Scourge of paediatric HIV is pegged back

THE rural setting is a makeshift stage at Nemamwa Clinic, Nemamwa Growth Point, Masvingo.

Hazel Ndebele

The actors are between five and 16 years old.

The subject of their drama is an all-too-familiar one: HIV and Aids.

The young actors of varying abilities portray how to live positively with HIV, in an attempt to dispel lingering myths about the virus that leads to Aids. In one of the scenes, a five-year-old boy plays with an HIV-positive friend to demonstrate the infected child poses no risk to those he interacts with.

The appreciative audience comprising equal representation of men and women ululates as the drama unfolds.

In its fight against the spread of HIV and Aids, the Nemamwa community, about five kilometres from the Great Zimbabwe monuments, is using theatre to illustrate the prevention of mother-to-child transmission(PMTCT) of the deadly HIV virus.

The community, with a population of more than 8 000, is also tracking the scourge through poetry in a bid to fight stigma, discrimination and misconceptions about people living with HIV, as well as encouraging people to appreciate the benefits of knowing one’s status.

One of the scripts depicts the importance of exclusive breastfeeding for the first six months regardless of the mother’s HIV status to prevent mother-to-child infection.

While the subject of HIV and Aids used to be taboo, people now talk freely about the pandemic.

“To eliminate new HIV infections in children and keep mothers alive by 2015” is the motto at Nemamwa.

When Elizabeth Glaser Pediatric Aids Foundation and journalists visited the Nemamwa rural health centre recently, members of the community presented speeches, testimonies and drama, illustrating how infected people are living positively with the disease and steps taken to prevent mother-to-child infections, especially with the co-operation of men who have often been accused of taking a back seat in the fight against Aids.

A nurse at the health centre, Revai Baloyi, said: “Since the beginning of the programme in our small community in 2007, we have delivered 184 babies born from HIV-positive parents in which 180 were HIV-negative. Only four babies were unfortunately born HIV-positive because their parents delayed to get tested; so were the other two who were visitors to our community.”

Patrick (50) and Mildred Mukondo (41) from Shurugwi, who are on anti-retroviral drugs (ARVs) and openly talked about their condition, are an example of the programme’s success. They conceived their youngest child, now two years old and HIV-negative, a decade after they both tested positive.

However, National Aids Council communications director Madeline Dube bemoaned health workers’ paltry salaries saying it was unfortunate dedicated health workers such as Baloyi were not being remunerated adequately.

“I hope the new government will work on improving salaries of health workers so as to retain those who are already there to help eliminate pediatric HIV,” said Dube.

Statistics indicate that out of a population of about 12,9 million people, 1,2 million Zimbabweans are living with HIV and Aids, with 200 000 being children under the age of 15.

As at the end 2012, it was estimated there were 64 245 HIV-positive pregnant women and 14 000 newly infected children during that year. Statistics also show that 90% of these infections were through mother-to-child transmission.

Dube said in trying to eliminate the HIV pandemic, mechanisms to collect Aids levy from the country’s informal sector, said to constitute 80% of the employable population in the country, were underway.

“We are working with policy-makers on the modalities of collecting Aids levy from every worker in Zimbabwe,” she said.

As part of the implementation of the 2013 World Health Organisation (WHO) guidelines, Ministry of Health and Child Care national co-ordinator for Prevention of Mother-to-Child Transmission, HIV care and treatment, Angela Mushavi, said the ministry had started training health workers on the elimination of pediatric HIV.

She said they were also training them on the implementation of Option B Plus, which will see expectant mothers living with HIV and Aids being introduced to three life-long courses of therapy from the 14th week of pregnancy, through to labour, delivery and during breast-feeding.

“We are mobilising resources for Option B Plus and we will officially start implementation in about three months from now,” she added.
Mushavi also said adoption of Option B Plus would mean increased demand for ARVs, so it is important for nurses to be allowed to prescribe medication.

However, as reported in the Zimbabwe Independent two weeks ago, acute shortages of anti-retroviral drugs at public health institutions is seriously compromising the health of more than half a million people living with HIV and Aids, forcing patients to switch to drug combinations which further endanger their lives.

Zimbabwe switched to Tenofovir, a new ARV regimen that has lesser side effects compared to Stalanev, which was being prescribed to all HIV patients following recommendations by the World Health Organisation.

However, since the introduction of the new ARVs, there has been a decline in the supply of drugs at all public health institutions resulting in patients being given one-week supplies or the old ARV drugs with serious side effects.

Government has committed itself to the elimination of new pediatric HIV infections and keeping mothers alive in line with the global plan launched in June 2011 by the United Nations Children’s Fund in New York.

The strategy is to reduce mother-to-child transmission to less than 5% by 2015, while improving the survival of mothers and children in the context of HIV and Aids in Zimbabwe.

The southern African region has recorded a decline in the transmission of the virus from mother-to-child, with Botswana at 2%, South Africa 4% and Zimbabwe reducing transmission from 18 to 8,8%.
If more communities implement the same strategies as Nemamwa community, Zimbabwe would be on the right path to achieving the UN goal by 2015.