TEDGlobal 2010
Mitchell Besser: Mothers helping mothers fight HIV
Filmed:
Readability: 3.7
273,348 views
In sub-Saharan Africa, HIV infections are more prevalent and doctors scarcer than anywhere else in the world. With a lack of medical professionals, Mitchell Besser enlisted the help of his patients to create mothers2mothers -- an extraordinary network of HIV-positive women whose support for each other is changing and saving lives.
Mitchell Besser - HIV/AIDS fighter
How can mothers with HIV avoid passing it to their kids? In South Africa, Mitchell Besser tapped a new resource for healthcare: moms themselves. The program he started, mothers2mothers, trains new mothers to educate and support other moms. Full bio
How can mothers with HIV avoid passing it to their kids? In South Africa, Mitchell Besser tapped a new resource for healthcare: moms themselves. The program he started, mothers2mothers, trains new mothers to educate and support other moms. Full bio
Double-click the English transcript below to play the video.
00:16
I want you to take a trip with me.
0
1000
2000
00:18
Picture yourself driving
1
3000
2000
00:20
down a small road in Africa,
2
5000
2000
00:22
and as you drive along, you look off to the side,
3
7000
3000
00:25
and this is what you see:
4
10000
2000
00:27
you see a field of graves.
5
12000
2000
00:29
And you stop, and you get out of your car and you take a picture.
6
14000
2000
00:31
And you go into the town,
7
16000
2000
00:33
and you inquire, "What's going on here?"
8
18000
2000
00:35
and people are initially reluctant to tell you.
9
20000
2000
00:37
And then someone says,
10
22000
2000
00:39
"These are the recent AIDS deaths in our community."
11
24000
3000
00:43
HIV isn't like other medical conditions;
12
28000
2000
00:45
it's stigmatizing.
13
30000
2000
00:47
People are reluctant to talk about it --
14
32000
3000
00:50
there's a fear associated with it.
15
35000
2000
00:52
And I'm going to talk about HIV today,
16
37000
2000
00:54
about the deaths,
17
39000
2000
00:56
about the stigma.
18
41000
2000
00:58
It's a medical story, but more than that, it's a social story.
19
43000
3000
01:03
This map depicts the global distribution of HIV.
20
48000
3000
01:06
And as you can see,
21
51000
2000
01:08
Africa has a disproportionate share of the infection.
22
53000
2000
01:10
There are 33 million people
23
55000
2000
01:12
living with HIV in the world today.
24
57000
2000
01:14
Of these, two-thirds, 22 million
25
59000
3000
01:17
are living in sub-Saharan Africa.
26
62000
3000
01:20
There are 1.4 million pregnant women
27
65000
3000
01:23
in low- and middle-income countries living with HIV
28
68000
3000
01:26
and of these, 90 percent
29
71000
2000
01:28
are in sub-Saharan Africa.
30
73000
3000
01:32
We talk about things in relative terms.
31
77000
2000
01:34
And I'm going to talk about annual pregnancies
32
79000
2000
01:36
and HIV-positive mothers.
33
81000
2000
01:38
The United States -- a large country --
34
83000
2000
01:40
each year, 7,000 mothers with HIV
35
85000
3000
01:43
who give birth to a child.
36
88000
3000
01:46
But you go to Rwanda -- a very small country --
37
91000
3000
01:49
8,000 mothers with HIV who are pregnant.
38
94000
3000
01:53
And then you go to Baragwanath Hospital,
39
98000
3000
01:56
outside of Johannesburg in South Africa,
40
101000
2000
01:59
and 8,000 HIV-positive pregnant women
41
104000
2000
02:01
giving birth --
42
106000
2000
02:03
a hospital the same as a country.
43
108000
3000
02:06
And to realize that this is just the tip of an iceberg
44
111000
3000
02:09
that when you compare
45
114000
2000
02:11
everything here to South Africa, it just pales,
46
116000
2000
02:13
because in South Africa,
47
118000
3000
02:16
each year 300,000 mothers with HIV
48
121000
3000
02:19
give birth to children.
49
124000
2000
02:23
So we talk about PMTCT,
50
128000
2000
02:25
and we refer to PMTCT, prevention of mother to child transmission.
