The Story

A mother would do almost anything to make sure her baby is born healthy. Fundamentally, we want our unborn child to have the best chance in life. It's what we strive for. We are all the same. Wherever we live.

In South Africa, thirty percent of pregnant women are HIV positive. Most women do not have access to the drugs that prevent the disease being passed to their babies. As a result, over 70,000 babies are born HIV positive in South Africa.

The stigma and shame surrounding HIV creates a fatal silence. Many women choose death over disclosure. Women do not know that there are drugs available to save their baby nor do they have the power to ask. To these women, HIV is a death sentence, both for themselves and their babies. This does not have to be the case.

We follow three women given access to the drugs. They also receive much needed support from an American NGO 'Mothers 2 Mothers' (M2M). The power of M2M is the mothers themselves. Using peer to peer mentoring, mothers with first hand, intimate knowledge of how to prevent mother to child transmission of HIV, guide pregnant women through the process.

We witness the transformation of the women, from angry and despairing to powerful and hopeful for the future. The women are given everything to succeed.

As one mother said, “I can do anything now. I have saved my baby. I am powerful. I am beautiful. I am Andiswa”.

But sometimes, no matter what you do, there's a chance your baby will be positive. Will these mothers overcome the odds and beat the virus?

Story Background

Here in South Africa HIV/AIDS is so common place; it is a way of life. Or, more accurately, a way of death. Everyone knows someone who has died of it. A sister, a colleague, a husband. Perhaps a child. Many parents face the reality of losing two or three of their children to the virus. And many youngsters face the reality of watching both their parents die.

It is estimated that half the deaths in South Africa are AIDS related and a bewildering 71% of deaths among those aged between 15 and 49 are attributable to the virus.
 
Often, the unadorned statistics are too overwhelming to be absorbed and the suffering too immense to be imagined, perhaps especially by those who live in countries not as heavily burdened. But the impact of HIV on the people of South Africa is impossible to overstate.

Overwhelmed by the number of deaths, cemeteries can no longer cope. Running out of plots, graves are dug “three deep”. Municipalities expound the virtues of cremation. Funerals are the new social gathering places, now twice as common as weddings.

Over a thousand people in South Africa die every day due to AIDS related illnesses. Bluntly, this is akin to three jumbo jets crashing every day, killing all the men, women and children on board. But mostly women and children.

On Wednesdays they bury children. Wednesday funerals are half price.

One alarming and often overlooked way the virus spreads through the population is from mother to child. HIV/AIDS can be passed from a mother to her child during pregnancy, birth or breastfeeding. However, the transmission can be substantially reduced by giving the mother and baby the right drugs, at the right time, during pregnancy and birth.

Sometimes it can be as simple as giving the mother and baby one dose of medicine. With this “prevention of mother to child transmission” program (PMTCT), the risk of the baby becoming infected with the virus drops from around thirty (to forty) percent to about two percent.

But precious few women have access or utilize these simple drugs that could protect their babies’ health.

In a country with one of the fastest growing HIV epidemics in the world, preventing new infections is crucial. Yet 86% of HIV+ pregnant women in South Africa do not have access to these simple treatments that could save their babies’ lives.  Currently, South Africa is experiencing a rising wave of child mortality, and the leading cause is HIV/AIDs.

Medically it is relatively simple to prevent the transmission of HIV from a mother to her baby. Still, some 70,000 babies are needlessly born HIV positive every year. So what is going wrong? Why do women not take advantage of the drugs?

Quite simply, lack of knowledge. Most women do not know that the drugs are available. Stigma around HIV/AIDS abounds and many women would still prefer death rather than disclosing their status. This fear creates a fatal silence. Women tend not to ask questions, afraid of implicating themselves or their partner. Consequently, ignorance runs amok and the simple drugs remain unused.

An innovative American NGO, Mothers2Mothers, is working to change this. A network of mothers who have successfully completed PMTCT are trained to guide pregnant women through the PMTCT process.  These mentor mothers provide information, a daily meal and vital psychosocial support. They have significantly improved the adherence to the PMTCT regimen and general health of the women in the programme.

By following and filming three women through each challenging step of PMTCT – HIV testing, disclosing their status to their partners and families, understanding the PMTCT drug regimen, and learning how to feed their babies – the documentary will provide support and inspiration to mothers who do not have access to Mothers 2 Mothers.

