Although none of the participants reported themselves replacing ART with traditional medicine, they did report that acquaintances of theirs replaced ART drugs with traditional medicines. One male participant, for example — who has been on ART for between 1 and 3 years — reported how he combined his ART medication with traditional medicine:. You take it with tea or any foodstuff. In food, you put one teaspoon. It has worked. Immediately I started using it the CD4 improved. He is promoting herbal things. When I looked at his children, he now has mental problem because of using Back to Eden.
Religion played a big role in the research setting. Some participants reported that certain religions promoted faith healing and how such people followers of the religion were encouraged to abandoned ART when the priests told them to have faith that they were healed through prayer. I have seen two or three die because they believed pastors and stopped taking their drugs.
My neighbour, she went to church and was told she was healed and threw away her ARVs. She came back and is not healed. She got very sick and now she is back on ART. So if you want healing, stop ART. I had a sister — she took ART for 9 months and she stopped. She is just okay up to now - she is not taking them.
Some respondents who disclosed their HIV status to their families reported easy adherence because of the support that they received from spouses and children:. This disclosure makes it easy for me to take my medication.
We remind each other. You will wait for people to sleep and then take you medicine all laugh. By this time your timing for medicine would be past. Other participants, however, reported discrimination from their spouses upon disclosure of their HIV status. This made it difficult for them to openly take their medication:.
When taking medication, I was hiding and had to be in a private place. My wife was so annoyed, and she started blaming me that I was the one who will cause her to get sick.
We had serious problems and our marriage almost ended. In our study, many participants reported social barriers to ART adherence in the form of lack of food, which was brought about by high levels of poverty and unemployment. The strong interaction between having adequate nutrition and the taking of medication was illustrated in practical terms when participants chose not to take their ART drugs when food was scarce out of fear of severe side effects.
This finding is supported by studies in Uganda and Namibia, in settings where HIV patients were also poor and mostly unemployed. In addition, health services should consider alternatives to reduce the costs of having patients travel to health facilities to pick up medication, by establishing community pick-up points closer to the patients in the community.
This finding is consistent with that of Peltzer et al. Religion in many different forms appeared to play similar roles as traditional medicine because it was also shown in the study to be either used in combination with ART or as a replacement. This is consistent with the findings by Sanjobo et al. This study found that those who had disclosed their HIV status to their families and close acquaintances had no problems with adherence to ART because of the support rendered, while those who had not disclosed this had challenges regarding adherence to ART.
This finding is consistent with that of Obgochi who reported that patients in Malawi who had not disclosed their HIV status were more likely to suffer frequent treatment interruptions. This was an exploratory qualitative study and cannot be generalised to all patients attending LGH. However, it is conceivable that the findings of this study may be applicable to similar resource-constraint settings in other parts of Zambia and the continent.
Conducting FGDs and semi-structured interviews within the hospital premises may have inhibited some respondents from expressing their views freely. Lastly, the researcher, being a man, could have limited the depth to which female participants could have contributed because of cultural barriers. The current exploratory qualitative study conducted at LGH in Zambia demonstrates that factors influencing adherence to ART are complex and interrelated — combining social and economic aspects of HIV and health. The study gives support to the notion that the social determinants of health that influence HIV patients should receive as much attention as medical interventions.
Strategies to improve adherence should extend beyond health services and health care to include the general health and social welfare of HIV patients, particularly the need for adequate nutrition. The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Both authors approved the final manuscript. Social and economic barriers to adherence among patients at Livingstone General Hospital in Zambia. National Center for Biotechnology Information , U. Published online Apr Kaala Moomba 1 and Brian van Wyk 1. Author information Article notes Copyright and License information Disclaimer. Corresponding author.apimelisatest.sociocaster.com/chilton-manual-de-reparacin-2015-caravana-magnfica.php
Livingstone Revived | Zambia Travel Articles | Safari Lodges in Zambia
Corresponding author: Brian Van Wyk, az. Received Jan 9; Accepted Nov 7. The Authors. This work is licensed under the Creative Commons Attribution License. Methods An explorative, qualitative study was conducted with 42 patients on ART where data were collected through six focus group discussions 3 male and 3 female groups and seven in-depth interviews. Results Economic factors such as poverty and unemployment and the lack of food were reported as major barriers to adherence.
Conclusion Interventions to improve adherence among ART patients should aim to redress the socio-economic challenges at community and individual levels. Keywords: adherence, HIV, treatment, barriers, social, economic. Study design An explorative qualitative study approach was used. Open in a separate window. Data collection Data were collected by the researcher through six FGDs 3 female and 3 male groups and follow-up in-depth interviews with seven of the focus group participants. Data analysis Prior to data analysis, transcriptions were translated in to English, where necessary.
Despite being the home land for the Tonga speaking people, the language widely spoken in Livingstone City is Lozi from the Western province. Also across from the falls entrance, the Field Museum gives a good overview of the falls and their interesting geology. Among these cultural heritage sites, is the first shopping centres built in The buildings portray the old architectural ingenuity that has been passed on to the current generation.
