Team PATA

Newsletters

April 2006. Vol. 1 Issue 2.

Contents

• Two computers make a world of difference in Kenya
• News from Tanzania
• Progress in Mombasa
• What’s in a hi-tech bottle?
• New tunics good for kids
• Focus on three personalities

Two computers will make a world of difference in Kenya

The Kenyatta Hospital in Nairobi, Kenya, has recently purchased two new computers with the help of the One to One Children’s Fund.
According to Dr Margaret Makanyengo, one of the computers will be used to coordinate counselling at their HIV clinic’s counselling center. A database of counselled patients and outcomes will also be facilitated by this computer.
The second machine will help to monitor patients - especially children and their mothers - on ART in their pharmacy section.
"This is a really wonderful thing," says Dr Makanyengo, "And I hope we will endeavour to provide the best service for our children."
At the moment the clinic has about 300 children on ARVs, but they are hoping to double that number by the end of the year.
According to David Altschuler from the One to One Children’s Fund, they have also received specifications and a budget for a proposed new outdoor children’s play area, or ‘banda’, from Kenyatta Hospital.
One to One has asked for some revisions to the specifications and according to Altschuler, the plans for the play area will soon be available on the PATA Website for others to replicate or adapt to their own needs.

News from Tanzania

The number of clients at the Songea clinic has doubled to almost 1 400 patients of whom 82 are children. This is according to Dr John Budotela, who reports that the clinic “is going strong”.
Of these 82 children, 40 are currently on ARV treatment. “We have started counselling children of 10 years and older,” says Dr Budotela, “and for this reason three children have started to come for their monthly supplies themselves instead of their guardians.”
Bad news though, is that their CD4 count machine is out of order and that they have not been able to fix it. If there is anyone reading this who can help the Songea clinic secure funds for additional CD4 count machines, please contact us immediately.
Better news is that they have been able to get funding of about $40 000 to expand their Counselling and Testing Centre (CTC) and another $10 000 to conduct outreach services to provide relief to clients who presently have to travel to their Regional Hospital every month to get supplies.
They have also established twelve new VCT and PMTCT centres, but Dr Budotela says they still need more funds to establish more centres.
In their efforts to improve the access to and quality of their services, they recently held a three day training programme on ARV/CTC services for all the health workers at their hospital.

Progress in Mombasa

The AIDS Research and Family Care Clinic in Mombasa, Kenya has improved its management system in order to provide the necessary support for its staff.
According to Dr Shaffiq Essajee, their chain of supplies has also improved. “The required reagents and stock of medicine are always in abundance to cater for the clients needs,” he says.
One of their greatest achievements so far this year has been to lock down a meeting every second Friday to discuss the clinic’s progress and to update one another on what’s happening in the different departments.
Another achievement has been with advocating disclosure. “Most of the adolescents, especially those on ART, now know their status,” Dr Essajee says. They still run their old system to check adherence and also now have regular sessions to discuss adherence problems with clients.
As far as their treatment of adolescents goes, they are trying to have them visit the clinic on a separate day than the younger clients. “They usually feel out of place,” says Dr Essajee, “we will hold a support group for them, which will be easier as the majority of them have been disclosed to.”
The clinic has created a space for a television, but they are yet to purchase a TV set and educational tapes. They still don’t have adequate space for a children’s playground and could do with bigger space for the clinic in general.
They are also looking to source more funding to improve the pay of their staff and to provide financial assistance to impoverished clients. They are also busy getting more funds to catalyse income generating activities for their mothers support group.

German student investigating adherence with hi-tech bottles

Alexandra Müller is currently busy with research in Cape Town towards her PhD back home at the University of Göttingen in Germany. Working in the Paediatric HIV clinic at Groote Schuur hospital, she is assessing if and how patients of the clinic adhere to their ARV treatment regimen.
“I am using a method that has not been used in South Africa before,” Müller says, “The mothers or caregivers are administering the medicines so for this study, they get one of the three ARVs in a special study bottle. This bottle has a microchip in the cap that monitors the time and date each time it’s opened and closed.”
This allows Müller to see when the mothers or caregivers give the medicine to the children and she also compares this data to what the mothers or caregivers tell her when asked about when they administer the meds.
Some of Müller’s initial problems included getting funding for the bottles, which are specially manufactured by a Swiss company at a cost of about R600 each. Currently 75 patients are enrolled under her research programme and equipped with the microchip bottle. The monitoring period stretches over three months.
In an effort to help her, a self-described “western biomedically focused health care professional”, understand the mindset of the patients better, she also intends to include an anthropological part to her study in which she wants to assess the image that patients – or their mothers or care-givers – have of their own illness.
Müller hopes that her study will, in the long run, help to improve doctor-patient communication and health education. Her studies are sponsored by Aardex.

