HIV-positive… and fearless
During the first TEDxYouth event organized on 17 November in Kazakhstan, Baurzhan, age 13, and his mother Aliya spoke about living openly with HIV. This is his story. Standing before more than 100 people, Aliya asks if anyone in the audience remembers the incident in 2006 when 149 children in southern Kazakhstan were infected with the human immunodeficiency virus (HIV) at a local hospital. A few hands go up. Hesitantly. “Not too many,” sighs Aliya. “That’s 149 families facing profound pain, shock, complete lack of support and understanding.” Indeed, when the news first broke at the time, there was very little by way of public understanding and sympathy. On the contrary, the families affected have spoken about the pervasive rumors – including one suggesting that a special area would be built to quarantine the families – that they had to endure. Some families were even broken up. The sense of isolation still persists for many. “In our society,” Aliya says, “HIV is still perceived to be a ‘plague’ of the 21 st century. These families and children are hiding. They do not open up about their HIV status. These children are still invisible to society.” Then she adds, “They all live in great fear. All, but one.” A voice chimes in. “I am one of those 149 children. I am HIV-positive and today, I am the only teenager in Kazakhstan with HIV who is living openly,” says Baurzhan, age 13. Baurzhan and his mother at their home in Kazkhstan. Working towards acceptance Aliya’s son Baurzhan was just nine months old when she learned that the blood transfusion he had received for treatment was infected with HIV. When he started going to school, Baurzhan understood that there were different kinds of viruses and one of them happened to be living in him. He did not feel different, until teachers asked him not to play during recess or physical education class. “We realized that for school to be an understanding environment, we needed to organize training, raise awareness among teachers on the importance of tolerance towards children with such illnesses,” his mother says. The lanky teenager remembers crying in the school gym changing room after his classmate called him offensive names related to HIV. “I was not ready to hear it. It hurt a lot.” The incident made Aliya realize that students needed awareness training, too. She helped the school organize lessons on child rights and responsibilities explaining the universality of rights. After the first session, the boy who had offended Baurzhan apologised for what he had said. “For 11 years, I have been taking medications every day to control the amount of virus in my blood. My immunity is 900 cells. Do you know that the immunity of a healthy person is 1200 cells? So, my immunity is that of a healthy teenager,” he says. “My viral load is less than 50 copies. This means that I am just a carrier, but I cannot transmit the virus while I am taking medications.” Together with friends, Baurzhan created a self-help group called “Asian teens” where they share their experiences of living with HIV. “I want to support other kids who are living in fear because of their HIV status. I want to be a role model of living openly and without any fear.” As Baurzhan says these words, the audience erupts in standing ovation. After the TEDx talk, Baurzhan and his mother said that many people approached him and asked if they could give him a hug. “I really liked the feeling of speaking in that room – it was filled with warmth, the audience showed that they cared”, he said. “My friends who are also living with HIV cannot wait to see my video, I think they will be surprised to see the positive reaction my story received.” Baurzhan with his sibling at the family home. Baurzhan with his sibling at the family home. HIV today and steps for the future Since the outbreak in 2006, the HIV/AIDS situation has changed. By 2010, UNICEF helped decrease the rate of HIV transmission from mother to child in south Kazakhstan, which at the time had the highest number of deliveries by HIV-positive women. At country level, joint efforts of the Ministry of Health and UNICEF led to dropping the HIV transmission rate from 10.9 per cent in 2007 to 1.8 percent in 2014. Kazakhstan is now submitting a request to be certified as a country that virtually eliminated mother-to-child HIV transmission. However, more work remains, says UNICEF Health and Nutrition Officer Kanat Sukhanberdiyev. “Globally, we still see that many children are dying from HIV/AIDS. We have a long way to go until children and adolescents with HIV receive the full package of healthcare and psychosocial support.” On this World AIDS Day, UNICEF is calling on the world to increase investments in HIV prevention, testing and treatment programmes. Otherwise, by 2030, the lives of some 360,000 adolescents will be at risk of AIDS-related diseases. Find out more about UNICEF’s work on HIV in Kazakhstan.
"During crisis we realized, health is the most important thing."