The office for the prince of England, Prince George, built in , is presently used as the local court. The Livingstone Museum, which is the oldest museum of the Zambian museums , has on exhibit interesting discoveries. Among these discoveries are the local traditional fire guns used for witchcraft, traditional aero plane, local mappings depicting the entire Livingstone, a collection of David Livingstone's memorabilia and many more.
If you happen to be after some Zambian curios , the Mukuni Park Curio Market is the right place for you. Livingstone City has some fine restaurants that can restore your weaning appetite. A cruise through the following list will show you one restaurant that suits your taste. The list is by no means exhaustive. The types of restaurants differ as the following list shows:. Some important markets worth visiting include Mukuni Park, which has a good selection of curios, wooden carvings and baskets, the Maramba Market, which sells everything from fresh produce to hand-crafted furniture, and the craft and curio market next to the falls.
This will give you an insight into local culture. The villages include Musokatwane Village, a typical African Village situated 37 kilometres out of town. Harry Mwaanga Nkumbula international airport is linked directly or indirectly through Kenneth Kaunda International airport to the outside world. There are many tour operators based in the city which provide private road transportation in the form of transfers in and around Zambia.
Cars, as well as off-road vehicles are also available for hire at car rental outlets in the town. By road, the town has excellent links within or with neighbouring countries. What do you say to my going up to Abyssinia? This is talked of by many of the missionaries as a desirable object, and some propose doing it. Would it not promote our cause by making known to the churches he awful degraded state of an immense population? I think one may be quite safe if alone and without anything to excite the cupidity of the natives. I should cost the society nothing during those years I should be away.
It might be for six or seven years before I should return but if the languages are dialects of the Bechuana I should soon make known a little of the liberal plan of mercy to the different tribes on the way and if I should never return perhaps my life will be as profitable spent as a forerunner as in any other way.
On the journey Mary gave birth to a little girl and worries about the health of mother and child meant that Livingstone had to return earlier than he had intended and again failed to meet with Sebituane and the Kololo who dominated the area politically and whose language he spoke fluently. Livingstone, with his characteristic stubbornness went north again with Oswell in This time the travellers reached the Kololo capital of Linyanti and Livingstone was able to talk at length with Sebituane before the sudden death of that great man.
The well-watered and well-populated Zambesi basin was very different from the sparsely populated and semi-desert Tswana lands where Robert Moffat had planted his famous Kuruman mission and where Livingstone had worked at Kolobeng and Mabotsa. Not only was the Zambesi basin fertile with a large population, it was free from the threat of white invasion, unlike the Tswana lands that were under constant threat from the expansionary pressure of the Transvaal and of the British in the Cape. He was convinced that it as his duty to go back north and seek a route that would link the Kololo with the Portuguese ports on the Atlantic coast.
The long separation that ensued which saw Mary suffer so badly from loneliness in, for her, a totally alien environment, has been the source of severe criticisms of Livingstone in the latter decades of the twentieth century. Had Mary and David foreseen that the separation would be four years not eighteen months would they have made the same decision? It also has to be asked why Mary and children did not go to stay with her parents at Kuruman her old home. He was consciously or unconsciously acting out the kind of African travel he wrote of in those letters to Watt and company ten years before.
He turned to Sekeletu for help. Each of these men had affection for the other, but each also saw how they could use the other. It was as such an embassy that he and his party were received by the Portuguese Governor-General in the Angolan capital. Gabriel and the British naval officers received Livingstone with enthusiastic admiration and the Royal Navy offered him a free passage back to the UK on a man of war. The decision was forced on him by the increase of Portuguese slave raiding in the area he and the Kololo had just traversed.
He decided therefore to go back and try to find an East Coast route. He explained his situation to Gabriel and to the naval officers, adding that in any case the Kololo had to get back home. How far the naval officers or Mr Gabriel were responsible for the very different story that was presented to the British public, or how far a sober report from them was transformed by Tidman and Murchison or how far they all contributed to the story is not now clear. At that time, and for the majority of writers up to the end of the twentieth century, this journey has been described as a great feat of European exploration, the lone European traveller triumphing against the odds.
It was not. The journey to Loanda was an African embassy attempting to open a route for trade with the outside world. The march to the East Coast that followed, after Livingstone and his men returned to Linyanti, the Kololo capital, was an extension of that effort. Livingstone says so utterly unambiguously on page of his best seller, Missionary Travels and Researches in South Africa. On page of the same book Livingstone had already made explicit for the reader that his authority over these men on the journey was not that of an employer but that of an nduna of Sekeletu.
Nonetheless the great walk from the centre of Africa to the West Coast and the return back to Linyanti and on to Quilemane on the East Coast has remained in the British popular imagination and in the literature African travel as a great European journey of exploration. The new railway system and the beginning of a modern cheap press enabled him, on his return to the United Kingdom, to gain a national image in a way that would not have been possible earlier in the century.
He was run ragged by trying to fulfil as many as he could of the invitations to speak which flooded in. The only peace he had was when he sat down in a rented house in Sloane Square, Chelsea, to write his Travels and Researches. How alien he was in the British society which welcomed him so warmly is exhibited in the story told by Professor Sir Richard Owen about his escorting Mary Livingstone to a reception and display of photographs at Kings College, London. Mrs L. He could not conceive what badly dressed housemaid I had picked up to bring to such a place.
Carry was equally mystified.