Many social,
political and economical factors have led to the fact that up to now 70% of the
HIV infections is in Africa.
We may think of
poverty, ignorance, lack of information, wars, and inadequate health policies.
But the fact remains that in Africa we have seen the explosion of the disease
with the known negative effects on the social network as a whole.
Chaaria has been
working on HIV since 1998 when nobody believed that HIV could be present in
rural areas like the one we are in.
When I was proposing to my colleagues the possibility of the infection
in our patients, they were adamant. Even the patients were in total denial
believing that HIV was a disease for homosexual, drug addicts and prostitutes.
The normal way
of translating AIDS was for the common folk was: American Invention to
Discourage Sex.
Usually people
believed that the reason of their bad health was witchcraft.
Another problem
was that we did not even have a test. It is only in 1999 that we started buying
the first rapid HIV Kits: the tests were expensive but they gave us a clear
idea of how much the infection was common.
The normal
presenting features were the ones called in the books “slim disease”: patient very emaciated; fever of
unknown origin; diarrhea and vomiting; extensive oral thrush. With the advent
of the HIV test we could also prove that the immense number of TB infections
were actually associated with immunosuppression.
We have put a
great effort in preparing counselors who could convince people on voluntary
testing and on behavior change. But the crisis was that we had no drugs. Why to
test somebody only to tell him that he would die without any medication? My
stress was even bigger considering the fact that in Italy antiretroviral
treatment has been free since 1985.
We solved the
psychological problem with the help of the “Amedeo di Savoia” Hospital of Turin
(Italy), who accepted Chaaria in the “Esther Project” through which we have
been able to buy and to give ART to our patients without charging anything.
Proudly we can say that the distribution of ARV in Chaaria came about 3 years
before the big drive towards global ART availability promoted by various
national and international organizations (PEPFAR, Bill Gates’ Foundation, World
Bank, WHO, GOK).
For the
initiation of ARV we have relied on WHO clinical staging and on the total
lymphocyte count up to 2007, when an agreement with the “St Egidio Community”
of Rome (Italy) has allowed us to offer free CD4 count to all our clients. That
cooperation goes on very well up to now, and we are part of the “DREAM Project”
of the above Italian Organization.
Now the Esther
project is finished and Chaaria is part of the global strategy coordinated by
the government of Kenya: our clients receive a comprehensive clinical approach
taking into consideration not only health but also psychological and social
support. We have an integrated management for TB and HIV. In the antenatal
clinic we offer prevention of mother to child transmission while in the postnatal
clinic we assure all the clinical guidelines to make sure the new born remains
negative.
Although much is
still to be done, we believe that we have gone very far considering where we
started from in 1998.
Dr Giuseppe Gaido
Nessun commento:
Posta un commento