Reabetsoe waves and laughs as his mother, Motšelisi Tsubane, 23, leans in, singing his name and dangling a homemade ball. Reabetsoe is a healthy 4-month-old, learning how to focus his eyes and move his arms and legs. He has transformed this family.
“My son likes it when I sing lullabies for him–you see him smile and act happy,” says Motšelisi.
“I feel like a new mother again,” says grandmother ‘Mamotšelisi, who dotes on her grandson, as one would expect. “I’m very happy because I thought that Motšelisi would never have a child because she was sick growing up.”
Reabetsoe feels secure and loved in the arms of his mother and grandmother in their modest home in northern Lesotho. He is a special child–the living manifestation of a future that once seemed impossible to mother and grandmother, who are living with HIV.
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Reabetsoe is HIV-free.
Born With HIV
Motšelisi was born with HIV, having acquired it from her mother. At that time, one-quarter of pregnant women in Lesotho were living with HIV, and there was no available treatment, no method to avoid transmitting it to children during pregnancy, delivery, or breastfeeding. A quarter of those children were born with the virus. Without treatment, 80% of children born with HIV die by the age of 5. It was a heartbreaking time to be a mother in Lesotho.
‘Mamotšelisi spent sleepless nights throughout Motšelisi’s childhood, which was marked by bouts with tuberculosis and malaria and other illnesses that overpowered Motšelisi’s weak immune system. At the same time, ‘Mamotšelisi was also battling her own HIV-related illnesses. It was almost certain that neither would survive without access to the antiretroviral (ARV) medication and healthcare programs that could restore them to health.
As a developing nation, Lesotho simply lacked the HIV infrastructure that had slowed the spread of HIV and transformed the United States and other higher-income nations in the 1990s. ‘Mamotšelisi felt alone and hopeless.
But transformation for Lesotho began in 2007 with the arrival of the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR). Created by President George W. Bush, PEPFAR brought HIV programs in those locations hit hardest by the pandemic. Motšelisi and ‘Mamotšelisi could live.
Becoming a Mother
Despite her rough beginning, Motšelisi grew to adolescence and to adulthood–living with HIV, yes, but healthy because of HIV medication and programs. Still, as a young woman, Motšelisi wondered, “Will I pass HIV to my child, like my mother passed it to me?” When she became pregnant, that question became more urgent.
At Berea District Hospital, Motšelisi got her answer. An antenatal health worker assured Motšelisi that by adhering to ARV protocols throughout pregnancy and breastfeeding, her child would almost certainly be born without HIV. With that encouragement, Motšelisi paid careful attention to her health throughout pregnancy. She was excited to welcome a boy into the world, Reabetsoe–which means “We believed, and God provided.”
Then the first HIV test for her son came back negative, filling Motšelisi with elation and relief. She trusts other test results will also be negative because she continues to adhere well to her treatment.
Motšelisi admits that being a young mother is challenging, especially when Reabetsoe cries, and she doesn’t know why. But she adds that playing with and singing to her son has been the best experience of her life. And she is grateful for the support of her mother and other young women living with HIV as she navigates her new role.
Raising an HIV-Free Generation Together
Health workers at the hospital encouraged Motšelisi to join a peer support group for young mothers that had been established by the Elizabeth Glaser Pediatric AIDS Foundation in 2017 through PEPFAR funding. The group equips mothers with knowledge about elimination of mother-to-child HIV transmission, nutrition, and mental health.
Motšelisi and the other mothers share a common goal to raise an HIV-free generation in Lesotho so that their children do not go through the sickness and stigma that they experienced.
“The group motivates me to take good care of myself and my baby,” says Motšelisi. “It encourages me to persevere even in tough situations, knowing that there are other young mothers who experience similar challenges as mine, but they are still remaining strong. I learn how to avoid transmitting HIV.”
In a country with high levels of poverty and unemployment, birthing an HIV-free generation requires support beyond ARVs, according to Nkhebesoa Nqosa, a psychologist who works with the group at Berea Hospital. “As you probe into what’s actually happening, you might find that it’s a matter of social issues because the HIV-affected population is vulnerable. And considering the changing world, people are losing their jobs, parents have died. It is tough for them.
“If it wasn’t for this program, some of these young women would not have had the faith to continue with treatment,” says Nkhebesoa. “It helps knowing that there is someone you can cry to, someone who’s willing to give a helping hand.”
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Rewriting the Story
Empowered by the support she has received, Motšelisi looks toward finishing her secondary education and starting a business.
“I have a passion for baking muffins,” she says, brightly. “I see myself starting a bakery business, selling baked products and generating income to support my family.”
She imagines sending Reabetsoe to the shops to help her out when he gets older and then eventually a future in which she, herself, becomes a granny when Reabetsoe is fully grown and starts a family of his own.
Nkhebesoa says that she is inspired by young mothers like Motšelisi who are “rewriting the stories” that they were given at birth and, in so doing, rewriting the story of Lesotho.
Motšelisi’s mother, who lived through the worst of the HIV pandemic, sees hope in her wiggly grandson that she would not have imagined when her daughter was a child. She also sees the important role of young women in creating a healthy generation and the motivation and strength they must hold.
“There’s no question,” says Mamotšelisi. “We need an HIV free generation.”