Groote Schuur nurses get toddler-friendly tunics

Nurses at Groote Schuur’s Paediatric HIV clinic recently received brand new child-friendly tunics. The acquisition of 120 new tunics was made possible by a donation from the Jewish Women’s Organisation.
The tunics, decorated with prints of toys and dolls, will ensure that they can get their job done without having to get their uniforms dirty.
According to Dr Paul Roux, the new tunics are also “for staff morale as much as anything.” He says they help promoted team spirit in the ward and helps to “energise the nurses.”

Personality focus

Ever wanted to know what nurses, paediatricians or other health care workers in paediatric AIDS are up to elsewhere in Africa? And what they do in their preciously short free time outside of work? In this new section, we introduce you to your fellow colleagues.

Virgile Mahoro, Rwanda

Where do you work? At Partners in Health in the Rwinkwavu Hospital, which is in the Eastern Province of Rwanda.
What do you do there? I am the Paediatrics Programme Coordinator.
What is the hardest part of your job? It’s really difficult to make an accurate forecast of the materials, medicines and food supplies we need.
What has been your biggest success this year? Ensuring that everybody is responsible for what they do.
What do you do to relax? I like dancing and watching movies.
Tell us a bit about your family. I am the fifth child in the family. I grew up about 400km from where I live now. My mother is a nurse and my father is retired. I am unmarried.
Favourite saying: Don’t worry, things will be alright.
Biggest inspiration: My Mom.

Sara Stulac, Rwanda

Where do you work? At the Rwinkwavu Hospital in Rwanda.
What do you do there? I am a paediatrician and director of paediatrics.
What is the hardest part of your job? Babies dying just because they didn’t get the right medical care in time.
What has been your biggest success this year? The building and opening of a new paediatric ward and getting close to a hundred kids started on ARVs.
What do you do when you’re not working? I like to go jogging or read a book or do some baking – but there hasn’t been much time to do that since I’ve moved to Rwanda!
Tell us about your family. My mom, dad and three brothers all live in the United States. I grew up in St Louis, in the Midwest of the US. It takes a good two days of flights from there to here!

Imelda Ssekamate, Uganda

Where do you work? At the Entebbe Medical Research Council.
What is your position there? I am a paediatric nurse.
What is the toughest part of your job? Taking care of poor children, many of whom I cannot help.
What has been your biggest work-related success this year? All my children who are HIV-positive have really improved under the care they are receiving. It has also been great to share experiences with others who are looking after HIV-infected children since the PATA conference.
What are your hobbies? I like to read novels and news letters.
Tell us a bit about your family. I was the eightth of thirteen children and I grew up about 80 kilometres from where I live now. One of my brothers has died. My mom and dad are both retired. I have two children of my own.
Favourite saying: Nothing comes without God’s wishes.
Biggest inspiration: My Mom.

Please remember: The PATA Newsletter belongs to each and every one of you. We would like it to become a place where you can feel at home, where you can learn from your colleagues elsewhere on the continent and pass on some of your own knowledge to those who might need it. Please send us any news from you clinic or country – of successes achieved and of challenges that you still face. Anyone can contribute, simply send us an email. Send any news, information, requests or inquiries to info@teampata.org. We are here to assist you however we can.

Paediatric AIDS care workers and researchers contributing to this edition: Imelda Ssekamate (Uganda), Sara Stulac (Rwanda), Virgile Mahoro (Rwanda), John Budotela (Tanzania), Dr Shaffiq Essajee (Kenya), Dr Margaret Makanyengo (Kenya) and Alexandra Müller (South Africa). Thank you.