Médecins Sans Frontières - Webclip – Turning Loss Into Hope

Unique Identifier Code / URN MSB216089

Date taken / Date Recorded 02/12/2024 3:00 PM

Country Mozambique

Commissioning section MSF-SPAIN

Photographer / videographer / producer Marília Gurgel

Copyright Marília Gurgel/MSF

Usage Rights (MSF) External Media, MSF Fundraising, MSF Publications, Social Media

Formal Consent Copy available yes

Editor's rating ★★★ (F)

Video format h264 (Main) (avc1 / 0x31637661)

Duration 5m55s

Maximum Size 1920px × 1080px 693.12 MB

Additional Information / Shotlist MULTITRACK VIDEO FILE.
Several audio tracks on the file, as follows:
1-Full Mix
2-Voices track
3-Ambients track
4-Music track

––––––

SCRIPT

TEXTS

Mocímboa da Praia
Cabo Delgado, Mozambique

Turning Loss Into Hope
Treating HIV amid conflict in Mozambique

Mozambique faces
one of the highest HIV
prevalence rates globally

11.5% adults aged 15-49
are living with the virus

Over 2 million people
are receiving
antiretroviral therapy (ART)

There is an ongoing armed
conflict in Cabo Delgado
since 2017

It has severely disrupted
healthcare services and
affected the population

It specially limits access
to HIV treatment
for thousands

Cristina Virgílio works
as Mãe Mentora
at the same hospital

It means “Mentor Mother”
and is a peer-to-peer program

It focuses on the prevention
of transmission of the virus
from mother to child

Cristina Virgílio
Mãe Mentora

Germana Toni
Patient

SUBTITLES

1
00:00:00,875 --> 00:00:03,878
I have always been passionate
about medicine.

2
00:00:03,962 --> 00:00:06,673
My passion
grew even stronger

3
00:00:06,965 --> 00:00:09,092
when my mother developed diabetes.

4
00:00:09,342 --> 00:00:11,052
She also had HIV.

5
00:00:11,511 --> 00:00:13,555
She didn’t want to accept it.

6
00:00:14,014 --> 00:00:15,682
She eventually lost her life.

7
00:00:16,516 --> 00:00:18,727
So, I said: "I’m going to change
this reality."

8
00:00:19,102 --> 00:00:20,437
"I will pursue healthcare [studies]."

9
00:00:20,478 --> 00:00:23,356
"So I could take care of
my own family first."

10
00:00:23,898 --> 00:00:25,525
And to this day, I say:

11
00:00:26,109 --> 00:00:28,236
"Maybe, if I had been
a doctor back then,

12
00:00:28,319 --> 00:00:30,739
my mother wouldn’t have died."

13
00:00:35,827 --> 00:00:37,495
I am Filomena Januário,

14
00:00:38,329 --> 00:00:42,625
a general practitioner
for about three years now.

15
00:00:42,917 --> 00:00:47,922
I work with MSF as an HIV
and tuberculosis doctor.

16
00:01:01,311 --> 00:01:04,606
What I mainly do here is care

17
00:01:04,731 --> 00:01:07,776
for patients living with HIV
and tuberculosis,

18
00:01:08,109 --> 00:01:09,903
or with other comorbidities.

19
00:01:09,986 --> 00:01:11,988
We know very well
that these patients

20
00:01:12,072 --> 00:01:13,198
with immunosuppression

21
00:01:13,281 --> 00:01:16,534
are susceptible
to various infections.

22
00:01:17,160 --> 00:01:19,621
So, we've really been
conducting screenings,

23
00:01:19,704 --> 00:01:21,081
doing a bit of everything.

24
00:01:21,164 --> 00:01:23,374
We’ve improved greatly in testing,

25
00:01:23,458 --> 00:01:25,627
and in initiating treatment,

26
00:01:25,919 --> 00:01:30,215
but we are weak
in retention and adherence.

27
00:01:30,507 --> 00:01:32,842
We don’t know
if they don’t come back

28
00:01:33,009 --> 00:01:34,928
because they moved,

29
00:01:35,011 --> 00:01:37,972
or because they
aren’t informed enough.

30
00:01:38,306 --> 00:01:40,475
Many people here
are displaced,

31
00:01:40,558 --> 00:01:41,559
and that affects them.

32
00:01:41,643 --> 00:01:43,561
One day they are treated here,

33
00:01:43,728 --> 00:01:45,480
the next day
in another hospital,

34
00:01:45,897 --> 00:01:48,108
and the care
is not integrated.

35
00:01:48,233 --> 00:01:49,984
I could even risk saying:

36
00:01:50,235 --> 00:01:57,075
over 60% of the population here
has no fixed residence.

37
00:02:10,046 --> 00:02:12,924
These patients without
continuous treatment

38
00:02:13,341 --> 00:02:15,802
progress to advanced HIV disease.

39
00:02:16,010 --> 00:02:18,680
But they only come here
or go to any the hospital

40
00:02:18,805 --> 00:02:20,473
when they already
feel something,

41
00:02:20,682 --> 00:02:22,559
when they already
show symptoms,

42
00:02:22,851 --> 00:02:24,853
when the illness
is already established.

43
00:02:24,936 --> 00:02:28,356
During displacement,

44
00:02:28,439 --> 00:02:31,526
the person is more concerned
on seeking refuge.

