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Burundi: Service Yezu Mwiza

The best practice presented by the Service Yezu Mwiza (SYM) is a mobile clinic for people with HIV that has led to increased rates of treatment adherence and of healthy children born to HIV-positive mothers. The mobile clinic team goes daily to villages in Bujumbura Rural, the province surrounding the Burundian capital Bujumbura, to offer a complete set of services to more than 1300 people with HIV and 2,585 orphans and other vulnerable children.

Started in 2008, the mobile clinic has proved to be an essential element of the services offered by SYM, a Jesuit organization that aims to foster “life to the full” among people with HIV and their families. Before the mobile clinic started, SYM saw people in the terminal stage of AIDS because they didn’t have enough access to medical care while others gave up on their treatment. Stigma was pervasive and many hid their HIV-positive status.

The regular presence in the field of the mobile clinic’s multi-disciplinary team – a doctor, nurse, psychologist, health mediator, nutritionist, a priest or a sister and a person in charge of income-generating activities (IGAs) – did much to change this unhappy situation. The team provides medical consultations and treatment, goes on home visits and gathers people with HIV for educational sessions about a wide range of topics, from how to manage an IGA, to adhering to treatment, to nutrition. The meetings are also an occasion for people to support and encourage one another. All the groups of people with HIV have started IGAs to increase their income.

The hard work of the mobile clinic has seen adherence to antiretroviral therapy (ART) among SYM beneficiaries increase from 64% to just under 100%. The number of uninfected children born to HIV-positive women has risen by nearly the same extent while the number of people suffering from deadly opportunistic infections has reduced considerably. And more people are now coming forward to disclose their HIV-positive status. Each county has a team leader who is in constant communication with SYM, and all those who need assistance are easily and quickly identified and approached.

The mobile clinic is in line with the client-centred approach of SYM, which prioritizes care for the most vulnerable and encourages people with HIV to take their destiny into their own hands. This entails equipping the people to be involved in their treatment and to become as self-reliant as possible.

The mobile clinic complements the other services offered by SYM, which is a recognized centre for the treatment of ART and TB, with a day clinic and a lab. The services offered by SYM fill a yawning gap in a province that was badly affected by Burundi’s civil war and that still suffers from a lack of adequate health facilities and trained personnel.