July 11, 2005.

We have had 278 clients in the Care and Treatment Centre (CTC) at Bulongwa Lutheran Hospital to date who are HIV+, both male and female. We currently have 120 patients on ARVs.

Some are doing fine, but some are not. We think this is due primarily to poor nutrition - they simply have no food. Unfortunately, our program cannot afford to supply food to our patients. Nevertheless, we have some great success stories.

One man, whose name is Eskaka Morhan, is a farmer from Tukuyu in neighbouring Mbeya District. He arrived here on December 12th of last year for Voluntary Counselling and Testing (VCT). The HIV test result was positive. Worse, his CD4 count was an incredibly low 7! His body weight had already dropped to 45 kg and he had many opportunistic infections. We started by treating the infections. Then on February 4, 2005, we decided to begin ARVs; his CD4 count was still 7.

After four weeks, Eskaka had started to gain body weight, up 4 kg. In March, his body weight was 51kg, in April 53kg, and by May his weight was 58kg and his CD4 count had risen to 37. When he visited the CTC this week, his weight was 62.5kg and his CD4 count stood at 115. He is doing very well. When you look at him, you can't believe that he is sick. He is, of course, very happy.

Without even minor health problems, Eskaka is joining his renewed energy with others in a brand new Makete-based organization for people who are living with HIV/AIDS called PIUMA. That stands for Pima Uishi Kwa Matumaini which means "Test and Live with Hope."

Other good news from Bulongwa: we have started to give HAART to pregnant women who have tested positive and are eligible for HAART without any delay. We hope to prevent a lot of drug resistance by doing so.

Because HIV incidence is so high in the District, we usually give Niverapine mono to all expectant women arriving at the hospital in stage three of labour without even knowing their HIV test results. If we manage to get a result before labour and a mother turns out to be positive and even eligible for HAART according to WHO staging and cd4 count, instead of Nevirapine mono we start her HAART without any delay.

This is a great deal better for both the mother and the child, because compared to Nevirapine mono we can bring the transmission of the virus down further and at the same time we can prevent a lot of Nevirapine resistance.

Your reporter
Mary Musoma - CTC Nurse
Bulongwa Lutheran Hospital,
Makete, Tanzania.