ICAP News - February 2008

Kenyans Displaced by Political Unrest Find Care and Support
at ICAP-Supported Medical Camp

In response to the need for clinical care for people displaced by political unrest in Kenya, ICAP supported a mobile medical clinic on Jan. 18 at the Police Lines near Mathare slum in Nairobi.

More than 200 people whose homes had been burned or destroyed during the unrest received basic medical care at the clinic. This included providing care for respiratory symptoms and referring several people for suspected tuberculosis to appropriate programs. ICAP-supported staff also provided counseling for those needing to speak with someone about their experiences.

“ICAP is heartened to be able to provide medical services and support to the people of Kenya whose lives have been affected by the unrest,” said ICAP Director Wafaa El-Sadr, MD.

ICAP-Kenya Country Director Mark Hawken, MD, added that ICAP will continue to reach out to Kenyans during this difficult period and to offer whatever support they are able to provide as health professionals. “We are also working closely with the healthcare sites that we support to ensure that all patients continue to have access to HIV services and anti-HIV medicines,” he said.

Mathare, a poverty-stricken area of Nairobi, has been heavily affected by violence that ensued following December’s disputed presidential election. The unrest has resulted in the deaths of more than 600 people and the displacement of an estimated 250,000 individuals in the country.

In Kenya, ICAP supports 35 healthcare facilities providing HIV care to more than 34,000 people, including antiretroviral therapy to more than 14,700 individuals. These facilities are located in Central and Eastern Provinces and include both district hospitals and health centers.

Caption: Dr. Eliud Mwangi, a program officer for ICAP Kenya, consoles a child at the Mathare medical camp.
For more about ICAP Kenya, visit here.

Public Health Evaluation Finds HIV Care and Treatment Programs Succeeding in Rwanda

At a Jan. 18 dissemination meeting, the Rwandan Ministry of Health’s Treatment and Research AIDS Center (TRAC) released the findings and recommendations of its major public health evaluation of clinical and immunological outcomes of patients on antiretroviral therapy (ART) in Rwanda. The report details findings of a random sample of 3,578 patients who had initiated ART between Jan. 1, 2004, and Dec. 31, 2005. The evaluation found nearly 90 percent of all adults and children who had initiated ART during that period actively attending HIV clinics one year later.

To enhance the future ability to monitor and evaluate HIV care and treatment in Rwanda, the report recommends increased adherence by HIV service sites to national clinical guidelines and greater focus on collecting and documenting patient information during follow-up visits, such as body weight and CD4 counts. The report also recommends that a similar public health evaluation be conducted that is focused on outcomes of ART programs in children.

“We are very proud of ICAP’s contributions to this evaluation and to the larger efforts to scale up HIV care and treatment in Rwanda,” said Ruben Sahabo, MD, ICAP-Rwanda country director, who also moderated the report’s dissemination meeting.

In Rwanda, an estimated 49,000 people have initiated ART. Currently, ICAP supports 39 healthcare facilities in Rwanda providing HIV care to more than 31,600 people, including ART for 15,700 individuals. ICAP monitoring and evaluation staff in Rwanda and New York collaborated with TRAC, the U.S. Centers for Disease Control and Prevention, and other implementing partners in Rwanda on the public health evaluation.

National media in Rwanda afforded the TRAC report top coverage.

Caption: ICAP-Rwanda Country Director Ruben Sahabo moderated the report's dissemination meeting.

For more about ICAP Rwanda, visit here.

Director of CDC Global AIDS Program Visits ICAP-Supported Sites
in Mozambique

In late January, Deborah Birx, MD, director of the U.S. Centers for Disease Control and Prevention (CDC) Global AIDS Program, visited ICAP-supported laboratories in Mozambique as well as several ICAP-supported sites under renovation, including Hospital Militar in Maputo where a comprehensive care and treatment center will be located for HIV care and treatment, tuberculosis care services, laboratory, pharmacy, and food storage.

Dr. Birx’s visit was in conjunction with an international meeting in Mozambique of senior laboratory staff and other experts from CDC, the World Health Organization, and implementing partners. The meeting resulted in the development of a consensus on global standards for laboratory equipment and types of laboratory procedures needed to support programs for HIV and related conditions, such as tuberculosis and malaria. Also attending this meeting was Jessica Justman, MD, director of ICAP’s University Technical Assistance Program.

Caption: Dr. Deborah Birx (second from left) reviews plans for the renovation of integrated space at the ICAP-supported Hospital Militar in Maputo. Joining her are ICAP and hospital staff members.
For more about ICAP Mozambique, visit here.

PEARL Program to Foster Greater Treatment Adherence Among People Living with HIV/AIDS in Rwanda
Peer educators in Rwanda have joined with HIV service sites in actively promoting treatment adherence through a new ICAP-supported program called Peer Educators for Adherence Referral and Linkages (PEARL). The program builds on the success of the ICAP-supported community-based testing project which was spearheaded by associations of people living with HIV/AIDS and has resulted in more than 2,000 Rwandans getting an HIV test. Through PEARL, peer educators will promote treatment adherence through education, referrals, and linkages to community-based organizations. In addition to participating in post-test counseling, peer educators will provide guidance to newly diagnosed individuals on the importance of HIV care, antiretroviral therapy, and the value of adherence to care and treatment. Home visits also will be conducted as needed. PEARL will initially be piloted at district hospitals, with the goal of expanding to all ICAP-supported sites in Rwanda.

For more about ICAP Rwanda, visit here.

Mothers Mentor Mothers in Ethiopia about Preventing HIV Transmission to their Children
ICAP Ethiopia, in collaboration with regional health bureaus in Oromia, Somali, Harari, and Dire Dawa Regions, is supporting a new Mothers’ Support Group Program at 11 hospitals to strengthen prevention of mother-to-child transmission of HIV (PMTCT) services. In support of the new program, training sessions were recently held for both nurses and HIV-infected women who are themselves mothers who will coordinate the groups and serve as peer educators at these hospitals. A particular focus will be ensuring access to medical care for pregnant women and postpartum mothers, as well as promoting PMTCT interventions, including appropriate antiretroviral therapy and best infant feeding practices. ICAP and its partners hope that the Mothers’ Support Group Program will also help destigmatize HIV and empower HIV-infected women to overcome challenges they face in their lives. Plans call for the mothers’ program to be expanded to an additional seven hospitals in the coming months.

Photo caption: Mothers celebrate the completion of a seven-day peer educator training program on the basics of HIV/AIDS as well as prevention, care and treatment.
For more about ICAP Ethiopia, visit here.

ICAP’s MTCT-Plus Model Showcased for Lesotho Medical Association
The MTCT-Plus model of HIV care and treatment was showcased in a recent presentation at the Lesotho Medical Association’s Learning and Sharing Forum. ICAP-Lesotho staff used case studies to describe the MTCT-Plus model that links prevention of mother-to-child transmission of HIV services with HIV care and treatment for women, children, and their families. The Lesotho Medical Association is composed of a wide range of health professionals, including traditional healers, doctors, nurses, and policy makers, who participate in the monthly forum to learn about innovative health programs and share their own experiences. In Lesotho, ICAP supports five healthcare facilities providing HIV care to nearly 19,000 people, including antiretroviral therapy to approximately 4,000 people.

For more about ICAP Lesotho, visit here.