51
130000
3000
02:28
I think there's an assumption amongst most people in the public
52
133000
3000
02:31
that if a mother is HIV-positive,
53
136000
2000
02:33
she's going to infect her child.
54
138000
2000
02:35
The reality is really, very different.
55
140000
3000
02:38
In resource-rich countries,
56
143000
2000
02:40
with all the tests and treatment we currently have,
57
145000
2000
02:42
less than two percent of babies are born HIV-positive --
58
147000
3000
02:45
98 percent of babies are born HIV-negative.
59
150000
3000
02:49
And yet, the reality in resource-poor countries,
60
154000
2000
02:51
in the absence of tests and treatment,
61
156000
2000
02:53
40 percent -- 40 percent of children are infected --
62
158000
3000
02:56
40 percent versus two percent --
63
161000
2000
02:58
an enormous difference.
64
163000
2000
03:00
So these programs --
65
165000
2000
03:02
and I'm going to refer to PMTCT though my talk --
66
167000
2000
03:04
these prevention programs,
67
169000
2000
03:06
simply, they're the tests and the drugs that we give to mothers
68
171000
3000
03:09
to prevent them from infecting their babies,
69
174000
3000
03:12
and also the medicines we give to mothers
70
177000
2000
03:14
to keep them healthy and alive to raise their children.
71
179000
2000
03:16
So it's the test a mother gets when she comes in.
72
181000
2000
03:18
It's the drugs she receives
73
183000
2000
03:20
to protect the baby that's inside the uterus and during delivery.
74
185000
3000
03:23
It's the guidance she gets around infant feeding
75
188000
2000
03:25
and safer sex.
76
190000
2000
03:27
It's an entire package of services,
77
192000
3000
03:30
and it works.
78
195000
2000
03:32
So in the United States,
79
197000
2000
03:34
since the advent of treatment in the middle of the 1990s,
80
199000
3000
03:37
there's been an 80-percent decline
81
202000
2000
03:39
in the number of HIV-infected children.
82
204000
2000
03:41
Less than 100 babies are born with HIV
83
206000
2000
03:43
each year in the United States
84
208000
2000
03:45
and yet, still,
85
210000
2000
03:47
over 400,000 children
86
212000
3000
03:50
are born every year in the world today with HIV.
87
215000
3000
03:54
What does that mean?
88
219000
2000
03:56
It means 1,100 children infected each day --
89
221000
3000
03:59
1,100 children each day, infected with HIV.
90
224000
3000
04:02
And where do they come from?
91
227000
2000
04:04
Well, less than one comes from the United States.
92
229000
3000
04:08
One, on average, comes from Europe.
93
233000
3000
04:12
100 come from Asia and the Pacific.
94
237000
3000
04:16
And each day,
95
241000
2000
04:18
a thousand babies -- a thousand babies
96
243000
3000
04:21
are born each day with HIV in Africa.
97
246000
3000
04:26
So again, I look at the globe here
98
251000
2000
04:28
and the disproportionate share of HIV in Africa.
99
253000
3000
04:31
And let's look at another map.
100
256000
2000
04:33
And here, again, we see
101
258000
2000
04:35
Africa has a disproportionate share of the numbers of doctors.
102
260000
3000
04:38
That thin sliver you see here, that's Africa.
103
263000
3000
04:41
And it's the same with nurses.
104
266000
3000
04:44
The truth is sub-Saharan Africa
105
269000
2000
04:46
has 24 percent
106
271000
2000
04:48
of the global disease burden
107
273000
2000
04:50
and yet only three percent of the world's health care workers.
108
275000
3000
04:53
That means doctors and nurses
109
278000
2000
04:55
simply don't have the time to take care of patients.
110
280000
3000
04:58
A nurse in a busy clinic
111
283000
2000
05:00
will see 50 to 100 patients in a day,
112
285000
2000
05:02
which leaves her just minutes per patient --
113
287000
2000
05:04
minutes per patient.
114
289000
2000
05:06
And so when we look at these PMTCT programs, what does it mean?
115
291000
3000
05:09
Well, back in 2001,
116
294000
2000
05:11
when there was just a simple test
117
296000
2000
05:13
and a single dose of a drug,
118
298000
2000
05:15
a nurse, in the course of her few minutes with a patient,
119
300000
3000
05:18
would have to counsel for the HIV test, perform the HIV test,
120
303000
3000
05:21
explain the results, dispense a single dose of the drug, Nevirapine,
121
306000
3000
05:24
explain how to take it, discuss infant feeding options, reinforce infant feeding,
122
309000
3000
05:27
and test the baby -- in minutes.
