December 29, 2007

Report from The Citizen

Tanzania: Caring for the Sick Carefully

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Eric Kalunga

In 2000, When Anna was in standard five she had to take care of her parents who fell sick. She was 12 years old and was the oldest female child so it was her duty to take care of the parents. In 2001 the parents died.

Then Anna fell ill herself. At this time she was about to receive confirmation at the church. Reverend Winfred Joseph Mosha of the Lutheran Church there saw that the child was in trouble and thought he recognized her symptoms as of a person suffering from HIV/Aids.

"I talked to her and suggested that she goes to a testing centre," recalls rev. Mosha.

With the little girl they set off for Moshi town to Kiwakkuki, Kilimanjaro women's group against Aids. The NGO offers testing and counselling services as well as information on HIV/Aids accumulated through research.

Anna stayed at the centre and they tested her blood. The results came back positive. she was devastated and could not stop crying.

The counsellor asked her which people she would like to inform of her condition.

Anna said she would like her grandmother and the father to know as well as her elder brother who was at the Serengeti National Park at the time.

"When I went to pick her up at Kiwakkuki," says Rev Mosha, "she told me 'father, I have tested and I am infected'".

The ride back home was hard for the two. Anna was grappling with the new reality of her HIV status and resorting to tears while Rev Mosha was thinking of the best way of helping the little girl cope.

Eventually Anna continued with her education. She completed primary school and reverend Mosha took her to his sister in Moshi who was a librarian at Moshi Technical Secondary School. His sister took the girl to the clinic regularly.

The church supplied her with clothes and money for food. She also got help from Kiwakkuki. Anna now lives in Arusha with her grandparents.

Rev Mosha says Anna is just one of the thousands of orphans that are a result of parents who died of HIV/Aids. Aids is a big problem in this area.

"We are in a tourist corridor," he says.

The road that leads up to Mount Kilimanjaro passes through their town. Many tourists pass through here annually.

To cater for these hotels and lodges have sprouted all over Marangu.

Beautiful houses with satellite dishes on their roof tops and signs in front advertising rooms are numerous.

As you walk on this road you are bound to bump into a toutist or two making their way to the mountain or the waterfalls, Kinukamori, also in the same direction.

"People make money from the tourists, from tour guides. So you get a lot of people from other parts of the country coming here to make money," says Rev Mosha. These people come on their own as single men and women to do business.

The money and the availability of alcohol and guest houses combine to make the area conducive for unsafe sex and the spread of HIV/Aids. Ultimately local children suffer indirectly as orphans or directly as people living with the Aids virus. It is not clear how Anna contacted HIV/Aids.

While it might be easy to point a finger at her deceased parents and say that she got the disease while taking care of them, experts disagree.

The leading cause of HIV/Aids is sex taking up more than 90 percent of the cases. Then comes mother to child transimission and then the last category includes blood transfusion, sharing of objects and nursing.

Negligible as it is, nursing of the the Aids victim can lead to an infection. Dafiosa Itemba is the executive coordinator of Kiwakkuki and deals with Aids cases on a day to day basis at the centre.

She vaguely recalls the case of Anna, more than five years ago, but cannot give a lot of details. "We deal with a lot of children here," she says.

However she says that it is possible that the child might have gotten infected through washing and generally taking care of her sick parents.

"It is possible that she did not know that her parents had Aids. If that is so then her grandparents who live with her could be in danger of getting infected as well," she says.

According to data from HelpAge International, 90% of Aids related care is provided at home, often by older women.

Up to two-thirds of people living with Aids are cared for by their parents in their 60s and 70s and over 60% of orphaned children live in households headed by their grandparents in severely affected countries.

"This area is important to study. There is a research gap in this and great care will be needed because we wouldn't like to advocate stigma which we are fighting now," says Itemba.

"Telling people to be careful in their homes could lead to stigma. They will be afraid of touching someone who has diarrhoea for instance," she says.

Antipas Mtalo, a counsellor, agrees that informing people about the full extent of the risks needs to be handled with delicacy to avoid stigma.

He himself has witnessed what can happen when people are misinformed or given too little information and make decions based on that information.

"I was in church once when someone stood up at the pew and told us a story," he says.

The story was of a person who was HIV+. When this person was given food he would not finish all of it and children used to eat what he left. Then the children got infected.

"I was shocked," says Mtalo, "there were about 500 people in the church and they all heard this outrageous claim. Some of the people were doctors that I know but you couldn't go up there and argue with the man. It was in a church."

He says it is this kind of misinformed conclusions that institutions need to be aware of when stepping into area of Aids related care provided at home.

"It is the same case with barber shops. There is a risk involved. If they use razor blades go there with one of your own," he says.