For thousands of pregnant women in Kazakhstan, pregnancy coincided with the pandemic and the introduction of quarantine measures, which can vary from week to week. UNICEF estimates that around 116,000,000 children will be born worldwide during the pandemic.1 During the pandemic, 498,367 children were born in Kazakhstan (March 2020 - April 2021)2. From the very first months of pregnancy, a woman's life changes dramatically, and quarantine, self-isolation and additional precautions can limit access to medical services or add stress to women in labor. Aigerim is 40 years old; during the pandemic she was pregnant with her fifth child. Aigerim wanted to plan the birth the following year, but in early September 2020, she found out that she was expecting a baby. From the first days of pregnancy, Aigerim was registered at the district polyclinic at her place of residence in Nur-Sultan. 2021_Newborn_Family_Karaganda Aigerim with her newborn son ”I had constant access and contact with gynecologists and midwives. I got all my tests on time and I went to my routine check-ups," she says. Until the seventh month of pregnancy, Aigerim and her family lived in Nur-Sultan, and then moved to Karaganda, where she was transferred to the city polyclinic No. 1. Aigerim planned to give birth at her place of residence in the Karaganda Regional Perinatal Center. She didn't need to take a PCR test before giving birth. When frequent contractions occur or amniotic fluid is released, the woman in labour will have to call an ambulance or go to the hospital on her own. The PCR test will already be taken at perinatal centers. ”I was told that if a woman has any symptoms, she is taken to a separate quarantine zone. If not, then she gives birth and waits for the test results, " says Aigerim. The quarantine zone is a separate ward where a woman will give birth alone and will not have contact with other women in labor. If doctors do not detect COVID-19, then the woman in labor goes to the general ward. According to UNFPA Kazakhstan , in the event of a confirmed infection or suspected infection with COVID-19, health care workers should take appropriate precautions to reduce the risk of their own infection and that of others, including by wearing protective clothing. Aigerim herself had COVID-19 in June 2020, three months before the start of pregnancy, but did not feel any significant changes in her health or the possibility of becoming pregnant. According to Aigerim, this pregnancy went the same way as the previous ones, and she hardly noticed any changes in the situation and the new reality of quarantine measures. 2021_Newborn_Family_Karaganda Aigerim with her children The only difference Aigerim observed is in the work schedule and the timetable of the clinics. In the past, pregnant women had to wait 2-3 hours in a queue at the polyclinics; now, the reception is conducted strictly by appointment and there are no queues in the corridors. “I guess I was doing so well because I was prioritizing my health. It is very important for a woman," she says. "In the current time of crisis, we all realized that the most important thing is health and only a strong immune system can cope with the virus." Aigerim, being a nutritionist, always carefully monitors her well-being, so she did not worry about the upcoming birth. ”I had no concerns about my health, " says Aigerim. "I’m constantly checking my thyroid, haemoglobin, taking vitamins and eating right". In addition to maintaining immune function, Aigerim followed the necessary precautions to avoid contracting the virus. She avoided public places, shopping centres and other crowded places, and washed her hands frequently and thoroughly throughout the day. 2021_Newborn_Family_Karaganda Aigerim and her children reading a book Due to the pandemic, she was forced to go for walks only on the streets or in parks, in order to have minimal contact with passers-by. And masks and sanitizers have already become essential items when leaving the house. Aigerim already had four children. Her fifth pregnancy was going well, and in April she gave birth to a baby boy. "The birth went well. I am very happy and glad that my child was born healthy. I finally have him in my arms” " says Aigerim. Aigerim was discharged two days later, and her recovery is proceeding calmly and with her family. “I would also like to thank the doctors in the polyclinics. Despite the introduction of quarantine measures, they handled stressful situations perfectly and dealt with issues quickly, correctly and in a timely manner,” says Aigerim. Cooperation with the European Union allowed UNICEF to support the healthcare system of Kazakhstan during the COVID-19 pandemic by equipping it with the medicines and diagnostic devices necessary to effectively combat the coronavirus. Funded by the European Union Humanitarian Aid. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union. European Union cannot be held responsible for them.
Our goals for children
Half of all deaths among children under the age of five in the Region occur in the first month of life. 400,000 children under the age of one have not received the recommended three doses of DTP vaccine, and immunization rates are falling because of system failures and vaccine hesitancy. Less than 30 per cent of Roma children are fully immunized in parts of the Balkan countries. Only 32 per cent of babies in the Region are exclusively breastfed during their first six months of life – one of the lowest rates worldwide.
Navigating pregnancy during the COVID-19 pandemic
Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. “You do see a lot of adaptation happening at the moment in the world where midwives are doing clinics or certain appointments by phone, so that the actual looking at the baby and the growth of the baby appointment can be short,” says Cadée. “I expect that pregnant women will find they’re seeing their healthcare professional less, to protect them and the healthcare professional from getting infected and that they will be seen live when it’s necessary.” Modifications may also be tailored for individual patients depending on their respective conditions, for example lower vs. higher-risk pregnancies. Cadée advises mothers to find out what options are available to them from their healthcare professional and in their communities. “The person who’s taking care of you is perfectly geared to you and your own needs, so your midwife or obstetrician will know best.” After your child is born, it is also important to continue receiving professional support and guidance, including routine immunizations. Speak to your healthcare provider about the safest way to have these appointments, for you and your baby. >> How to get routine childhood vaccinations during COVID-19
30 years of child rights: Historic gains and undeniable achievements, but little progress for the world’s poorest children - UNICEF
Although more children are immunized than ever before, a slowdown in immunisation coverage rates over the past decade is threatening to reverse hard-won gain in children’s health:
Strengthening national health capacity for refugee and migrant children
At first glance, helping a 10-year girl from Iran, now living in Bosnia and Herzegovina, get a new pair of glasses might seem a simple thing. For Maisa, however, this is the end result of a continuum of intensive support, from identifying a girl who struggles with an eye condition, to connecting her to a skilled ophthalmologist. And now Maisa stands in front of a mirror, trying on the glasses that will enhance her life, learning and play. Such a momentous day is only possible when an established health system is equipped to accommodate and respond to the complex needs of refugee and migrant children. Support from the ‘RM Child-Health’ initiative aims to reinforce and enhance health systems across five European countries (Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia) so that these systems can deliver the high-quality services that are the right of every child – and that every child needs, regardless of their origins. The aim: to ensure that health systems catch every refugee and migrant child who is in danger of slipping through the gaps. And there are additional benefits: a health system that works for these vulnerable and excluded children is a health system that works for every child, and that can reach those who are so often the very hardest to reach. This 24-month, €4.3 million initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, aims to strengthen the capacity of health systems to deliver health care to refugee and migrant children. That means ensuring access to life-saving immunization, to mental health and psycho-social support, and services to prevent and respond to gender-based violence, as well as maternal and new-born health care and nutrition. Stronger health systems are needed to overcome the bottlenecks that confront so many refugee and migrant families when they try to access health care. “ The profound challenges that often confront populations – especially children – on the move can include cultural and language barriers, stigma and discrimination on the part of health providers, and a lack of detailed medical records or paperwork,” says Dr. Basil Rodriques, UNICEF Regional Health Advisor. “They may also have their own reasons to distrust state-provided services, including fears of deportation.”