A Story from Dr. Buki Adesina, Project Manager
PMTCT Project – University College Hospital
Ibadan, Nigeria

Season of Hope

In the hospital community, HIV/AIDS often elicits irrational fears among hospital workers. This is the result of myths and misconceptions surrounding the disease. An HIV positive mother who was neglected at delivery for over 12 hours provides a good example of the seriousness of these fears. The patient was referred from another hospital on account of her being seroreactive at screening for HIV. This was stated in the letter of referral. The screening was most probably done without prior counseling and consent. She delivered about 14 hours after admission into hospital. The mother called the attention of the staff after she had delivered. The baby girl was delivered at a gestational age of about 34 weeks, about 6 weeks before the expected delivery date. Even in our environment, given our poor facilities, a 34-week baby has a reasonably good chance of going home with proper care. The mother was left to herself to manage her baby as best she could. No health worker would move near her to render any assistance. The pediatrician was called in after hours only to discover that the baby had died as a result of exposure. The mother was hurriedly discharged as soon as her physical condition could allow. This happened in December 2000.

However, in the last 1 year the APIN Prevention of Mother to Child Transmission (PMTCT) project at UCH has held several health education workshops for health workers. In addition, several batches of workers (nurses and doctors) have attended APIN funded skills building workshops in voluntary testing and counseling (VCT) and universal precaution. The goal was to ameliorate the stigma and discrimination often experienced by HIV/AIDS patients. In addition, workers were empowered to better enable them care for HIV/AIDS patients. Funds from APIN have also been used to provide equipment and consumables that are often sometimes not available to ensure application of universal precaution in patient care. This has encouraged workers to care for patients more readily.

The result has been a gradual shift in attitude from intolerance to tolerance. Since the formal launching of the PMTCT program by the Federal Government in June 2002, six HIV positive mothers have delivered in our labour ward and five are pregnant women are being followed up. All 6 babies went home healthy. Five babies are on replacement formula feeding and one on exclusive breast feeding. All 6 babies are gaining weight adequately, doing well and being followed up by the paediatrician. The first new mother at her last visit to the paediatrician touched the hearts of the counselors by her simple expression of gratitude for the love and care shown by the counselors.

In counseling HIV positive patients, one of the counselors gives them hope by telling the patients that one year ago nobody offered VCT at UCH, anti-retroviral drugs were not readily available, and staff were often afraid to care for HIV positive patients. However, with the APIN project and Federal Government commitment there has been a drastic change in the outlook for HIV positive patients. There is light at the tunnel and there is now reason to believe that we are in a season of hope.