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EE - V1


Thursday, November 11, 2010


IN THE fourth instalment of her series from Zambia, Evening Echo reporter Helen Walsh looks at the impact of HIV on children in Zambia and the efforts being made to reduce infection rates.

F DOCTOR Chishala Chabala had just one wish, it would be that no child would be HIV positive. “HIV is preventable. No child should be HIV positive today,” he told me during an interview at Our Lady’s Hospice in Lusaka. The paediatrician has held a weekly clinic here since 2005 and has seen firsthand the tremendous benefits of antiretroviral treatment (ART). “Before ART, the majority of infected children wouldn’t live beyond the age of one and most wouldn’t make it beyond the age of five. “With treatment available, as long as children are diagnosed early and start treatment early, the outlook is wonderful,” he added. More than 95,000 children in Zambia are HIV positive and in 2007, there were some 600,000 Aids orphans in the country. Thousands of these children are abandoned due to stigmatisation or a simple lack of resources, while others run away because they have been mistreated and abused by foster families. Double orphans are particularly vulnerable and are less likely to be in school compared to children who have at least one parent. Most orphans are cared for by elderly grandparents or siblings in child-headed households. Although ART is freely available for children, one of the main difficulties that has arisen is ensuring that the drugs are taken as directed. ART has to be taken twice a day at the same time every day. Dr Chabala said: “Here at Our Lady’s we have few adherence problems, but it is easy to predict who is going to fail. If a child has no parents, then there’s no social support and it is more likely the child won’t receive proper treatment. “Our biggest challenge is access to healthcare. Although everyone has free access to treatment, we still find that we’re not able to diagnose some children early,” he said. In the Chikuni Mission Hospital, children aged between five and 14 receive counselling to explain what being HIV positive means and how to take their drugs correctly. The hospital, which is located in a remote area in the southern province, has just one doctor, Italian Claudia Carriccolo, and its staff are battling to prevent the transmission of HIV to newborn babies. Dr Carriccolo said: “It is important to prevent the transmission of the disease as quickly as possible. There’s always a risk with breastfeeding that HIV will be passed on.” Every Wednesday, the hospital holds vaccination clinics for pregnant women and children under five. Maternal and Child Health Nurse, Clara Nuchimba explains that hospital staff also holds outreach clinics up to 21 kilometres away at ten different outposts, visiting two a week. “Children here are vaccinated against measles, TB, polio, whooping cough, diphtheria and hepatitis B. Pregnant women are vaccinated against tetanus and are tested for HIV If they test positive, they are . started on prophylaxis at 14 weeks until they deliver.” After the birth the women are allowed breastfeed until the child begins teething when it is more likely they could become infected. “We also encourage the husbands

to escort the women to the clinic and also get tested. There is no point treating the woman if her husband is positive and won’t get tested,” Clara added. The nationally run ‘Prevention of Mother to Child Transmission (PMTCT) Initiative’ was launched in 1999, beginning with a three-year pilot programme in the Copperbelt Province. In 2004, it had expanded so that 74 health facilities in four provinces offered ART to expectant mothers and newborn infants, increasing to 939 centres by the end of 2008. In 2007, an estimated 47% of pregnant women living with HIV received ARTs for preventing mother-to-child transmission. By the end of 2009, this figure had increased to 69%. Centres like Our Lady’s Hospice and Chikuni Mission Hospital are instrumental in delivering ART. These missionary projects rely on funding from Irish donors like

Kids on frontline in war on HIV
misean cara to deliver quality education and healthcare to hundreds of communities that would otherwise have nothing. Located about 10 kilometres south east of Monze town, the Chikuni Mission Hospital is run by the Sisters of Charity, who also manage a secondary school for girls in Chikuni. The sisters first established a health centre at Chikuni in 1948, which has now grown to a 96-bed hospital with ante and post-natal care. A large sign painted on to the wall serves as a reminder that the hospital offers care to all people regardless of their status, which in Chikuni, refers to a person’s HIV status. Dr Carracciolo has worked at the centre for the past five years. “Everything is free of charge at the hospital, which has led to a drastic reduction in mortality rates — from 5.5% in 2006 to 2.2% in 2009. “This is because of the out-patients’ clinic, the exams and tests that we can now carry out here in Chikuni. “We don’t need to transfer people to Monze for liver function tests and other exams. It is a big benefit and saves the patient time. It means they can get back working in their fields. When they have to go to Monze, they have to spend money and therefore, many don’t go,” Claudia said. The new out-patient centre, funded by misean cara, is a bright, airy building that has transformed the way staff work and how patients are treated. The new waiting room has large open windows, which help to reduce the spread of infection, while a television plays educational programmes about the danger of STDs and malaria. Beatrice Moonga is a volunteer at the hospital and both she and her family frequently use the facility. She has five children, three of whom were born to her sister, who

MAIN PICTURE: Dr Claudia Carriccolo in the Chikuni Mission Hospital, where staff fight to prevent the transmission of HIV to newborn babies, and (inset) Nurse Clara Nuchimba taking a blood sample from baby Chimunya. Picture: Amy Colley

died of malaria in 2003. “The children are between five years and 16 and I come here with my family. When my sister passed away in 2003, her children had no parent so I take care of them now. “The centre is a very nice place now. Even if there are 200 people here, there is room to sit down. It is more private and there is nothing that you can’t say to the doctor,” she added. She paid tribute to the Sisters of Charity for their commitment to Chikuni, saying their presence in this rural area has transformed the lives of thousands of people. ● Tomorrow, in the final day of our series, we visit a special needs school in Lusaka and look at how a community school run by the Sisters of the Sacred Heart of Jesus and Mary has changed the lives of children living in the adjacent township. ● Helen Walsh travelled to Zambia with misean cara.