Guest blog by Thirza Stewart and Mariette Hamers
We are sitting in the waiting room of the Roadside Wellness Centre (RWC). Through the door we see women in colourful kangas preparing food. One lady is preparing chapatti on a little stove. Under a big tree an elderly lady is rinsing plates and cups in a bucket. Men are eating and laughing, a skinny cat steals some bones from under the table. If you wouldn’t know any better this looks like the perfect place to spend a sunny Sunday afternoon.
Slowly the smell of gasoline enters our noses. A loud claxon reminds us we are at the harbour of Dar es Salaam. A big truck with a large sea container parks in front of the wellness centre. For kilometres on end trucks are parked on the side of the road. Truckers are hanging around everywhere.
The waiting room starts to fill up. In front of us, a young couple. Both young, the girl wearing a head scarf and henna on her hands and the guy with jeans low on the hips. We hear the contagious laughter of Margret when they enter the consulting room but after a few minutes we hear the guy’s angry voice through the thin door of the clinic. Ten minutes later, the young couple reappears looking happy and thanking Margret gracefully.
Margret receives us with open arms: Karibu! She tells us about her day so far. Seventeen people visited her clinic for an HIV test; two of which were positive. Margret reaches out to sex workers, male and female, who work along the road or in rented rooms. In group sessions Margret talks about protection; condom negotiation; HIV testing and STI treatment. During outreach Margret sometimes has to tell a sex worker that she is HIV positive. Unfortunately Margret can’t give immediate post counselling due to stigma or suspicion of the other sex workers. According to Margret 3 out of 10 female and 5 out of 10 male sex workers are living with HIV in Dar es Salaam. Margret invites these women to the clinic for post counselling and refers them to the governmental hospital for treatment. Not being able to give treatment and providing delayed post counselling has serious consequences for them. We realized that our partners have a lot of challenges.
In Dar es Salaam we did a counselling training with a very diverse group of 30 counsellors, clinicians, nurses and regional officers from Tanzania, Kenya, Uganda and Democratic Republic of the Congo. We were not sure how our counselling method (‘motivational interviewing’) would be received in these East African cultures but we didn’t meet any cultural barriers. Language did not turn out to be an issue either, as we discovered that the French participants spoke Swahili. Overall, we had a very good and inspiring three day session with positive feedback from the participants.
I liked this training because our clients often feel rejected and now they are invited into the conversation. It also puts the counsellor in a different light, clients will be happy to come back to our clinics.
But the participants didn’t just learn from us. We also learned from them. Nothing is ever what it seems! We left Dar es Salaam tired, but inspired.