by Dr Connie Osborne.
Stories can help people learn more about HIV/AIDS. This story can be used as a training exercise with health workers or carers. Tell the story, changing the names to common ones in your area and then go through it again slowly, asking the discussion questions.
When Nakala became pregnant for the fourth time, she hoped for a boy this time, as she already had three lovely girls. She went to the antenatal clinic for regular check-ups, including a blood test and checks on blood pressure and weight gain.
The new baby was a girl, Ilinanga, who was born healthy and strong. Nakala breastfed her baby knowing this was the best food for her. However, during her first year, Ilinanga had many illnesses and infections and stopped gaining weight at nine months. Nakala was surprised and upset since this had not happened with her other children. Then Ilinanga developed a bad cough that would not go away. The nurse suggested an HIV test which Nakala and her husband agreed to, although they were sure the baby didn’t have HIV. They hoped the nurse would look harder for other causes for Ilinanga’s illness once she knew the test was negative.
However, when the results came back, Nakala and her husband, Samson, were shocked. The test was positive. Both Nakala and Samson were then tested and both were found to be infected with the HIV virus. Nakala asked herself ‘When did I get infected?’ She and Samson had never used condoms in their marriage. Nakala had been a faithful wife and had never slept with anyone else, but could she say the same for Samson? And when did Ilinanga get HIV? Before or during her birth, or from breastmilk?
Nakala worried about the health of all the family. She worried about how to tell the girls about Ilinanga’s illness. She and Samson agreed not to have the three girls tested but they worried about whether they might get infected through close contact. For many of their concerns there didn’t seem to be easy answers. The nurse could give them only the facts about HIV infection and what support was available locally to help them. Nakala and Samson had to make their own decisions and try to keep themselves as healthy as possible – eating well, taking regular exercise and preventing infections or treating them early. Their faith helped them to ‘put God first’ and learn to trust him for the future.
Dr Connie Osborne is a consultant Paediatrician at the University Teaching Hospital, Private Bag RW1X, Lusaka, Zambia. This article was adapted from an article which first appeared in Child Health Dialogue/AIDS Action.
- Most women do not know if they are HIV positive when they become pregnant. Should health workers provide information on HIV during antenatal clinics? What sort of information would be useful?
- Samson probably passed HIV to Nakala during sex. Could Nakala have done anything to prevent herself from being infected?
- What should health workers consider before suggesting an HIV test?
- How might a parent feel knowing they have infected their child with HIV?
- How could health workers help parents not to worry about passing the infection to their other children?
- Who needs to know that a child has HIV infection? Do teachers need to know the real reason why a child may be sick more often than other children?
- Why might one of Ilinanga’s sisters not want to talk about HIV infection?
- Are Ilinanga’s sisters likely to become infected with HIV through living with other family members?
- Where can people in the community find out more information about HIV/AIDS?
For information on HIV and breastfeeding, write to WHO for their pack (produced with UNICEF and UNAIDS) called HIV and Infant Feeding, from: Avenue Appia, CH- 1211, Geneva 27, Switzerland. Fax: +41 22 791 0746
- AIDS is in almost every country in the world.
- 50 million people have been infected with the HIV virus.
- 16 million people have so far died as a result of AIDS – 85% of them in Africa.
- Over ten million African children have lost one or both parents to AIDS.
- A recent UN report suggests that half of all teenage boys in Africa will die of the disease.
- One quarter of the adult population of some African countries are infected.
- Infection rates double every three years without intervention.
- The HIV virus can be passed on ONLY through sexual intercourse (80% of cases), unsterilised needles or razor blades (5%), blood transfusions with infected blood (5%) or from mother to child during pregnancy, birth or through breastfeeding (10%).
- The HIV virus damages the body’s immune system so that it cannot fight off diseases.
- A number of vaccines have been developed but none has yet provided an answer.
- In India and SE Asia, four million people are infected with AIDS and the infection is spreading rapidly.
- In Latin America and the Caribbean, the number of people with HIV is rising to very high levels.
- There is still no medical cure for HIV or AIDS. Education remains vital to prevent the spread of AIDS.
- Treatment to slow down the rate at which the HIV virus develops into AIDS is available in a few countries, but has many side effects, needs careful medical supervision and costs a minimum of US $2,000 per patient, though much cheaper drugs are now being developed.
Sources: WHO, Financial Times, Newsweek, ACET, UNAIDS