45
00:02:32,569 --> 00:02:34,779
Right now, we are developing
strategies

46
00:02:34,863 --> 00:02:36,573
on how to ensure retention.

47
00:02:36,656 --> 00:02:39,868
We are thinking of working
with community actors

48
00:02:40,034 --> 00:02:42,287
who can help us improve retention.

49
00:02:42,662 --> 00:02:46,541
This includes involving
health promoters and APs,

50
00:02:46,791 --> 00:02:48,835
who are polyvalent health agents

51
00:02:48,918 --> 00:02:50,044
from the Ministry of Health (MISAU),

52
00:02:50,128 --> 00:02:53,882
to see if they can help us
in the community

53
00:02:54,132 --> 00:02:56,593
to retain patients.

54
00:03:12,442 --> 00:03:14,736
Many mothers
are abandoning treatment.

55
00:03:14,819 --> 00:03:17,238
When they come here, they only open
their file when they’re pregnant.

56
00:03:17,280 --> 00:03:19,449
They take the medications,
but after giving birth,

57
00:03:19,782 --> 00:03:21,743
they stop coming, they move.

58
00:03:22,202 --> 00:03:25,246
This is a big problem for us,
a significant challenge.

59
00:03:25,496 --> 00:03:26,539
We’re struggling.

60
00:03:26,623 --> 00:03:28,625
How do we keep
these mothers in care?

61
00:03:31,794 --> 00:03:33,922
I found out about the infection
at the Nanduadua health center.

62
00:03:34,923 --> 00:03:36,299
I feel fine,

63
00:03:36,966 --> 00:03:40,720
but when I take the medication,
the next day I feel very tired.

64
00:03:40,929 --> 00:03:44,307
When I take it without eating,
I feel nauseous,

65
00:03:44,766 --> 00:03:47,352
and when trying to find
something to eat

66
00:03:47,435 --> 00:03:49,187
before taking the medication,

67
00:03:49,604 --> 00:03:52,315
I often miss the scheduled time.

68
00:03:52,982 --> 00:03:54,817
This complicates adherence.

69
00:03:55,693 --> 00:04:02,033
The Mentor Mother has encouraged me
not to abandon treatment,

70
00:04:02,951 --> 00:04:08,414
even when I was pregnant
with my son.

71
00:04:08,998 --> 00:04:10,416
As a Mentor Mother,

72
00:04:10,500 --> 00:04:12,293
you must set an example.

73
00:04:12,669 --> 00:04:15,672
Say, 'I’m taking the medication,

74
00:04:15,755 --> 00:04:16,798
and so should you.'

75
00:04:16,965 --> 00:04:18,716
You stay with her [the mother]

76
00:04:18,841 --> 00:04:20,760
and let her relax.

77
00:04:21,386 --> 00:04:24,055
You say, 'This is not
the end of the world.

78
00:04:24,514 --> 00:04:25,431
Look at me.

79
00:04:26,516 --> 00:04:28,851
I’ve lived this long.
I’m taking my medication,

80
00:04:29,852 --> 00:04:32,563
using all the treatments
provided to me,

81
00:04:33,189 --> 00:04:34,607
and nothing bad
is happening to me.

82
00:04:35,358 --> 00:04:38,361
I have my daughter, born in 2010.

83
00:04:39,237 --> 00:04:41,531
To this day, she is HIV-negative.

84
00:04:41,990 --> 00:04:44,450
She’s grown now;
this year she’ll turn 13.

85
00:04:44,742 --> 00:04:47,745
See how I am?
For you to be like this,

86
00:04:47,954 --> 00:04:50,957
you must always come,
take your medication, and adhere.

87
00:04:51,916 --> 00:04:54,127
Don’t think, ‘Oh, I’m already dead.’

88
00:04:54,210 --> 00:04:55,920
No, it’s not the end of the world.

89
00:04:56,212 --> 00:05:00,300
We can live a positive life,
and live it very well.'

90
00:05:00,758 --> 00:05:04,637
If the proper treatment is followed,
it is possible to live healthily.

91
00:05:05,138 --> 00:05:07,682
The main goal is
to raise awareness that

92
00:05:07,765 --> 00:05:09,934
'You don’t have AIDS.'

93
00:05:11,352 --> 00:05:12,895
'You have HIV.'

94
00:05:14,856 --> 00:05:17,984
There are challenges;
it’s not just about treating,

95
00:05:18,484 --> 00:05:20,611
but about sustaining
and improving

96
00:05:21,321 --> 00:05:25,199
the lives of patients living
with HIV and tuberculosis.

97
00:05:25,533 --> 00:05:27,076
I will only be satisfied

98
00:05:27,160 --> 00:05:28,619
once I achieve

99
00:05:28,828 --> 00:05:32,540
a patient retention rate
of over 80%.

100
00:05:33,041 --> 00:05:35,001
I will do my best,

101
00:05:35,084 --> 00:05:37,128
with the help of my colleagues
from the Ministry of Health (MISAU),

102
00:05:37,295 --> 00:05:39,380
to establish retention.

103
00:05:39,756 --> 00:05:41,632
This is a challenge
I’ve taken on,

104
00:05:41,716 --> 00:05:45,803
and I hope to leave
Mocímboa [da Praia]

105
00:05:46,054 --> 00:05:49,557
having achieved my goals.

Webclip – Turning Loss Into Hope – INT

Webclip – Turning Loss Into Hope – INT