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Quiet revealing moments at Kolandoto



I like to think that I am a pretty tough one. Afterall, who doesn’t want to quietly believe that he/she can confront tough situations and handle them well. The excuse is,-a typical African man, I am!

But this one in Kolandoto on Monday quite left me feeling silly and after all,- human. I used a daladala to move to Kola ndotooutside Shinyanga town. Not a four wheeled daladala like seen in Dar es Salaam but a bicycle daladala as they are referred to down here.

Just a few minutes on the bicycle daladala,I found myself  at a village hospital, by the side of young women, possibly in my generation, lined up to access drugs.

In the process of  playing ‘facial games’ with some four year old crawling and making noise on the side, I would later  eventually have  to confront one fact that came  like a sharp sudden slap in my face. These are HIV positive babies whose mothers are accessing ARV drugs for them as they play along in a separate room.Here,the service is called ‘Family friendly HIV Clinics.’

Something inside betrayed my ‘artificial toughness’, I should say. In me , was  a subtle cry for future  dreams lost, for the babies, I thought.

But at least, I said  to myself- with this, these few year old  babies are  assured of hitting their 5th birthday and beyond, keeping them  safe from opportunistic infections that kill tens of thousands others born with HIV and unable to access drugs.

A 2009 National Aids Control Programme report shows 120 children are infected everyday through Mother to Child Transmission ( MTCT) .

At the country level, almost a quarter of the HIV new infections in 2008 which were 217704, some 43,300 were due to mother to child transmission.

And from the 596 people infected with HIV every day, some 118 children are infected by their mothers, which is 20 percent of all infections happening daily.

However, even as there are mothers who get pregnant with positive zero status, the gap for Prevention of Mother to Child Transmission (PMTCT) services countrywide is still huge.

Current settings show that 6 out of 10 HIV positive women access PMTCT services through 12.5 percent facilities which offer the service, a situation that puts 20 percent of the people on ARVs, who are children in more life danger.

Therefore, in simple terms, it is evident that 21,500 of 43,300 infants infected will die before their second birthday and 34,450 of 43,300 will die before their fifth birthday.

And economically, the remaining 10,450 babies will need life-long treatment and the cost of maintaining life health expectancy will be high to the family and the government as well. This also results into part of the generation struggling with its health.

The children are innocent because they have no control over whatever their mothers do when still in the womb.

On a continental picture, Tanzania ranks 6th out of 10 high burden countries among the African countries with the highest number of pregnant women who are HIV positive, where, every year, 122,000 pregnant mothers and 48,000 babies are infected with HIV.

In a move to cut children’s infections and improving PMCT, public eyes will be focused to December this year when Tanzania is expected to have adopted provision of PMTCT and pediatric services to be provided under one roof at all major hospitals.

The same month should see the government adopting the World Health Organisation (WHO) new guidelines for PMTCT and infant feeding.

And by the end of next year, the health sector should have adopted a policy of using expert patients in the care and treatment program.

For the health sector, this will mean that by end of this year, at least 50 percent of all the children born by HIV Positive mothers are diagnosed and receive results within 10 weeks.

The care and treatment clinic forms will also have to be reviewed to include infant development parameters and at least 80 percent of infected children who are eligible to start Anti Retro Viral Treatment are accessing appropriate medication.

But looking at the bigger picture, funding will also be an issue such that at the end of this year, the government and development partners should have increased the PMTCT budget at least by 10 percent of the baseline.

As things stand now, on average, national response to the HIV and AIDS scourge receives about (743bn/-) $ 550 million per year with 96 percent of it supported by donors. This is against the current year requirements of 1.1 trn/-.

However, available funds is only 726 bn/- hence the gap of 374 bn/- which is almost a 50 percent deficit.

The issue of funding should be on the agenda this year as the 2010/2011 budget is tabled, even as it is already clear that the  budget for the Health and Social Welfare ministry would be  cut by 30 per cent from the 96bn/-  allocated in the current financial year to 678bn/-,as it is read in Parliament today.

