With the increased availability of anti retro viral treatment (ART) HIV AIDS is not the death sentence that it once was in sub-Saharan Africa. However there was a whole generation that was decimated by this unrelenting disease. This lost generation are the ones who should now be working the land to look after the older people and the younger ones. This loss has had an impact on social cohesion and the consequences will be felt for generations to come. Many elderly grandparents are caring for their grandchildren and struggling to feed and educate them. At the clinic we have a social policy that allows the destitute, such as these grandparents and their grandchildren to access healthcare totally free.
Buburi like many other areas in Kenya has suffered, but at the clinic we are fortunate to have a voluntary counselling and testing (VCT) centre where our counsellor John tests patients. He also undertakes outreach work where he visits susceptible groups, such as the fishing community and talks about HIV AIDS and conducts testing. The nursing staff manage a comprehensive community care clinic where positive patients are checked regularly and given their ART.
All pregnant women have a blood test for HIV when they visit the midwife for the first time and if found to be positive they then start on ART, for life. When delivered, the baby is also given a short course and this has reduced the mother to child transmission rate from between 15 – 45% to less than 5%, which is an amazing success story.
Historically, part of the problem has been the stigma associated with the diagnosis and this will only be reduced through meaningful education. One of the nurses at the clinic said, “If you aren’t affected then you will be effected”. Which although a cliché, is still true. To help with education, the clinic has a peer educator. Her name is Esther and she is a mother of four. She has been positive for 10 years and all her children are negative. Her role is to encourage people, especially women, to know their HIV status so that like her they can live positively. Education needs to start with the youngest and it is not uncommon to hear young children reciting poems about HIV AIDS or even singing songs with what we would consider an adult theme. These sorts of programmes in schools will help to bring it out into the open and enable discussion.
The UN Sustainable Development Goal on health, plans to end the HIV epidemic by 2030. Buburi community clinic is making its contribution to this endeavour with the hope that most of those living with HIV know their status and are receiving their ART and are managing to live their life positively.