During the 20 years that mothers2mothers (m2m) has employed women to guide other women and their families throughout sub-Saharan Africa on the journey to good health, we’ve seen a lot.
A lot of progress.
A lot of impact.
A lot of hope where there was seemingly none before.
And throughout those two decades, our vision has become sharper about how m2m can best reach its mission of ensuring healthy, thriving families and an end to paediatric AIDS.
Our experiences have refined and deepened our focus, which has translated into life-changing, life-saving, and life-affirming opportunities for the millions of clients we have reached since our birth in 2001.
We have seen how our pioneering model of African women living with HIV—trained and employed as community health workers—can deliver high-powered health and economic empowerment impact for marginalised communities.
We have scaled and evolved our Peer Mentor Model from a few colleagues working in healthcare facilities, to a professionalised workforce of more than 1,700 change agents spanning ten countries who deliver integrated services at health facilities, door-to-door in communities, and remotely through eServices.
And we have expanded our geographic operational footprint, as well as our programming, so that today we provide a range of comprehensive health solutions that include clinical services.
However, not once in our existence—not even for a moment—have we ever lost sight of our organisational vision of delivering health, hope, and an HIV-free future.
Join us as we share the perspectives of several people who have shaped and been touched by m2m during our 20-year journey. When you see where we have been, the impact we have made, and where we are headed, you too will believe that when women lead, communities get what they need.
Seeing the Invisible
Twenty years ago, Dr. Mitch Besser envisioned something others could not see.
A volunteer obstetrician/gynaecologist working at Groote Schuur Hospital, one of Cape Town, South Africa’s busiest public health facilities, Mitch, like his colleagues, witnessed a lot of pain, suffering, and death.
South Africa’s HIV infections were near their peak in 2001, and a potent cocktail of stigma, fear, and misinformation meant most pregnant women living with HIV could not access the treatment required to stay healthy and prevent their unborn children from contracting HIV. A generation or more of children were at risk of contracting the disease.
What Mitch could see was remarkably simple, yet equally visionary.
He recognised, as a non-South African who was not living with HIV and did not speak local African languages, that he couldn’t necessarily understand the complete social and cultural context of his patients’ lives. Working with Elaine Maane, a health counsellor and translator who was herself a mother living with HIV, Mitch arranged for one-on-one mentoring sessions in which pregnant women with HIV could share their health and related family issues with Elaine in their native language. This allowed the duo to establish deeper patient relationships and offer better healthcare support.
What started as conversations led to the light bulb idea that mothers living with HIV could serve as peer counsellors to other women sharing similar experiences. The Mentor Mother Model was born.
Mitch received a $7,000 grant from the U.S.-based Starr Foundation to kickstart the idea. From the outset, he believed Mentor Mothers should be paid professionals, which offered them further household financial support, established a deeper commitment to their roles, and promised a greater sense of well-deserved dignity. Each day, he would visit a cash machine to withdraw funds to pay his staff.
Almost 12,000 Mentor Mothers later, this idea has expanded from a single room at Groote Schuur Hospital to hundreds of health centres and communities in ten sub-Saharan African nations, and offices spread across three continents. m2m’s Mentor Mothers have reached more than 13.5 million clients, helping people live their lives to their greatest potential.
Looking back, Mitch explains what he saw during those troubling times, and what he envisioned with this simple, yet revolutionary, peer mentor concept.
There are many words to describe the profound impact of receiving an income for your professional efforts:
Pride, security, confidence, self-respect, independence, satisfaction, recognition, fulfilment, achievement, and success.
When it comes to why we established a professionalised workforce of frontline community health workers throughout sub-Saharan Africa, we use all of these words and many others to describe this important ingredient in m2m’s “secret sauce” that has seasoned our 20 years of success.
But the word we use most often is “empowered.”
By employing Mentor Mothers to serve m2m’s clients—rather than relying on a volunteer workforce—we create opportunities for these women to move beyond the initial fears and challenges that came with their own HIV diagnosis, to a position of strength. As a Mentor Mother, they can establish and reinforce household financial security, help provide for their families’ immediate and long-term needs, reinforce their self-esteem and self-efficacy, contribute to organisational goals, and feel more confident about their future. They empower themselves in ways they never previously imagined.
We did not set out to become what is likely one of the world’s largest intentional employers of women living with HIV.
It happened as a result of our proven success, excellent health outcomes, the generosity of donors which allowed us to hire more Mentor Mothers, and the expansion of our model to additional African countries.
We’re also proud to contribute to two related United Nations Sustainable Development Goals: 1. Gender Equality, and 2. Decent Work and Economic Growth.
For the more than 12,000 professional Mentor Mothers we’ve hired since our first Peer Mentor Elaine Maane, and for their families who benefit as well, m2m’s employment model offers the opportunity to take charge and radically improve their life direction.
Here’s just one example:
Limpho Nteko from Marabeng, Berea in Lesotho was just 21 years old when she learned she was living with HIV. In 2013, pregnant with her second child, she met m2m at a local clinic and a year later applied to be a Mentor Mother. Limpho has since forged a highly successful career at m2m. By 2020, she was directing 84 Mentor Mothers across 16 health facilities in Lesotho, and has since transitioned to an m2m monitoring and evaluation management leadership role in her country.
