Providing health care to 1000s in Bujumbura slum

Introduction by Dave Zarembka: Among the many issues that HIV/AIDS has brought, the fate of children born HIV+ is often neglected. “At the end of 2015, 2.6 million children throughout the world ages 15 and younger were living with the virus, but only about one-third of them were getting treatment (WebMD).”  Clearly the children themselves are not responsible for their HIV+ condition, but must live their whole lives with the negative consequences. If they receive proper treatment and take the appropriate drugs they can lead long, healthy lives.

This Report covers two aspects of HIV+ children. First is a short description of a dialogue session with three HIV+ children under treatment at the Friends Women’s Association’s Ntaseka Clinic.

The best “cure” for HIV+ children would be for the children not to be infected by their HIV+ mothers. One of the methods of doing this is to give birth under professional care at a maternity ward rather than at home with unqualified assistance. The Ntaseka Clinic now has 199 young HIV+ women under their care and many will give birth. To lower the chance of these women conveying their positive status to their infants, the Clinic is building a Maternity Ward so that women can give birth in a safe environment. The second part of this report, mostly pictures, covers the current building project for the Maternity Ward.

Dialogue Session on September 7, 2018 with Children infected with HIV/AIDS.

Theme: Compliance with antiretroviral therapy and drug conservation.

Target group: Children aged 10 to 14 followed at Ntaseka Clinic.

Number of participants: 3 children.

Venue: Ntaseka Clinic.

Objective: The objective of the session was the respect for taking medication and good preservation of drugs.

Methodology: The participatory method was adopted so that each child could express himself/herself freely.

Description:

The session began at 1 pm with greetings. Then we proceeded to the introductions. Both the facilitator and the participants introduced themselves. The facilitator then asked the children to tell her what time they take their medications. They all participated without hesitation.  Each one of them indicated the time of taking the drugs. Then the facilitator asked them to describe their daily schedule from morning to bedtime at night. Each child shared his daily schedule. Some children indicated the time of taking their medications; others forgot to mention this.

Then after the facilitator showed them pictures from the picture folder and asked them to describe the pictures that indicate the consequences of good or bad observance, the children described these pictures. Some of them said that they sometimes forget to take their treatment and that they also happened to get sick with diarrhea or vomiting. From these images children understood that this is due to poor compliance.

Towards the end of the session, the facilitator showed them pictures indicating a good preservation of medications. The children described the pictures and each child shared the place where he/she keeps his/her medication.  From these images, children have learned that keeping their medications in a well-ventilated place promotes the effectiveness of treatment but also that they must be kept in a place where their little brothers or sisters cannot reach because they can throw them away or take what is dangerous for them.

Observation:

The children were interested in the session and all participated by sharing their experiences and knowledge. Some children are observing the treatment while others are not. This happens because of the lack of follow-up by the parents or guardians of these children.

Recommendations:  

• It would be necessary to multiply these dialogue sessions and to organize playful meetings with these children so that they can create strong relationships with each other.
• There should be also similar sessions for the parents and/or guardians of these children in order to sensitize them to make sure that the children are taking their medications properly.

Conclusion:

The session went well in a good atmosphere because all the participants expressed themselves without fear.

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Progress on construction of the Maternity Ward.

Please see pictures of the constuction.

For a long time, FWA has had a vision to extend its services offered in Kamenge community through our Ntaseka Clinic. While our main focus was to provide treatment to people living with HIV, we realized that it has to go hand in hand with Prevention of HIV Transmission from Mothers to Children. Kamenge is amongst the most populated areas (slums) of Burundi and with one of the highest rates of HIV/AIDS. Our dream is to create a healthy community in Kamenge and its surrounding areas and we want to have a strong focus on increasing the number of HIV free babies. On one hand the main objective is to make available all the services in the poor community of Kamenge where we are working. On the other hand we must have the minimum package of service required by the Minister of Public Health in the fight against HIV/AIDS.

