Chris Mbunwe
4 December 2008
interview
In this exclusive interview, Professor Pius Muffih Tih, Director of Health Services Cameroon Baptist Convention, CBC, harps on the efficacy of the anti-retroviral drug which is now free of charge, in restoring hopeless cases of AIDs infection back to normalcy. He says they are currently handling over 5,500 HIV/AIDS patients in the Northwest Region and they have gone further to introduce "Contact Tracing" to track the spread of HIV/AIDS and possibly break the chain of its transmission, besides trying to get prostitutes (high-risk) group to go back to school, regroup other sex workers in gainful activities with the view of employing them very soon.
The Post: How far have you gone with the fight against the HIV/AIDS pandemic and what are the challenges?
Prof. Pius Muffih Tih: We started by educating the people on how they can prevent the disease from ravaging lives. Then we progressed to pregnant women, insisting they that must take niverapin to prevent transmission from mother to child.
What new component would you say you have added to sensitisation campaign?
We brought on board men as partners in the prevention of the HIV virus in the community. We sensitised men because they play a leadership role in their homes and in the community where they find themselves.
So, we did what we call "men as partners' map," by training them to understand the disease well and to be able to train their family members, train those in "njangi" groups so that they may take the lead in the prevention of the spread of HIV in the communities. We also intensified treatment and care.
How do you go beyond just sensitising the people?
The Cameroon Baptist Health Board has five HIV/AIDS treatment centres where people tested HIV positive and who have fulfilled the criteria for treatment are placed on anti-retroviral treatment, ARV. Once a person is placed on ARV, the person regains his/her health and is able to function normally in the society and sometimes it reduces even the viral load in the body down to a minimum, such that you may almost not detect it in their blood when an AIDS test is done.
So we have intensified treatment as long as ARVs are available. Now that the Ministry of Public Health has declared that ARVs are free, we are encouraging everybody to get tested and we do their CD4 counts and if the CD4 counts drop too low, and we estimate that you have met the treatment criteria, we place you on treatment.
We, again, came up with another strategy which the CBC Health Board calls Contact Tracing or Partner Notification. This is a health strategy that started way back in 1946 in England where those who had syphilis, once they tested positive, they were asked to trace their positive syphilis partners and bring them back to the clinic.
How is CBC Health Board doing it here?
We are applying that strategy by dialoguing with HIV-positive people to bring along their sexual partners. When they bring them, we go right into the community where they hail from and tell the people there that they are exposed to HIV. They may ask 'how do you know that I am HIV?' We tell them we are under oath not to tell on whoever informed us that they are exposed.
We tell them that they are not infected, but simply that that they are exposed to what causes AIDS, which is HIV. So, they better test themselves and in case they are still fine, they will try to avoid their sexual partners because one of them is infected. If they are already infected, they should know how to live with the infection, either by going for a CD4 count or at least try to live with it positively.
That is what we call contact tracing. We have trained many health advisers whom we have sent into various communities. They are educating the masses.
Why Did you introduce this contact tracing?
Because the moment you are highly infectious, you can infect many people within the very acute phase of that infection within the first days, weeks and months when your viral load is very high. That is why we are trying to break the chain of transmission by telling people who went out with somebody who has been living with the virus not go out with any person, but rather go get tested.
If you are free from it, thank God don't go out with any person you have gone out with in recent times. If you are not free from it, please know how to live with it and not pass it on to other people. We believe by this method we will break the chain of transmission of HIV/AIDS very easily.
How many people have you on the Contact Tracing list so far?
We have more than 300 persons and they have given us the chain; that is further contacts. The first person we tested, we called the index patient. So those 300 persons, some of them have named two, three, six and we have contacted more than 400. So in all, we are dealing with more than 700 people we have contacted and we are very happy with their responses.
It is not easy tracing these people. Let me tell you that all my health advisers including myself are under oath, never, never to tell anybody no matter the circumstances that you A or B is positive. No. Our third strategy has to do with sex hawkers. We are aware that people shun them. Many of them have been pushed into this old trade for various reasons.
