Stop the Spread of HIV from Mothers to Babies

“I did not know I could breastfeed my boys exclusively and still have them HIV Negative! ‘’ exclaimed Carol, with a green.

27-year-old HIV positive Carol has been coming to Alive Medical Services since 2018 to receive her ART treatments. Not remembering how, where and when she was infected, the 2 months pregnant Carol wanted to know her HIV status before enrolling in for Ante Natal Care.  She tested from a local clinic that was commonly known to be owned by a white man, “mzungu”. 

“I chose the mzungu’s clinic because it was quite private compared to other clinics around and as an expectant mother, I wanted to know my status before enrolling in antenatal care.”

When Carol was tested, her results were confirmed HIV positive. In so much denial, confusion and disbelief, Carol headed back to her house in thoughts of having an abortion due to the worry of infecting her unborn child. She thought it was the best thing to do. She remembers crying herself to sleep because she was devastated by the sad news that was going to change her life forever.

“The next morning, I was surprised that the mzungu came to check how I was doing, he gave me a few words of wisdom and educated me about HIV in which he assured me that I can continue living life to the fullest and have a safe baby while I take my medications. It took me sometime to believe him. He then referred me to Alive Medical Services as it is known for HIV care and treatment. He even supported me and gave me transport to come here.” Carol enlightens.

When Carol came to Alive Medical Services, she was tested again as the usual procedure, which still confirmed the same result. “I kept on praying for the results to change.”

“I was handled very well, right from the counselling point to the doctor in the clinical room. It felt like these people had known me before or they were expecting me.”

At first Carol was challenged with getting used to the daily dosage of twice a day which led to poor adherence and its related side effects of non-suppression. This led to intensive adherence counselling sessions so that she could get on track and save her unborn child too. During these sessions, Carol had a chance of meeting some of the peer mothers around the clinic who shared their success stories with her. She was moved by how some of them even started Anti-retroviral treatment at a tender age. This made Carol accept and understand who she was, and she was convinced that she can live up to her dreams and desires despite her status. Carol had a bouncing healthy baby boy.

“I always like it when I come to the clinic because everyone is concerned about how your life is, where you sleep, what you are eating, they generally will ask how you are, putting HIV aside. Their concerns keep me wanting to take my medicines every day because I know someone, Alive Medical Services cares about me, my life and my family. In fact, the psychosocial therapy starts right from the gates of Alive Medical Services.”

Carol has been receiving anti-retro-viral treatment here at Alive Medical Services for the past 3 years now to fight the virus. Her tests like viral load and CD4 suggest that she is taking her medication well and that the virus is well under control.

 “I have been taking the drugs to make me better ever since. I must take tablets every day to make sure I do not get sick. I do not feel sick at all, not even a headache. I can do all the things my friends do, like go to the market and do business.” Carol’s expresses.

“No one around me knows about my illness. I don’t think I’d even love to let them know because I never talk about it. I like all the health workers at the hospital. Apart from ART, they give me emotional, spiritual and psychosocial medicine to make my life better,” Carol says. 

“I learned that it’s possible to be HIV-positive and have HIV-negative children,” says Carol, “which might not have been possible had I not joined Alive Medical Services or if I hadn’t decided to test earlier while I was pregnant.”

Despite her HIV status, Carol breastfed all her two sons for the first six months and during this period, she ensured that she adhered to the mother and child antiretroviral therapy interventions recommended by the health workers at the hospital.

As a young lady living with HIV, the mother of two healthy and happy children has had the odds stacked against her. But today, thanks to the generosity of donors like you, she is receiving the health, nutritional and emotional support she needs to thrive and pursue her dreams.

• CAROL.docx (DOCX)

Alive Medical Services Comprehensive Elimination of Mother To Child Transmission of HIV  package 

Through the specialized program for maternal and child health ensuring the birth of HIV-negative babies to HIV-positive mothers. AMS’ Comprehensive EMTCT package ensures early identification and timely intervention of high-risk mothers that include newly diagnosed HIV positive expectant mothers and virally unsuppressed expectant mothers living with HIV. These are intentionally followed up during antenatal care (ANC) and post-natal care (PNC).  The babies are then followed up until they are 18 months when they are discharged from the EID clinic. 