123
312000
3000
05:30
Well, fortunately since 2001,
124
315000
2000
05:32
we've got new treatments, new tests,
125
317000
2000
05:34
and we're far more successful,
126
319000
2000
05:36
but we don't have any more nurses.
127
321000
2000
05:38
And so these are the tests
128
323000
3000
05:41
a nurse now has to do
129
326000
2000
05:43
in those same few minutes.
130
328000
2000
05:45
It's not possible --
131
330000
2000
05:47
it doesn't work.
132
332000
2000
05:49
And so we need to find
133
334000
2000
05:51
better ways of providing care.
134
336000
3000
05:56
This is a picture of a maternal health clinic in Africa --
135
341000
3000
05:59
mothers coming, pregnant and with their babies.
136
344000
3000
06:02
These women are here for care,
137
347000
2000
06:04
but we know that just doing a test,
138
349000
2000
06:06
just giving someone a drug,
139
351000
2000
06:08
it's not enough.
140
353000
3000
06:11
Meds don't equal medical care.
141
356000
3000
06:14
Doctors and nurses, frankly,
142
359000
2000
06:16
don't have the time or skills
143
361000
2000
06:18
to tell people what to do in ways they understand.
144
363000
2000
06:20
I'm a doctor -- I tell people things to do,
145
365000
3000
06:23
and I expect them to follow my guidance --
146
368000
2000
06:25
because I'm a doctor; I went to Harvard --
147
370000
2000
06:27
but the reality is,
148
372000
2000
06:29
if I tell a patient, "You should have safer sex.
149
374000
2000
06:31
You should always use a condom,"
150
376000
2000
06:33
and yet, in her relationship, she's not empowered --
151
378000
3000
06:36
what's going to happen?
152
381000
2000
06:38
If I tell her to take her medicines every day
153
383000
3000
06:41
and yet, no one in the household knows about her illness, so
154
386000
3000
06:44
it's just not going to work.
155
389000
3000
06:47
And so we need to do more,
156
392000
2000
06:49
we need to do it differently,
157
394000
2000
06:51
we need to do it in ways that are affordable
158
396000
3000
06:54
and accessible and can be taken to scale,
159
399000
2000
06:56
which means it can be done everywhere.
160
401000
3000
06:59
So, I want to tell you a story --
161
404000
3000
07:02
I want to take you on a little trip.
162
407000
2000
07:04
Imagine yourself, if you can,
163
409000
2000
07:06
you're a young woman in Africa, you're going to the hospital or clinic.
164
411000
3000
07:09
You go in for a test
165
414000
2000
07:11
and you find out that you're pregnant, and you're delighted.
166
416000
2000
07:13
And then they give you another test
167
418000
2000
07:15
and they tell you you're HIV-positive, and you're devastated.
168
420000
3000
07:18
And the nurse takes you into a room,
169
423000
2000
07:20
and she tells you about the tests
170
425000
2000
07:22
and HIV and the medicines you can take
171
427000
2000
07:24
and how to take care of yourself and your baby,
172
429000
2000
07:26
and you hear none of it.
173
431000
2000
07:28
All you're hearing is, "I'm going to die,
174
433000
2000
07:30
and my baby is going to die."
175
435000
2000
07:32
And then you're out on the street, and you don't know where to go.
176
437000
2000
07:34
And you don't know who you can talk to,
177
439000
2000
07:36
because the truth is, HIV is so stigmatizing
178
441000
3000
07:39
that if you partner, your family, anyone in your home,
179
444000
3000
07:42
you're likely to be thrown out
180
447000
2000
07:44
without any means of support.
181
449000
2000
07:46
And this -- this is the face and story
182
451000
2000
07:48
of HIV in Africa today.
183
453000
3000
07:51
But we're here to talk about possible solutions
184
456000
3000
07:54
and some good news.
185
459000
2000
07:56
And I want to change the story a little bit.
186
461000
3000
07:59
Take the same mother, and the nurse, after she gives her her test,
187
464000
3000
08:02
takes her to a room.
