In a bland and sterile hospital room in the Southwest Region of Cameroon, two women, both HIV-positive, sit at a table talking to each other. One of them is Bertha, a volunteer for a local micro health insurance scheme and the other has come for counseling at the treatment center for persons living with HIV. Bertha is a smallish woman who more than makes up for her size with her spirit. Her respondent however is nervous and declines to give even a first name.
Bertha works as an “expert patient” at the Buea Regional Hospital Annex.
The expression “expert patient” is used by micro health insurance schemes known as Mutual Health Organisations to describe someone living with HIV, the virus that causes AIDS, taking antiretroviral drugs and willing to go public about their HIV status under the umbrella of the Mutual Health.
Describing her duties, Bertha says, “I come to the treatment centre twice a week and I talk to clients on a one-on-one basis. I also have to make myself available for radio or TV interviews if need be.”
Mutual Health Organisations use expert patients, generally to encourage positive living for persons living with HIV, but mostly to promote commitment to antiretroviral treatment – a mixture of drugs essential to managing HIV.
The Regional Advisor charged with the promotion of Mutual Health Organisations in the Southwest region of Cameroon, Samuel Monono, says “we use their experiences as people living with HIV and AIDS and their exposure to the antiretroviral drugs to advice … other patients who are about to or who are equally taking these drugs.”
The activity receives funding from the German Technical Corporation, the GTZ.
UNAIDS estimates that only about 20% of more than five hundred thousand people living with HIV or AIDS in Cameroon, have access to care and treatment.
Monono says finding expert patients is challenging because stigmatization is still rife in Cameroon and not many persons are willing to say they are HIV-positive in front of cameras and microphones. “It takes a lot of bravery to come out, talk about your health, talk about your experiences without reserving the greater part”, he says. Especially when you are not paid for it.
As an expert patient, Bertha gets 25000 FCFA, approximately US$50 a month to cover her transportation costs.
About her reason for volunteering, Bertha says “I’m doing this because of my own experience.” After overcoming self-stigmatisation and that of the public, she has been able to remain positive and she feels the need to help other HIV positive persons do the same. “You have only to fight it for yourself but also to extend it to your brothers and sisters”, she says.
Bertha wants no money for her work. Her reward is in seeing hope in the eyes of those she has helped. And so she smiles when her timid respondent says “since I started coming to the treatment centre and talking to Bertha, I am not so worried anymore because I know that I’m not alone.”