ThisDay, Vol. 14. No. 5155. Wednesday, June 3, 2009. Page 25

Hajia (names withheld) started attending antenatal clinic for ante-natal care (ANC) at the

General Hospital, Dutse, capital of Jigawa State when she was just two months old pregnant. It was the result of intense campaigns by the state government and other stakeholders in the health care sector. As part of the ANC, she was advised on the importance of HIV test for the mother and the unborn child. Without hesitation, she agreed to have the test; after all, she was attending the clinic because she wanted the best for her baby.

Unfortunately, when the result came out, the unexpected happened. She tested positive for HIV. Narrating her story to THISDAY at the General Hospital, Dutse, Hajia said even though she did not fully understand what the diagnosis meant, she was devastated. “Though I did not fully understand what it meant, I immediately felt as if I received a death sentence. Kanjamau (AIDS)? Every body knew that meant death. I just didn’t know what to do. I was devastated” she explained.

Though Jigawa State is one of the states with the lowest infection rates in the country, almost everyone is aware that HIV/AIDS exists. Known by several names with Kanjamau being the most used, many also know that there is no cure for the disease yet. So, when anyone is suspected to have the disease, the belief is that the person would die very soon. And for fear of contracting the disease, people living with HIV/AIDS (PLWHA) are avoided like plague.

Hajia confessed that she had the same attitude to the disease and its sufferers before she was diagnosed. That she explained was why she was devastated. She just kept thinking of death. “We didn’t even know the difference between HIV and AIDS. Once there is the rumour that somebody has kanjamau, we think death.” She explained that because of this belief, people used to say a PLWHA, ya hadi Leda (has swallowed leather). “You know there is a belief that when a goat swallows leather or nylon, it would die. So, they use that analogy for PLWHA; meaning, like the unfortunate goats, the PLWHA would soon die” she explained further.

Those were not the only fears she entertained however. After the shock had died down, her thoughts turned to how she was going to tell her husband and her relations. She recalled with pains in her eyes the agony she went through in the period immediately after she was diagnosed. She said, “the Imam and other traditional rulers in our community had to wade in before my husband and other members of my family accepted that it was the will of Allah.”

But when she was going through the lowest period in her life and was battling rejection at home, Hajia received love and care from the General Hospital in Dutse. The love and care that helped her survive her most difficult and trying period came from special clinics established with the assistance of the Institute of Human Virology, Nigeria (IHVN). She benefited from the three programs established at the hospital and supported by the Institute.

First, she had the test in the first place through the HIV Counseling and Testing (HCT) program. It was through the counseling program that she was persuaded to find out her HIV status in the first place. As soon as her status was established to be positive, she was counseled to participate in the Anti Retroviral Therapy (ART) program. Most importantly however, she became one of the pioneer beneficiaries of the Prevention of Mother to Child Transmission of HIV (PMTCT), the third program in 2007. And it was this third program that saved the life of her baby who was born negative in 2008.

“I received counseling and support from the hospital through the PMTCT program. My husband and some of my relations were also counseled and with the help from the clinic. I was able to face the challenges posed by my new status. Through the program and the staff in the clinic, I was able to start living life again after the shock and pain of my discovery that I was HIV positive. I received love and care from the hospital and their programs, and that is why I decided to attend this special occasion today,” she explained.

The special occasion she was referring to, was the visit of the United States Ambassador to Nigeria, Robin Renee Sanders to the General Hospital. The occasion was the hand over of laboratory equipment, consumables and other materials that would help the IHVN’s AIDS Care and Treatment in Nigeria (ACTION) project in Jigawa State.

That Thursday was an important day for people like Hajia who understand how significant the additional equipment are to the lives of PLWHA and how important they would be for people who for one reason or the other may need to find out their HIV status in the near future. She understood that the equipment were more tokens of love and care from a far away land.

Welcoming the US Ambassador, Mr. Charles Olalekan Mensah, the Managing Director of IHVN’s ACTION project noted that her presence was a manifestation of her “grass roots commitment in all issues of health, especially HIV/AIDS, Malaria and TB in Nigeria.” He also noted that the occasion undoubtedly “shows the United States commitment in mitigating the spread of HIV/AIDS.”