188
467000
2000
08:04
The door opens and there's a room full of mothers, mothers with babies,
189
469000
3000
08:07
and they're sitting, and they're talking, they're listening.
190
472000
2000
08:09
They're drinking tea, they're having sandwiches.
191
474000
3000
08:12
And she goes inside, and woman comes up to her and says,
192
477000
2000
08:14
"Welcome to mothers2mothers.
193
479000
2000
08:16
Have a seat. You're safe here.
194
481000
3000
08:19
We're all HIV-positive.
195
484000
2000
08:21
You're going to be okay. You're going to live.
196
486000
3000
08:24
Your baby is going to be HIV-negative."
197
489000
3000
08:29
We view mothers
198
494000
2000
08:31
as a community's single greatest resource.
199
496000
2000
08:33
Mothers take care of the children, take care of the home.
200
498000
3000
08:36
So often the men are gone.
201
501000
2000
08:38
They're working, or they're not part of the household.
202
503000
3000
08:41
Our organization, mothers2mothers,
203
506000
2000
08:43
enlists women with HIV
204
508000
2000
08:45
as care providers.
205
510000
2000
08:47
We bring mothers who have HIV,
206
512000
2000
08:49
who've been through these PMTCT programs
207
514000
2000
08:51
in the very facilities,
208
516000
2000
08:53
to come back and work side by side with doctors and nurses
209
518000
3000
08:56
as part of the health care team.
210
521000
2000
08:58
These mothers, we call them mentor mothers,
211
523000
3000
09:01
are able to engage women
212
526000
2000
09:03
who, just like themselves, pregnant with babies,
213
528000
2000
09:05
have found out about being HIV-positive,
214
530000
2000
09:07
who need support and education.
215
532000
3000
09:10
And they support them around the diagnosis
216
535000
2000
09:12
and educate them about how to take their medicines,
217
537000
2000
09:14
how to take care of themselves,
218
539000
2000
09:16
how to take care of their babies.
219
541000
3000
09:19
Consider: if you needed surgery,
220
544000
3000
09:22
you would want the best possible technical surgeon, right?
221
547000
3000
09:26
But if you wanted to understand
222
551000
2000
09:28
what that surgery would do to your life,
223
553000
2000
09:30
you'd like to engage someone,
224
555000
2000
09:32
someone who's had the procedure.
225
557000
2000
09:34
Patients are experts on their own experience,
226
559000
3000
09:37
and they can share that experience with others.
227
562000
3000
09:41
This is the medical care that goes beyond just medicines.
228
566000
3000
09:45
So the mothers who work for us,
229
570000
2000
09:47
they come from the communities in which they work.
230
572000
2000
09:49
They're hired -- they're paid as professional members of the health care teams,
231
574000
3000
09:52
just like doctors and nurses.
232
577000
2000
09:54
And we open bank accounts for them
233
579000
2000
09:56
and they're paid directly into the accounts,
234
581000
2000
09:58
because their money's protected;
235
583000
2000
10:00
the men can't take it away from them.
236
585000
3000
10:03
They go through two to three weeks
237
588000
2000
10:05
of rigorous curriculum-based education, training.
238
590000
3000
10:08
Now, doctors and nurses -- they too get trained.
239
593000
3000
10:11
But so often, they only get trained once,
240
596000
2000
10:13
so they're not aware of new medicines,
241
598000
2000
10:15
new guidelines as they come out.
242
600000
2000
10:17
Our mentor mothers get trained every single year
243
602000
2000
10:19
and retrained.
244
604000
2000
10:21
And so doctors and nurses --
245
606000
2000
10:23
they look up to them as experts.
246
608000
3000
10:26
Imagine that: a woman, a former patient,
247
611000
3000
10:29
being able to educate her doctor for the first time
248
614000
2000
10:31
and educate the other patients
249
616000
2000
10:33
that she's taking care of.
250
618000
2000
10:36
Our organization has three goals.
251
621000
2000
10:38
The first, to prevent mother-to-child transmission.
252
623000
3000
10:42
The second: keep mothers healthy, keep mothers alive,
253
627000
3000
10:45
keep the children alive --
254
630000
2000
10:47
no more orphans.
