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Rwanda, 15 July 2011: Providing comprehensive care to young people living with HIV

© UNICEF Rwanda/2011
Guillaume, 19, has benefited from the comprehensive HIV treatment programme at Rwinkwavu hospital in Southern Kayonza, Rwanda, for the last six years. Approximately 570 children are now enrolled in the hospital's much-praised paediatric HIV programme.

By Jenny Clover

KAYONZA, Rwanda, 15 July 2011 – A UNICEF-supported hospital in one of Rwanda’s most rural and isolated areas is offering a ray of hope to hundreds of young people living with HIV.

Rwinkwavu Hospital is located in the district of Southern Kayonza in Rwanda’s Eastern Province. Since 2005, the hospital has been renovated progressively from its run-down state by Partners in Health and the Rwandan Ministry of Health with UNICEF support.

Holistic and comprehensive

It now boasts a holistic and comprehensive HIV care programme which goes far beyond medical treatment. The HIV care package is so well respected that people come from all over the country to access it. At 3 percent, Rwanda has a comparatively low rate of HIV prevalence, but more than 22,200 children under the age of 15 live with HIV.

Guillaume, now aged 19, was one of the very first beneficiaries of Rwinkwavu’s paediatric HIV programme. By the time he was just 13, Guillaume had already lost his mother to AIDS, his father to the 1994 Rwandan genocide and found out that he had contracted HIV as a baby from his mother.

© UNICEF Rwanda/2011
The new paediatric wing at Rwinkwavu hospital in the district of Southern Kayonza, Rwanda. UNICEF helped build and equip the wing, as well as a malnutrition ward and child-friendly room.

In a further blow to the young teen, when his HIV status was revealed the extended family members who had been caring for him said they would no longer do so. Luckily, his grandmother agreed to take him in and that was the first step in the start of his progression from a sick, orphaned child who was receiving no treatment for HIV, to a healthy, happy, high-performing student who has dreams of becoming a psychologist.

"I was relieved when I started receiving treatment and my body began to feel better, but I was still uncertain about the future. I didn't know what to expect or what would come,” says Guillaume.

Approximately 570 children are now enrolled in the hospital’s paediatric HIV programme. They receive not just essential anti-retroviral therapy (ART) for HIV, but also attend peer support clubs that meet every month and get education from teachers specially trained to be more sensitive to the needs of children living with HIV.

Support for the future

The support groups really helped Guillaume. “It was a relief to know there was a community there which could support me and they helped to change my outlook on things,” he says. “I began to learn that life would go on for me, even with HIV. To be able to talk to other children my own age who understood what I was going through was invaluable to me.”

Affected children and their families are given counselling about what the status will mean for their futures, the importance of adhering to treatment and how to deal with the stigma that is still attached to HIV. They receive expert farming and nutritional advice by Partners in Health agronomists and some vulnerable families also receive food parcels.

Guillaume is now looking forward to a healthy future, and feels looked after and cared for by the programme. He only wishes his mother had the same opportunity during her life.

"I am sad that there was no programme like the one I am benefiting from to help my mother, but I feel very happy that I have a future now. Even though I have no parents I have had a good life and I have a good life ahead of me,” he explains.

The hospital's comprehensive child survival package begins with eliminating new HIV infections in infants and children. This includes the testing of all pregnant women, ART and regular check-ups for those found to be HIV positive. The programme is so robust that currently 98 percent of infants who have been through the programme are HIV-free at 18-months-old.

Reaching new goals

Thanks to this and other initiatives, Partners in Health estimates that there are now virtually no children in the district living with HIV who are not enrolled in one of the hospital's treatment programmes.

As well as supporting these projects, UNICEF has also contributed towards helping to build and equip new malnutrition and paediatric wards and a child-friendly room at the hospital where children can learn of their HIV status.

Rwanda has made remarkable progress in scaling up services for children living with HIV and UNICEF has contributed to this achievement by building partnerships to improve treatment and advocating on their behalf.

The number of children receiving ART in Rwanda increased from 5 percent in 2004 to 70 percent in 2010. The target is now to reach 80 percent by the end of 2012.



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