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PATA Newsletter Volume IV Issue 6

PATA to fine-tune adolescent care at Regional Forum

Contents:

1. PATA Southern African Regional Forum themes revealed
2. Application process for funding to attend the Southern African Regional Forum
3. Six-monthly clinic progress reports due
4. Lesotho hosts PATA workshop
5. Want to work for PATA?
6. Rwanda 2008 forum proceedings now available
7. New clinic focus: Livingstone Hospital, South Africa
8. New clinic focus: Kericho District Hospital, Kenya

1. Southern African regional forum themes: Advanced ARVs, adolescent care revisited and practical tips for improving paediatric care

The 2009 Southern African Regional forum will take place in Johannesburg from 2 to 5 November 2009. There are three themes for this year's conference.

The first is 'Advanced ARVs' which will deal with treatment failure, second line treatment regimens, problems with 'fragile regimens', technical and managerial aspects of a massive roll-out, developing the national ARV programme, the benefit of weight bands for calculating dosages and common toxicity.

The second theme is 'Adolescent Care Revisited' which looks at why we need to be adolescent friendly and what we can do to achieve this in our clinics. It will also include practical life-skills training instruments for working with children.

On the third day of the forum, PATA teams will be treated to presentations under the headline topic of 'A Psycho-social Clinic Toolkit (Practical approaches to common problems)'. Teams who would like to share innovative or practical measures which have helped to overcome challenges in their own clinics during the year are encouraged to share these with other forum attendees in November. Please contact melanie@teampata.org in advance.

As in previous years, the 2009 PATA Regional Forum (Southern Africa) will provide teams with opportunities to network and share experience with others, to receive technical updates/presentations on topics directly relevant to their everyday work and to plan a work schedule for the next PATA year. This schedule will be based on the output of the forum and a review of their past progress.

Teams from the following ten countries may apply to attend this regional forum: Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia, Zimbabwe. Simultaneous English/ Portuguese interpreting will be available throughout the forum. Teams need to consist of a doctor, nurse, counsellor / social worker / psychologist and pharmacist. Applications to attend the Southern African Forum can be requested from melanie@teampata.org or by contacting the PATA office: +27 21 686 9710

Teams from East and West Africa will have the opportunity to attend the East African Forum (planned for April 2010) and the West African Forum (Francophone) planned for October 2010. If teams from these countries would like to host the forum, they are encouraged to contact melanie@teampata.org.

2. Application process for funding to attend the Southern African Regional Forum

There are limited travel and accommodation scholarships available. Teams are encouraged to find their own funding to attend the forum. Scholarships will be awarded based on the following criteria:
A balance of new / returning teams will be allocated scholarships.
Returning teams that have reported regularly on the progress they have made towards achieving the goals they set for 2009 will be given preference.
New and returning teams that identify a particular challenge pertaining to the forum themes will be given preference.
Teams that have demonstrated that they have attempted to fund / partially fund their own travel will be given preference.
Teams that missed out on the opportunity to attend last year due to space constraints will be given preference.

For self-funding teams that would like to attend, the cost of registration fees and accommodation at the venue is R5 000 per person (three nights accommodation, all meals and registration fees) ie R20 000 per team. No individual participants may attend as this is a team forum.

There is limited space for local Johannesburg-based teams to attend. Registration fees for attendance for local teams is R 1 500 per person (R6 000 per team). Scholarships are available for local teams too.

Based on our previous experience of the number of applications for scholarships, there will be a high demand for attendance at the forum and space is limited to twenty teams. No late applications will be accepted. The deadline for submitting applications is the 15 September 2009. Teams applying for funding need to submit their progress reports and letter of motivation for funding at the same time.

3. Six-monthly clinic progress reports are now due

Teams that attended the 2008 PATA forum in Rwanda set goals for themselves in the year ahead. Now, six months into 2009, PATA asks teams to reflect on the progress made towards achieving these goals, or on the challenges faced in this process. Teams are asked to email the following information to melanie@teampata.org by the end of August 2009.

Please answer the following questions as comprehensively as possible:

• What changes have been made to your service since the 2008 PATA forum?
• What challenges have you faced in 2009?
• What still needs to be done to meet the goals set since Rwanda 2008?
• How can PATA better assist you to meet these goals?

Please also supply clinic statistics on the following:

• The number of children under 12 months on treatment
• The number of children from 1 year to 18 years of age currently on treatment

If there are any queries, please don't hesitate to contact melanie@teampata.org.

4. Lesotho local PATA meeting

The first Lesotho national PATA meeting was held on 10 July 2009 in Maseru, the nation's capital.

This localised meeting is part of PATA's new strategy which aims to focus more on country-specific paediatric HIV problems while still organising the larger continent-wide meetings to consolidate and share knowledge gained in other regions.