255
632000
2000
10:49
And the third, and maybe the most grand,
256
634000
3000
10:52
is to find ways to empower women,
257
637000
3000
10:56
enable them to fight the stigma
258
641000
2000
10:58
and to live positive and productive lives with HIV.
259
643000
3000
11:02
So how do we do it?
260
647000
2000
11:04
Well, maybe the most important engagement
261
649000
2000
11:06
is the one-to-one,
262
651000
2000
11:08
seeing patients one-to-one, educating them, supporting them,
263
653000
3000
11:11
explaining how they can take care of themselves.
264
656000
3000
11:14
We go beyond that;
265
659000
2000
11:16
we try to bring in the husbands, the partners.
266
661000
3000
11:19
In Africa, it's very, very hard to engage men.
267
664000
3000
11:22
Men are not frequently part of pregnancy care.
268
667000
3000
11:26
But in Rwanda, in one country,
269
671000
2000
11:28
they've got a policy
270
673000
2000
11:30
that a woman can't come for care
271
675000
2000
11:32
unless she brings the father of the baby with her --
272
677000
2000
11:34
that's the rule.
273
679000
2000
11:36
And so the father and the mother, together,
274
681000
2000
11:38
go through the counseling and the testing.
275
683000
3000
11:41
The father and the mother, together, they get the results.
276
686000
2000
11:43
And this is so important in breaking through the stigma.
277
688000
3000
11:47
Disclosure is so central to prevention.
278
692000
3000
11:50
How do you have safer sex, how do you use a condom regularly
279
695000
3000
11:53
if there hasn't been disclosure?
280
698000
2000
11:55
Disclosure is so important to treatment,
281
700000
3000
11:58
because again, people need the support of family members and friends
282
703000
3000
12:01
to take their medicines regularly.
283
706000
2000
12:04
We also work in groups.
284
709000
2000
12:06
Now the groups, it's not like me lecturing,
285
711000
2000
12:08
but what happens is women, they come together --
286
713000
3000
12:11
under the support and guidance of our mentor mothers --
287
716000
2000
12:13
they come together, and they share their personal experiences.
288
718000
3000
12:16
And it's through the sharing
289
721000
2000
12:18
that people get tactics of how to take care of themselves,
290
723000
2000
12:20
how to disclose how to take medicines.
291
725000
3000
12:24
And then there's the community outreach,
292
729000
2000
12:26
engaging women in their communities.
293
731000
3000
12:29
If we can change the way
294
734000
2000
12:31
households believe and think,
295
736000
2000
12:33
we can change the way communities believe and think.
296
738000
3000
12:36
And if we can change enough communities,
297
741000
2000
12:38
we can change national attitudes.
298
743000
2000
12:40
We can change national attitudes to women
299
745000
2000
12:42
and national attitudes to HIV.
300
747000
3000
12:45
The hardest barrier really is around stigma reduction.
301
750000
2000
12:47
We have the medicines, we have the tests,
302
752000
2000
12:49
but how do you reduce the stigma?
303
754000
3000
12:52
And it's important about disclosure.
304
757000
2000
12:54
So, a couple years ago, one of the mentor mothers came back,
305
759000
2000
12:56
and she told me a story.
306
761000
2000
12:58
She had been asked by one of the clients
307
763000
2000
13:00
to go to the home of the client,
308
765000
2000
13:02
because the client wanted to tell the mother and her brothers and sisters
309
767000
3000
13:05
about her HIV status,
310
770000
2000
13:07
and she was afraid to go by herself.
311
772000
2000
13:09
And so the mentor mother went along with.
312
774000
2000
13:11
And the patient walked into the house
313
776000
2000
13:13
and said to her mother and siblings,
314
778000
3000
13:16
"I have something to tell you. I'm HIV-positive."
315
781000
3000
13:19
And everybody was quiet.
316
784000
2000
13:21
And then her oldest brother stood up and said,
317
786000
2000
13:23
"I too have something to tell you.
318
788000
2000
13:25
I'm HIV-positive.
319
790000
2000
13:27
I've been afraid to tell everybody."
320
792000
2000
13:30
And then this older sister stood up and said,
321
795000
2000
13:32
"I too am living with the virus,
322
797000
3000
13:35
and I've been ashamed."
