The project, which had small beginnings in Cape Town’€™s Groote Schuur Hospital in 2001 is rapidly expanding into Africa, enrolling 20% of the women in the world living with HIV who gave birth in 2009. Anso Thom spoke to m2m’€™s founder Dr Mitch Besser.

The only sign that Besser is not a youngster is his greying hair, otherwise the Harvard graduated gynaecologist is a bundle of energy, optimism and excitement when he discusses his work. The recurring theme throughout the interview is his absolute admiration of the Mentor Mothers who are the pillars of the programme. m2m has ballooned to 588 sites in seven countries, employing over 1 500 women living with HIV who have in turn enrolled over 300 000 pregnant women onto the m2m programme (2009). This year the Mentor Mothers conducted over 2 million one-on-one and group encounters. The programme is now present in 333 sites in seven of South Africa’€™s provinces.

At Khayelitsha’€™s bustling Site B clinic, for example, 2 648 women were tested as part of government’€™s ante-natal care programme over a six month period. Of this, 887 (33%) of the women tested positive and  881 of them (99%) enrolled in the m2m programme.

What is the m2m programme? ‘€œYou want the elevator pitch,’€ smiles Besser, his eyes twinkling behind his oval spectacles.

‘€œMothers2mothers offers an effective, sustainable  model of care that provides education and support for pregnant women and new mothers living with HIV/AIDS,’€ says Besser.            

How do they do it? ‘€œWe take mothers who are living with HIV and have been through the prevention of mother to child transmission programme ‘€“ we employ, train and educate them to in turn offer education and support for the mothers living with HIV and who come into contact with the health system,’€ says Besser, who believes that programmes such as m2m could change the world’€™s perceptions of women in Africa.    

‘€œWomen are an extraordinary resource and they are undervalued and underutilised and it was clear very early on that we needed to solve the problems that were cropping up in the PMTCT programme, among the women,’€ says Besser.

In 2000 Besser served as a consultant for the clinical roll-out of Prevention of Mother-to-Child Transmission (PMTCT) in South Africa. While working at Groote Schuur Hospital, he realised that even when medical treatment was available to these women, it was often less than effective because of social, emotional and psychological barriers to success.

To help break through those barriers, Besser enlisted other new mothers living openly with HIV/AIDS who, as Mentor Mothers, began to connect with and educate their pregnant peers. The result of these efforts is m2m today.

The mentor mothers are playing a huge role in filling the gap left by overworked and overburdened healthcare workers and counselors who are unable to spend quality time with mothers, answer burning questions or explaining complex conditions.

‘€œWe had a sense it could be impactful when we started, but we had no sense of the depth of it,’€ says Besser. ‘€œWe unpacked every single thing that was going wrong in the PMTCT programme and tried to see where we could make the most meaningful impact,’€ he says.

While Besser literally worked out of the back of his car in the early days, he quickly gathered a team of people who have succeeded in applying business principles to the programme ‘€“ seeing it go from primarily a South African based programme to being present in Kenya, Rwanda, Zambia, Malawi, Swazliand and Lesotho. The project will by next year add Uganda, Tanzania, Namibia and Mozambique to the m2m family.

Today the organisation employs 70 people in the project’€™s Cape Town headquarters with former bankers and executives setting the pace. Their main funder is US President’s Emergency Plan for AIDS Relief (PEPFAR).

‘€œWe have more MBAs in the organisation than medical degrees,’€ quips Besser, adding that they are focused on adding the human dimension to PMTCT delivery, not the medical aspect.

He adds that the m2m programme would never hire nurses or doctors to address gaps: ‘€œ We do the opposite, we support the systems that are already in place, but we will articulate to managers the gaps or problem areas we identify. It’€™s about looking at how you take resources, applying them where you believe you will have the greatest impact.’€

Research conducted in 2007 by the Population Council’€™s Horizons Study revealed that of the mothers on the m2m programme, 95% received nevirapine while 88% of the babies also received the prophylaxis.

 Almost 90% of the m2m mothers opted for exclusive infant feeding while 70% used contraception after giving birth. The study also reported that the m2m pregnant mothers were significantly more likely to feel they could do things to help themselves, cope with taking care of the baby and living positively.

After giving birth the m2m mothers were significantly more likely to feel less alone in the world, overwhelmed by problems and hopeless about the future.

‘€œWe try to do what we do really well. You don’€™t for example go to Starbucks when you want a meal, you go for the best coffee. m2m wants to offer the best for mothers engaging with the PMTCT programme,’€ says Besser.

‘€œThis is not a complicated programme, it doesn’€™t have to be. I believe it can be embraced in way which would see it go global,’€ he says.