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in Harare’s leafy suburb of Borrowdale.
She stays in the servants quarters, is married and has two children aged 11 and 6.
Molly looks after three minor children who are Jacob (3), Natalie (7) and Tapiwa (15) (not real names) and earns a monthly salary of US$150.
A school dropout at the age of 14, Molly has worked hard as a housemaid for the past 18 years for three different families and was excited when her new employer told her that her salary would be almost equal to that of many educated civil servants.
But her well paying job came with a price as her employer had a “secret” she did not want Molly to know about her son Jacob.
Jacob is HIV positive and is on ARVs, but his parents have not yet disclosed his status to Molly who spends up to 10 hours with him per day. The parents have asked Molly to disclose her status and she did earning her the job.
Just like generations of HIV positive children before him who are on treatment, Jacob is growing up well and better as he is in the capable and loving hands of Molly who is like a second mother to him as his parents are always on business trips.
When she started working for the family in January last year, Molly’s employer only told her that Jacob was on medication and the child was to take it twice a day at certain times.
No further explanations’ were made as to why Molly was supposed to give the child medicine at that particular time each day and at some point she did not see anything wrong with skipping.
“Vakandiudza kuti mwana uyu ane mushonga waanonwa (they just told me this child is on medication). She said since I could read, the dosage was on the bottle and that was it.
“I did not know why it was important for me to give him the medicine at 7 in the morning and also at 7 in the evening. I would sometimes forget to give him the medicine at the specified time and would do so two or three hours later and never told my employer of the mistakes I made.
“When one of the children told the madam that I had been delaying to give the child the medicine, she was very angry with me and told me to just stick to the times she had given me.
“I still had no idea about why it was important to give the child medicine at those times and did not take it that seriously,” explained Molly.
She revealed that after a while, the employer’s 15 year old son told her that Jacob was HIV positive and on pediatric ART.
“It dawned upon me why my employer had gone over the top about my failure to give the child her medicine on time. I was a little bit worried at first because at one time, I had a cut on my hand and the child had blister like wounds on his body and I had bathed him without wearing gloves.
“I wanted to confront my employer about why she had kept it a secret from me because I spent more time with the child than she did as she is always at work, but was afraid of losing my well paying job.
“I went for testing and my results were negative and am now sticking to the child’s medicine time, and taking the necessary precautionary measures where needed and have bought latex gloves using my own money. I am just grateful that the 15 year old son told me otherwise I could have continued ignoring the medicine timetable and putting the innocent child at risk,” explained Molly.
She says she loves Jacob more and would stay with him until when he knows how to take his own medication as she fears his parents may keep hiding his status to care givers if she leaves.
Molly is just one of the many housemaids who are expected to look after HIV positive children, but their employers keep the child’s status a secret, thereby hindering the administration of ART.
Most employers seem more worried about knowing the HIV status of a housemaid before employing them, but do not see the importance of disclosing their children’s status to the person, who will spend more time, bathe and feed their children. In many cases, many child minders like Molly have no training on caring for HIV positive children and if not told the reason why a child is taking medicines tend to administer it past the recommended time or even stop altogether. They are also not given latex gloves to use in the event that they have cuts are likely to be in contact with the child’s blood through wounds. With such happening behind the scenes in many homes, it is important to ask whether parents should or should not disclose a child’s HIV status to a housemaid.
Mr John Chihota of Westgate, who is a father of five, says it may become necessary to disclose the HIV status of a child to a maid especially if parents do not spend much time with their children.
“If you are not with your child at all times that child still needs to maintain the routine for drugs and not giving your child enough information means the child will be skipping and this may have serious consequences,” he said.
Mr Albert Nhamoyebonde of Queensdale echoed Mr Chihota’s sentiments saying it was important to tell a new housemaid or child minder a child’s HIV status.
“The parents or guardian should explain the dosage a child should take, tell the maid what could go wrong if medicine is properly administered and safeguard the child from opportunistic infections,” said Mr Nhamoyebonde.
He said the maid should be given protective clothing. Mrs Mutapira of Mufakose says she would not disclose the HIV status of her child to a maid as she feared the information may end up in the wrong ears.
“There is no privacy in high density suburbs no matter how much you try and I am afraid that the maid may end up revealing my child’s HIV status to the whole neighbourhood.
“If my child is not yet on ART, I will keep it a secret. I will only reveal the status if my child is always sick,” she said.
Hospice Association of Zimbabwe (Hospaz) has for years been screaming out loud on the importance of disclosing a child’s HIV status to whoever will be taking care of him or her.
The NGO says adherence in children’s ART was identified as one of the major challenges in providing effective ART. This, the organisation said is due to reasons that include the improper handover between guardians taking care of OVC’s.
“Different people may take children to hospital but fail to update each other on the child’s progress.
There is a lot of movement of OVCs amongst relatives when parents or guardians die thus compromising pediatric ART delivery services. Orphans usually do not have a permanent caregiver
With the high number of children living with HIV and Aids, and on ART, it is important communities to be given as much information as possible on treatment literacy.
The Zimbabwe National Aids Estimates (2009) says the number of children living with HIV and aids initially peaked at 114 316 in 2003 and declined to 107 388 children in 2008 and 105 740 in 2008. The upward trend is estimated to start again in 2014. The increase could be a reflection of the survival of children on cotrimoxazole and ART.
The number of deaths among children increased from 181 per year in 1981 to a peak of 26 687 in 1997. The numbers of deaths is expected to drop sharply with the scale up of ART programmes.
Children needing ART peaked in 1997 at 50 710. Children in need for ART in 2008 and 2009 were 34 337 and 35 189 respectively. MOHCW started ART for 90 children in 2004 increasing to 1985 children in 2006.
What parents with minor children on ART should be worried about is that there are serious consequences if one stops taking ARVs or if they are not consistently taken. According etharc. org, it is important to take ARV medicines in the right way to prevent resistance.
Resistance is when the ARV medicines stop having an effect on the amount of HIV in one’s body resulting in the CD4 count dropping, and the viral load getting higher.
The body develops resistance beca-use one has not taken ARVs medicines in the right way or stopped taking them altogether. But sometimes, the body can develop resistance even if one has been taking the medicines the right way, according to the website.
Some side-effects may be serious. They may be a sign that the ARVs are not working or are causing serious damage to the body. Examples of these side-effects include a reddish skin rash all over the body (arms, legs, hands, feet), bad pain in the middle of the stomach, vomiting that does not stop, no appetite and weight loss, pain, burning or numbness in the hands and feet.
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