Washington, D.C. — The Coptic Mission in Africa has operated the Coptic Hope Center, a comprehensive HIV health facility, in Nairobi since 2004. The facility, which has been very successful in providing the poor with access to care, is quickly reaching its capacity.
The program currently has about 6,000 patients enrolled, of which about 3,400 are on free anti-retroviral drugs. In 2006, the program expanded so quickly that the Church opened three more clinics.
Bishop Paul [as he is referred to in church protocol], Bishop of Mission Affairs for the Coptic Orthodox Church, and Nadia Kist and Mary Andrawes of the Coptic Hope Center, spoke with allAfrica.com about their work and the challenges they face.
Tell me a little bit about what you do in Nairobi.
Bishop Paul: We mainly work on health programs, like hospitals and HIV centers. We also have other projects with orphans, children, and widows.
Nadia Kist: The Hope Center for Infectious Diseases is a comprehensive HIV management program that's a specialized HIV clinic within the Coptic Hospital in Nairobi, Kenya, which is the mission's medical facility.
The Hope Center is the culmination of a lot of work that the mission has been doing concerning HIV for many years related to spiritual relief, humanitarian relief, and medical support. The Hope Center is a Pepfar [the United States’ President’s Emergency Plan for Aids Relief]-supported program that was established in 2004, initially as a small clinic that was the initiative of the Coptic Mission, with no external support. In 2005, it expanded to a fully comprehensive and fully free program on a much larger scale with the Pepfar funding.
The Hope Center provides a full range of medical services related to the management of HIV or Aids - medical consultations, anti-retrovirals [ARVs], and treatment of opportunistic infections, as well as lab testing that includes CD4 counts [a measure of immune system strength], and viral load testing. We also have a full range of psychological counseling, social work services, nutritional counseling, and food supplements. It's very diverse - we have programs catering towards women and the prevention of mother to child transmission, anti-natal and delivery care, and cervical cancer screenings. It's a very comprehensive all-in-one type of medical facility, specifically for people who are HIV-positive.
We are specialized in counseling people who are living with HIV/ Aids. The same is true for the medical doctors and clinicians. Some are pediatric specialists and some are adult HIV management specialists and it's completely free.
About 80 percent of [patients in] our clinic are earning less than 45 dollars a month, so they are really living hand-to-mouth. And being able to access medical services this comprehensive and of this quality is virtually impossible for any of them, at least in any ongoing nature.
For us, the clinic is a place that is not "come and you leave," but a long term medical care program. Right now in Nairobi we have just fewer than 6,000 patients enrolled, of which about 3,400 are on ARVs. In 2006 the program expanded so much and so quickly, that we opened three daughter clinics. That was after the first year that our program was running, so as we were entering the second year, we opened three additional clinics. Two of them are also within Kenya catering to different populations. One is in the remote rural area of Maseno, the other one is in an industrial area just outside Nairobi, and the third is in Lusaka, Zambia at the Coptic hospital there. It's really grown very rapidly in terms of the types of services we are offering and the amount of people we are reaching.
What about your involvement with the Church? What element of religion comes into the care given at the facility, the counseling, and the like?
Bishop Paul: We offer Christian counseling, but we have a lot of Somalis and non-Christians there. We welcome and counsel them, but we don't force Christian religion upon them because they are coming to be treated. But the care and love touch people very much and every one says this center has love.
Do you do any prevention work, or is it all treatment and counseling?
Nadia Kist: Yes, we engage in different aspects of prevention work in the clinic. There are two main points of entry. One is through VCT [Voluntary Counseling and Testing] where people can access rapid testing and counseling, pre- and post-knowledge of their results. In those sessions the prevention messages are always delivered, both for people who are positive and people who are negative because we recognize that people who are negative need to know how to remain negative and at the same time people who are positive should also know how they can prevent both re infection and transmission.
We also have the clinic for people who are already HIV positive, [who] already know their status and are just joining the clinic for the management of their health.
There is a third element of prevention work - a community outreach and training program, where we are going out into the community to schools, organizations, companies, faith based institutions, - a variety of types of organizations - and we do outreach work [teaching people about] what options are available for people who know they are HIV positive and how to support people when you find out that they are positive, psychologically and socially.
Do you receive any funding from the Kenyan government?
Nadia Kist: We receive in-kind support from the Kenyan government, so we are a partner and we are active participants with work that is happening in the country nationally with the Ministry of Health. They support us with free test kits for our VCT, and some generic ARVs.
What are some of the greatest challenges that you face on a day-to-day basis?
Bishop Paul: We are really fighting to expand the center. There are no places for patients; it is overcrowded and we've used all available space. We started to put tents outside in the garden—outside and with the rain.. We been challenged to double our capacity – highlight figures somewhere… by mid-2007 we should reach 9000 patients. By the end of the year we should reach 12000. The medicine is there, everything is there, but the problem is space. So we are fighting. Who can help us to expand the place so that we can help more people?
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Do you face any particular challenges with children seeking care or who are not able to access care because of stigma in their families?
Mary Andrawes: We have other community support projects, and among those are programs for children. One of our biggest programs is our orphan project in western Kenya, a region with a very high prevalence of HIV. We support children in their relatives' homes or we place them in homes where they can be in a family setting. These families might not have been able to care for these children because it's very expensive for them to take them in, but we support them financially and provide spiritual and emotional support. We pay for the children's school fees and we pay for their medical fees.
We also work with street children and train in a certain skill or something else that will allow them to support themselves.
Bishop Paul: From this March we will open our first pediatric HIV center in Zambia and by mid-2007 we'll also open one in Kenya. It will be the first program in Africa caring for children that will give them a place to play and gardens so that they are not coming to hospital to be fearful, it will be more like a home place or a club for them.
