ARVs give hope to children living with HIV/AIDS

© UNICEF/MOZA/01262/L.Clemente

Maputo - Thirty-four-year-old mother of three children, Albertina, discovered her youngest son Pedro was HIV positive three years ago when he was just a baby.

Pedro was admitted to the hospital six times with respiratory infections and severe diarrhoea. “He could barely sit up. He had no body; he was just bones,” remembers Albertina. (The names of mother and child are pseudonyms to protect their privacy).

Today, it is a completely different story. Pedro looks robust. He started a course of anti-retroviral treatment in July last year. Albertina no longer spends weeks in the hospital looking after her son. “He is now at home and able to play with his brother and sister and his friends,” says Albertina smiling at Pedro, who has come for a routine check up at the Paediatric Day Hospital in Maputo, the only specialist centre in the country.
The Paediatric Day Hospital was opened in May 2004 with support from UNICEF and the French Embassy. It offers new hope for thousands of children living with HIV/AIDS in Mozambique.

Dr. Paula Vaz, who heads the Paediatric Day Hospital, has already been working for ten years with children with HIV/AIDS in the Maputo Central Hospital. She welcomes the new support for children living with HIV/AIDS.

The Paediatric Day Hospital – with its brightly painted and spacious rooms - is conveniently upstairs from the Paediatric Emergency Ward and its laboratories of the Maputo Central Hospital, and it is equipped with consulting rooms for medical doctors, nurses and a psychologist. It also has its own pharmacy.

It will soon open a day ward where very sick children can stay and receive treatment for a 24-48-hour period. It replaces the previous space in the Maputo Central Hospital, where children with HIV/AIDS were treated without the range of support services.

Although full of energy and joking affectionately with her young patients, Vaz concedes that over the years, “it has been a tough job. Thousands of children with HIV/AIDS who have had consultations with me have died,” she says. “I have felt frustrated that these children did not had access to anti-retroviral drugs (ARVs).”

During the past ten years, UNICEF has already been supporting the provision of free drugs for the treatment of opportunistic infections for children with HIV/AIDS, and now with the onset of the Government’s five-year plan to unroll free ARVs, UNICEF has supported a programme for ARVs for children.

UNICEF has procured ARV syrup for 195 young children, who are treated in Maputo, Xai-Xai and Chokwe. Children below 15 kgs of weight should be given ARV syrup to ensure proper dosage and avoid toxicity, so the drugs for adults are not recommended.

Pedro is one of the more fortunate ones.  Only 500 children are now on the Government’s free ARV treatment programme in Mozambique, which began officially one year ago. Yet, some 69,025 children aged 0-14 years require ARVs to prolong their lives, according to Vaz’ calculations.

Despite the small number of children receiving ARVs, Christiane Rudert, UNICEF project officer for Nutrition and Child Health, says that “it is encouraging to see that children are now on the agenda for ARV treatment and to see the further expansion of the ARV programme in the coming year,” a positive step for one of the world’s poorest countries where only 40 per cent of the country’s people have access to basic health care.

Nationally some 14.9 per cent of the population is living with HIV/AIDS, and a total of 200,000 need ARV treatment, because of their low CD 4 count, which measures the state of their immune system. Today just a little over 6,000 people receive free ARV treatment under the government’s programme.

In 2003, there were only 12 sites providing ARVs compared to 25 sites in 2004. The target for the end of 2005 is to have 47 sites providing treatment for 29,000 patients, including additional 1,800 children. Maputo is however the only place where there is a special Day Hospital for children with HIV/AIDS. The other day hospitals treat children together with the adults.

Every year, over 30,000 children are born with HIV/AIDS in Mozambique. More than 50 percent of them die within the first year. The rest usually do not survive the second year.

Vaz now has 78 children on ARVs; the eldest is 14 years old, and the youngest six months old. Most of them are doing well, although two of her young patients died last year because their conditions were very “advanced.” “Most of those on ARVs are just so much better,” she says.

Vaz explains that they are up against major constraints, which include lack of trained personnel and few laboratories and reagents to measure viral loads and CD4 counts. At present there are only four laboratories in the country, which is a major problem considering Mozambique is vast, with poor transport routes and is sparsely populated.

Albertina says that she never imagined that her family would be able to access ARVs. “I used to hear about ARVs on the news when my son was first diagnosed with HIV, but I never thought we would be able to have them in our house. We are too poor.”

Albertina has also just learnt that she is also HIV positive, although she had always suspected she was after finding out about Pedro. She appears to take it calmly and manages to remain focused on her son.

 “I can cope with my situation. But it was very painful when I found out that my son was HIV positive,” Albertina concedes. “I’m so happy now that he has been given a chance.”



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