323
800000
2000
13:37
And then her younger brother stood up and said,
324
802000
3000
13:40
"I'm also positive.
325
805000
2000
13:42
I thought you were going to throw me out of the family."
326
807000
2000
13:44
And you see where this is going.
327
809000
2000
13:46
The last sister stood up and said, "I'm also positive.
328
811000
2000
13:48
I thought you were going to hate me."
329
813000
2000
13:50
And there they were, all of them together for the first time
330
815000
2000
13:52
being able to share this experience for the first time
331
817000
3000
13:55
and to support each other for the first time.
332
820000
3000
13:58
(Video) Female Narrator: Women come to us,
333
823000
2000
14:00
and they are crying and scared.
334
825000
3000
14:03
I tell them my story,
335
828000
2000
14:05
that I am HIV-positive,
336
830000
3000
14:08
but my child is HIV-negative.
337
833000
3000
14:11
I tell them, "You are going to make it,
338
836000
3000
14:14
and you will raise a healthy baby."
339
839000
3000
14:18
I am proof that there is hope.
340
843000
3000
14:24
Mitchell Besser: Remember the images I showed you
341
849000
2000
14:26
of how few doctors and nurses there are in Africa.
342
851000
2000
14:28
And it is a crisis in health care systems.
343
853000
3000
14:31
Even as we have more tests and more drugs,
344
856000
2000
14:33
we can't reach people; we don't have enough providers.
345
858000
2000
14:35
So we talk in terms of what we call task-shifting.
346
860000
2000
14:37
Task-shifting is traditionally
347
862000
2000
14:39
when you take health care services from one provider
348
864000
2000
14:41
and have another provider do it.
349
866000
2000
14:43
Typically, it's a doctor giving a job to a nurse.
350
868000
2000
14:45
And the issue in Africa
351
870000
2000
14:47
is that there are fewer nurses, really than doctors,
352
872000
2000
14:49
and so we need to find new paradigm for health care.
353
874000
3000
14:52
How do you build a better health care system?
354
877000
3000
14:55
We've chosen to redefine the health care system
355
880000
2000
14:57
as a doctor, a nurse and a mentor mother.
356
882000
2000
14:59
And so what nurses do
357
884000
2000
15:01
is that they ask the mentor mothers to explain
358
886000
2000
15:03
how to take the drugs, the side effects.
359
888000
2000
15:05
They delegate education about infant feeding,
360
890000
3000
15:08
family planning, safer sex,
361
893000
2000
15:10
actions that nurses simple just don't have time for.
362
895000
3000
15:15
So we go back to the prevention of mother to child transmission.
363
900000
3000
15:18
The world is increasingly seeing these programs
364
903000
2000
15:20
as the bridge to comprehensive maternal and child health.
365
905000
3000
15:23
And our organization
366
908000
2000
15:25
helps women across that bridge.
367
910000
2000
15:27
The care doesn't stop when the baby's born --
368
912000
2000
15:29
we deal with the ongoing health of the mother and baby,
369
914000
3000
15:32
ensuring that they live healthy,
370
917000
3000
15:35
successful lives.
371
920000
2000
15:37
Our organization works on three levels.
372
922000
3000
15:40
The first, at the patient level --
373
925000
2000
15:42
mothers and babies keeping babies from getting HIV,
374
927000
2000
15:44
keeping mothers healthy to raise them.
375
929000
3000
15:47
The second, communities --
376
932000
2000
15:49
empowering women.
377
934000
2000
15:51
They become leaders within their communities.
378
936000
3000
15:54
They change the way communities think --
379
939000
2000
15:56
we need to change attitudes to HIV.
380
941000
3000
15:59
We need to change attitudes to women in Africa.
381
944000
2000
16:01
We have to do that.
382
946000
2000
16:03
And then rework the level of the health care systems,
383
948000
3000
16:06
building stronger health care systems.
384
951000
2000
16:08
Our health care systems are broken.
385
953000
2000
16:10
They're not going to work the way they're currently designed.
386
955000
3000
16:13
And so doctors and nurses
387
958000
2000
16:15
who need to try to change people's behaviors
388
960000
2000
16:17
don't have the skills, don't have the time --
389
962000
2000
16:19
our mentor mothers do.
