UNITE FOR CHILDREN UNITE AGAINST AIDS

September 3, 2007

My travel to Rwanda's Eastern Province

It was on an early Friday morning, the last day of August that I traveled to the District of Kayonza in Rwanda's Eastern Province. There, I visited a hospital where UNICEF and partners support HIV and AIDS activities. I want to tell you about the HIV positive children and mothers who I met that day at the hospital.

Currently in Rwanda, the dry season is ending. The marvelous scenery has disappeared: now that the grass is so dry the landscape is no longer green. When I drove out to these rural areas, I could feel how warm the country of a thousand hills is. Rwinkwavu is located in Rwanda's Kayonza District, in the land of the Akagera National Park. From Kigali city to the Eastern Province, the road is smooth but after 150 km, I had to deviate and take the dusty road. 

On my way to the hospital, I noticed that not many seeds had been planted in the land and that's not a good sign for the people living in these areas. Poverty, infectious diseases, including HIV and AIDS, as well as malaria and tuberculosis are all knocking at these people's doors.

Typically, the mothers and fathers work miles away from the hospital where they bring their sick children. In the areas of Kayonza, malaria, fever, pneumonia, diarrhea and malnutrition are the main diseases which affect children but there are also children here who are HIV positive. After the medical diagnosis, serious cases are transferred to the hospital.

At the Rwinkwavu pediatric hall, I met with recently-admitted children. That day, 34 kids had been admitted for different diseases including malaria and fever. There were three cases of cancer and various malnutrition diseases. The Hospital houses 196 HIV positive children who are on treatment. The pediatric hall can accommodate approximately 50 children and the malnutrition hall 30 children. Every bed has a mosquito net. At the entrance, a board listing admitted children hangs on the wall, providing the first picture of how many are laying on the beds in the hall. I talked with many of the children able to talk along with their mothers and fathers.
 
I met with Josiane Muragijimana, a nice 6 year-old girl who is HIV positive at the pediatric hall. Josiane talks to me with a smile on her face. I can see how confident, friendly and open she is. Josiane is an orphan who lost both her parents to AIDS. A neighbour brought her to the health center three days ago when she had a fever. She was transferred and admitted to the hospital and was expected to be discharged the next day.

Josiane has been on treatment since last year and she has been coping well with her status but like all orphans here, her life is difficult. She lives with her uncle who does not come home every day because he works far away, she usually sees him only once a month. But despite all this, Josiane is full of hope for life. She tells me she wants to go to school next year when she turns 7, the age when children start primary school in Rwanda.

Josiane is one of 27,000 children who are HIV positive in Rwanda. Among them, 5,158 are in need of ARVs and only 2,757 are on treatment. The care, support and treatment of children infected and affected by HIV and AIDS has various dimensions. The cost implications makes it very difficult for these impoverished communities. The biggest challenges concern health care services, food and clothes, education, housing and other such basic requirements. So many AIDS orphans are heading households and need to care of their younger siblings. With your support we can help these children reach adulthood and help keep them HIV free. I believe that it is possible to have a society free of HIV and AIDS!

Depending on the season, the Rwinkwavu Hospital receives, on average, 20 to 30 children each day. In August, 17 children were found HIV positive through Voluntarily Counseling and Testing. They were transferred to the infectious diseases department for proper monitoring and follow up. When a child is found HIV positive, social workers organize a talk with parents or guardians for counseling, and then a test is done to find out if the child is at a stage to start ARVs. Home visits are also organized for follow up.

During my visit to the Prevention of HIV from Mother to Child Transmission programme at the Rwinkwavu health center, I met with HIV positive pregnant women and their husbands. The Prevention of HIV from Mother to Child Transmission programme receives 3-5 new pregnant mothers each week. A pregnant woman who is HIV positive sees the doctor once a month for a proper follow up and to monitor side effects to protect their unborn babies. When the pregnancy reaches 7 months she starts the prophylaxis to prevent transmission of the virus down to her child. In August, 105 women were in the programme, among them 89 women were following treatment.

During my visit, I also met with Nyinawabashayija, a 23 year-old HIV positive mother. She has one kid and is pregnant. Her husband is also HIV positive. She is discouraged and needs more counseling and follow-up to help her cope with her status and receive care for her pregnancy. Nyinawabashayija tells me "this is the most challenging time of my life, I feel like I‘m going to finish with it, I am at the end of myself…..I have to do some work which requires energy that I don't have anymore".

The care, support and treatment of HIV positive women and their families is very challenging. These women still have many responsibilities. They need to carry on domestic tasks and take care of their families, this, after a tenuous day of working in the field from early morning until the afternoon. The land they cultivate is not always near their homes and they have to walk miles to and from their houses. Widows try to earn money with construction work but they can't work when they are sick and weak.  With your support, these women can be empowered which would in turn help support their families. In the end, the wellbeing of children relies on the survival of these mothers.