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  1. Loy Nabeta

    10/06/2010 at 11:02 am

    Orton, I’m sure they will leave beyond their fifth birthday if they are attending such a centre. HIV is now our everyday reality and those at risk are the ones unable to access these drugs either because of ignorance, stigma or unavailability. Government needs to work on those aspects. Otherwise, may they all live to see their Happy 18th!

  2. Orton

    10/06/2010 at 12:45 pm

    Thanks Loy.But the pediatric aids programmes (both government and NGOs combined) can only reach 14 percent of those who need the services generally.So lets project and see how long it would take before 50 percent of them are reached.30 years may be??And how many children or pregnant mothers will have already been affected and infected then??Oh yes,government attention will have to focus,refocuss and re-refocus

  3. Sylivester Ernest

    10/06/2010 at 5:12 pm

    If only 14% get the needed service then we are in danger. Mind u, there might be some areas in Shinyanga and even allover the country where the situation is even worse. Again, the gvt cut the MOH budget by third….it’s annoying. Let our leaders revitalize the country’s priorities!!!

  4. Paul Dotto

    10/06/2010 at 5:24 pm

    Orton, nice piece, revealing realities.. I think an alternative should be found in addressing this mess,Am no longer a disciple of trusting what numerous NGO’S are doing..and the government mmmh????!good work man

  5. Paul Dotto

    10/06/2010 at 5:25 pm

    Get it right is KOLANDOTO

  6. Orton

    10/06/2010 at 8:38 pm

    @Dotto and Sylvester,keep me on my toes.Thanks.But may I assure Dotto that there are many credible NGOs who are not just after giving average service,but world class support

  7. kenneth

    10/06/2010 at 9:13 pm

    inaitwa NGO economy.Pesa za sekta ya afya ni muhimu.Ni lifeline yetu hata kabla ya kwenda kazini

  8. fredrick

    11/07/2010 at 1:20 am

    “The children are innocent because they have no control over whatever their mothers do when still in the womb” THIS statement is bad because it is too judgemental!!!and thus it is stigmatory!!!!!

    nevertheless,we hope that establishment of child-friendly HIV services in all Care and Treatment Centers(CTCs) in the country will increase the number of children enrolled in the CTCs and thus they will get better healthcare and with current situation on the availability of ARVs,AIDS is no longer a deadly disease it used to be rather it has become a manageable chronic disease.

    one challenge that is still a problem in getting full coverage on PMTCT is in male involvement,many men do not want to get tested for HIV or allow their wives to attend PMTCT clinics,thus these women bear children who are already infected with HIV.

    i’m also optimistic that the new PMTCT guideline which will be adopted in come DECEMBER will be very helpful in reducing the MTCT,since it will ensure that pregnant women starts to get ARVs as early as in their 14th week of pregnancy and also they will be free to breastfeed their children for up to one year,contrary to the current guideline that want a woman who is HIV
    +ve to start using ARVs in 28th week,and also stop breastfeeding once a child is 6 months old.i saw challenges with the current guideline this year during the famine period in our region when women who are +ve continued breastfeeding their kids because there was no food thus breastmilk was the only food and though they knew that by doing so they were exposing their children to the risks of getting infected,they had no other choice since wfood was not available.
    also the new gidelines offers up to 97% chances of prevention of mother to child transmission.

  9. Shigela Kubeja ganja

    17/08/2010 at 3:17 pm

    Thanks Orton for your revellation,Keep it up and probably through such information; policy makers will wake up and ensure programmes are comprehensive and inclusive.Initially VCT was targeting adults but later on through learning like this they launched PIT (Provider initiated Testing) and now we are moving to Household counselling and Testing although it is partly PIT but it is more meaninful as it covers every member at household level where Children are inclusive too.Children delivered at home missed and are still missing the PMTCT opportunity as you all know the geographical variability from one location to another.This programme will complement to PMTCT and make easy follow up to children who are HIV positive.Hongera sana

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