Wise counsel for women – prevention of mother to child transmission of HIV and AIDS in Sudan
By Andrew Heavens, UNICEF writer
[Some names have been changed in this story to safeguard people’s privacy.]
Omdurman, Khartoum State- Fatima was well into her fourth pregnancy by the time anyone got round to telling her that a mother could pass HIV/AIDS on to her child.
The news came as a bit of a shock. “I never knew this. No one told me this before,” said the 21-year-old from Sudan’s historic city of Omdurman.
Fatima received the information from a trained counsellor working out of an airy, well lit room in Omdurman’s Saudi hospital, close to the western banks of the River Nile. The young mother was taking part in a pioneering UNICEF-backed project tying antenatal care into a push to prevent mother-to-child transmission of HIV.
More than 50 pregnant women had come to the hospital at 8.30 that morning to join the session. They were called in by a team of volunteers who had spent hours trailing around Omdurman’s winding lanes, advertising the antenatal project by shouting out at street corners and making announcements through megaphones.
Once they had arrived the women were given a half-hour talk on the antenatal services available to them at the hospital.
The two trained counsellors taking the session also covered the basics of HIV/AIDS – how it was transmitted, how it was not transmitted, how there was a risk of mothers passing it on to their babies, how there was a lot they could do to minimise that risk, how there were a range of free and confidential services available to the women right there and then if they wanted them.
Towards the end of the talk, the counsellors mentioned that they were also offering HIV/AIDS testing at the hospital that morning, backed up by confidential one-on-one counselling before and after the tests.
Out of the 50 women present, about 30 decided to take the test. It was a good result for Selim Ahmed, one of the counsellors at the hospital.
“There is so much bad information going on about AIDS. People think you can get it through coughing, through sharing swimming pools.”“There is so much bad information going on about AIDS,” she said. “People think you can get it through coughing, through sharing swimming pools. A very common misconception is that you can catch it through mosquito bites.”
“But one you have shared the right information, people generally react very positively. They can see what we are doing.”
Selim spoke in the hospital’s smaller counselling room after seeing the women who had agreed to take tests from the morning’s meeting. The walls were lined with bright posters, each pushing a different message about HIV/AIDS – one each for the classic ABC of HIV prevention (Abstinence, Be faithful, correct Condom use), others encouraging people to befriend people living with HIV.
One the table was a pile of A3 sheets, covered with facts and figures and positive pointers about what to do to prevent HIV transmission or how to live with the condition once infected. All the materials had been drawn up and designed by artists working closely with UNICEF and federal and regional health authorities.
There is currently little detailed and up-to-date information about HIV prevalence in Sudan, Africa’s biggest country. But across the region, mother-to-child transmission remains a serious problem.
More than 2 million pregnant women were living with HIV across the world in 2005. The vast majority (about 90 per cent) of HIV infections in infants and children had been passed on by their mothers during pregnancy, labour, delivery or breastfeeding.
But, despite the scale of the problem, just one out of every ten infected women in low and middle-income countries had access to antiretroviral prophylaxis to reduce the risk of transmitting the virus to their infants during the same year.
According to UNICEF, access rates were as low as three per cent in west and central Africa, 14 per cent in the eastern and southern parts of the continent.
It was in recognition of the scale of the problem that UNICEF teamed up with health authorities in Sudan in 2007 to launch the tailored ante-natal sessions in a handful of hospitals in Sudan’s Khartoum State and beyond.
“It is an exciting time because we were really starting something from scratch,” said chief of UNICEF Sudan’s HIV/AIDS programme, Severine Leonardi. “There are already signs that it is having an impact and we have all the support we need to expand the scheme still further.”
Back at Omdurman’s Saudi hospital, Fatima had studied the leaflets and listened to the introductory session. Her only contact with HIV/AIDS up to then had been through a neighbour, another mother, who had become infected two years earlier and eventually died.
“No one knew much about it,” said Fatima. “They knew it was something to do with sexual behaviour. They just kept away from her.”
Fatima had another look through the leaflets and heard the counsellors repeat the promise that the tests would be totally confidential. “I think I will have the test,” she said.
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