Effective counselling is key to quality HIV services that are responsive to patients’ needs. However, cultural and language differences may affect overall patient satisfaction and quality of care. Nowadays, there is a rising trend in the number of patients who have migrated from their home region and in non-local healthcare workers posted in remote health posts.
May Zin Htun is an ART Promoter with Pyi Gyi Khin. She is attached to Hakha Township National AIDS Programme (NAP) in Chin State, where she has been working since January 2019. Her daily tasks include counselling for ART patients, community education, providing voluntary confidential counselling and HIV testing (VCCT) services, condom promotion, and assisting medical officers and healthcare teams during mobile outreach activities and hospital ward rounds.
May Zin Htun has counselled many people living with HIV. Being an experienced counsellor, she is always ready to find solutions independently to provide better quality healthcare services for the community there. She finds that health literacy on HIV is generally low among village communities and premarital sex among youth is quite common, which increases their risk of HIV exposure. One of the challenges to reach communities with effective health education is the language barrier.
However, that has not been an issue for her, as she has worked diligently to gain an insight into the local language, culture, customs, practices, beliefs and taboos. If needed, she does not hesitate to get translation help from native co-workers, health workers and other health staff in the team.
She is always looking for solutions to better reach people in the community with higher quality and more appropriate HIV prevention and health education services. She regularly attends state coordination meetings with other frontline partners and shares her experiences and challenges. She even reaches schoolchildren and traffic police with HIV health information, education and communication materials distributed through village stakeholder meetings, community gatherings, traffic education campaigns and school health programmes.
She has helped many HIV patients and built their trust through her friendly day-to-day rapport, which promotes their access to HIV services and adherence to the treatment provided by Hakha NAP.
Among her patients were 37-year-old U Mya and his 35-year-old wife Daw Hla (not their real names), both farmers from Falam Township. They have two children under 7 years old. The husband was worried about his HIV status. Although they are from Falam Township, they preferred to come to Hakha Township for HIV testing for privacy concerns.
After many counselling sessions, U Mya finally decided to get tested for HIV. When the result was HIV-positive, his wife also agreed to get the test and she too was HIV-positive. The whole family received health education on how to prevent transmission of HIV. The couple were especially worried about the dangers of HIV spreading through the non-sterile needles that local healers use during traditional acupuncture to relieve aches and pains, known as ‘mat kalaung’ scratching.
May Zin Htun was finally able to get them onto ART, thanks to her counselling skills and her awareness of their culture and, most importantly, her patience and willingness to help. “My knowledge of their culture, customs and practices empowered me to help the couple get onto ART through effective counselling. Today they are enjoying a normal life again with their two children.”
May Zin Htun knows that she still has work to do in Hakha Township. She wishes to expand her knowledge horizon – even though it means more hard work – to achieve more effective interaction with the community. She believes her contribution matters for better quality healthcare outcomes for the remote community there.
Her motivation to understand the community ways of life, their beliefs and customs has opened a way to successful community involvement and awareness of HIV prevention, treatment, care and referral services available through Hakha NAP, supported by the Global Fund.
Pyi Gyi Khin has been implementing HIV prevention services with key populations such as sex workers, men who have sex with men, and people living with HIV, as well as community home-based care and ART provision with the support from Global Fund since 2011.