After Parfaite Ntahuba, FWA’s National Coordinator, visited Canada in 2017, Vancouver Island Monthly Meeting (VIMM) pledged $21,400 (USD) to start construction work on the clinic’s Maternity Ward. Thus in April 2018 we contracted an engineer to develop plans and specifications. Then in May 2018, we contacted the National Laboratory of Building and Public Works to do the study of the soil. We used funds received funds through GlobalGiving Platform for the site installation. The Vancouver Island Monthly Meeting funds reached us at the end of August 2018. At the same time we received $440 through Global. With these funds we began our construction project. We are in partnership with the construction company "Generation Trading Company" which closely follows this construction work. With the amount already received and other funds that we hope to collect through GlobalGiving and other sources, we hope to complete the ground floor by the end of this year.

DONATE

FWA would appreciate continued donations for the building of the Maternity Ward. To support Building FWA’s Maternity Ward through GlobalGiving, click on goto.gg/32980.

The section below summarizes the work done during the month of September 2018.

ACTIVITIES

Rape Survivors’ Support (RSS)

One trauma healing workshop for Gender Based Violence survivors was done on September 26-28, 2018.

At the end of September 2018, 22 self-help groups were functioning

Caring for HIV Positive People (CHIVPP)

During this month of August 2018, medical follow up and home visits were done for our HIV positive people.

Through Red Cross Burundi, nutritional support is provided to our HIV positive beneficiaries.

One discussion group was done for children born with HIV/AIDS.

Maternity Ward Building (see pictures)

FWA has initiated this new project to extend its services in Kamenge and its surroundings. In the month of September 2018, we have started building.

Improving Women’s Reproductive Health (IWRH)

FWA community health workers have continued to mobilize people for HIV voluntary test and family planning.

Action on Gender-Based Violence (AGBV)

In the month of September 2018, both narrative and financial reports were provided to Quaker Service Norway (QSN).

Medical Team

CONSULTATIONS

82 cases were consulted by our medical doctors, including 16 children, 23 adults and 43 people under ARVs treatment. The nurse received 327 patients including 228 adults and 99 children.

LABORATORY

In the month of September 2018, apart from HIV voluntary testing, there were a total of 218 tests.

Test                              Test completed   Positive  Negative

G.E. - Malaria test                   89                 24          65

Quick malaria test                     8                    4          4

ECBU - Urine test                    10                  10          0

Sells - Stool test                      27                   26          1

Pregnancy                               28                   14        14

Sero-widal - Typhoïd fever          35                   31          4

Glycémie - Diabetes                  9                     3          6

RPR VDRL - Syphillis              12                     2         10

                                     Total Tests: 218

FAMILY PLANNING

330 people received contraceptives from FWA’s nurse, including 201 old cases and 47 new ones. 248 received the contraceptive injection, 20 were given pills, 8 received implants, 1 received DIU, 2 received collar method and 19 received male condoms. 

PRENATAL CONSULTATION (PNC)

In the month of September 2018, 20 women came for prenatal consultation (PNC), including 11 came for PNC 1, 3 for PNC 2, 6 for PNC 3 and 0 came for PNC 4.  

Anti-Retroviral SITE

At the end of September 2018, we had 252 patients under retro drugs followed at NTASEKA clinic including 199 women and 53 men.

PHARMACY

FWA had all necessary medicines for the month of September 2018.

PSYCHOSOCIAL TEAM

In the month of September 2018, a total of 238 people received pre and post HIV test counseling and were tested for HIV; 55% of them were women and among the 9 people detected HIV positive, 6 were women with 4% of seropositivity.

Total Number of People Tested: 238

Total Number of Women Tested: 130

% of People Tested Who Are Women: 55%

Average Age:  28

Median Age: 26

Total HIV+: 9

Total HIV-: 229

Number of Women HIV+: 6

Total % Seropositivity: 4%

% of Women Tested Who Are HIV+: 5%