, she became ill and could no longer work. She decided to visit Witkoppen Health and Welfare Centre, as she heard the clinic’s services were the best in the area. Upon her first visit in February 2014, she was diagnosed with TB and HIV. By March, she had begun treatment for both diseases and with regular clinic visits, was on the path to recovery.
Annah discovered she was 4 months pregnant in February 2016. Her clinic visits were moved to Witkoppen’s antenatal clinic for the remainder of her pregnancy. She recalls: “The antenatal clinic helped me a lot. I visited the HIV counsellors who made certain I understood how to ensure my baby would be healthy at birth.” Her pregnancy was very difficult, however, and she struggled immensely for funds as her boyfriend left her and returned to Zimbabwe. On July 24, 2016, Annah gave birth to Sandile, healthy and free of HIV.
Giving birth to a healthy boy made up for her tough times, and Annah was very happy to be able to hold him and care for him. Three days after birth, they visited A FRESH Start in order to ensure they received all the information and help they needed. Annah was still taking her medication and began breastfeeding Sandile to avoid paying for formula milk as her financial situation was still very poor, as she only had sporadic employment and was very badly paid. By November 2016, when Sandile was 4 months old, living alone with Sandile and without any support, stress began to mount along with her HIV viral load. High levels of stress can deplete one’s immune system, allowing the virus to propagate and take over. For HIV-positive breastfeeding mothers it is very dangerous to the baby if their viral load gets elevated since the virus can be transmitted through the breast milk. In the past, if the viral load increased to a dangerous level, mothers would be told to use formula milk and they would no longer be allowed to breastfeed. Now, however, the Witkoppen/Gift of Hope Dietician Elmare Theron and other clinicians have taken on a new approach: pasteurizing the breast milk. The mother expresses her breast milk into a metal container, which is placed in boiling water. This kills the virus while leaving the milk’s vitamins and minerals intact.
Annah recalls, “I visited the clinic and my viral load was very high. Elmare taught me how to express and pasteurize my breast milk so I did not have to spend money on formula. It took effort, but it kept Sandile healthy and saved me money”. Furthermore, it gave Annah an opportunity to decrease her viral load and return to breastfeeding before Sandile reached the age of 1. He is now 6 months old, and Annah’s recent blood test shows the viral load is at a safe level! She can now return to breastfeeding for 6 more months. Thanks to the antenatal clinic, the postnatal clinic and A FRESH Start, Sandile continues to be HIV-free and Annah has been able to cope with her stress and financial issues. As Annah simply puts it, “if I was at another clinic, I don’t think my life would be okay”.