Conflict, lack of food, and homelessness: a potentially deadly concoction for the HIV-positive in Central African Republic

تم النشر: 8 يوليه 2015 13:00 CET

By Nelly Muluka and Happy Tchokote, IFRC

Persistent violence in the Central African Republic has impacted negatively on health services, with vandalism and looting of health care facilities greatly affecting the ability of those living with HIV to access medication.

“Several facilities offering HIV services in the country have closed due to insecurity and vandalism, but this centre remains operational,” says Dr Simaleko Mbeko, national director, centre of reference for sexually transmitted diseases and anti-retroviral therapy in Bangui. “We receive surging numbers of patients, some of whom have fled insecure areas, and others who are residing within camps in Bangui. However, we are also seeing large numbers of HIV patients who have stopped coming for their medication.”

HIV prevalence in Central African Republic is high, with close to 150 consultations being done daily, and at least 5,000 positive test results for the AIDS virus being recorded annually. The reference centre reported 400 drop out patients in 2014, and already 243 this year.

“Interrupting anti-retroviral therapy can be detrimental. Such patients risk contracting opportunistic diseases such as pneumonia or tuberculosis. In addition, they are likely to develop resistance against the current drug, thus weakening the immunity further,” explains Dr Marie Sana, a government doctor who works alongside Dr Mbeko at the centre.

Unable to access their medication

Yache, 29, displaced in Bangui, is HIV positive, and suffers from tuberculosis. She is also a drop out patient. She was on anti-retroviral treatment until December 2013, when the conflict forced her from her home.

“It was late in the night and there was continuous shooting; everyone fled but I was too weak. I hid behind a bush and waited. In no time, armed people arrived and searched inside and around the house. Fortunately, they did not see me and, shortly after, they left,” says a teary Yache.

She was rescued by a neighbour three days later. “He came by to check on the situation of his house. I pleaded with him to not leave me behind. After several hours of walking, tired and frail, I settled in this camp. Unfortunately, I did not carry my medication for fear that if I went inside the house to get it, my neighbour would probably leave me,” Yache continues.

With treatment disrupted, Yache grew weaker and dependent on her neighbours within the camp, at times going without food.

Pounguinza, 55, HIV-infected and on medication, says several HIV patients, especially those who are displaced, want to continue their medication but they lack food, which is an essential part of the treatment process. Without food, people get horrifically sick if they take their anti-retroviral medication, so even some who do have medication, stop taking it because they do not want to feel sick.

“Before the violence I worked as an operator and fed our daughter and my wife, who is also HIV-positive. But currently, we eat a single meal a day and any little money I make goes to buying food in order to continue the medication,” says Pounguinza.

The International Federation of Red Cross and Red Crescent Societies (IFRC) has partnered with the Global Fund to deliver HIV and tuberculosis services to people like Yache. The grant, worth more than 20 million Swiss francs, aims at reaching 18,478 people by the end of June 2016.  The grant support includes the provision of treatment in health centres to deal with issues of transmission from mother to child. Others activities include supplying drugs to people living with AIDS, rehabilitation of government HIV treatment centres, and enabling biomedical examinations for HIV/TB at several laboratories in the country.

As of May 2015, all four sub-recipients of the IFRC/Global Fund HIV and TB grants have signed contracts with IFRC and implementation of activities is on course. To date, treatment for at least 17,372 patients is ongoing, at least 7,914 women have benefitted from the free testing services, and 443 are currently on HIV treatment. IFRC, in collaboration with the Ministry of Health and other partners, including the National Society, is delivering these health services through 81 health facilities countrywide.