2008: Dedication and partnership in Mpika: Mobilizing against mother-to-child transmission of HIV
In Lusaka, recent data from the University Teaching Hospital (UTH) indicates that an estimated 40 per cent of all infants and children admitted to the malnutrition ward are HIV-exposed.
This shocking data has been produced as a result of the hospital’s policy of offering voluntary testing for every mother, infant, and child that is admitted. To date, the acceptance rate for HIV testing in the UTH malnutrition ward is between 70 and 95 per cent – encouraging news, especially considering that testing is an important step in stopping the spread of HIV.
UTH’s impressive results in providing initiated HIV counseling and testing are not found throughout Zambia in part because outside of urban centres like Lusaka and Ndola, hundreds of thousands lack easy access to hospitals and clinics. For example, Zambia’s largest district, Mpika, is home to about 165,000 people scattered across a distance of nearly 200 kilometres. There is one government hospital, Mpika District Hospital, and one doctor, Mulindwa Tarcis.
Respectfully known throughout the district as “The Doctor,” Tarcis may seem alone in his mission to serve the people of Mpika, but he is surrounded by some of the most capable and dedicated nurses and health workers anywhere. Together, Tarcis and his team tirelessly reach out to the people in Mpika District, especially those for whom he holds a special passion: mothers and children vulnerable to HIV and AIDS.
Last year, UNICEF supported the Mpika District Health Management Team and Dr. Tarcis to help in organizing an innovative project designed to reach the unreachable: a mobile unit offering services in prevention of mother-to-child transmission of HIV and AIDS (PMTCT), voluntary counseling and testing (VCT), and antiretroviral therapy (ART). He recruited some of his best staff, including district nurse Bowas Lukama, who now serves as Head Coordinator for the Mobile PMTCT/VCT/ART Service Unit.
“Most people here are willing to be tested and want to know their status. The problem is that it is a very rural setting,” Lukama said. “There are few decent roads in the district and no one has transportation anyway. We needed to find a way to reach them, so UNICEF donated the vehicle and essential supplies to get us started. Now we travel the district regularly, visiting selected rural health centres throughout the area. Sometimes we arrive to queues of over 100 people waiting to be tested.”
A frequent stop on the mobile unit’s journey is Mpepo, a tiny village about 100 kilometres from the district hospital. Mubita Clement, coordinator of the local rural health centre, is always happy to see the unit arrive. “We are lucky to be on the route. Without the mobile service unit, our people might never get tested or treated.”
HIV and AIDS has taken a huge toll on this small community. On a recent visit to Mpepo, the unit encountered a community meeting in progress in which dozens of health workers and community volunteers were discussing the impact of HIV and AIDS.
“We are all affected. I am caring for my brother’s children, now that he has been killed by AIDS,” claims a local headsman whose position is to help provide leadership in the village. Then there is Jonathan*, a slight boy wearing tattered, dirty clothes. Just before the meeting ends, he stands up in front of the crowd and asks for help returning to school.
“Both my parents are dead because of AIDS. I quit going to school, but I want to go back. Can someone help me?” he pleads. It turns out that he lives with his grandmother, 10 kilometres away, and simply stumbled upon the meeting in hopes of finding food or water to take home.
Dr. Joanna Nikulin, UNICEF Programme Officer, believes that by supporting innovative efforts like the Mpika Mobile Unit more children are saved from HIV infection and fewer lose their mothers and caregivers.
“Thanks to this team of dedicated professionals, one of Zambia’s most vulnerable communities has access to prevention of mother-to-child transmission as well as voluntary counseling and testing, not to mention on-the-spot anti-retroviral therapy. Even infants and children can be given ART now that the government with help of partners is providing free drugs and medications,” Nikulin explains.
* Name changed to protect privacy.