By Steve Felton
LUANDA, Angola, 2 August 2010 – The bright red train carriage looks slightly out of place beside the square concrete architecture of Luanda’s Bernardino Paediatric Hospital, but the children love it. Inside the carriage, a group of toddlers are happily playing with building blocks under the supervision of social worker Frangueira Bernado António.
|VIDEO: UNICEF's Steve Felton reports on a programme to help Angolan families living with HIV.|
"We have an odd situation here, where children ask their mothers to bring them to the hospital because it's fun," said Mr. António.
Although it began as a distraction for the children awaiting consultations and treatment at the hospital, the train car has become a useful therapeutic tool in itself – providing much-needed recreation, in particular, for the children at Bernardino being treated for HIV.
Angola is home to an estimated 190,000 people living with the virus, including 110,000 women. Alongside local activists and social workers such as Mr. António, UNICEF is working to support mothers here and prevent the spread of HIV from women to their babies.
Most of the children playing at the train carriage are too young to know they have HIV. They were infected through mother-to-child – or ‘vertical’ – transmission, which is highly preventable.
|© UNICEF Angola/2010|
|A child plays with toys at the Bernardino Paediatric Hospital in Luanda, Angola's capital. The hospital provides therapy for mothers and children living with HIV.|
Throughout Angola, the prevention of mother-to-child transmission is a major component of UNICEF's work. Staff in hospitals and clinics in 16 municipalities are currently being trained in prevention, and UNICEF is running country-wide education campaigns.
The idea is simple: If a pregnant woman goes for an HIV test and finds that she has the virus, she will be referred to specialist treatment when giving birth. With a short course of anti-retroviral (ARV) therapy, the child has a much better chance of being born HIV-negative.
Work is also under way to support children already born with HIV. For them, a special ARV treatment regime is required and doctors must have specific paediatric training. Bernardino Hospital has eight paediatricians on hand, including three specialists and five fully qualified doctors undergoing further training.
Treatment and advice
One of the doctors, Elisete de Assuncão Fernandes João, has been working with children living with HIV since 2002. She can remember the case that motivated her to become a paediatric specialist.
|© UNICEF Angola/2010|
|A mother and child attend a support group at Bernardino Paediatric Hospital in Luanda, Angola.|
“There was a child whose mother died,” said Dr. João. “I followed the case and found that the child was severely malnourished. We treated the child, who is now eight years old, in school, almost never sick and leading a normal life.”
The link between nutrition and ARV therapy is an important one. ARV tablets must be taken with a meal – a requirement that is not always easy for people living in poverty. Mothers may also need help learning to buy nutritious food cheaply and how to cook it properly. Mr. António and the paediatric team make home visits to provide that advice.
HIV activist Paulina (not her real name) also visits families, giving advice and support to mothers. But as HIV is misunderstood in Angola, and the fear of stigma is very real, Paulina’s own neighbours still do not know that she and her five-year-old son are living with HIV. Many women in Angola are afraid even to take an HIV test.
|© UNICEF Angola/2010|
|A child plays with building blocks at Bernadino Paediatric Hospital in Luanda, Angola.|
UNICEF works through community-based groups like the Christian Children's Fund to educate people about HIV. Paulina works with them, not only giving support, but also receiving it. She feels lucky that her husband, who is also HIV-positive, is supportive.
When their second son was born, Paulina received ARV treatment to prevent mother-to-child transmission, and the baby was born free of the virus.
Paulina stops by the train carriage on her way to a counselling and support session at Bernardino Hospital, led by a team including Dr. João, social workers and a representative from UNICEF. In a bare room on hard chairs, a group of mothers share their experiences, giving each other emotional support and exchanging practical tips. Like Paulina, most of them can't talk to neighbours or family.
But the support group has helped Paulina. She says that she now sleeps well, knowing that the next day she will talk with friends. “I don't have words to describe it,” she said. “The group has really changed my life.”