Ethiopia: Saving Lives through Religious Leaders’ Intervention for Antiretroviral Therapy (ART) Adherence

 {Photo credit: Genaye Eshetu/MSH.}Merigeta says he is "now alive and healthy" thanks to the teaching of a religious leader trained by ENHAT-CS.Photo credit: Genaye Eshetu/MSH.

“I was angry at life! I was too weak to work; I couldn’t even feed myself. When I took my [antiretroviral] medicine on an empty stomach, it gave me stomach pains. So I decided to quit the medicine and instead go to a monastery and use holy water,” says Merigeta.

Merigeta was one of hundreds of people waiting to use holy water at Teklehaimanot, a monastery in Tigray, Ethiopia. The voice of a religious leader speaking to the crowd attracted his attention, and he turned to listen. The religious leader asked those in the crowd who have been prescribed antiretroviral therapy (ART) medicine to raise their hand. Merigeta lifted his hand hesitantly, along with around 70 people.

The priest then preached to the crowd that they should not stop their ART, even if they are using holy water.

Like Merigeta, many people living with HIV (PLHIV) stop ART when they start using holy water. According to Aba Haileselassie Kalaya, the administrator of the monastery, some churches teach people not to use medicine while using holy water, as it is considered a lack of faith, and a sin.

But Kalaya is one of the religious leaders trained by the Ethiopia Network for HIV/AIDS Treatment, Care and Support (ENHAT-CS) program, a US Agency for International Development (USAID) initiative funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and led by Management Sciences for Health (MSH). Kalaya was trained on HIV-related subjects, including incorporating HIV messages into his religious teaching to address stigma and discrimination; providing spiritual support to PLHIV and referring them to a health facility for care and treatment; and promotion of prevention of mother-to-child transmission and safe motherhood practices, such as giving birth in a health facility.

After his training, Kalaya became determined to teach PLHIV attending the holy water sites at his area churches and monasteries. Merigeta says:

I know three people who died recently because they stopped taking their ART while using holy water. I am now alive and healthy because of Kalaya's teaching.

Kalaya continually counsels patients at the holy water sites, stressing that they can take their ART medicine along with holy water. Due in part to Kalaya’s effort, more than 43 patients who had stopped their treatment have restarted. Since ENHAT-CS started in October 2011, the program has trained over 600 religious leaders such as Kalaya through a partnership with the Ethiopian Interfaith Forum for Development Dialogue and Action (EIFDDA). 

Merigeta regained his health after restarting ART at an ENHAT-CS supported health center, Mayichew, and is now working as a daily laborer to support himself and his family. He adds proudly:

I now teach other HIV-positive people to not stop taking their medicines while using holy water.