South African Koketso Mukubani is a public relations officer for the South African Network of People Who Use Drugs, supported by the United Nations Office on Drugs and Crime (UNODC).
On the eve of World Hepatitis Day, celebrated every year on July 28, Mukubani spoke to UN News about how he was diagnosed during needle exchange programwhere people who use drugs can get clean, unused needles.
“My mother died of HIV when I was 14 years old. I was a single mother. That’s when I started using drugs. His death was overwhelming to me. For my grandmother, this was also a stunning event.
After the death of my mother, a week later, we also lost our grandfather. My grandmother became an alcoholic and sold our house because she couldn’t live with the memories.
At that time, I smoked marijuana because I was chubby and I was very ashamed of my body. I thought marijuana would help me lose weight. But after my mother died, I started using it more to cope with the situation. Then I started drinking heavily, and then I continued to use heroin and everything else that came my way. My life is out of control. We moved to the countryside and I couldn’t adjust. So I ran away and went outside. I was 20 years old.
I feared for my life
I found out that I tested positive for Hepatitis C in this building, Sediba Hope Medical Center in Tshwane, near Pretoria. They told me about an initiative in which they would shed our blood and for which we would be paid.
I didn’t know what my blood would be used for at the medical center. My motivation was money for additional doses! So, in 2017, I agreed to a needle exchange program in Marabastad.
They explained to me that they would do an HIV test and screening for hepatitis B and C.
(When the results came in) I was scared for the rest of my life when they told me I tested positive for hepatitis C. I didn’t know what hepatitis was and I was afraid for my life.. They say men don’t cry, but I couldn’t hold back my tears.
The doctor was compassionate. He reassured me, explained what hepatitis is and that you can fight it with a healthy lifestyle. I blamed myself. I contracted the disease through reckless drug use. The prevalence of the disease among people who use drugs was then 80%.
(Despite this) I went back to the street and continued to use drugs, but the diagnosis was on my mind.
take back control
I wanted to control my drug addiction, better control my health.. I joined the Community Based Substance Use Program at the University of Pretoria where I started opioid substitution therapy (OST).
I started taking methadone, a drug used to treat opioid use disorders. They also took blood from me to check the functioning of the liver. I didn’t miss a single day. After completing the 12-week program, I was bled again; was free of the virus. I also received the hepatitis B vaccine.
There was an element of family reintegration in the program that brought me joy and relief. I began to communicate with my loved ones again, but due to stigma, I did not disclose my medical status.
My family found out about this when I was free from the virus. I’m glad they found out about it when I was clean because the only thing i was afraid of was the stigma. It can overwhelm me so much that I may go out again or use drugs even more than before.
We need a comprehensive harm reduction package that is immediately available and easily accessible (in South Africa). We also need to scale up needle exchange, opioid substitution therapy and testing programs.
We need to include people who use drugs in the planning and implementation of all health care initiatives and the services that will be provided to them.
These people play a very important role in debunking myths and identifying treatment recipients. They should be hired for demand reduction work, campaigning, needle distribution, etc.
We (people who use drugs) do volunteer work, but this is real work. We deserve the same compensation as the medical staff doing the same job.”