Autore: Redazione Cuamm

Fight against Hiv/Aids Music at the service of the community

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Involving meaningful testimonials to raise community awareness on public health issues is a widespread practice around the world. More and more often institutions and organizations rely on prominent personalities such as singers, actors and athletes to promote messages of prevention and treatment among the population.

It is precisely this approach that led to the collaboration between Doctors with Africa CUAMM and Fareed Kubanda, the Tanzanian Hiphop artist popularly known as FID Q, who was involved in some awareness-raising days on the issue of Hiv/Aids treatment and prevention, within the Test & Treat project that CUAMM implements in Shinyanga and Simiyu regions.

Very active in community-based projects, FID Q has been an ambassador for the fight against Aids since 2020 and recognizes the great opportunity as an artist to be able to help in the sensitization and education of communities on fundamental issues such as early diagnosis of the disease, correct use of medicines and the importance of continuity of treatment. The artist, flanked by the project staff and the community coordinator who has in-depth understanding of the community and its resources, visited several health centres in the districts involved in the intervention and met the students of the secondary school of Bariadi.

“I thought I knew everything about Hiv/Aids but after joining the “Test & Treat” team, I realized that I didn’t know many important things” admitted FID Q and then added: “The work done through the Test & Treat program is truly remarkable and I am happy to collaborate to mobilize and educate the community on the importance of undergoing the test, promoting an approach to fight against discrimination and social stigma linked to the disease. Hiv/Aids patients are people, not their disease “.

The reactions of community members and operators who participated in the awareness-raising activities were also very positive: “Events like these are fundamental in the community because they promote the importance of the fight against Hiv infection in order to reduce the size of the problem – some of them say – “The presence of FID Q allowed to involve many people, encouraging them to check their health status through tests and sensitizing patients on the appropriate use of antiretroviral drugs” concluded the participants. Finally, some people affected by the disease shared their experience and testimony on the importance of treatment and early diagnosis.

This is the proof of how effective the involvement of personalities from different fields that seem very distant from healthcare can be, but personalities that can make a difference in the dissemination of awareness-raising messages on fundamental issues for the health of an entire community.

The results of the work in Goro Woreda Ethiopia

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Helping mothers and children to survive and thrive has always been the main goal of Doctors with Africa CUAMM’s commitment, particularly in the most challenging contexts. The work in Goro Woreda, in Ethiopia, together with our partner Women and Children First UK and funding from Comic Relief, is a concrete example of how lives can be saved by improving reproductive, maternal and newborn health through strengthened access to quality healthcare services and dissemination of “home-care practices”.

The joint action has made possible to reach nearly 39, 893 beneficiaries of 100 different communities. In particular, 100 women’s groups have been established with the aim of identifying priority maternal and newborn health issues and enabling the communities to find sustainable solutions to overcome them – all this using a participatory approach. The groups’ activities have been led by the so called “health development army leaders”, namely 345 women and peer mothers trained on maternal and newborn health, from hygiene and disease prevention to danger signs and the importance of healthcare services. The groups have therefore become learning spaces and at the same time, safe spaces where women can share  fears, experiences and taboos, drawing on mutual support. In addition to helping communities, 4 health centres throughout the Woreda have received medical equipment, supplies and drugs to ensure the continuity of healthcare services.

These actions have resulted in great achievements: skilled birth attendance has increased to 77% and the number of safe deliveries handled by skilled birth attendants up by 13% compared to the surrounding areas where no groups activities took place. Moreover, there was a 8% increase of deliveries with major obstetric complications successfully treated in a health facility. Finally, among the most significant achievements, there is sustainability: 80% of women’s health groups continue to run after projects come to an end.

This is therefore not an intervention focused only on health, but also aimed to strengthen women’s empowerment to benefit the community as whole. Together, they find and develop local solutions to transform their health.

Once again, solidarity and “joining forces” turn out to be fundamental for a better health.

 

The mothers’ song of hope

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“We often hear a song rising in the hospital corridors, initially we did not understand, but then we realized that they were the mothers outside the neonatal pathology ward. They sing to make themselves and give strength together. This is a beautiful image, which conveys a great message of resilience and how important the community is especially in the most difficult moments.

Living in the hospital allows you to get closer to people in their moments of greatest vulnerability and to witness the way they deal with pain and waiting. Singing, for example, is a collective activity that mothers use to gain strength, to convey a message of resilience during difficuThe mlties. Alessandra Gosetto and Matteo Arata are two JPOs in Gynecology and Obstetrics, arrived in Freetown, Sierra Leone, in August, to take up service at PCMH, the reference hospital for maternal and child health in the country.

