|© UNICEF DRC/2009/Marinovich|
|An antenatal class in Likasi, DR Congo. A prevention of mother-to-child transmission programme was first introduced in Katanga province in 2004 and has now expanded to 26 sites.|
UNICEF Executive Director Ann M. Veneman is in the Democratic Republic of the Congo for a five-day visit to assess the situation of women and children amidst what is widely seen as Africa's worst humanitarian crisis. Here is one in a series of related reports.
By Shantha Bloemen
KATANGA, Democratic Republic of the Congo, 27 August 2009 – Louise Ngone is the head nurse of the Kikula Health Centre in Katanga. Ms. Ngone – or ‘Mama Louise’ as she is affectionately called – is a tireless advocate for all children born in her clinic, and she is passionate about making sure as few of them as possible are born with HIV.
Although Kikula is a busy clinic with an average of 25 babies being delivered each week, the staff and volunteers are committed to patient confidentiality, close monitoring and follow-up care for their patients.
Perhaps because of this extra attention, the Kikula centre currently has the highest number of pregnant women who accept HIV testing in the province.
A strong feature at the clinic is its network of outreach volunteers like Elizabeth Ida Muteta – a community leader, schoolteacher and mother of 10 children. She visits pregnant women at home, encouraging them and their husbands to be tested for HIV.
“I volunteer to help the community change their behaviours,” says Ms. Muteta. “We need to educate the community and bridge the gap between the community and the health centre.”
Ms. Ngone and her team work to build trust with women, as many are typically afraid to disclose their HIV status or even be tested. Stigma towards people who are living with HIV remains a troubling issue here.
“For confidentiality reasons, we encourage the women to explain their status themselves to their husband. Once she has done that, we contact the husband so he can be tested,” says Ms. Ngone. “There are only a few husbands who agree to get tested. Some husbands have abandoned and divorced their wives without being tested themselves.”
Preventing mother-to-child transmission
Nationally in DRC, only an estimated 9 per cent of pregnant women living with HIV receive anti-retroviral (ARV) treatment.
The prevention of mother-to-child transmission, or PMTCT, programme was introduced in the province in 2004. Kikula Health Centre is one of four facilities providing PMTCT services to the district’s 124,000 residents. With UNICEF support, these services are now available in 26 sites across Katanga province.
The PMTCT programme offers prenatal and antenatal lessons, which show new mothers what to expect in pregnancy and childbirth, how to stay healthy and how to protect their unborn babies from HIV.
In 2008, the Congolese Government approved a national strategy to further expand PMTCT services. But it will require a massive investment in the health system and infrastructure, especially to rural areas.
Improved treatment options
There is a long way to go in strengthening the country’s HIV and AIDS care. With around 6,000 doctors for a population of about 60 million in DR Congo, health delivery systems are weak and mainly exist in urban areas.
“This area is characterized by a lot of mining quarries and people living in poor conditions,” says the Chief Doctor with the Ministry of Health in Likasi, Ndjiby Delor, who also notes that there are high levels of prostitution. “We fear that if we don’t create an HIV programme, a lot of people will contract it.”
With access to treatment slowly improving, especially now that the country receives assistance from the Global Fund to Fight AIDS, Tuberculosis and Malaria, public attitudes are changing.
“Now that we have the medicine, it is easier,” says Ms. Ngone of the Kikula centre. “Before, the husbands would ask, ‘What are you going to do for me once I test? You won’t give me anything except advice.’ Now we can explain to them the importance of being tested and getting treatment.”
Humanitarian crisis in DR Congo
Press release: Veneman visits Dungu, a community terrorized by the LRA
Press release: Executive Director calls for peace and security for eastern DRC
Children and families in DR Congo face multiple crises
Reaching out to mothers to prevent HIV