HIV/AIDS and drug-resistant tuberculosis (DR-TB) are hard-fought wars because patients often think of giving up the harsh treatment associated with these. Counselling plays an important role in making them recognise the circumstances and motivating them to continue. Zothangpui Gangte, a counsellor in the Manipur programme of Doctors Without Borders/Médecins Sans Frontières (MSF) explains why.
There are rarely times when people just accept that they have HIV/AIDS – some people go into denial or cry, yet others start feeling hopeless. I’ve been a counsellor since 2011 and I help people with HIV and DR-TB cope with their diagnosis and treatments. I support patients by making them share their troubles, and by relieving the psychological distress that is all too common in such patients.
A very difficult session
Sometimes people come on their own to be tested following noticeable symptoms. On other occasions doctors refer them to the MSF clinic. We do pre-test counselling to help them understand HIV, because people often confuse HIV and AIDS. A person can have HIV, but not AIDS. Similarly, the person may have the TB bacteria present in their body, but it need not have manifested itself as yet. We tell them about the disease progression, inform them about precautions that they should take around their families, and clear any misconceptions they might have about their diagnoses.
Most importantly, my team is with them whenever they face issues with their treatment (which in the case of HIV/AIDS means lifelong medication). Pre-test and post-test counselling sessions which are done before and after the relevant tests are important for us.
One time, a young woman, I think she was around 22 years old, came for an antenatal care visit. She was 3 months pregnant and had no suspicion that she was HIV-positive. When I saw the results I called her in, showed the results to her and told her that she did have HIV. She broke down. Patients outside the room could hear her wail.
Her husband had HIV/AIDS but he hadn’t told her. We started her counselling soon and after many false starts, she started attending our sessions regularly. She still comes.
In my years as a counsellor, I’ve found that a lot of patients are worried about their finances more than their HIV-positive status. They are anxious to not be a ‘burden’ to their families. Our role is not to instruct them, but to be their support.
My life as a counsellor
I had heard about MSF a long time ago. In 2004, MSF was building one of its clinics then and I enquired about it. The HIV/AIDS and DR-TB programme started in 2007 and I joined as a health educator a year later. I wanted to become a counsellor because I felt that there was so much more I could learn this way. I also really wanted to help people who were suffering psychologically.
At first it was overwhelming to hear about the patients’ life – their trials and challenges. But I overcame this with the help of the MSF team. Even now, when I exit the counselling room at the end of an emotional session, I generally talk to my colleagues. In my heart, I know that MSF has been the opportunity through which I have been able to reach out to people who need help.