A new experience, the first time in Africa for both. “The initial visual impact was very strong, almost disorienting – they say. The hospital, although one of the largest in the country, is very different from the hospitals we are used to seeing in Europe. The resources here are limited, just think of the quantity of deliveries compared to the staff: from 10 to 25 per day, for a total of 8,000 deliveries per year with the medical staff dedicated to the Gynecology and Obstetrics department composed of 4 structured and some trainees who do 24 hour guards. In Padua, in a hospital that gives about 3,000 births a year, there are more than double the number of structures to manage the ward and the guards are 12 hours. Here we face various obstetric pathologies on a daily basis that are almost never seen in Italy and there is a high rate of obstetric complications “.

In Sierra Leone for now, Covid-19 is present in a limited way, positive patients are a minority of hospital admissions, but the reality is that the resources to screen the population are still lacking. Furthermore, the difficulty of accessing the hospital, even if only due to the costs of transport, risks enormously increasing the complications and dangers of childbirth.

Ensuring the health of mothers and children is a daily challenge that we have been trying to make concrete for 70 years in all our countries of intervention.

 

TB: a challenge that needs dedication and care

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In the “Western world”, hearing the word tuberculosis does not generate much fear, if it is treated promptly and with the appropriate instructions, it is not even perceived as a serious disease. Unfortunately, this is a “privilege” for the few.

In Africa, tuberculosis is still a disease that causes many victims, 1,4 million in 2019. Every year, only in Uganda, nearly 89,000 new cases of Tb occur, among them 6,176 in Karamoja Region (WHO). But not all stories have an inevitable ending. Doctors with Africa CUAMM is committed to offering care and knowledge to those in need, even in the most remote places, as in the case of Ochan Richard, a former soldier of Uganda People’s Defence Force. Ochan, 50, already infected with HIV, was first diagnosed with TB in 2011, which worsened into multi-drug resistant tuberculosis (MDR TB) a few years later. Tuberculosis is one of the major causes of death for HIV patients who, with the progressive weakening of their immune system, contract the disease more easily and often with lethal consequences if it is not treated.

Ochan’s story, which seemed to have a written ending, changed when he arrived at St. Kizito Hospital of Matany in the Napak district of Karamoja. After many years of interrupted treatments due to work needs and difficulties in obtaining the necessary medicines, Ochan was finally able to have access to the care he needed thanks also to the encouragement and support of his family who prompted him to seek help at the Matany Hospital despite the distance from his home. A 75 km route full of hopes that have given him confidence in a still long life.

After two months he was discharged and personally taken home by the CUAMM hospital team specialized in tuberculosis which was responsible for raising awareness among the family and the entire community on the signs and symptoms of tuberculosis, on how it develops, on the adequate treatment and finally on how to avoid its spread.

“The same day I got home, my family and some community members were screened and all were healthy.” – said Ochan, adding – “I am deeply grateful to the hospital staff of Matany and to the CUAMM staff, for all the efforts they have made to save my life and that of many others. Whenever I come back for treatment, I am sure that I will get reimbursement for transport and meals, and given my situation it is a great incentive to be able to continue treatment regularly”.

A similar story to that of Santos, 32, who was diagnosed with multi-resistant tuberculosis. After numerous interruptions in treatment, in which skipping even a single day of treatment means starting over each time, Santos had decided to abandon himself to his fate and leave the Kotido Hospital where he was being treated.

“I left the hospital and went to stay with my older sister, Martha. As soon as I arrived at her house, my cough and health conditions only got worse. Therefore Martha insisted that I go back to the hospital where I was examined and diagnosed with multi-resistant tuberculosis. The doctors immediately contacted the Matany Hospital, the only institution specilized in this disease and able to offer adequate care and support where I was reffered to and hospitalized by the team of Doctors with Africa CUAMM”, says Santos.

After a month and a half of treatment, Santos could no longer bear the kanamycin injections that were administered to him daily so he escaped from the hospital returning to his village. Victor, the CUAMM regional official did not give up and went to his home convincing him not to renounce and to resume treatment.

Although tuberculosis is still a deadly disease in Africa, at Matany Hospital there is the hope of adequate care and treatment, which is not limited to the administration of the necessary drugs but it offers the opportunity to be followed by medical staff with dedication, and be accompanied in the understanding and acceptance of one’s illness.

These happy ending stories were made possible thanks to the intervention in Karamoja to improve the quality of  services for diagnosis and treatment of Tb and multi-drug resistant Tb, particularly within the projects: “It’s Good Tb free! Project to contribute to a TB Free Uganda by 2020“, financed by the Italian Agency for Development Cooperation, as part of the expenditure for technical assistance to the Global Fund for the fight against aids, tuberculosis and malaria and implemented by Doctors with Africa CUAMM in partnership with the University of Milan and the University of Makerere, and the project ” Support to St. Kizito Hospital of Matany and to the Napak Distrcit in Karamoja”, financed by Fondation Assistance Internationale (FAI).