Mensah then pledged that IHVN ACTION project would continue to support the Jigawa State Government in the fight against HIV. “On behalf of the Institute of Human Virology, Nigeria ACTION project, I pledge out continuing support in partnership with the Jigawa State Government and other implementing partners in ensuring that the state is saturated with HIV services.

Considering what was already on ground, the pledge meant PLWHA would continue to have love and care. This much the Chairman of Dutse General Hospital Management Committee, Dr Shehu Sambo confirmed in his brief remarks. He expressed the gratitude of the entire staff of the hospital to the US and the IHVN for their support. According to the chairman, the support which started in 2006 has brought benefits in terms of capacity building, equipment and infrastructural upgrades.

He said “I want to make it clear that we have benefited immensely from IHVN in the areas of capacity building (various training programs), provision of equipment and infrastructural upgrades (renovation of ante natal clinic and laboratories).” He then reeled out a long list of statistics to show how well the support the hospital got has affected progress in the care for PLWHA.

According to him, because of the successes recorded, the hospital was upgraded to a PMTCT stand alone site in 2008. He further explained that, “in 2008 alone, we registered 6836 new ANC clients. Out of these, 6736 (about 98 percent) accepted to be tested for HIV after counseling. One hundred (or 1.48 per cent) were found to be positive. 62 HIV positive women delivered in the hospital in 2008 and 45 and their babies tested for HIV (early infant diagnosis) of which 37 were negative.”

The statistics no doubt impressed everyone present at the special occasion as people marveled at the miracle of a HIV positive mother giving birth to a HIV negative child. One of the ACTION project officials at the venue explained to THISDAY that such “miracles” were possible with proper care during pregnancy, labour and actual delivery. The officer who spoke on condition of anonymity said PMTCT program of the ACTION project “offers a lot of ways which help to protect the unborn baby from becoming infected with HIV.”

He however noted that the different ways may only be ascertained after thorough medical examination and “a discussion with doctors, health care givers and counselors.”

On how the ACTION works, he said the project which is an IHVN project is funded by the US government PEPFAR (US President’s Emergency Plan for AIDS Relief) through the Center for Disease Control (CDC). He explained the IHVN which was established in 2004 as an affiliate of the University Of Maryland Institute Of Human Virology now has 103 HIV Counseling and Testing (HCT) centers and 107 Prevention of Mother to Child Transmission of HIV (PMTCT) centers in the country.

“IHVN supports the government of Nigeria through collaboration and capacity building with the Ministry of Health and the National Agency for the Control of HIV/AIDS (NACA). We focus on Anti-Retroviral Therapy (ART) treatment for PLWHA, including pregnant women. We also provide laboratory diagnosis and tracking of patient’s status as well as care and support for PLWHA and people affected by HIV/AIDS (that is, relations and friends of PLWHA)”, he further explained.

The Dutse General Hospital experience is no doubt a clear example of the success of the collaboration between the US and the people and Government of Nigeria. And this was Ambassador Sander’s position too when it was time to present the gifts from the people and government of the US to the people and government of Jigawa State. She expressed delight at what she saw on ground at the hospital. “This is my first visit to Jigawa State and it is clear that the partnership between the people and government of Jigawa State is working to mitigate the effects of HIV/AIDS throughout the state. It is encouraging to see the progress that General Hospital, Dutse is making” Sanders said.

She also expressed happiness that through the programs, many lives have been saved or made better. “The women in this hospital who have benefitted from these services have given birth to babies who are not infected with HIV. I share in their joy. And I celebrated that these children – the future of Jigawa State and the future of Nigeria – will grow up health and have every opportunity to live the life of dignity that they deserve.”

The ambassador then presented two HIV/AIDS laboratory machines on behalf of the laboratory machines on behalf of the US government to the General Hospital, Dutse. He expressed hope that the items would help the items would help the hospital “properly monitor patients who are on treatment with antiretroviral medications, as well as those receiving care and support.” She stressed that with the machines and the ones provided by the state government, “the burden of transporting samples to distant sites for analysis is a thing of the past.”

For Hajia and many other PLWHA who have benefited from the services provided by these agencies in collaboration with the state government, love and care has come from a distant land and with it, they would continue to live good lives in spite of their status.

ThisDay, Saturday, May 23, 2009. Page 7.