Small United Methodist clinic serves large population with AIDS


By Kathy L. Gilbert*

HARARE, Zimbabwe (UMNS) - Roberta Hupprich arrives at Epworth HIV/AIDS clinic to find the building already full and people waiting for her.

Before she can make it to the door, a man stops her and pulls up his pant leg to reveal a seeping sore. She tells him she will try to get him some medicine.

Coming from the building is the sound of loud, racking coughing occasionally punctuated with the softer cough of a small child. The clinic is mostly full of women and children who are sitting patiently in white plastic chairs waiting for their turn to see the nurse. Everyone here is in the third or fourth stage of AIDS.

A long day at the clinic begins with everyone joining hands in a circle, a prayer and singing.

Epworth AIDS clinic, located in a poor rural area outside of Harare, serves about 200 people with HIV/AIDS. The clinic was started in 2000, when Hupprich was assigned to Zimbabwe as a United Methodist missionary. It is supported by donations from churches in the United States. Hope Morgan Ward and 15 others from the Mississippi Conference visited the clinic in August on their trip to Zimbabwe.

Serving the underserved
Irene Mapedzamombe, the part-time nurse who helps out in the clinic, says the people coughing probably have tuberculosis, one of the common opportunistic infections that bring them to the clinic. People with HIV/AIDS can get many opportunistic infections because the disease weakens the body's immune system.

Hupprich, a professional nurse, is busy trying to set up the table with records and medicine so Mapedzamombe can begin seeing people. While she is working, one of the volunteers tells her about a patient who has committed suicide.

"There is a quarry here in Epworth. It is a place where people go if they want to commit suicide," she explains quietly. "She was one of our home patients." The volunteer tells Hupprich that at the last home visit the women was complaining about not getting better, that her husband had died and she had children to raise.

Hupprich pushes on past the tears to the task at hand. Every other week, she and Mapedzamombe open the clinic on Tuesday. On Wednesdays, they make home visits to patients too ill to come into the clinic.

"We can only do this program every other week because we share a vehicle and only have a part-time nurse," she says. "We would like to have our own vehicle and hire a full-time nurse. We would like to come out every week and serve more people."

The number of people coming into the clinic varies because many of the homes in the area were destroyed in the government's campaign called "Restore Order." The United Nations reports nearly 92,500 dwellings were torn down in the campaign, which started in May 2005.

"Many of our people have either relocated to other rooms in Epworth or are staying in plastic, making a shelter out of the rubble, or they have moved back to the rural areas or with relatives," Hupprich says. "The shelters keep coming up like weeds on the very spot where their home was destroyed."

Hupprich was assigned to Zimbabwe in 2000 along with her husband, Glenn. He is also a United Methodist Board of Global Ministries missionary assigned as area financial representative for the conference.

"Mostly I got it going," she says of the clinic. "A Zimbabwean nurse and volunteers make it work. The groundwork was done the first year. We feel part of the community."

Volunteers, many from a nearby United Methodist church, help Hupprich. They carefully record the patient's name and reasons for seeing the nurse on worn paper schoolbook folders. A United Methodist cross and flame is stamped on the page and the date of the visit is recorded.

One of the volunteers, Never Mujikwa, started out as a client early in the program. He became a volunteer about one and a half years ago, Hupprich says. "He is quite ill at the moment. He needs prayers."

Betty Siwela, another volunteer who has been in the program for a long time, is now displaced and "living in plastic," Hupprich says. She started in the antiretroviral program at Harare Hospital and is having a bad reaction, Hupprich learns from her son.

"Betty used to come to the office and pack medicines in small plastic bags for me," she says. "She has two boys, one finishing high school and the other in primary school. She is alone. Sad case. Please, she needs prayers."

Treatment begins
A small room on one side of the building functions as the examining room. The first patient today is a tiny boy dressed in a sweater, wool cap and shorts. He sits on his grandmother's lap during the examination.
He shyly pulls up his sweater for the nurse to see the rash covering his small body. The boy is almost 9, his grandmother says. He is one of three children she is raising since his parents died of AIDS. Today she tells the nurse she fears she is suffering from symptoms of the disease as well.

"The grandmother started complaining of symptoms; I don't know if she got it (AIDS) from the wounds when she was washing the children," Mapedzamombe says. "She is complaining of chest pains. We are going to give her Cotrimoxazole today."

Cotrimoxazole is the drug the clinic most often dispenses for infections, Hupprich explains. The clinic also offers antibiotics, medicine for diarrhea, vitamins, iron, something for throat thrush and antacids. One unique product used for skin rashes is a homemade ointment of coal oil. "It is really quite effective," Hupprich says.

"Most of the people don't have a lot of food and the antacid helps when they take medicine on an empty stomach," Mapedzamombe explains.

"We used to have enough money to give them food, now we just hope for enough to buy medicine," Hupprich adds.

"We treat respiratory infections, skin diseases, diarrhea and people who have cancer associated with AIDS," she says. As patients get sicker, she works with a local hospice center because it can dispense pain medication. "There is no medicine in the (area) clinics and less and less in the hospitals," she adds.

Everyone affected by AIDS
Epworth is a large, poor community. "Some of the people first settled here during the liberation struggle as refugees. We see lots of widows, lots of grandmothers with grandchildren who are orphans."

Hupprich says the statistics vary on the number of people in the area infected with AIDS. "It used to be 35 percent, but our nurse and others think it is more than that. I don't know one person out here who has not been affected by AIDS in one way or another."

Since she came to Zimbabwe in 2000, she says the economy has grown worse. "Prices for basic food have made it prohibitive for most people to buy the staples - mealie meal, rice, beans."

Transportation is a "nightmare," she says. People wait for several hours for transportation to and from work, and then all the money they earn is used for transportation. Fuel is getting harder and harder to buy also.

Hupprich says the only way the program can survive is through donations from United Methodist churches and individuals.

"The only source of income we have for this program is the United Methodist Advance," she says. "Without the churches back home, we would not be functioning, we would not be able to take care of these people. It is not huge donations, but it is a lot of small donations that add up. It is our only source of support at this time."

The Board of Global Ministries was able to send 15 medicine boxes and 50 home health kits to the clinic in September. "It saved our lives," she says. The clinic also received 35 boxes of medicine and 460 blankets from UNICEF.

Roberta and Glenn will be leaving the field in July and will retire in 2007.

"I am desperately looking for a conference or church that will support this program on a steady basis," she says.

"We don't have a large death rate; we do lose some," Hupprich says. "We have been very lucky, we are very thankful. God has really given his blessing to this program and to our people."

Contributions to the Epworth AIDS Clinic may be sent through a local United Methodist church or annual conference, or by mailing a check to Advance GCFA, P.O. Box 9068, GPO, New York, NY 10087-9068. Checks should be written to "Advance GCFA" with Zimbabwe HIV/AIDS Ministries, Epworth AIDS Clinic (Advance Special #13796A) on the check memo line. Call (888) 252-6174 to give by credit card.

Every day, the number of people infected by HIV/AIDS increases by about 14,000. Already 23 million have died. The 2004 United Methodist General Conference established the Global AIDS Fund and committed to raising at least $8 million during the four years of the quadrennium. A gift of $1 per member before the 2008 General Conference would underwrite this effort.

*Gilbert is a United Methodist News Service news writer based in Nashville, Tenn.