Teddy Atim sees things completely differently today than before she met m2m.
Teddy hails from Banda, a rural village in Uganda. It’s an economically depressed community with widespread unemployment, where women are often financially dependent on their partners, and polygamy is common.
When she was 20 years old and pregnant with her first child, Teddy tested positive for HIV during her initial routine prenatal exam.
Devastated, confused, and desperately worried about her unborn child, she mustered the courage to share her test result with her husband, who called her useless, threatened to take a second wife, and shunned her, leaving her to fend for herself and their baby.
At that point, all Teddy saw and felt was hopelessness. It’s the type of stigma that many m2m clients experience when they share their positive HIV diagnosis with others.
Thankfully, Teddy met an m2m Mentor Mother at her local clinic who showed her compassion, ensured she started and adhered to antiretroviral medications, counselled her through pregnancy and childbirth, and encouraged her husband to attend educational support groups and to get tested himself for HIV.
After seeing that it is indeed possible to break the cycle of HIV infection, Teddy decided she too wanted to become a Mentor Mother, and today is an m2m Community Mentor Mother assisting fellow Ugandan women and adolescent girls with vital medical services and health education.
Respected, healthy, and confident, Teddy financially contributes to her household through her m2m salary, is an empowered healthcare professional, and is also the proud mother of three children who are all HIV-free.
And her husband? That’s one of the best parts of Teddy’s story. Together, they worked through their challenges. Today, he calls Teddy “Hope” and says she is his future.
See how Teddy’s perspective has shifted as a result of m2m.
Step one is to end mother-to-child transmission of HIV. By doing so, we get started on an HIV-free generation of children who can then mature into healthy adults.
But what about all those years in between?
As m2m matured itself, we saw opportunities to engage with families at multiple steps along the way so that they not only survive, but thrive.
Two programmatic examples demonstrate m2m’s commitment to the next generation.
The first is that we now follow children from birth to toddlerhood through integrated Early Childhood Development (ECD) programming that ensures African children have the opportunity to thrive.
Mentor Mothers help promote an environment of nurturing care by providing advice and support to parents and caregivers on early learning stimulation, responsive and playful parenting, health, nutrition, safety, and protection.
First introduced in our South Africa programming in 2015, we now provide ECD services in four countries to tens of thousands of children and their caregivers each year. The impact of the steps we’ve taken is remarkable: In 2020, 94.5% of our ECD clients (ages 0-3) achieved all their developmental milestones at nine months of age.
The other next-generation solution was adding adolescents to our client base. Tallying nearly 1,000 HIV infections each day, sub-Saharan African adolescent girls and young women are the new frontline of the battle against HIV. m2m now works to create health and wellbeing for adolescent girls and boys, as well as young women and young men, with age-appropriate sexual and reproductive health services.
To achieve this, we went back to our roots, applied the Peer Mentor Model, and employed young adults to connect with adolescents in their communities. These Peer Mentors promote HIV testing, support adolescents and young adults in preventing new HIV infections, provide them with education to avoid unplanned pregnancies, and help them establish and embed their independence and self-reliance.
Today, we support hundreds of thousands of adolescents annually on a healthy journey to adulthood. Betty Harunda, a 19-year-old Ugandan, explains how the education delivered by Peer Mentor Mary Kagabo has given her the power, and helped her feel unstoppable.
Ending HIV is Just the Start
While his feet are firmly planted in overseeing m2m’s current realities, Frank Beadle de Palomo spends significant time peering down the road at our organisation’s next destinations, and even where m2m might be in 20 or 30 years given global megatrends, such as climate change, rapid urbanisation, economic power shifts, demographic and social adjustments, and technological breakthroughs.
Serving as m2m’s President & Chief Executive Officer since 2012, Frank has spent his entire 30-year professional career battling HIV. He has spurred innovations at m2m which are today reshaping how we address HIV from a holistic perspective, such as:
We’ve expanded our prevention of mother-to-child transmission (PMTCT) of HIV programming from strictly a facility-based model, to an integrated platform that now encompasses community engagements with clients and their families, as well as eServices that allow Mentor Mothers to reach hundreds of thousands of clients annually via telephone and smartphone apps.
From PMTCT, we’ve widened our services to include much broader reproductive, maternal, newborn, child, and adolescent health programming.
m2m’s frontline community health worker team now encompasses more than Mentor Mothers living with HIV. We employ physicians and nurses who deliver clinical expertise in some of Africa’s most marginalised communities. We’ve added adolescent Peer Mentors who specialise in health and wellness education outreach to young adults. And we even have men now working in communities as “expert clients” who connect with the male partners and family members of women living with HIV, encouraging them to get tested for HIV, and providing them with potentially lifesaving education.
And we’ve begun to tackle HIV co-morbidities such as malaria, tuberculosis, and diabetes with programmes and educational services that help clients understand how these diseases are closely intertwined and can lead to greater health challenges.
Are we wide-eyed dreamers for believing that ending HIV is just the start for mothers2mothers, and that everyone should be able to access their basic human right to healthcare services?