Fighting HIV/aids by caring?

As a child growing up in the 90’s, when the spread of HIV/aids was causing word-wide panic and sorrow, I was confronted with the knowledge that not all will be well in the end. I was young and unaware of the exact workings and effects of this virus, but I was told that this was a disease that would surely kill you, and no doctor would be able to help. It scared me (I was not sure how exactly you got this disease at this point), and while medication is more effective now, it still scares me. It is not that I am scared to become infected myself. What truly scares me is the fact that so many men, women and children do get ill. Even though there is medication that can keep you relatively safe and alive, many will not be able to get tested or receive treatment because of their specific living situation. In Uganda, there are several ‘high-risk’ groups, such as long-distance truck drivers, prostitutes and barmaids (Ntozi et al. 2003).  

Mama Watoto and RICODE are aware of the need to stay on top of the spread and effects of HIV/Aids infection. The group of street children that they care for is a high-risk group; they belong to a particular kind of group or community that is extra vulnerable for infection and the effects of the disease. These children are more vulnerable to become victims of sexual violence because of their living conditions on the streets. Some will need to prostitute themselves for money, food or shelter, and they have no way of ensuring the use of condoms. They might become sexually active earlier than other peers, increasing their risks. They are also less likely to be tested or receive the needed care and medicines. The young teenage mothers might transmit their infection to their infants at birth. Brahmbhatt et al. (2005) did a study on the transmission of HIV from mother to child and the mortality rates of the infected infants in Rakai District in Uganda. In their study, 16.9% of the mothers was infected with HIV. The infection rate for these women’s infants was 20.9%. The study continues to conclude that more than half of these infected infants died in less than two years time after their birth. Brahmbhatt et al. therefore conclude that treatment, so-called antiretroviral therapy, needs to be started earlier for this group of infants. By starting their therapy in an earlier stage, more infants could be helped and prevented from dying in their early years. But, as Nakiyingi et al. (2003) argue, infants with an infected mother are at greater mortality risk either way, whether they are infected themselves or not. If their mother cannot care for them because of her own illness, the young infant finds itself at risk of becoming an orphan.

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Especially the infants of young teenage mothers, such as those that Mama Watoto and RICODE try to help, are vulnerable. Their mothers might not have any ties left with their families, and therefore the infants have nowhere to go when their mothers turn very ill or die. Of course, the other street children are in need of protection and healthcare too. Because of this reason Mama Watoto and RICODE made sure they were well informed on the health status of all children. A couple of weeks ago all children were tested for HIV. To their great joy, the results showed that none of the street children or young infants were infected with this life threatening disease.

Unfortunately, there is no other way of treating HIV/aids then through rigorous antiretroviral therapy. This is an illness that cannot be cured by singing together, dancing, or witchcraft (some might disagree of course, but as far as I am aware there is no such solution). Therefore it is so very important to do these tests, to be able to interfere as soon as possible before the virus damages the body until a point of no return. But, before treatment comes prevention! As I wrote, street children are at higher risk of becoming infected. Mama Watoto and RICODE are actively trying to change their situation for the better, and this includes trying to keep them healthy. By taking them off the streets, giving them a safe place to sleep, food without asking for favours in return. This means the children are at lower risks to catch this awful infection, and therefore I would argue that the work of Mama Watoto and RICODE is in a way also prevention. Let us hope that their work; including singing, praying, dancing and eating together, prevents these children from the need for antiretroviral therapy against HIV/aids.

 

Brahmbhatt et al. (2005): http://journals.lww.com/jaids/fulltext/2006/04010/mortality_in_hiv_infected_and_uninfected_children.15.aspx?trendmd-shared=0

Nakiyingi et al. (2003): http://journals.lww.com/aidsonline/Abstract/2003/08150/Child_survival_in_relation_to_mother_s_HIV.12.aspx

Ntozi et al. (2003): http://www.ajol.info/index.php/ahs/article/view/6846