Between elections and a pandemic a suspended Christmas in Bangui

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This past Christmas was a suspended Christmas. Due to the limitations on travel in Italy and between the various countries, many found themselves spending this day away from loved ones and very often stuck in the city where they live and work.

But what is it like to spend Christmas in Africa at this time during the elections? The stories come to us 8from the   through the voice of colleagues in the field.

“It’s hot these days, the temperature reaches 35 degrees, we are in the dry season, only a few occasional showers remind us of the rainy season that has just passed, heat and red dust fill the streets of the capital. Ours is a “short-sleeved” Christmas, without coats, without scarves, without fireplace, there is no white of the snow  but only the white of the health workers who work at the Bangui Pediatric Complex, a hospital for children only, it is the only one in Central Africa where CUAMM has been working for a few years. ” says Filippo Pistolesi, who arrived in Bangui a few days before Christmas, who spent his Christmas in quarantine using technology as a bridge to connect Italy to Africa, but also to communicate with colleagues, who live in his own home.

In the Central African Republic it was a special Christmas, not only for the restrictions imposed by Covid-19, but also for the tense electoral climate that crystallized the country in the weeks leading up to the elections, held on December 27.

“December 27 was Election Day, to put it in the American way. The date had hovered over our heads for weeks now. The silence was surreal; you could not hear a fly flying, you could hear the sound of your breath… a sensation perceived more at night, not suitable for a hot sunny day at 10 in the morning. Then some children went out to play in the opposite compound, a rooster crowing, someone hoeing… it seemed more like a Sunday like any other.

In recent weeks, there have been clashes in many parts of the country, the armed groups of the former dictator Bozizé have brought chaos and violence, and above all fear, to the people who still have in their eyes and hearts the destruction perpetrated by the militias in the past.

Now we are all waiting for news, to know what will become of Central Africa and its people, if these elections will have any validity and will maintain the stability, albeit precarious, of the country or will create an institutional gap that will leave room for an even more serious destabilization.” tells Daniela Ramadani, project administrator for Doctors with Africa CUAMM in Central African Republic.

A different Christmas that of Bangui, which in any case smells of hope especially at the pediatric hospital that Doctors with Africa has been running since July 2018, where despite the pandemic and the tension for the elections at Christmas, children’s beds are filled with small bags of rice, some biscuits and pieces of soap. There are no shiny toys and plastic superheroes down here, the only superheroes are them, the hospitalized children, and perhaps the greatest gift is being able to witness the dignity and determination with which they face treatment.

A new-born cry to greet 2021

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On December 31st at 11 pm in Chiulo, Angola, Giorgio Pellis’s phone rings: there is an obstetric emergency and Alice, the Angolan doctor who works in the hospital, asks for support in managing the birth because the child struggles to be born.

“When I arrive, I immediately notice that the mom is tired after hours of labor and is laying in a very uncomfortable position. There is no time and it is immediately clear to me what needs to be done. I calmly explain to the lady, the doctor and the nurses what we will do, while my hands are already preparing the local anesthesia and the instruments for the surgery. The soon-to-be mother gives me a look of hope. She doesn’t know, but that look digs me inside. She is giving me a huge responsibility. While I am performing a very small operation, I put the dr. Alice’s hands on the scalpel and I make her feel what cannot be seen but is clearly perceptible. The pelvis is widening little by little and this will make a difference for her baby. ”

After a while the baby is born and with a loud cry he greets the new year. He is the first child born in Chilulo in 2021. “Here the emotions are very strong, every day,” says Giorgio. “Being able to transform a potential caesarean into a delivery without trauma is beautiful. But the greatest thing is the gratitude of the mothers and their families who, sometimes, as a sign of gratefulness bring to the hospital a bag of flour as a gift. Needless to say what a great emotion this is. ”

Doctors with Africa CUAMM has been working in Chiulo, Angola, since 2000 where it supports the hospital thanks to a team that is at the forefront every day , trying to do their best at the service of “the last mile”.

CARING FOR HOMELESS PEOPLE IN LA SPEZIA

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Doctors with Africa CUAMM delivered today in La Spezia the renewed showers that will help homeless people of the city, ensuring their personal hygiene. Run by the “Gruppo di Volontariato Vincenziano San Giovanni Bosco”, the pre-existing facility has been used over 3,550 times since July 2020. The renovation, which will guarantee a more efficient and comfortable service, was funded by the U.S. Government through the United States Agency for International Development (USAID).