We have reached out and talked to them. We are working with many of these prostitutes in town here. They are more than 80 and they are very happy and open. We have sent a good number back to school, while others are learning a trade to survive. Our intention is to empower them so that they are able to live more positive and purposeful lives without going back to prostitution where they may contract AIDS and die.
Since you started this fight against HIV/AIDS, how many patients have CBC recorded?
First, it may interest you to know that CBC has five hospitals, 23 health centres, 40 primary health centres. On HIV/AIDs treatment, we have had 5,500 individuals who are receiving treatment in the three treatment centres in the Northwest Region. The three HIV/AIDS treatment centres of the CBC are in Mbingo, Nkwen and Banso Baptist Hospital BBH. Concerning the number of women who have passed through our clinics for the prevention of mother-to-child transmission, they are in the hundreds of thousands since 2000.
How many HIV support groups do you have?
We have close to 5000 men and women who dole out nutritive education and other health talks on how to live healthy lives. Some of them are married and some have babies free of HIV. It is really wonderful.
Have you at any time terminated the contract of a worker or denied employment to persons tested HIV positive?
I will regret that act of 1999, because I remember it was like if you keep HIV-positive people in your hospital or health centre, it would cost you a lot, which means you are going to drain your resources trying to treat them or take care of them. So in 1999, we were tempted to say since you are positive we could not employ you. That is a thing of the past. We cannot today discriminate somebody by virtue of his/her HIV status.
Whether you are positive or negative, we will employ you, but at no time in our service did we ever say a staff who was already employed should be terminated because he/she was positive. We have never done that and we don't hope to do that at all. Rather, we give those who are positive the care they need.
Our workers have gone ahead to create a fund which they call "Support Health Care Worker" and all our workers contribute to that account. It has over FCFA 15 million in its account. If a staff falls sick at any time, that staff is fully supported from the fund.
Have you received any support from government?
The Ministry of Public Health supported us by authorising the five treatment centres which the CBC Health Board is running. In addition, they gave us support in our prevention of mother-to-child technically like the protocol under the Global Funds; government reimburses us in the five treatment centres just as they do to government treatment centres. As for opportunistic infections and taking care of staff, we bear the burden.
How much would treatment cost?
In the neighbourhood of FCFA 3,000. We are hoping to increase it to a little bit to about FCFA 5,000 because it is becoming very expensive to take care of opportunistic infections to administer care and treatment throughout because the government doesn't take care of everything.
Any hope in view?
Yes. You see, when we started this thing in 1999, anti-retroviral drugs were only available in the West and were very expensive, but now they are right here with us in Africa and free for everybody. I am pleased to inform you that one of the patients living with HIV/AIDS just surprised all of us because her CD4 count had gone down to 79, too low that even if it were 100, you would expect that the patient should die.
I will tell you that now her CD4 count has gone up to 1014 even higher than some of us here. You cannot detect even the HIV virus in her blood again. We are very surprised and happy for this result. So the hope we have is that there are ARVs, though we are using mostly the first line treatment, second line treatment is already available.
We may have even third line or other alternatives that may be more effective and can actually restore the health of the individuals almost to completion and so we have the hope that drugs will be available and for everybody. The second hope is that any person who is infected with HIV doesn't mean that they are automatically out of God's plan. The third is that ARVs are available to almost everybody in the West who is infected.
However, out of the people placed on treatment world wide, 95 percent are in the West. Yet, out of the 33 million people living with HIV, 22 million are in Africa south of the Sahara, which means that even in Cameroon there are so many people; the drugs are free but not accessible to everybody.
We also hope that leadership in Cameroon will be more proactive in seeing that every person that needs treatment criteria is placed on treatment. Our advice is that everyone who enters the health unit be tested for them to know their status.
Tuesday, 02 December 2008 at 06:54 AM in HIV/AIDS, Interviews | Permalink
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