Cot­lands gives hope to HIV-pos­i­tive chil­dren

330 000 are in­fected and only 160 000 re­ceive an­tiretro­vi­rals, says 2010 UNAids re­port

Weekend Argus (Saturday Edition) - - NEWS - SARAH MARCH­MONT

COT­LANDS staff lit 10 can­dles this week at their an­nual me­mo­rial ser­vice on World Aids Day.

Seven can­dles were to com­mem­o­rate the seven years they’ve been op­er­at­ing in Som­er­set West as a non-profit or­gan­i­sa­tion that cares for many HIV/Aids in­fected chil­dren in a res­i­den­tial hospice set­ting, as well as sup­port­ing other HIV-pos­i­tive chil­dren in the com­mu­nity through their home-based pro­gramme.

Three more can­dles were lit in me­mory of the chil­dren in their care who died this year. All three chil­dren were HIV pos­i­tive, and two died from measles-re­lated com­pli­ca­tions.

It’s not the virus that usu­ally takes the chil­dren’s lives, but an­other ill­ness they con­tract be­cause their im­mune sys­tems are so low, said Cot­lands project man­ager Mon­ica Bui­tendag.

In the hall­way of Cot­lands’ hospice – which cares for up to 30 chil­dren from in­fancy to the age of two – is a wall of re­mem­brance for the nearly 40 chil­dren who have died there.

But they’ve cared for nearly 900 chil­dren in that time, and many of them are liv­ing healthy lives back in their com­mu­ni­ties un­der the watch­ful eye of Cot­lands’ home-based care staff who en­sure the chil­dren are con­sis­tently re­ceiv­ing their an­tiretro­vi­ral ther­apy.

Gen­er­ally, over 50 per­cent of the chil­dren in Cot­lands’ res­i­den­tial care are HIV pos­i­tive, says so­cial worker Ma­ri­etjie Turck. All 86 of the chil­dren in the home-based pro­gramme are on an­tiretro­vi­rals.

Be­yond the hospice for the youngest chil­dren, Cot­lands also tem­po­rar­ily houses two-to six-year-olds, but those chil­dren are gen­er­ally health­ier and are at the chil­dren’s home for other rea­sons.

Through­out South Africa, of all peo­ple tested, 330 000 chil­dren are HIV pos­i­tive and 160 000 of them are re­ceiv­ing an­tiretro­vi­rals, ac­cord­ing to this year’s UNAids re­port on the global epi­demic.

If these chil­dren are able to con­tinue their treat­ment, they can of­ten live full life spans.

Cot­lands ser­vices the whole of the Western Cape, and it all started with this hospice seven years ago on World Aids Day in 2003.

One very sick, HIV-pos­i­tive four-year-old girl was ad­mit­ted; her mother had al­ready died from Aids. Her fa­ther was alive, but he was car­ing for his other chil­dren. Cot­lands found a spon­sor for the child’s med­i­ca­tion, and she started mak­ing an in­cred­i­ble re­cov­ery.

To­day she is a smil­ing 11-year-old liv­ing with her fa­ther.

“That’s why we know what we’re do­ing here makes a big dif­fer­ence,” said Heidi Hes­keth, Cot­lands spokes­woman.

They opened their fa­cil­ity about the same time as the govern­ment’s an­tiretro­vi­ral roll­out plan started.

Be­cause the chil­dren are now liv­ing longer thanks to the drugs, Cot­lands is ex­pand­ing its out­reach to the com­mu­nity, which fo­cuses on mak­ing sure chil­dren get their med­i­ca­tion once they leave Cot­lands, Hes­keth said.

Cot­lands isn’t a long-term res­i­den­tial fa­cil­ity, so chil­dren stay for up to a year be­fore be­ing re­turned to their com­mu­ni­ties, placed in fos­ter care, or with a care­giver, or are adopted.

One of the chal­lenges HIV­pos­i­tive chil­dren face is un­der­de­vel­op­ment, which is a side­ef­fect of the med­i­ca­tion.

Be­cause these chil­dren are liv­ing longer, but are be­hind de­vel­op­men­tally, Cot­lands helps pre­pare them for main­stream school­ing once they leave.

An­other chal­lenge is stick­ing to the med­i­ca­tion – mak­ing sure the chil­dren re­ceive ev­ery dose at the right time – and that’s where Cot­lands’ home­based care staff try to help.

The care­giver is re­spon­si­ble for get­ting the med­i­ca­tion from a clinic, but some­times the par­ents are ill and they can’t get to the clinic, Hes­keth said.

Some­times neg­li­gent par­ents may for­get to give the chil­dren the medicine, and some­times the chil­dren vomit up the medicine and par­ents don’t know what to do.

Home-based care co-or­di­na­tor Michelle Machelm said they needed to go out to check drug ad­her­ence ev­ery month, or some care­givers wouldn’t be ef­fi­cient in giv­ing it.

Bui­tendag said if HIV-pos­i­tive chil­dren got an­tiretro­vi­rals, “they get a sec­ond chance and they get to live life a lit­tle longer”.

But with­out the med­i­ca­tion the pic­ture was grim.

Be­fore an­tiretro­vo­rals were avail­able, most HIV-pos­i­tive chil­dren died be­fore the age of nine, and many died be­fore they were six months old.

Ac­cord­ing to the UNAids re­port, South Africa is one of the few coun­tries where child and ma­ter­nal mor­tal­ity has risen since the 1990s, with Aids be­ing the largest cause of ma­ter­nal mor­tal­ity and also ac­count­ing for 35 per­cent of deaths in chil­dren younger than five.

How­ever, mother-to-child trans­mis­sion is on the de­crease. In South Africa, of the 83 per­cent of HIV-pos­i­tive women who have re­ceived an­tiretro­vi­rals, only 16 per­cent of their chil­dren are bor n with HIV.



HELP­ING HAND: One of the chil­dren who lives at the Cot­lands Chil­drens Home in Som­er­set West.

HOPE­FUL: One of the ba­bies at the Cot­lands Chil­drens Home.

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