Phuong’s case: A catalyst for action in Viet NamCute little Phuong was named by nurses in the Hanoi hospital ward where she was born. She has HIV, transmitted by her mother who abandoned her shortly after her birth. Hard as they tried, the nurses at Hanoi Maternity Hospital in Viet Nam’s capital city were unable to find a home for the newborn baby. The response from childcare centres, including those for orphans and disabled children, was always the same: negative. So Phuong had no choice but to stay on at the children’s ward. Thus started her care by hospital staff who took it in turns to feed and bathe her, change her nappies and check her health. When the hospital could not afford her upkeep, they donated their own money to pay for the things she needed. The little girl seemed aware of her situation and always tried to be good. She stayed in her corner quietly, rarely crying but also rarely smiling. Sadness was etched on her face. At two years old, Phuong was a lovely little girl. The problem was, she could not speak. Although they did the best they could, people in the hospital were too run off their feet to spend much time talking or playing with her. What the nurses realized was that she needed proper care to develop normally. New efforts were made to find a caring home for Phuong. This time, the hospital staff sought the help of the media, so Phuong’s case became known to the public. When UNICEF heard about her, it organized a meeting with relevant ministries and the hospital to search for a way to help her and other HIV-infected and affected children who had been abandoned. This was a very real chance to create a policy that might prevent such situations developing again and UNICEF seized it. At the meeting, it was clear that there were no government regulations identifying which agency should look after abandoned children with HIV. As a result of UNICEF’s advocacy, the Ministry of Labour, Invalids and Social Affairs (MOLISA), issued a regulation to encourage all the Social Protection Centres under its jurisdiction to care for abandoned HIV-positive children. However, when MOLISA contacted these centres about Phuong’s case, they still rejected her. “They all said that kids are very active and that they can injure each other while playing,” Bui Thi Thanh Ha from MOLISA said. “If Phuong was present, they believed there was a possibility that other kids would get the virus from her.” Finally, after several months of searching, Phuong was sent to a Social Protection Centre for women in Hanoi. “At first, we meant her to be there only temporarily while we looked for other solutions,” Ha said. “This centre has some HIV-positive women and the doctors have experience in caring for people with HIV/AIDS. We thought that at least Phuong could enjoy fresh air there and that hopefully some of the people would play with her.” No one could have foreseen how Phuong’s arrival at the centre would transform life for the child and the women. From day one she brightened up the atmosphere. Most of the women were depressed, having recently found out they were HIV infected. “I felt myself useless and a burden for my family and society,” said Vien, who is HIV-positive. “But when I saw Phuong for the first time, I stopped feeling so sorry for myself. I wanted to do something for her.” “When I visited Phuong a few months later, she had become another person,” Ha from MOLISA said. “She looked healthier, cheerful and was so active. I was amazed to hear her talking. The women told me that they really enjoyed her being there and were willing to help other HIV-infected kids. So the idea of setting up a childcare centre there for abandoned HIV-positive children was formed.” Two big rooms next to the health centre were reserved for children. Individuals and different agencies donated the furniture. A kindergarten teacher was hired and some HIV-positive women were recruited as carers. UNICEF trained the doctors in how to manage HIV-infected children. The doctors, in turn, trained the carers. The UNICEF training had a big impact. “We feel more confident after being trained,” said Dr. Lich of the Social Protection Centre. “Before, we only knew how to take care of adults with HIV but children are different. These children are special and they need extensive care, love and affection.” Six-year-old Phuong now has 16 younger ‘siblings’ (girls and boys) whom she enjoys playing with. Her favourite game is riding a toy motorcycle. In a simply furnished but clean room, the children play cheerfully with toys. The carers watch or play with them. Some are holding, playing and chatting with the smaller kids. UNICEF continues to provide much-needed support to improve the situation of children infected with HIV. “We are now providing training to staff from the Social Protection Centres. Using the principles of the CRC (Convention on the Rights of the Child), we are training the carers, providing counselling skills and basic care for children,” said Le Thi Hong Loan, Chief of UNICEF’s child protection section. “Hopefully they will feel more confident to accept abandoned HIV-infected children in their centres.” It is widely accepted that children are best off living with families in the community. To that end UNICEF supports community-based care for children infected with or affected by HIV/AIDS. But until all children can find such support, the Social Protection Centres will continue to play an important role in sheltering and protecting abandoned children. Alongside these efforts UNICEF has also begun a project to prevent the transmission of HIV from mother to child. This includes voluntary counselling and testing, post-test counselling for pregnant women who are HIV-positive, the supply of medicines during delivery and follow-up care and support. With committed efforts like these there is much hope that one day Phuong’s experience will be a thing of the past.
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