Zimbabwe: Diet rotation club helps HIV-positive women maintain medication schedule

July 22, 2019
A translation for this article is available in French

Maude Jaure* pours white sugar into her sorghum porridge and stirs until it dissolves. Mrs. Jaure is happy that her diet rotation club is enabling her to eat foods like sorghum porridge. The club helps HIV-positive women farmers diversify their food sources and maintain their medication schedule.

She says, “In our diet rotation club, this meal sparks power for us who take HIV medication…. Our motto is that every antiretroviral pill must go with a nutritious meal.”

Mrs. Jaure lives in Hakata village in the Chivi district of Masvingo province, in southeast Zimbabwe. The district is one of Zimbabwe’s most drought-prone areas. Many families experience hunger frequently. This is devastating for people like Mrs. Jaure who must eat a nutritious meal every time they take antiretroviral pills.

Before she formed the diet rotation club with 10 other women in 2017, Mrs. Jaure struggled to eat nutritious food. She explains: “During the dry season, from June to November, I used to miss drinking my HIV antiretroviral pills because I used to have no food. Nurses say we must not take pills on an empty stomach.”  

Mrs. Jaure learned about diet rotation clubs in South Africa where she worked as a maid. Illness forced her to return to Zimbabwe in 2015. Two years later, she established a diet rotation club with support from a clinic in her area.

The women in the club preserve and exchange foods so that every member eats a nutritious diet. Each has responsibility for the type of food they share. Mrs. Jaure explains, “I am the carbohydrates woman. I grow sorghums and I also harvest and dry Mopani worms. That’s my role.”

Community outreach nurses from the local clinic encourage the women to eat nutritious food to ensure that their medication is effective. Mrs. Jaure says: “We fear to fail on antiretroviral treatment and develop drug resistance. We were instructed to eat a mix of vitamins, carbohydrates, zinc, fats, and many more [nutrients] that are helpful to our bodies.”

Janet Tsanza* is another HIV-positive farmer in Hakata village who belongs to the club. She produces protein-rich food and shares it with club members. She says, “My role is to preserve goat meat, beans, and other legumes.”

She adds: “Our food rotation method goes like this: A protein member gives out five kilograms of beans to each of the women. In return, a fats nutrition member gives out five kilograms of groundnuts to every woman of the club. This happens at agreed dates.”

To join the club, a woman pledges the type of food she can provide. For crops and grains, she shares a kilogram with other members every two months—or five kilograms at harvest. For milk, she shares three litres every two months or five litres at harvest. For dried meat, members share three kilograms twice a year.

Chipo Shange* is a club member from Hakata village who joined in July 2017 after nurses recommended the club. Ms. Shange shares fatty foods with other group members.

She joined the diet club because she became sick whenever her crops failed—because of the limited variety of nutrients in her diet. She explains, “Now I know that even if my harvest is low, I have my colleagues to boost me up with food like goat milk for calcium. This is helpful.”

Felistas Vambe is a community outreach nurse at Chivi hospital in the district and also a diet mentor for HIV patients. She says, “Diet rotation clubs are becoming popular…. For people living with HIV, securing protein, carbohydrates, zinc, or starch is key to achieving good treatment outcomes.”

Ms. Vambe adds: “Traditional donor agencies supplement the diet clubs with iron, zinc, vitamin B12, and calcium products, but we emphasize that clubs themselves focus on groundnuts, goat milk, Mopani worms, and sorghum porridge because these are drought-resistant foods, extremely rich in nutrition, and cheap to produce.”

Mrs. Jaure says that before they formed the diet rotation club, her youngest son was malnourished. But now he has great appetite and his wounds heal quickly. She says: “Our children missed classes because they were too hungry, but now it is a thing of the past. Thanks to the diet rotation club, I am full of energy. I have never defaulted on drinking my pills in the last two years.”

*Note: The women in the club requested that their surnames be changed for this story because of the hostility and discrimination suffered by HIV-positive women in their area.