Early Infant Diagnosis clinic

Every Tuesday, AMS gives special attention to HIV positive mothers and their babies aged 0-2 years whereby there is the provision of care, support, and treatment to ensure that the baby turns out negative at the last antibody test. 

The clinic continues to offer immunization services, pre- and post-natal services to all expecting mothers irrespective of their HIV status. This year, 1,469 babies were immunized. 165 of those are fully immunized babies. The clinic also provides pre-and post-natal care services to both HIV positive and negative mothers. Other diseases immunized include tuberculosis, polio, tetanus, diphtheria, whooping cough, hepatitis B, pneumococcal pneumonia, and measles, among others.

Prenatal care clinic

The prenatal care clinic is held every Thursday for pregnant women to have access to ultrasound scan services by a sonographer and a full examination by a designated midwife and clinician. This clinic focuses on monitoring the viral load for HIV positive expectant mothers, client assessment, CD4 and ART refill to safeguard the birth of an HIV free and healthy child.

This year 410 women received ANC services; 570 women were provided with ultrasound scan services.

During these ANC services, there is also the provision of psychosocial support and health education sessions to the HIV positive expectant mothers on the acquisition and administering of the Nevirapine syrup to their babies as soon as they are born, as well as safe infant feeding practices and schedules for both PCR and anti-body tests.                                                               

• HOW_NADYA_TOOK_A_STAND_TO_STOP_THE_CYCLE_OF_HIV_.pdf (PDF)
  

“My name is Rachel (not real name), I used to live with jjajja in Salaama but I now live at FoodStep Uganda in Entebbe. I am not certain of my age because I have never celebrated any birthday ever, but jjajja says I am about 11 years old, that is all. She never tells when I was born, possibly because she does not remember. 

Jjajja and I did not have enough food, and we never used to eat well, basically, it was posho with beans or silverfish “mukene” which was not always sufficient. Sometimes we went hungry for days and yet we were on daily medication. It would get very depressing when we did not have food to eat. This caused my Viral load to go up hence never suppressing making it easy for me to get many illnesses and infections. In July 2020, I was not well which led to admission for over two weeks. I thought I was going to die.

The health workers at the clinic got interested in why I was not getting discharged from the centre. Then came aunty Winnie (a pharmacy attendant) and Peace (a peer educator) who wanted to get to the bottom and realised I wasn't having enough food and took it upon themselves to make sure I ate the right food during my stay at the centre. They then linked me to Foodstep Uganda, a home where I can get the health and physical guidance to live a healthy life. At Foodstep Uganda they will be able to provide the services I need because my grandmother cannot.

After consulting my grandmother and gaining consent for the support, I officially joined Food Steps Uganda on the 30^th of July 2020.

At Food Steps Uganda, I have met so many people, aunty Aisha, aunty Annette, papa, mama. Everyone is nice, friendly and we even eat well. The food is really nice all the time, especially my favourite, matooke and rice. The best part is the home-schooling part and I love it a lot, I know that if school begins, I will be able to join school since I can at least write my name.”

Ever since Rachel joined FoodStep Uganda, she is happy and healthy. She takes her medication without any fear of hunger.  When she came back to the clinic, the girl who could barely answer to a simple question like “How are you?'' is now ready to respond to all questions with a smile on her face.

Joy (not real name) is a 19-year-old peer educator working at Alive Medical Services. She is a young lady who was miraculously chosen by a foreign lady (Natalie) in 2007 during one of her visits in prisons where she used to explore and engage with street children. On this specific visit, Natalie noticed a group of young children in the prisons cell and felt drawn to Joy, she asked for her file and any form of information they had on her. She also asked about the procedure it would take for her to take Joy into her care.

Joy, 8 years old at the time didn’t know anything about her family nor had she heard from or of her parents and since there was no one to claim her, the process for Natalie to become her legal guardian was a successful one, she finally got a family.

After a series of being sick and sessions at Mulago hospital, Joy and her new foster mother Natalie did not know exactly what was happening with her health. She decided to consult a friend who referred her to Alive Medical Services, she was looking forward to getting free treatment at AMS.  Joy received several tests, the first one being an HIV test which confirmed she was HIV positive and the reason why she was getting ill more often. Joy was then started on ARVS.