Pierluigi Peracchini, mayor of La Spezia, visited the spaces, with mgr. Luigi Ernesto Palletti, bishop of the city, Fr. Fabrizio di Loreto and Anna Iavazzo from the “Gruppo di Volontariato Vincenziano San Giovanni Bosco”, implementing partner, Fr. Dante Carraro, director of Doctors with Africa CUAMM, and Andrea Atzori, chief of party of the project “Italian Response to Covid-19” (IRC19).

Andrea Atzori, chief of party of Doctors with Africa CUAMM’s IRC19 project, stated, “Over the last few months we have been delivering a series of interventions throughout Italy. Most of them are aimed at strengthening and making more resilient pre-existing services, as we have done here in La Spezia. Since July 2020, 370 people have had access to the services available here, and showers have been used 3,550 times. But the activities of the group of volunteers is much wider: over the last months they put on the table over 24,800 meals, they made 1,300 laundries with the news machines we delivered and they distributed 2,600 food kits to around 350 families, in addition to homeless people assisted, for a total of 740 people reached”.

Fr. Dante Carraro, director of Doctors with Africa CUAMM, stated, “We are used to work in Africa, at the last mile. But this pandemic calls us to new kind of closer solidarity, here in Italy. Many of our doctors who came back from Africa, prepared to handle emergencies and epidemics there, wanted to put their experience to use for the people in need in their own communities. Here in La Spezia we had Marina Trivelli, who worked with us in Ethiopia and Angola, and made us know the group of volunteers run by Fr. Fabrizio Di Loreto and Anna Iavazzo. They were working with homeless people before our arrival and we wanted to help them to give continuity to their important service even in these hard times. We must take care of the most vulnerable people, in Italy as in Africa, because this pandemic shows us that we are deeply linked: the virus does not look at the borders, neither should solidarity.”

Doctors with Africa CUAMM has provided support to the volunteer of La Spezia thanks to the U.S. Government, which through USAID is supporting a number of initiatives in Italy, aiming at reducing the impact of the COVID-19 epidemic. USAID is the U.S. Government’s premiere development organization operating in more than 100 countries worldwide.

 

This press release is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Doctors with Africa CUAMM, recipient of the Fixed Amount Award (FAA) No. 7200AA20FA00013 and do not necessarily reflect the views of USAID or the United States Government.

Prevention and control for women in Mozambique

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In Mozambique, the screening program for uterine and breast cancer began in 2009 and in just 10 years it has reached 23% of all women of reproductive age. A result to be very proud of, obtained from a fruitful collaboration between the Ministry of Health and international organizations such as CUAMM that support services within the Health Units. Despite the good results, it is important to be aware that 77% of Mozambican women have never had a check up and do not know the risks associated with uterine cancer. Percentage that becomes much higher in rural areas of the country.

And it is with this awareness that CUAMM is promoting the project “Prevention and Control of Non-Communicable Diseases“, funded by the Italian Agency for Development Cooperation. Among the results it aims to achieve is precisely that of increasing the availability and quality of cervical diagnosis and treatment services in 3 regions of the country.

In the Sofala Province in particular, the effort was greater because most of the health units were destroyed by the violent cyclone IDAI that hit the Province in March last year.

In addition to the training and accompaniment sessions of the health personnel, it was therefore necessary to restructure the health units to create clinics where diagnosis and treatment services were guaranteed. In the small Health Centre of Mutua, located about thirty km from the city of Beira, the works were very urgent because the outpatient visits took place in a tent and the Centre also received the women of the adjacent refugee camp which houses about 800 families who they lost their homes as a result of the cyclone.

The Health Centre was enlarged and a new equipped and functioning clinic was created; the health authorities wanted the inauguration to take place precisely in conjunction with the closure of the awareness activities on uterus and breast cancer that the region carried out during the month of October. And, despite the necessary precautions to reduce the spread of COVID, all the main authorities did not fail to give their support to this important initiative.

The wife of the Governor of the Province wanted to speak on behalf of everyone: “Having uterine cancer does not have to be a death sentence and a health centre like this can prove it – she said – We are aware that many efforts still need to be made, but the role of each of us is fundamental for raising awareness of other women ”, she concluded.

She then thanked the CUAMM nurses who, as the Minister of Health said, work tirelessly every month of the year to improve the health of other women like them.

