13 Oct, 10 | by BMJ Group
Our story starts in March 2006.
Tayler Bequest Hospital is a beautiful looking building with a Cape Dutch exterior that concealed the true awfulness of what was seen there every day. When I arrived at 8am, a long queue already snaked out into the car park. People waited all day, most with HIV/AIDS related complications. The children’s ward was full. About 10 children had spent more time in the hospital than at home. Many had not been tested for HIV but the clinical signs spoke for themselves.
The children were wonderful; we made lots of young friends! One little boy seemed no longer than my stethoscope even though he was 5 years old. He was on oxygen, had spoon-like clubbed blue fingers and a barrel chest. He was taking anti-TB and heart failure medication. Despite his clinical condition he was leader of the gang and had the loudest laugh! He had been treated for TB several times but hadn’t improved. He was HIV positive and wasn’t going to survive the next year. “You could start him on ARVs,” we piped up. The suggestion was greeted with total misbelief that a child in such a state could ever survive.
Our mission was obvious: to build confidence, to teach about paediatric HIV care and how to practically use ARVs. We led workshops, tasted the medication with the staff, and reviewed the South African guidelines. Our parting shot was: “we’ll be back in 6 months.”
6 months later we arrived back on the ward. Where was he? Having started ARVs, our young friend was out of oxygen and running round the ward, giving orders and organising games with his mates. The doctor and the nurses had a skip in their heel that we didn’t see the first time we were there.
We visited Tayler Bequest every 6 months for 2 years until we realised we were no longer useful. Pearl and Graham, our B&B owners, gave us free board and lodgings. They introduced us, and we introduced the hospital, to Jenny, director at the local children’s home. A whole system grew: house parents at the children’s home were trained to give ARVs to the children, and a step-down facility to monitor children already on ARVs was created by the local community.
In March 2009 we touched base again. The children on the hospital ward had gone home. The staff at the hospital have become experts in using the treatment – the children’s ward is half empty and the ward doctor has been promoted to hospital director. It might be clichéd but it feels like a miracle. It’s a success story that other health care sites have not reached yet. Now we want these staff to volunteer for CHIVA Africa to help the others!
And whatever happened to our young friend? Steps are in place for his potential adoption into the USA. It’s an amazing story and the best thing is that it’s completely true.
Colin Ball is a consultant paediatrician at King’s College Hospital, London. He has been volunteering with CHIVA Africa since its inception in 2006 and co-coordinates the doctors group.