She continued to take her medication all through school until high school when she stopped because she was confused about why she should take medicine indefinitely. After a while, she started getting sick because of not taking her medication.

 “In my high school days, we learned about STIs where the teacher mentioned most of the signs and symptoms of HIV and I happened to have one physical sign, the skin rash,” Joy sadly said.

Joy had an irritating skin rash and her fellow students saw her taking medication daily, which led them to become suspicious of what illness she might have, making her even more uncomfortable. She was now even more depressed than usual and was finally sent home to seek medical attention as her illness seemed to be getting worse. Once home, she confided in her foster mother about her insecurities, this paved way for them to return to AMS as she realised it was time to disclose to Joy the actual status of her health.

At AMS she met with Dr Elizabeth who was very professional at handling her case, she explained to her what it meant to be HIV positive and why she had been told to take her medication, the benefits of taking it more effectively. She remembers the first weeks being the toughest, but with the support from her foster mother, she was able to cope.

AMS has become more than the family, friends, and parents she has ever wished to have. “AMS embraces you the way you are, at some facilities, you go pick your drugs and that’s it. The rest is usually not their business”. Joy acknowledges.

Joy is glad she was chosen among the young people at the centre to train and become a peer educator at AMS, and this is giving her plenty of opportunities like sharing her story, attending summits, conferences as well as visiting other facilities, being able to interact with other peers on their daily challenges. Most of all she has become more confident and is not lost in the self-stigma that had built up during her high school days. She is very hardworking, easy to talk to with a dream to improve her life and grab onto future opportunities.

Joy is now a peer network coordinator who is using her story and life experiences to change lives and she is grateful to AMS staff for the endless support and unconditional love with all adequate services available all the time. She wants to work so hard and facilitate herself for further education in Public health so that she can help people who have gone through the same experience. She also wants to own an orphanage for abandoned children so she can be able to give back to the community especially those on the streets.

Sara (not real name), a 28-year-old single mother of two boys, works as a housemaid for an Indian family and resides in Kanyogoga, a slum area in Namuwongo. Sara joined Alive Medical Services in 2010 after a series of what seemed like signs of HIV. She had a skin rash, an irritating cough and she was consistently losing weight, these were all signs of HIV according to what people said. She used to escort her friend who was already in care at Alive Medical Services for drug refills. Her friend kept on encouraging her to test as she showed some of the signs of HIV. Sara was at first afraid to take that step of knowing her HIV status as she was a breastfeeding mother of a 17-months-old baby. She courageously took the test and the result was positive as she had suspected. 

“I was at first traumatised about the news; I was even afraid to tell the counsellor that I had a breastfeeding child at home ("Naka were") and when I told my husband, he left me with the child,” Sara said sadly.

Sara did not disclose to the health worker that she had a baby before she confirmed her status. As her child grew up, he repeatedly fell ill and then developed a skin rash at 5 years; not to mention the child has a mental disability and is deaf. “I felt like he already had so much to deal with, but I had no choice”.  She then decided to bring him for medical attention where they suggested for an HIV test. Sadly, the result turned out positive.

Sara felt hopeless because she did not have any psychosocial support and her friend had died. She got the courage to disclose to her mother after five years as she could no longer handle the situation by herself. Fortunately, her mother was supportive, compassionate and she has never been judgemental towards her daughter.

From the day Sara found out her HIV status, she has gotten the best counselling and health tips especially on the importance of having a balanced diet. Sara regained hope, self-love through all the support offered at Alive Medical Services, from food to medication and she is more stable now and managed to get a job where she earns fair pay which she didn’t expect once her life had taken a turn. “Even if my child barely speaks or hears, he usually looks at the clock and when it clicks 8:00 pm, he taps me as a reminder and gives me the sign that it’s time for medication, the only challenge will be disclosing to him in such a situation when he gets older”.

Sara restored her life back and had a second baby who was under the guidance of the health workers in the EMTCT section at the clinic. Her second child is happy, healthy and HIV-negative.

For all these years she has spent on medication, Sara would love to thank the whole staff of Alive Medical Services especially the lady in the EMTCT section (Linda) who has been very supportive; “she tells the truth of what will happen if you do it the way you are told to do and she will show and help you how to do it the right way”.

Mwebale nyo, mwebalilire ddala.

(Thank you so much)