390
964000
2000
16:21
And so in redefining the health care teams by bringing the mentor mothers in,
391
966000
3000
16:24
we can do that.
392
969000
2000
16:27
I started the program in Capetown, South Africa
393
972000
3000
16:30
back in 2001.
394
975000
2000
16:32
It was at that point, just the spark of an idea.
395
977000
3000
16:35
Referencing Steven Johnson's very lovely speech yesterday
396
980000
3000
16:38
on where ideas come from,
397
983000
3000
16:41
I was in the shower at the time --
398
986000
3000
16:44
I was alone.
399
989000
2000
16:46
(Laughter)
400
991000
4000
16:50
The program is now working in nine countries,
401
995000
3000
16:53
we have 670 program sites,
402
998000
3000
16:56
we're seeing about 230,000
403
1001000
3000
16:59
women every month,
404
1004000
2000
17:01
we're employing 1,600 mentor mothers,
405
1006000
3000
17:04
and last year, they enrolled
406
1009000
2000
17:06
300,000 HIV-positive pregnant women and mothers.
407
1011000
3000
17:09
That is 20 percent
408
1014000
3000
17:12
of the global HIV-positive pregnant women --
409
1017000
3000
17:15
20 percent of the world.
410
1020000
2000
17:17
What's extraordinary is how simple the premise is.
411
1022000
2000
17:19
Mothers with HIV caring for mothers with HIV.
412
1024000
3000
17:22
Past patients taking care of present patients.
413
1027000
2000
17:24
And empowerment through employment --
414
1029000
2000
17:26
reducing stigma.
415
1031000
2000
17:28
(Video) Female Narrator: There is hope,
416
1033000
2000
17:30
hope that one day
417
1035000
2000
17:32
we shall win this fight
418
1037000
2000
17:34
against HIV and AIDS.
419
1039000
3000
17:37
Each person must know
420
1042000
2000
17:39
their HIV status.
421
1044000
3000
17:42
Those who are HIV-negative
422
1047000
2000
17:44
must know how to stay negative.
423
1049000
3000
17:48
Those who are HIV-infected
424
1053000
3000
17:51
must know how
425
1056000
2000
17:53
to take care of themselves.
426
1058000
3000
17:56
HIV-positive pregnant women
427
1061000
2000
17:58
must get PMTCT services
428
1063000
3000
18:01
in order to have
429
1066000
2000
18:03
HIV-negative babies.
430
1068000
2000
18:05
All of this is possible,
431
1070000
3000
18:08
if we each contribute to this fight.
432
1073000
3000
18:13
MB: Simple solutions to complex problems.
433
1078000
3000
18:16
Mothers caring for mothers.
434
1081000
2000
18:18
It's transformational.
435
1083000
2000
18:20
Thank you.
436
1085000
2000
18:22
(Applause)
437
1087000
2000
ABOUT THE SPEAKER
Mitchell Besser - HIV/AIDS fighterHow can mothers with HIV avoid passing it to their kids? In South Africa, Mitchell Besser tapped a new resource for healthcare: moms themselves. The program he started, mothers2mothers, trains new mothers to educate and support other moms.
Why you should listen
In the developed world, daily care and drugs have turned HIV/AIDS into a manageable condition, and mothers with HIV rarely, anymore, pass it along to their babies. (Take a minute to be grateful for that.) But in developing nations where access to healthcare is difficult, drugs and day-to-day care and support are harder to come by, and rates of maternal transmission of HIV are much higher. Doctor Mitchell Besser works in Cape Town, South Africa, and in 2001, he began a program called mothers2mothers that aims to close this gap, by drawing on the power of community support.
Mothers2mothers employs HIV-positive moms themselves to complement the work of doctors and nurses. After a two-month training, mentor mothers work with other moms with HIV to help them understand how to keep from transmitting HIV to their babies. Equally important, the members of mothers2mothers connect at an emotional level with other moms, offering the support of true peers, helping to reduce the social stigma around HIV diagnosis, and helping each mom stick to her own treatment regiment so she can watch her baby grow. From its beginnings in 2001, mothers2mothers now operates in 600 clinics in seven countries; 1,600 mentor mothers "touch" an estimated 200,000 patients a month -- accounting for 20 per cent of the HIV-positive patients in Africa.
Mitchell Besser | Speaker | TED.com