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Church agencies battle spread of HIV from mothers to babies

Dec. 1, 2005

NOTE: Photographs, video and related stories are available at
http://umns.umc.org.

By Kathy L. Gilbert*

Mena Damodharan became a bride at 19 and a mother at 20, but she
probably won't live to celebrate her child's 7th birthday.

The marriage that was supposed to save her became a death sentence after
she became pregnant and found out her husband had AIDS. The doctors at
Christian Medical College in Vellore, India, were able to save
Damodharan's child from contracting AIDS, but they do not have the drugs
or money to save her.

Through the United Methodist Committee on Relief and the United
Methodist Board of Global Ministries, critical work is being done to
save the next generation from being born with HIV. But the question of
saving the mothers so they can raise their children is still a struggle,
says Cherian Thomas, an executive with the health and relief unit of the
board.

Saving the babies

The use of the drug Nevirapine has been shown to dramatically increase
the chances a baby will be born without AIDS, Thomas says. The board has
been trying to start programs that encourage the use of Nevirapine in
several countries.

A workshop on the drug's benefits was held in Zimbabwe two years ago,
and as a result, a Canadian agency based in Harare agreed to fund the
work at three United Methodist hospitals in Zimbabwe - Nyadire, Old
Mutare and Mutambara.

The United Methodist Chicuque Hospital in Mozambique has also used
Nevirapine but has had to suspend the program because the drug is not
available from the government at the moment, says Jeremias Franca,
hospital administrator. In Mozambique, the government controls all
drugs, and there is no private health care.

"Nevirapine will not be available for the rest of the year," Franca
said. "The government has promised a good supply, and we hope to start
the program again without stopping in January."

"There is a 30 percent chance that an infected mother will transmit the
virus to her newborn, and this is halved when one dose of Nevirapine is
given to the mother at the time of delivery and one dose to the baby
after birth," Thomas said. "The rate is reduced further if Nevirapine is
combined with AZT."

In 2004, around 640,000 children under 15 became infected with HIV,
mainly through mother-to-child transmission, according to recent reports
from world health agencies. About 90 percent of these infections
occurred in Africa. The AIDS crisis in India is growing and is second
only to that in Africa.

The World Health Organization reports that in the absence of any
intervention an estimated 15-30 percent of mothers with HIV will
transmit the infection during pregnancy and delivery, and 10-20 percent
through breast milk.

In high-income countries such as the United States, mother-to-child
transmission of AIDS has been virtually eliminated because of voluntary
testing and counseling, access to antiretroviral therapy, safe delivery
practices, and the widespread availability and safe use of breast-milk
substitutes. If these interventions were used worldwide, they could save
the lives of thousands of children each year, the World Health
Organization reports.

At Chicuque Hospital, Jeremias Franca knows the importance of educating
women about the risks of AIDS and pregnancy.

"We want to mobilize pregnant women to come in for testing," Franca
said. "But the dilemma then is once the baby is born, what happens
next?"

Once the baby is born, the chances are high that it will get AIDS from
the mother's breast milk, he said. Mothers are not encouraged to use
baby formula because "we know they will not use it."

"Now you have two people needing AIDS treatment; these are the things we
are dealing with. Only prayer can answer these questions."

Thomas said in many countries such as Mozambique the lack of safe
drinking water gives mothers no choice other than breastfeeding. "If you
give the baby water that is contaminated, then the baby gets diarrhea
and dies."

"Most people do advocate breastfeeding," he said. "In Africa, there is a
stigma that after you give birth and you do not breastfeed and you use
formula that means you have HIV, so mothers don't want to do that
either."

An initiative that was launched on World AIDS Day two years ago - Dec.
1, 2003 - to provide antiretroviral treatment to 3 million people living
with AIDS in developing countries by 2005 has not been met, Thomas said.

"Just about a million are being treated, and 2 million are not getting
the drugs at all. That includes women who are HIV-positive," he said. "I
don't see any immediate solution."

The annual report published by the Joint United Nations Programme on
HIV/AIDS and the World Health Organization found, despite decreases in
the rate of infection in certain countries, the overall number of people
living with HIV has continued to increase in all regions of the world
except the Caribbean.

In 2005, there were 5 million new infections. An estimated 40.3 million
people, up from 37.5 million in 2003, are living with HIV globally. More
than 3 million people died of AIDS-related illnesses in 2005; of these,
more than 500,000 were children.