Why did we chose to make this documentary?

"Mothers to Mothers to Be" is a one hour documentary for broadcast internationally. The documentary will also be distributed to rural and urban health clinics and used to empower HIV+ women.     

In this documentary we use personal stories to provide insight into larger social issues, contributing to the global effort to fight AIDS. By producing a documentary that breaks through the overwhelming statistics, we believe that we will enable viewers to connect to AIDS sufferers. But more than this, we intend for this documentary to empower HIV+ mothers, mother mentors and act as a teaching aid for health policy leaders.     

Women are disproportionately affected by HIV. Young women between 15-24 in South Africa are 4x more likely to have HIV than their male peers  as a result of gender realities, biological susceptibility, and power in relationships. The unprotected sex that transmits HIV often leads to pregnancy, where HIV can then be transmitted from a mother to child, usually during labor. But 44% of pregnant women with access to treatment for the prevention of mother to child transmission (PMTCT), never test for HIV. Their babies could be protected from HIV infection, but because of severely limited sites, limited awareness of the benefits of PMTCT and counseling practices, nearly 70,000 HIV positive babies are born each year who could have been born HIV negative.

In 2001, PMTCT care was accessible by 9% of pregnant women. Now, over four years later, only 14% of pregnant women currently have access to PMTCT care.  As a result, 70,000 babies are born HIV positive each year in South Africa, who could have been born HIV negative. 

This film will empower pregnant women through the stories of their sisters.  Once a woman sees the impact she can have on her child’s life, she will become the motivated and informed patient who will be more likely to demand good medical care for herself and her child. 

Medical staff will be exposed to an innovative patient-centered peer education PMTCT care method with an impressive record of success (Mothers2Mothers).  They will see the efficacy of methods documented in the film and decide whether they can be appropriately incorporated into their clinic settings.

To educate the public on the prevention of mother to child transmission of HIV (PMTCT), which will lead to increased numbers of pregnant women testing for HIV, increased numbers of pregnant women enrolling in PMTCT programs and increased pressure on the government to expand PMTCT services so that all pregnant women have access to this essential health care service.  This film also documents Mothers2Mothers, which is an innovative health intervention that could improve PMTCT delivery if its methods are adopted.

This film captures the experience of the HIV epidemic through the eyes of women and mothers.  It documents the critical historical shift from the lack of medical services where HIV meant an early death for you and likely also for your unborn baby, to recent improvements in KZN, Gauteng and the Western Cape, where HIV has become a manageable life-long condition with access to ARVs, and your baby can be born HIV negative as a result of PMTCT.

The screening and distribution of this documentary will increase public awareness of PMTCT and the importance of HIV testing for pregnant women.  The national broadcast of this film will encourage government expansion of the PMTCT program and encourage mothers to complete PMTCT treatment and choose safe feeding options for their babies.

Thro this doc., the general public will become aware of the benefits of PMTCT by seeing HIV negative babies born to HIV+ mothers.  They will understand that every pregnant women should be tested for HIV and advocate for their friends and family members to access PMTCT care.

However, once they realize that only 14% of mothers are able to access PMTCT care and that 70,000 babies are born HIV+, although treatment could be made available to prevent transmission, there will be an upsurge of public opinion to pressure the government to expand PMTCT sites to all areas.

By seeing the experience of another woman through her pregnancy and birth of her child, a pregnant woman will realize that she too can have a baby born HIV negative. 
By understanding that she has the power to change her baby’s future, she will become a motivated and informed patient who will be more likely to demand good medical care for herself and her child.

The film will be created to document the lives of women who make up the Mothers Program as well as the work that is done by this program as a successful example of PMTCT in South Africa.  It serves as a case study to demonstrate a way forward for PMTCT in the country as well as for other developing nations. The film broadcast and outreach screenings with medical staff will support wider public interest in the public policy forum to recommend expansion and improvement of PMTCT services in South Africa.                             

Finally, outreach screenings with pregnant women as well as communities who with high HIV prevalence and low PMTCT enrollment will encourage women to get HIV tests when they are pregnant, and if positive enroll in treatment.  Mentor mothers and women currently in the Mothers2Mothers program will be consulted on the documentary focus and appropriateness.   Focus groups were arranged with pregnant women in the community and clinic staff.  The film will have preliminary draft screenings with samples of each target group to elicit feedback.