annie in swaziland

Day 7:

Today the girls went off with Kait on safari in hopes of seeing Lions and Tigers and Bears, oh my!… okay, well at least maybe the first one or two.  I’ve been to Hlane Royal National Park so many times that I decided to stay back and get some work done.  I met with the Clinton Health Access Initiative (CHAI) and it was very interesting and informative!  As it turns out, the country – and many of the NGOs (nonprofit organizations) – spend most of their HIV funding on PMTCT (prevention of mother to child transmission) as does Baylor’s Pediatric HIV center.  This is at the expense of vital programming for preventing adolescents from contracting the disease.  They said the median age for girls to start becoming sexually active is 15 years old nationwide.  And girls aged 15-25y have a much higher prevalence rate than boys of their age group (38% in girls!!) due to the fact that they commonly have sex with older men who are able to make empty promises of becoming their providers. This is the most vulnerable group with the highest infection rate in the entire country!  A major CHAI program, funded by the Dutch, aims to minimize adolescent transmission rates by conducting HIV prevention programming geared toward teenaged girls. 

The other main topic I learned from the conference was that now in Swaziland they are hoping to start treatment when an HIV victim reaches only 500 T-cell count (a measure of their immune system drop due to the HIV virus) rather than the usual 350 T-cell count after a suggestion made by the World Health Organization (WHO).  In my opinion, this creates multiple additional challenges for the tiny country.  When I first started working here in Swaziland 7 years ago, they didn’t start patients on drugs until they reached the 200 level.  This was difficult for the patient because at the 200 level, the patients are experiencing full-blown AIDS and they are very susceptible to opportunistic infections (like TB) that will kill them due to their extremely reduced immune system. But, by waiting until patients reached this level, the country had enough medication for all HIV positive patients seeking treatment AND the patient hypothetically had that much longer to live before they developed resistance to the only 2 lines of drugs available here in Swaziland and inevitably died.  Then, a few years later, they said anyone who hit the 350 mark could receive free treatment.  And commonly in the last few years, we have heard Baylor complaining of drug shortages.  This is a major detriment to people on ARVs (HIV medication) because while they are waiting for drugs, they are more likely to develop a resistance to them once they become available again.  I can only think that by offering ARVs to even more patients by increasing the drug administration limit to 500 T-cell count, that it will exacerbate the problem of inadequate supply of drugs and increased resistance to the drugs that are available.  Hopefully a third line of drugs becomes available to Swaziland very soon.  Until then, I am not sure what the “answer” is but I will continue to pray for our precious Mazwi and talented Sharon who have been living with this wretched disease since birth.  

I cannot believe that our first volunteer’s time is almost over! Tomorrow Kait will drive them back to Johannesburg and pick up the next team (Maureen, Catherine and Alina – we are very excited to see you!).  Thanks for your support of Give Hope, Fight Poverty… we could not do any of this without you.