PATA hopes that this approach will be both more cost-efficient and also more effective in that it allows for countries to have more discussion time for their own specific needs.

The Lesotho conference was chaired by Dr Prithi and the focus was on the patient referral system with which there have been problems in Lesotho. With very few paediatricians in the country, an efficient referral system is needed since children in need of this specialist attention tend to be seen and often turned away by less qualified doctors, despite a referral letter. By making the PATA clinics better aware of the referral system and giving out contact details of the few specialist paediatricians, the meeting attendees were able to see how best to refer without the hiccups of the child being lost in the system and turned away from the specialist. Dr Paul Cromhout (from East London, South Africa) was the guest speaker at the meeting and he summarised the aims of PATA which include improving access and care for children and mothers and families affected by HIV/AIDS. He also reminded the Lesotho attendees that PATA could help teams to set their own visions, targets and measures and provide links with other groups with similar challenges. Dr Cromhout outlined the use of a logframe which teams may find helps them to address priorities in their clinics and to achieve their visions. This involves teams describing ideals and challenges that they face in terms of prevention, treatment, care, support and mitigation.

The event was a great success and another meeting has been scheduled for mid-August.

5. PATA vacancies: Advocacy officer & assistant project director; and personal assistant

PATA is looking to fill two positions and we are awaiting qualified candidates to apply. The first position is for an advocacy officer and assistant project director and the second position is for a personal assistant to support the project director. Please pass this information on to individuals who may be interested in applying for either of these positions. More details can be requested from melanie@teampata.org.

6. PATA 2008 proceedings now available electronically and in book form

The 2008 PATA proceedings from the Kigali forum are available for download on the PATA website, or you can request a free hard copy by emailing your postal details to teampata@gmail.com. Thanks very much to Dr Paul Roux for compiling and editing these proceedings.

7. Clinic focus: Livingstone Hospital, South Africa

Livingstone Hospital is in Korsten, a suburb of Port Elizabeth in the Eastern Cape province of South Africa.

They are an ART accredited site and have been pioneers of the Wellness Clinic in Port Elizabeth since 2004. Back then, Dr Jam-jam was the head of the programme and they had one professional nurse. In the beginning they only treated adults, but eventually also children.

At the moment they have 41 paediatric patients, of whom 18 are on ARVs. They have a new doctor now who is still learning about paediatric HIV management and they will only start paediatric transfer-ins from other sites again in August. Their patient numbers are therefore bound to grow this month.

They hospital clinic has a multi-disciplinary team which consists of two doctors (one part-time, one full-time), a pharmacist, a dietician, a social worker, an ART co-ordinator, three professional nurses, one enrolled nurse, a nursing assistant, two data capturers, a receptionist, a community liaison officer, seven lay counsellors and two general assistants.

8. Clinic focus: Kericho District Hospital

Mwangalizi Project is based at Kericho District Hospital in Kenya. They currently serve two districts, but children from outside their catchment area also come to the clinic.

They have 927 children enrolled in their Highly Active Antiretroviral Therapy Clinic. Of this number, 459 (aged 0 – 15 yrs) are enrolled in the Mwangalizi Project. The mission of this project is to integrate paediatric treatment and care from the clinic to the family and community level.

The project is now one year old and has had a great deal of success and challenges. They are interested in networking and linking with organizations that are able to help them form a strong HIV paediatric team.

"This is why I was impressed with PATA," says Tabitha Rono, project co-ordinator of the Mwangalizi Project. "I found PATA on the internet. I am impressed that there are organisations helping infected children to get onto ARV treatment."

"We have found that HIV-infected adolescents face major challenges in terms of their treatment and care, especially adherence to ARVs," Rono writes. "It is challenging, but we are reaching out through adolescent and caregivers support group meetings and training of staff."

Rono believes that there are more children who have not yet been captured by their project. In their experience home visits by community health workers and people living with AIDS help to reduce stigma. They have been asked to hold community meetings because people have expressed interest in learning more about HIV and its treatment.

"Our PMTCT program has inadequate capacity to follow up exposed infants thus Mwangalizi project was asked to assist," Rono explains. "We have 33 wangalizi (accompagnateurs) who do home visits, follow-ups and bring the children to the clinic."

"I am interested in working with PATA in helping our project reach more children and expand to other districts in the South Rift. I wish to link to PATA for the benefit of the children, their caregivers, and the clinic."

Contributors to this edition: James Millar, Melanie Evans, Hannah Hussey, Paul Roux, Tabitha Rono, V.V. Ludwaba, Virgile Mahoro

P.O. Box 13657, Mowbray,
South Africa, 7705.
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