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OCTOBER 2005 – The Mto wa Mbu settlement sits on the slopes of the Rift Valley in northern Tanzania. The town is growing fast, supported by tourism at the region's game parks and by rice and banana farming. But with economic and demographic growth has come an increase in HIV transmission that has affected many local families.
One young resident, 11-year-old David, has been ill for much of 2005. For three months, he didn't go to school because he was too weak to get out of bed. David's father died five years ago, and his mother Salma has also suffered bouts of illness in recent months. Salma, fearful of stigma, had refused an HIV test until recently, after a volunteer counselor working for the Tumaini Program convinced her to get herself and David tested. Tumaini is implemented by a network of community- and faith-based organizations that assess HIV-positive patients, provide them with home-based care, and refer them to clinics for treatment and counseling and to other providers that address socioeconomic, psychological and legal needs. With funding from the President's Emergency Plan for AIDS Relief through the U.S. Agency for International Development, Family Health International (FHI) provides technical assistance to Tumaini to develop service standards, training materials for staff and protocols for cross-referencing among implementing agencies. FHI also trains Tumaini's volunteers and health workers. Both David and his mother tested positive for HIV and, with Tumaini's help, registered at the Mto wa Mbu Health Center's Care and Treatment Clinic (CTC), the first facility to offer antiretroviral therapy in this largely rural region. The Health Center is accredited by the Ministry of Health to manage the National Care and Treatment plan under the ART Quickstart Program, which provides treatment, care and related services to people with HIV. FHI also provides technical assistance to ART Quickstart to develop standard operating procedures, training manuals and other materials to ensure high-quality services. Between February and July, 2005, 67 HIV-positive patients were registered at the Mto wa Mbu CTC, and 23 – three of them children – began receiving antiretroviral medication. David and Salma have now been on antiretroviral therapy for several months, which has significantly improved their health. Their Tumaini volunteer visits them at home twice a week to give them food and nutritional supplements and to remind them to take their medications on schedule. Thanks to community sensitization programs conducted by both Tumaini and ART Quickstart to decrease AIDS-related stigma, both David and his mother feel much more accepted by their community than they once feared they would be. Neighbors visit the family frequently and provide valuable social support, and during David's recuperation, his friends continued to come over to play with him. And when David returned to school in August, he was welcomed back by classmates, happy to see him again. — Gottlieb Mpangile Photo: David has returned to school, thanks to antiretroviral medications that have improved his health. (Steven Mchau)
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