Fwd: Ebola hampers HIV/AIDS care in Liberia

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Chifu wa Malindi

Nov 21, 2014, 10:01:05 AM11/21/14
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From: IRIN <no-r...@irinnews.org>
Date: Fri, Nov 21, 2014 at 9:47 AM
Subject: Ebola hampers HIV/AIDS care in Liberia
To: Chifu Wa Malindi <chif...@gmail.com>

Ebola hampers HIV/AIDS care in Liberia

MONROVIA/DAKAR, 21 November 2014 (IRIN) - Ebola has crippled the
provision of treatment and care to people living with HIV/AIDS in
Liberia, according to health workers and patients.

"We cannot get treatment normally now because of the outbreak of the
Ebola disease in Liberia," said 36-year-old Jeff Thompson, from
Monrovia's Jallah Town, who was diagnosed with HIV in 2011. "Our care
centres are closed and all the health workers are scared to come to

There are an estimated 30,000 people living with HIV in Liberia,
according to UNAIDS.

Before the Ebola outbreak, more than 70 percent of them had access
treatment via 144 HIV/AIDS care centres scattered across the country.
But now, due to a shortage of health workers and fear about Ebola
transmission, more than 60 percent these facilities have shut their
doors, according to the National AIDS Control Program (NACP)

"My condition is getting worse by the day," a 43-year-old HIV-positive
woman in Monrovia, who declined to be named, told IRIN. "I used to get
treatment at the [St. Joseph's] Catholic Hospital, but the place is
closed down and now there is no way to get treatment. I think we
[HIV/AIDS patients] have been forgotten."

Home-based care

To help ensure uninterrupted care, save lives and prevent new
infections, NACP says they are now going door-to-door in Montserrado
County to either deliver antiretroviral drugs each week or else refer
people to mobile treatment centres to fill prescriptions.

"We have launched an outreach programme. because if we don't go out to
them then we will be having a disaster," said Sonpon Blamo Sieh, who
heads the NACP. "Our focus is to avoid reinfection and treatment
failure leading to death. We made a lot of gains [in HIV/AIDS
treatment access over the past 10 years], but if we are not mindful of
the gains, we will be dragged down again."

AAF has also been going door-to-door offering psychosocial and
counselling services to people living with HIV/AIDS, making sure they
take their drugs on time and trying to identify new patients.

"Our door-to-door treatment care is going very well," Sieh said.
"Right now we are reaching hundreds of our people who were taking
treatment at the care centres."

Disrupted services

While some HIV services are still offered at operational general
health facilities, many people say they don't know where to go or when
such treatment services will be available at which clinics.

"Right now, some of them want to give up because the normal centres
for treatment are not open," said Koffa Morris, director of the
Anti-AIDS Foundation (AAF) in Monrovia. "But we tell them not to give

For those who do still have access to HIV care services, some are too
afraid to enter a hospital or clinic for fear of catching Ebola.
Others report being turned away by health workers who mistake them as
suspected Ebola cases.

"In terms of diagnosis, the similarity and the conditions in question,
Ebola comes with fever, rashes and red eyes, just like HIV," Sieh
said. "And some of the health workers at the existing facilities are
afraid to treat the patients because of the lack of Personal
Protective Equipment materials at the centre."

Sieh said that denying care to people with HIV/AIDS or disrupting
their treatment not only negatively affects their health, but can lead
to drug resistance.

"Treatment failure is quite dangerous," he said. "And when it comes to
resistance for HIV, what that means is all of those patients will now
get on with maybe second-line drugs, which are most costly."

There is also a risk that Liberia could see an increase in the number
of HIV cases if care facilities are not functioning.

"The idea is that many people will not be identified who [could] be
HIV positive [and this] will lead to a multiplication of new cases,"
he said. "That is a serious problem."

An imperfect solution

Due to financial constraints, the outreach programme, which is both
time and labour intensive, currently only targets people living in
Montserrado County.

"Unfortunately, the home treatment programmes have been hit with a
lack of funds," Sieh said. "This is a serious bottleneck to the

While many patients have welcomed the door-to-door service, they say
there are also many challenges.

"I appreciate this new way," said Marlene*, a 45-year-old woman who
has been living with HIV since 2009. "But the only thing I don't like
about the house treatment is that other people get to know you are
HIV-positive. However, something is better than nothing."

The care centre she used to frequent also offered treatment for
malaria, tuberculosis and other diseases, so no one could tell what
you entered the clinic for, she explained.

Other patients complain about missed appointments from the
door-to-door service and late drug deliveries.

"I think they are grabbing the idea [of home-based care]," AAF's
Morris said. "The only thing is that most of the times their drugs are
not on time. There is often a delay in getting the drugs to the people
due to a lack of logistics and other funding, which are needed to
speed up the exercise."

Health workers have also raised concerns about mother-to-child
transmission, now that more women are giving birth at home because
home-based HIV care services aren't available to pregnant women.

NACP says it is working with the Ministry of Health and donors to
expand the programme nationwide. They are also working "around the
clock" to reopen some of the closed centres.

But for many, it may already be too late.

"His situation is terrible," said Matthew Sampson, the father of an
18-year-old with HIV. "Since the Ebola outbreak began, he has been
forgotten. [There is] no hospital to take [him to for] treatment. They
need to focus on them too," he told IRIN. "My son is dying slowly."

*Not a real name



This report online: http://www.irinnews.org/report.aspx?reportID=100869

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