Saving the Next Generation
December 24, 2007, GULU, Uganda —By David Snyder
GULU, Uganda — For Betty Ayaa, the joy of pregnancy turned into a nightmare one day in 2005 during a routine prenatal exam.
"I found out I was HIV-positive at the prenatal clinic. By then I was four months pregnant," Betty explains. "I thought I would deliver a baby who was infected, and I thought the baby would not even survive."
For the mother of eight living in Gulu, Uganda, the news came as a devastating blow. Her fears ran wild. How long had she carried the HIV virus? Would any of her other children also be positive? She thought immediately not only of her unborn child but also of her other young children.
"When I tested and was found positive, I thought of taking all of the children for testing," Betty says. "I was so worried."
Unfortunately, her fears were confirmed when her youngest child at the time tested positive. The news left her devastated but determined not to pass the virus on to her next child.
Fortunately for Betty, help was available. Soon after her test, Betty was told about a program designed to prevent mother-to-child transmission of the virus — called PMTCT for short. By taking powerful antiretroviral medications, Betty learned that a mother can dramatically reduce the likelihood of passing the HIV virus on to her infant. Better still, Betty learned that the medications were available at the local Lacor Hospital.
Ideally, pregnant mothers living with HIV are first tested to assess the current state of their immune system. Depending on results, they receive either two or three antiretroviral drugs in the last few weeks of pregnancy.
Newborns also receive antiretroviral medications to further suppress virus transmission. Based on services available at the given facility, newborns are then typically tested for the HIV virus after six weeks.
Mothers who enroll in PMTCT programs are also counseled on breastfeeding. In Northern Uganda, they are advised to exclusively breastfeed until their babies are 6 months old. While breastfeeding carries some risk of transmission of the HIV virus from mother to child, in many settings it is the recommended practice due to concern over infants falling ill from drinking formula mixed with untreated water. Some mothers living with HIV, however, choose to use infant formula when they can both afford it and prepare it properly.
Lacor Hospital's PMTCT program has shown the combination of such counseling and antiretroviral treatment to be highly effective. Of the 450 infants enrolled in the program in November 2007, only 5 percent have contracted the virus — a huge drop from the 30 to 35 percent expected to contract the virus otherwise.
Lacor Hospital, as well as 18 other treatment facilities in Uganda, are now providing additional HIV services through AIDSRelief, a consortium of five partners funded by the U.S. President's Emergency Plan for AIDS Relief. Led by Catholic Relief Services, the consortium provides antiretroviral treatment and other care to people living with HIV in nine countries in Africa, Latin America and the Caribbean. In Uganda, this is good news for the more than 62,420 people receiving general care and more than 20,785 patients receiving antiretroviral treatment from AIDSRelief, including Betty and her child living with HIV.
In the case of Immaculate — the name Betty gave to her newborn — the news is also good: He tested negative for the HIV virus. Although additional tests will need to confirm that result in coming months, he seems to represent one small victory in the war on AIDS in Uganda.
David Snyder is a photojournalist who has traveled to more than 30 countries with CRS. Most recently, David visited country programs in southern Africa and East Africa, including Uganda.