Strength in adversity: UN’s joint efforts to enhance refugees’ resilience to cope with HIV.

When the 2015 political violence broke out in Burundi, Olive (a given name to protect her real identity) and her three children decided to flee their home. Unlike other refugees, Olive, however, carried a heavy burden that added to her refugee challenges – she was HIV positive.

Seeking safety and a new beginning, Olive and her children arrived in Rwanda, finding temporary refuge at the Nyanza transit centre before eventually settling in Mahama camp. Their arrival brought them hope, but Olive faced another obstacle – access to adequate healthcare for HIV-positive people.

Olive had discovered her HIV status a few years earlier during a routine prenatal visit back in Burundi. She was in her eighth month of pregnancy when she was diagnosed with the virus. She struggled to come to terms with the fact that she would live with the virus for the rest of her life.

“I was devastated when I found out that I was HIV positive. I isolated myself and could not digest how I contracted the virus. I felt like it was the end of my life,” she says.

When she arrived, humanitarian actors provided some assistance, but initially, it was not enough, especially for people living with HIV who require regular medication.

“When we arrived here in Mahama camp, I had no medicines. I was worried about my health, and I was always chasing health personnel asking for medication,” the 43-year-old Burundian refugee recalls.

UN’s joint collaboration to support HIV-positive refugees

The Joint United Nations Programme on HIV/Aids and UNHCR with support from the government of Rwanda through Kirehe District Hospital, are collaborating to assist HIV-positive refugees with antiretrovirals on a regular basis.  The Joint efforts also continue to provide assistance to strengthen the resilience of refugees living with the virus.

In the first six months of being in the camp, Olive kept herself apart from others because she didn't want her fellow camp residents to learn about her HIV status.

“When I began taking antiretrovirals, I was concerned that my neighbors might discover my HIV status,” she says. “Whenever I encountered my neighbours on my way back from the health centre and they inquired about my whereabouts, I would fib, claiming that I had been to the UNHCR office or elsewhere, so as to avoid revealing my condition. After consuming all the antiretrovirals, I would discreetly dispose of the medication containers.”

However, the anxiety faded away after receiving counseling. Since then, Olive has been able to openly tell her neighbors about her HIV status.

“I came to realise that continuing to isolate myself would likely lead to mental health problems,” she says.

Recalling her arrival in the camp, Olive remembers that refugees living with HIV were provided with assistance that included Tanganyika Sardine, potatoes, beans, porridge, and other nutritious foods intended to help strengthen their immune systems.

“My neighbours often asked where I obtained these food supplies, and I would tell them that I received them from the health centre due to health issues. This way, I started to reveal more about my health condition,” she adds.

Refugees like Olive are invited to report to the health centre every six months as per the established ARV treatment plans for stable HIV-positive patients. During the visit, they can receive various types of support such as replenishment of ARV treatment for the next six months, discussion on treatment observance, screening for opportunistic infections including TB, mental health and psychosocial support, and laboratory follow-up to sample viral load, kidney, and liver functions depending on the combination of drugs the person is having.

The World Food Programme (WFP) also provides monthly porridge rations to HIV-positive refugees to support positive nutrition and a healthier diet. Olive adds that they also undergo a nutrition assessment once a year and are educated on how to prepare a balanced and healthy diet.

The fruitful collaboration of UNHCR, UNAIDS, WFP, and the government contributes  to various Sustainable Development Goals, especially SDG 3, “Good Health and Well-Being”, and to the outputs of strategic priorities of the UNSDCF to achieve the intended outcome “by 2024, people in Rwanda, particularly the most vulnerable, enjoy increased and equitable access to quality education, health, nutrition and water, sanitation, and hygiene (wash) services.”