NIMART trained nurse administers ARV treatment at St Apollinaris, Diocese of Mzimkhulu.

The Southern African Catholic Bishops Conference (SACBC) with funds from PEPFAR supports the Ethembeni HIV clinic at the St Apollinaris Hospital, the government hospital for the Sisonke health district. This hospital serves a population of 192,145 in the Ingwe municipality of kwaZulu Natal Province.

Many patients in this rural district live a great distance from the hospital and find it difficult to keep their appointments and collect their medications. Four district down-referral clinics are now operating, staffed by professional nurses

It is a challenge to recruit doctors to this mountainous area. The distances are long, and the amenities in this impoverished area are few. To meet the needs of the many people living with HIV in this region, the SACBC organized government-accredited (NIMART) training for nine nurses to qualify them to initiate patients on life-saving antiretroviral viral treatment in the Ethembeni clinic as well as in the surrounding down-referral clinics and outreach stations. Now those patients who live far from the hospital no longer need to travel long distances for care. Well trained nurses can provide treatment for them in the communities where they live and work.

Mr. Thabani Zuma is one of the nurse graduates of this PEPFAR-funded program. Mr. Zuma achieved a score of 96% on the NIMART certifying examination and was selected to undergo additional training to qualify as a mentor for the other nursing staff. I spoke with him about his work.

Mr. Zuma is a tall, slim thirty-four year old Zulu man. He is dressed in his nurse uniform—blue slacks and sweater, white shirt, and the maroon, military-style epaulets that nurses in this part of the world wear to signify their status. When he speaks, his sentences are punctuated with laughter and his whole face is lights up and dances.

“It used to be nurses just take care of sick people, follow doctor’s orders. But here most of the things we do ourselves. This clinic is different from working in the wards. What we do we are accountable for.”

Mr. Zuma has become quite the expert in HIV care and treatment. When the nurses have a problem, he is the one they call. When he himself has a problem or a question, he gets in touch with one of the doctors in his network or phones the 24 hour hotline for HIV clinicians.

“If I am not sure of what I am doing, I am putting that life in danger. I should ask.”

“I love what I’m doing right now. I must tell you. I really like ART’s [antiretroviral therapy]. I can see progress. That’s the main thing. You see the client today. When you see the client three months down the line, you see progress. That’s lovely. You say, at least I’ve done something that helped this client. That keeps me here. I’m happy.”