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12 NEWS (YHQLQJ (FKR 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.

I
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 infec-
ted 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 diffi-
culties 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 prob-
lems, but it is easy to predict who is
going to fail. If a child has no par- MAIN PICTURE: Dr Claudia Carriccolo in the Chikuni Mission Hospital, where staff fight to prevent the transmission of HIV to newborn babies, and (inset)
ents, then there’s no social support Nurse Clara Nuchimba taking a blood sample from baby Chimunya. Picture: Amy Colley
and it is more likely the child won’t

Kids on frontline
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 import-
ant to prevent the transmission of
the disease as quickly as possible.
There’s always a risk with breast-
feeding that HIV will be passed on.”
Every Wednesday, the hospital
holds vaccination clinics for preg-
nant women and children under
five.
Maternal and Child Health Nurse,
Clara Nuchimba explains that hos-
pital staff also holds outreach clinics
up to 21 kilometres away at ten dif-
ferent outposts, visiting two a week.
“Children here are vaccinated
against measles, TB, polio, whoop-
ing 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 al-
lowed breastfeed until the child
begins teething when it is more
likely they could become infected.
“We also encourage the husbands
in war on HIV
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 preg-
nant women living with HIV re-
ceived 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
misean cara to deliver quality edu-
cation 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 Sis-
ters 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 hospit-
al 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-pa-
tients’ 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 tele-
vision plays educational pro-
grammes 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
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 chil-
dren living in the adjacent town-
ship.
● Helen Walsh travelled to Zambia
with misean cara.