December 1: World AIDS Day In Africa young women are the most at risk

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Young people and women are the most vulnerable to HIV in sub-Saharan Africa. On World AIDS Day, on December 1, while the pandemic strains health systems around the world, Doctors with Africa CUAMM is making an appeal not to overlook the indirect effects of Covid-19 and remember the millions of people whose lives, in Africa as in the rest of the world, are still at risk from another virus and another epidemic that continues to kill without making news.

The World Health Organization (WHO) estimates that in 2019 there were 38 million people living with HIV in the world, 1.7 million new infections, and 690,000 deaths. Two-thirds of HIV-positive people (25.7 million) live in Africa and, according to UNAIDS — the UN agency working to end AIDS — 25% of new HIV infections in sub-Saharan Africa are young women between 15 and 24 years; 80% of HIV-positive people aged 15 to 19 in Africa are girls.

As young women are the most affected, we must start from them to stem the spread of HIV in Africa. Doctors with Africa CUAMM focuses on this with many actions in the countries where it works, including by offering tests and treatment in all the hospitals where it is active, training health care personnel, as well as promoting activism among HIV-positive women, as happens in Beira, Mozambique, with the Kuplumussana group (“women who help each other”) and adolescents of Geração Saudavel (“conscious generation”).

The pandemic has also changed how these activists work, but they have not been discouraged. In Beira, Mozambique’s second largest city, the young activists, can no longer make house-to-house visits and so started working in the new call center set up by Doctors with Africa CUAMM, to offer advice and support to HIV-positive patients at least by phone. Because of the restrictions required by the health emergency, tests fell by 49% between April and July and meetings in counseling centers open to adolescents by 41%, but since the initial fear has passed, numbers have been slowly returning to pre-Covid levels with 32,000 consultations and 7,000 tests per quarter.

“Epidemics are won by involving communities,” Don Dante Carraro emphasizes, explaining the problem and risks, highlighting the important role of the individual for the health of all. HIV, coronavirus, and Ebola are all viruses and epidemics that must be addressed globally, thinking as one community, taking care of our most vulnerable members, who are most exposed and most at risk. For this reason, though in Italy in recent months our thoughts immediately go to the coronavirus, we cannot lower our guard now on AIDS and let the pandemic make us lose the important progress made in recent years.”

MOTHERS WHO HELP EACH OTHER

In Beira, Mozambique, since 2005, the group of HIV-positive mothers of Kuplumussana (“women who help each other” in the local language), have been at the forefront of awareness-raising activities for other women, helping those who discover they are HIV-positive and showing them that a life without shame is possible. Often HIV destroys more than people‘s immune systems, hurting their social network too as women are marginalized and stigmatized.

Geração Saudavel (“conscious generation”) is the sister association for that of the mother-activists, who often have their children born with HIV. It brings together adolescents involved in raising awareness among their peers, with meetings in schools, counseling centers, marches, and street theater.

Among tradition and change being born in Capo Delgado

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“The first 1,000 days” project deals with future mothers and their children, from pregnancy to the first 2 years of life, in the rural districts of Balama and Montepuez, in the Province of Cabo Delgado, Mozambique. The intervention takes place at several levels: community, health centres and at the Montepuez hospital with the aim of increasing the demand for and access to quality health services, and reducing maternal and neonatal mortality. In particular, the project supports the maternity and neonatal wards and the operating room of the Montepuez hospital through health personnel (3 nurses, 1 doctor and 1 surgical technician), clinical assistance, medical equipment and disposable material. Refresher courses and training internships were held for the maternal and child health nurses of the two districts and the “health centre-community” link was strengthened with the involvement of the health committees of 30 villages.

In rural communities, the role of the traditional midwife is essential to encourage pregnant women to go to antenatal visits, to direct and accompany them to give birth in health facilities and to encourage them to go to check-ups after birth with their new-borns.

In this context, the “The first 1,000 days” project collaborated with the local health authorities to train 30 traditional midwives from 15 villages in the Balama district and 15 villages in the Montepuez district. In particular, traditional midwives have been trained to recognize situations at risk and complications in pregnant women and new-borns, promptly transferring patients with complications to health centres with specialized health personnel. The midwives were provided with: a telephone to alert the nurse at the health centre and request an ambulance, a flashlight, boots and raincoat to be operational 24 hours a day, in any season.

In the health area of Mirate, where the project trained 7 traditional midwives, in the first 10 months of the project over 40% of the women who gave birth in the health centre had been sent by traditional midwives. A really encouraging sign.

The intervention is part of the broader project “The first 1,000 days. Ensuring quality healthcare services for mothers and children in Cabo Delgado”, financed by the Italian Agency for Development Cooperation (AICS) and implemented by Doctors with Africa Cuamm with AIFO, Wiwanana Foundation and Centro per la Salute del Bambino Onlus (CSB).