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Burundi: Working from the heart

30 April 2013 - Elizabeth was diagnosed with HIV 11 years ago. Her job is to help others live positively with the same virus that infected her, especially by following their antiretroviral treatment (ART) correctly. Meeting Elizabeth at her workplace, Service Yezu Mwiza (SYM) in Bujumbura, it quickly becomes clear that she is passionate about what she does.

“I’m very happy because I’m with my brothers and sisters and I can help them,” she beams. “We try to give all the information about treatment to help people live with their illness, to show them how to integrate HIV in their life, to learn how to take responsibility for themselves and to live well.”

Elizabeth and her colleagues leave nothing to chance: “Even if we don’t see patients here, we go to visit them at home to see what happened. But not many people miss out because we hold regular meetings.”

The director of SYM, Fr Désiré Yamuremye SJ, says Elizabeth “does her work from the heart”. The same can be said of the rest of the staff at Service Yezu Mwiza, which explains why this Jesuit-run project for people affected by AIDS manages to get so much done and to touch so many people through meaningful prevention and care activities.

Armed with a poignant motto, “We are people who want to live”, SYM reaches out to rural areas around the Burundian capital and in neighbouring provinces from its well-equipped base in downtown Bujumbura. As a recognised centre for ART and testing for HIV as well as TB, SYM runs a clinic and laboratory with a staff of doctors, nurses, pharmacists, animators and more. Thousands of people benefit from its activities.

Members of the SYM team go on outreach to dozens of village health centres. One typical educational activity took place on 14 February, when the psychologist, a health mediator, a nurse and an education officer went together to Kiriri to animate a meeting about adherence to treatment. Forty-eight people turned up to listen to the team explain, in easily understood language, the technical terms related to their condition and its treatment. The difference between viral load and CD4 was outlined, as well as the therapeutic reasons for measuring both. The equilibrium between the two was likened to weighing scales: the more the CD4 rises, the more the viral load diminishes and vice-versa.

The participants understood that compliance is a key factor in the success or failure of their treatment, which in turn will determine their quality of life. The more the patient adheres, the longer she will be able to take her initial drug combination without developing resistance to treatment.

The support offered by SYM goes far beyond medical care. The organisation prides itself in offering a comprehensive service that meets the multiple needs of people with HIV and their families: counselling, support groups, income-generating activities, prevention of mother-to-child transmission (PMCT) and much more.

Good news spreads fast. The glowing testimony of beneficiaries has led to heightened interest in the frequent prevention activities of SYM. More than 200 people attended a recent activity held in Mutumba parish on 13 March, not least because they had heard about HIV-positive women who gave birth to babies free of the virus after attending the PMCT program of SYM. The session focused on the epidemiology and transmission of HIV, testing and diagnostics as well as PMCT. Local SYM animators organised the meeting, choosing the materials, inviting support from the main office and using peer education – the methodology of choice of SYM – to get their message across.

The questions that participants asked evinced a lively interest, among them: At what age should the child of an HIV-positive woman be tested? Who is more exposed to sexual transmission of HIV, men or women? Why is it said that all pregnant women should do an HIV test, preferably in the first antenatal check-up? Why should all pregnant women with HIV go on ART? At the end of the meeting, the participants asked for another session for voluntary HIV testing and an appointment was fixed on the spot.

A call for testing also followed prevention activities held by SYM in three high schools in January. Many students asked for an HIV test and SYM responded by promptly mobilizing its staff for pre- and post-test counselling. Results were given the same day: 844 students were tested and one turned out to be positive.

Much remains to be done to defeat AIDS in Burundi, where 80,000 people are living with HIV and women bear a disproportionate burden of infection. But the tide is turning – latest UNAIDS reports note decreases in the HIV incidence rate, in AIDS-related deaths and in the number of newly infected children – and community-based endeavours like SYM surely have a large stake in this success.