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Russian Federation

A full-service ‘triangle of support’ helps Russian families cope with HIV

© UNICEF video
In the city of Chelyabinsk, Russia, a young mother holds her newborn in a paediatric ward exclusively for infants born to women living with HIV.

On 3 April, the Unite for Children, Unite against AIDS campaign will launch its second stocktaking report on efforts to protect young people from HIV and AIDS. Here is one in a series of related stories.

CHELYABINSK, Russia, 28 March 2008 – Weeks old but already at risk, the newborns sleeping in the sun-drenched rooms of the No.8 Paediatric Hospital here have special needs that are being carefully monitored.

One of just a handful of paediatric facilities in the country designated exclusively for the infants of mothers living with HIV, the ward is crucial to the city’s AIDS strategy.

“When we created this ward, the first thing we did was demonstrate the need for earlier contact,” explains hospital director Irina Kastyan. To meet that need, a staff person from the hospital regularly travels to maternity departments throughout the region to examine babies born to HIV-positive mothers, admitting them here if there are any postnatal complications.

Just as important, a short stay in the ward gives medical professionals a chance to gauge the physical and mental health of the mothers. In a city where a high percentage of mothers with HIV are drug users, preventing vertical transmission of the virus is only the first step in ensuring a child’s well-being.

© UNICEF video
At a government-funded, UNICEF-supported kindergarten for children at risk in Chelyabinsk, about half of the children are living with HIV.

A pioneer programme

A heavily industrial city located on an active drug trade route, Chelyabinsk has a rate of HIV prevalence that is twice the national average. Since the beginning of the epidemic in the mid 1990s, over 1,500 babies have been born in the region to women living with HIV.

A well-developed medical infrastructure ensures that most of these children will stay as healthy as their peers, but many will still suffer because their parents don’t take advantage of the legal, social and counselling services available to support them.

To help bridge the gap between infant medical services and longer-term family support, the city of Chelyabinsk, with UNICEF’s support, is piloting a new programme called ‘Compass’.

At the newly renovated log cabin that Compass uses as headquarters, patients arrive for appointments with the resident social worker, lawyer or psychologist. Some of them – the new mothers – have come at the suggestion of Ms. Kastyan at the paediatric ward. Others have been steered here by members of the Compass outreach team, who travel the city talking to drug users and offering free testing, clean needles, condoms and literature.

The director of the centre, Sergey Avdeev, holds regular training sessions for teachers and medical professionals in the centre’s conference room. But just as often, he is out visiting his younger constituency.

© UNICEF video
The director of the UNICEF-supported 'Compass' programme, Sergey Avdeev, holds a baby from one of the families served by his organization, which provides long-term social support to HIV-affected households.

Developmental attention

On a recent weekday, Mr. Avdeev visited a kindergarten set up by the city two years ago. The unusual school functions around the clock, from Monday morning until Friday night, caring for those very children who once passed through Ms. Kastyan’s ward and now require more developmental attention.

Only half of them are living with HIV, but all of them live with parents who neglect them due to drug use, illness or both.

“I know all these kids,” says Mr. Avdeev as he bounces a toddler on his knee. “Their parents were my first patients.” He notes that many of the children first arrived at the kindergarten unable to feed or express themselves. They learned these fundamental skills at school.

Like Compass and the paediatric ward, the kindergarten operates on the municipal budget, but counts on UNICEF as its primary sponsor. “We have a sort of triangle of support here,” adds the director of the child-care programme, Nelly Korovchenko.

Indicators of progress

In recent years, the incidence of HIV infection has stayed steady in Chelyabinsk – at about 1,800 cases per year. Drug use has not fallen significantly, but Compass outreach workers say more addicts are taking part in rehabilitation every month.

“For us, every individual is important. If just one person kicks the habit and changes his life, that’s a good sign,” says Compass consultant Ilya Akhlustin.

UNICEF takes heart in a rise in active counselling for mothers living with HIV. Close to 100 mothers and pregnant women have visited the centre since its founding a year and a half ago.

But for Mr. Avdeev, the Compass director, the most significant indicator of progress in Chelyabinsk is the very existence of Compass.

“It’s hard to measure whether the population as a whole is more educated about HIV/AIDS,” he says. “But you can see from the actions of local authorities – the creation of Compass and of a new day-care centre, for example – that they are paying much more attention to the problem.”




February 2008:
UNICEF correspondent Elizabeth Kiem reports on the city of Chelyabinsk’s advanced network of social and medical support for families affected by HIV and AIDS.
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