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“My journey as a refugee has helped me find my purpose in life”

Ntezimana Fidès, from Burundi, works for Médecins Sans Frontières/Doctors Without Borders (MSF) in Nduta refugee camp, northwestern Tanzania, where she provides support to pregnant women with HIV, who often face stigma, even from their own husbands. She outlines how her work has changed with COVID-19 and describes the joy of being able to help her community. 

Ntezimana Fidès [© MSF/Alawiya Mohammed]

“It was a day like any other day. I prepared breakfast for my family: fresh bread with tea for my father; fried banana for my mother. I received a call from my boyfriend and his voice was shaking. He said he had to leave Burundi immediately and for now I should not contact him.

I did not go to school that day. I was in my last year of secondary education, with a major in teaching. We were planning to get married once I graduated. This sudden change of events shattered my dreams.

A year passed and I completed my studies. One day, I received a message on Facebook from my lover saying he wanted to reunite. He told me to be ready the following morning.

Before dawn, I grabbed a bag stuffed with three favourite pieces of clothing, a bar of soap and a toothbrush. A friend of his offered me a ride to the Tanzanian border on his rusty old motorcycle. Thirty minutes later, I was able to pass into Tanzania, and that is how my journey as a refugee began…

I arrived in Nduta camp where my lover was living. Everything was different from where I came from: the dried earth was turning into a sandy, reddish dust; people were sheltering under white and blue plastic tents; huge lines of people were waiting to receive food. Regardless, I was overjoyed to be with him again.

From then on, everything happened very quickly: from getting married, to starting work for MSF, to eventually giving birth to a healthy son.

I am now in my fourth year as a community health educator with MSF. It is a challenging and demanding but also very rewarding occupation. My time is shared between supporting patients with chronic diseases, and supporting pregnant women who have tested HIV-positive, as part of MSF’s prevention of mother-to-child transmission programme.

Midwife attending a pregnant mother living with HIV at the PMTCT clinic. On the right is Fidès assimilating instructions for patient support, education and counselling after the consultation.[© MSF/Petro Jengela]

In the course of my work, I’ve noticed that women are often more willing to take HIV tests than men, perhaps because of their desire to protect their soon-to-be-born infants.

One day I received a pregnant woman who had just tested HIV-positive. She was shattered and confused. I advised her to start taking medication. She said: ‘I cannot start the medication; my husband will divorce me if he knows I am HIV-positive.’

It happens often that men divorce their wives if they test positive for HIV. I said to her: ‘The first thing is that you start the dose; we will figure out the rest later.’

She agreed to enrol herself in the programme and start on medication. But still she hesitated. ‘If my husband sees the medicines, he will kill me,’ she said.

Her worried, tear-filled eyes melted my heart. I held her hand and said in my most calming voice: ‘I will give you all the support you need. I will ask you to prepare your husband to come for a test without mentioning that you already know your status.’ It was a sensitive situation but I was convinced we could prevent the worst possible outcome.

Fortunately, we lived in the same neighbourhood. At 8 pm every night, she would come to my house to take her dose. One day she could not come, so I found a reason to go to their house. We went behind their house so she could take the dose secretly.

It went on like this for almost two weeks. The day of her husband’s test finally arrived. I planned to be present to help navigate the situation. I prepared the clinical officer: ‘Please remember the wife has already tested positive and started taking medication. We need to convince her husband to accept the results of both his wife and himself.’

It is my duty to build the confidence of our patients and support them emotionally. When the test results came back, they learned that the husband had tested negative while the wife had tested positive. The plan succeeded and both accepted their results. They chose to overcome the situation together.

In the post-test counselling session, I talked to them about safe measures to protect each other’s health: they must use condoms all the time and I gave them some to take home. I told them: ‘It is very possible to live healthy and happy lives, regardless of this challenge. The wife must protect her husband and the husband must protect his wife.’ The husband promised to provide her with the support she needed.

To date, the woman continues to take her medication. Neither her husband nor her baby, now a two-year-old, have tested positive for HIV. Her health is progressing well and they all live happily. When I see them smiling on my way to work every morning, it fills me with happiness.

During the pandemic, we made some changes in the clinic. When mothers visited the hospital to collect their medication, they were provided with masks at the entrance and their temperatures were checked before they enter the triage area. I advised them how to wear a mask, to maintain a physical distance of one metre from other people, and not to shake hands in greeting.

Essentially pregnant women with HIV are at high risk of being infected with coronavirus because of their pre-existing condition. I strongly encouraged them to keep on taking their doses as instructed by the doctor.

Normally, when a mother comes in for a consultation, I hold her baby while she stands on the scale to be weighed. But during the pandemic, because of the safety measures, I was not able to do this. I remember when a mother asked me to hold her baby and I refused, she felt very bad, as if she was being treated differently because of her condition. But then I reminded her about the changes in lifestyle that have come with COVID, and repeated the messages about the importance of protecting each other. I said to her: ‘I may have been infected with coronavirus without me knowing. I might end up infecting other people – like you, your baby and people at home.’ In the end she came to terms with it and understood that it was not me inventing things, but that life has indeed changed.

I feel proud and privileged to be instrumental to my community and to be able to have a positive impact on people’s lives. My journey as a refugee has helped me find my purpose in life.” 


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