Once the drugs are administered, a certain amount of follow-up needs to
be done, and that is "pretty weak in Africa and in other countries where
the virus is rampant," Thomas said. "Basic infrastructures need to be
improved."

Chicuque has recently built and devoted extra space to testing,
educating and counseling pregnant women with AIDS. Once a woman tests
positive, Franca said, she is put on a program to receive treatment for
the rest of her life.

"Counseling before testing, post-testing when they test positive ... all
this takes a long time," he admits. Another complication in Mozambique
at the moment is a drought that is making it difficult for people to get
basic nourishment.

"We have on average 165 births a month, and the numbers are increasing,"
he said. "We also have a program of distributing mosquito nets to each
newborn." The program is not only preventing malaria, it is also
encouraging women to come into the hospital to have their babies.

"I think it is good that we continue and get support on mobilizing many
expectant mothers to come to the program. Many don't come to the
hospital for delivery. We need to get them to come to the hospital."

Saving the mothers

Columbia University in New York is working on a program called MTCT
Plus, Thomas said. The mother-to-child-transmission program advocates
specialized care to HIV-infected women, their partners and their
children.

The MTCT-Plus Initiative was established in 2002 to address the
treatment and care of HIV/AIDS in resource-limited communities. It was
created in response to the U.N. Secretary General's Call to Action and
coordinated by the Mailman School of Public Health at Columbia
University.

This care includes a comprehensive list of services, including
psychosocial, nutritional, and adherence counseling; peer support;
infrastructure development; antiretroviral procurement; staff training;
and monitoring and evaluation services. MTCT-Plus supports 13 sites in
nine countries in sub-Saharan Africa and Asia, with more than 8,000
individuals enrolled in HIV care and treatment to date.

For women like Damodharan, help is needed soon. Her grandmother gave her
in marriage as a second wife to a man she thought would look after her.
The man knew he was HIV-positive when he took Damodharan as his wife,
doctors at Christian Medical College said.

"We did a Caesarean section and followed up with the baby, who was born
negative," said Dr. Jessie Lionel. The doctors are trying to help
Damodharan, her grandmother and the baby by giving them their own money.

A neonatal service and scholarships for Christian Medical College are
supported by the United Methodist Church's second-mile giving program,
the Advance for Christ and His Church, through the Board of Global
Ministries.  Donations can be made by check and designated for Advance
#12435 or #09952.

Contributions to Chicuque Rural Hospital may be sent through a local
United Methodist church, annual conference or by mailing a check to
Advance GCFA, P.O. Box 9068, GPO, New York, NY 10087-9068. The check
should be written to "Advance GCFA" and designated for Chicuque:
Hospital Revitalization, Advance #09734A on the memo line. Call (888)
252-6174 to give by credit card. For more information visit the Advance
Web site gbgm-umc.org/advance <http://www.gbgm-umc.org/advance> .

Global AIDS Fund

The United Methodist Church wants to raise $8 million in the next four
years - $1 for every U.S. member - to help fight the global HIV and AIDS
pandemic.

A resolution passed by the 2004 General Conference, the denomination's
legislative assembly, called for the creation of the United Methodist
Global AIDS Fund to be used to support programs offering HIV and AIDS
education, prevention, treatment and care services in the United States
and around the world. The resolution also established the Global AIDS
Fund Committee to oversee the fund.

AIDS is the fourth leading cause of death in the world. Seventy percent
of the estimated 40 million people living with HIV are in sub-Saharan
Africa. About 600,000 children each year are infected, and 14 million
have been orphaned due to parents dying of AIDS.

Anyone interested in giving to the Global AIDS Fund can contribute
through their local United Methodist church or send gifts to UMCOR
Advance #982345 Global AIDS Fund, P.O. Box 9068, New York, NY
10087-9068. Credit-card donors may call (800) 554-8583. One hundred
percent of contributions will go directly to AIDS programs.

*Gilbert is a United Methodist News Service news writer based in
Nashville, Tenn.

News media contact: Kathy L. Gilbert, Nashville, Tenn., (615) 742-5470
or newsdesk@umcom.org.

********************

United Methodist News Service
Photos and stories also available at:
http://umns.umc.org

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