|AVSI at AIDS 2012: It will take relationships to ‘turn the tide’|
In the midst of the 25,000 attendees of the XIX International AIDS Conference, the July 25th satellite event “Born FREE from HIV: PMTCT Lessons Learned from Uganda,” organized by AVSI with World Youth Alliance and Caritas Internationalis, drew in a crowd interested in understanding the great success in northern Uganda—an acceptance rate for testing above 95% for mothers, and male partner involvement of 73% where the national average is 15%—thanks to a community-based method AVSI and its local partners lead, ensuring that mothers can give birth to children born free from HIV (through PMTCT or Prevention of Mother To Child Transmission).
Among the 70 attendees at the event were Dr. Christine Ondoa the Hon. Minister of Health (MoH) in Uganda and other Uganda MoH officials, Amb. Dickson Ogwang, Minister Counselor from the Ugandan Embassy to the U.S. and representatives of other African Embassies, representatives from the National Ministries of Health of South Sudan, Liberia, and others, from USAID and other bi-lateral or multi-lateral funders, from Makerere University –Johns Hopkins in Uganda, and other friends and colleagues from agencies working to support the people, especially mothers and children, most affected by HIV/AIDS.
Amb. Jimmy Kolker, Principal Deputy Director of the Office of Global Affairs at the U.S. Department of Health and Human Services and former ambassador of the U.S. to Uganda, expertly moderated the session, using his passion and knowledge of the Ugandan context to clarify the successes within the particularly challenging context of northern Uganda as cited by the other panelists: Dr. Lawrence Ojom, Superintendent of St. Joseph Hospital-Kitgum, and Ketty Opoka, Director of Meeting Point-Kitgum, who presented the short video FREE and AVSI’s 10 years providing PMTCT services in collaboration with the hospital and Community-Based Organization (CBO) Meeting Point; Dr. Esiru Godfrey, National PMTCT Coordinator speaking on the perspective of the Uganda Ministry of Health, May Anyabolu, Deputy Representative intervening for UNICEF Uganda, Rev. Msgr. Robert J. Vitillo, Special Advisor on HIV/AIDS for Caritas Internationalis, and finally Elyssa Koren, J.D. and Emily Matich, Director of Advocacy and Director of Operations for North America, respectively, for World Youth Alliance. On behalf of AVSI Foundation, Jackie Aldrette made closing remarks.
The session covered a 360 degree view of the work being done in Uganda, including beautiful stories of mothers and children whose lives were changed; the challenges in implementing programs including the need to strengthen systems, secure long-term funding, and to integrate health programs like PMTCT to most effectively and efficiently meet the needs of patients; and indications for the way forward. In front of the bold goals of total elimination of mother-to-child transmission of AIDS and universal coverage of treatment, the range of actors represented on the panel made clear the essential added value of local community- or faith-based organizations, and the necessity that the person and his or her good remain the first criterion, ensuring our efforts and resources go “the last mile” to reach the most vulnerable members of communities.
Taking points from the various speakers, Aldrette underlined value of the panel presentation which offered concrete lessons of what we have seen makes a difference in the lives of people in AVSI’s and other projects around the world as a starting point for working towards an "AIDS Free Generation."
“The answer is more than just medicine, because this disease is more than just medical,” Aldrette said. “Drugs are not enough. People need to be accompanied
and looked at with love, because in front of a disease such as AIDS, people need to be helped to reawaken their reason to live, to work and to struggle for something good.”
In introducing Ketty, Amb. Kolker made reference to the significance for him when he first visited Kitgum, shortly after arriving in Uganda as U.S. Ambassador back in 2002, making a point to visit the area most affected by violence, unrest and disease.
Kolker recounted, “When I encountered St. Joseph’s Hospital and Meeting Point, where they had already started to organize the women living with HIV/AIDS and the community, I thought it was one of the best examples of ‘treatment readiness’ I have ever encountered. They were already supporting and mobilizing the people, connecting the community to the hospital, making people aware of the disease and its symptoms; all that was missing were the medicine and supplies.” And medicines and supplies did follow, much of it funded by the U.S. PEPFAR (President's Emergency Plan for AIDS Relief) initiative.
Giving the perspective of a large funder such as UNICEF, Anyabolu spoke about the importance of partnerships, also describing how AVSI fit the guidelines UNICEF looks for in an implementing partner: “AVSI brought a great added value to the PMTCT program because they were there in the region, in northern Uganda, from the beginning. They already had the relationships with the local communities and health institutions.”
A question and answer session included questions about, first, the secret to the unusually high (73%) rate of male involvement, the role of People Living With HIV/AIDS (PLWHA) as leaders in programming, and clarification about how PMTCT services connected with other maternal health standards, for example the number of women who give birth outside of a hospital or integration of Traditional Birth Attendants.
Starting from his over 20 years of experience at St. Joseph’s, Dr. Ojom answered that in general the PMTCT program, including its system of referrals and home visits through community health workers connected with Meeting Point, has increased the number of people coming to the hospital for services. He spoke of the ‘family support groups’ which involve not only those infected by HIV, by all community members because they are affected also. This helps overcome stigma and sets the stage for men to feel more connected and interested in their own and their family’s health.
Later, Aldrette reiterated these points stating that pre-natal visits often tap into the motivation propelled by the unique love of a mother for her child which can become a new beginning for both the mother and the father to take their health and future more seriously.