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By Sharifa Kalokola
The Citizen Reporter
Dar es Salaam. Tina Pius , 31, realised that she had an HIV infection when she was pregnant with her second child, three years ago.When receiving the results from a counselor at a voluntary counseling and testing centre (VCT), her first thought was whether that was a death sentence to both of them. But she would despair easily and declared: “Neither me nor my child will die.”
Tina walked her talk. She delivered her baby without transmitting the deadly virus and her daughter is now one year old. For her, this was part of motherly love that she wanted to give her child. Unlike Tina, many HIV positive mothers fail to protect their children from getting the virus due to several factors, such as ignorance, poverty and lack of access to facilities.
Mother-to-child transmission (MTCT) occurs when an HIV-infected woman passes the virus to her baby during pregnancy, labour and delivery, or breastfeeding.
MTCT is the principal source of death of children under the age of 15. It accounts for 95 per cent of children living with Aids worldwide. Without treatment, around 15-30 per cent of babies born to HIV-infected women would be infected with HIV during pregnancy and delivery. A further five to 20 per cent will become infected through breastfeeding.
Ninety per cent of children living with HIV reside in sub-Saharan Africa where, in the context of a high child mortality rate, Aids accounts for eight per cent of all under-five deaths in the region.
Werner Schimana, a paediatric adviser at the Elizabeth Glaser Paediatric Aids Foundation (EGPAF), that deals with preventing paediatric HIV infection and eliminating paediatric Aids through research, advocacy, and prevention, care, and treatment programmes, says that stigma is one of the major factors that increase MTCT.
“When we test and then break the news that they are infected, they are likely not to return for further treatment,” he says. Schimana adds that in Tanzania, half of the women deliver in the hospitals and so the other half are likely to affect the children because of lack of skilled staff. Tina is among mothers in rural Tanzania who benefited from the Help Expand Antiretroviral Therapy (HEART) that has supported the provision of HIV care and treatment service since its launch in 2004.
The eight-year project that ended this year enrolled more than 143, 000 people into care and treatment programmes, about 78,000 of whom have started antiretroviral treatment (ART), including 7, 000 children below the age of 15 years in Arusha, Kilimanjaro, Lindi, Tabora and Shinyanga regions.
According to Schimana, the support will continue, but this time, focusing more on community involvement.
“The success of these projects shows that it is possible to reach the goal of eliminating paediatric Aids by delivering quality comprehensive services, including prenatal care for pregnant women, and care and treatment for those already living with HIV,” Van’t Pad Bosch, the country director of EGPAF Tanzania, said.
He added: “ The involvement of families, communities and governments is a critical component of reaching that success.” Tina is an ordinary woman living in Karatu, Arusha, who missed the opportunity to study and she was not raised to be dependent. Her situation reflects the lives of many Tanzanian women.
Her husband abandoned her when she revealed her HIV status. Tina attended antenatal care at the nearest hospital and she was able to deliver her baby safely.
During her gestation period, she was doing petty jobs like plaiting hair, mopping houses, and washing clothes.
“It’s hard being unemployed and taking care of two children. I was doing petty jobs just to get food to eat and not saving for hospital or any emergency,” she says. Under the care of PMTCT services in her area, Tina breastfed her baby for four months.
“It was easy for me to get help because I learned to accept my condition. I believe stigma starts within oneself. My landlord, friends and neighbours treat me the same as before because I am so open and comfortable in my skin,” she says.
Tina who had been single for two years rekindled her love life with an uninfected man.The discordant couple had a healthy baby girl together but the man has since abandoned her too.
Men’s involvement
Experts say that men’s involvement could reduce mother-to-child HIV transmission a great deal.
A study in Kenya revealed that where women are supported and accompanied by their male partners, they are more likely to consistently visit antenatal clinics. It has been shown that when male partners are involved, both partners can get tested for HIV, know their status, and therefore, improve the baby's chances of survival.
A study on male involvement in PMTCT services in Mbeya Region showed that barriers to ANC/PMTCT attendance included lack of information, no time, and the services representing a female responsibility, or fear of HIV-test results. Only few perceived couple HIV counselling and testing as disadvantageous.
Jacob Kamaga, a general doctor from Urambo District in Tabora, says that, society is not well sensitised on the importance of PMTCT. At his hospital, they are encouraging men to come to the clinic. “At our clinic, a woman who comes with her husband is served early,” he says. Sabina Kishiwa, a mother from Busangi Village in Shinyanga, is another beneficiary of EGPAF. Without her husband, she says, she could not have managed to go through the rough period.
The 36-year-old was in a patriarchal marriage and she was the second wife. The mother of five realised she had the infection in the first trimester of pregnancy, when the first wife died of HIV.
Facing the bitter truth
Accepting HIV status is not easy in countries like Tanzania, where stigma is still high.
For Rose Maongezi, her husband did not want to accept the situation until she was bed ridden for a year.
The three children she had with her husband, who had passed away, were taken by her in-laws. But Rose has started her life again and she has hopes of living longer. “I got my groove back when I started using anti-retroviral (ART)drugs. They really helped me to start my life afresh,” she says. She rekindled her romantic life when she met a man who is also HIV positive in a hospital queue.
The two are living together and they have a baby who has no HIV infection.
“I just followed the rules as given by the PMTCT service providers and they worked; I believe my baby will live longer,” she says.
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