HIV
Treatment & Care
Kenya’s adult HIV prevalence rate is 9%. One million Kenyan children have been orphaned and 100,000 infected. HIV has fueled a massive resurgence of tuberculosis. The life expectancy has plummeted from 65 to 48 years in less than two decades. Kijabe Hospital has confronted this catastrophe through efforts aimed at both prevention and treatment.
Kijabe’s HIV care program is marked by the following principles:
1. Community-based care and prevention
Kijabe nurses and other professional staff team-up with volunteer community
health workers, many of whom are patients themselves, to provide home-based
care, counseling and prevention messages. A unique program to train patients
as community health workers is being replicated at other hospitals in Kenya.
Compassionate care for the affected and a message emphasizing behavior change and abstinence are key to our community efforts. A network of 60 support groups provides ongoing psychosocial and spiritual care.
2. Quality clinical care and training
Kijabe’s HIV clinic has a very low death rate (below 4%). We aim to provide
quality care in the form of antiretroviral therapy and treatment of
opportunistic infections.
As of November 2006, over 2000 patients received care at four different clinic sites in the region.
3. Training of HIV care providers
In partnership with the AIDSRelief consortium and the University of
Maryland, an innovative, hands-on mentorship program has been developed.
Nurses and physician assistants, mostly from other mission hospitals, come
to Kijabe for two to four week blocks to learn basic and advanced concepts
regarding the care of patients with HIV. As of November 2006, 75 trainees
had completed this popular program.
4. Spiritual care
As a Christian hospital, Kijabe seeks to meet both the physical and
spiritual needs of our patients. Without regard to race, gender, religion,
or ethnicity we reach out with the Gospel of Christ to all those who are
suffering and have been labeled outcasts by HIV. Through training of pastors
and lay members, we seek to engage local churches in the fight against HIV
so that they may care for their own congregations and communities.
The history of the HIV work at Kijabe shows that compassion, dedication and generosity truly can impact even the most difficult medical and social problems.
Drs. Nate and Kim Smith, now serving their second term at Kijabe, started a program to prevent mother-to-child transmission of HIV (PMCT). The project is funded by the Elizabeth Glaser Pediatric AIDS Foundation. Thanks largely to the vision of the Smiths, a network of Protestant and Catholic mission health institutions now exists throughout Kenya to provide care to HIV-positive pregnant women.
Beginning in mid-2001 and using a variety of donated and discounted antiretrovirals, Dr. Smith began treating HIV-positive adults; the then pediatrician began doing the same for children. Given cost and availability, most patients initially received dual therapy (i.e. two drugs only). The hospital was able to expand provision of ART because of a dedicated “Kijabe HIV Patient Fund,” which subsidized the costs of ARVs and other essential care. This money came from concerned individuals, churches, and corporations in the West.
Based upon this experience and demonstrated excellence, in August 2004 Kijabe Hospital was selected for inclusion in the AIDSRelief consortium, a network of mission hospitals providing HIV care with support from the President’s Emergency Plan for AIDSRelief (PEPFAR). Under this program, community initiatives and the number of patients receiving antiretroviral therapy have expanded dramatically. A team of forty now provides comprehensive services to the HIV-positive community.
This rapid expansion has also brought challenges. The generous AIDSRelief program is not able to pay for hospitalizations, non-HIV-related conditions, antenatal care, surgeries, or the expansion of infrastructure necessitated by the influx of so many patients. For these reasons, the partnership Kijabe has with generous supporters in the West is critical to the program’s ongoing growth and success.
In this part of Africa, HIV has gone by many names: ukimwi (a combination of Swahili words meaning “disease that has no treatment”), slim disease, sina dawa (“I have no medicine”), and ugonjwa hatari (“the dangerous disease”). Kijabe Hospital is providing hope to those with nowhere else to turn. Perhaps, with enough commitment and faith, the names of this plague may change—or disappear forever.
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