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Local Church Group Takes Reins of HIV Care

By Kim Pozniak

Nine months' pregnant and in labor, Rose Muleya sat painfully on an old bicycle when she started from her home in rural Zambia to the nearest clinic. Over dusty, bumpy roads, it took Rose and her husband, Glandwell, half a day to get to Chikuni Mission Hospital in Monze District, Zambia, the closest facility where she could safely give birth to her sixth child. After some complications, exhausted and in pain, Rose delivered a healthy baby boy. What's more, Glandwell Junior was born without HIV.

Glandwell Muleya with his son

Because of the HIV care and counseling Glandwell Muleya, right, and his wife—both HIV-positive—received at one of Zambia's AIDSRelief facilities, their youngest son, Glandwell Junior, left, does not have HIV. Photo by Kim Pozniak/CRS

Rose and Glandwell, both HIV positive, had lost two children to AIDS-related illnesses. But despite their traumatic losses, and their HIV, they wanted another child. That's when they went to the Bunyina Center for help.

"Bunyina," which means "together as brothers and sisters" in the local language, is an HIV testing and treatment facility at Chikuni Hospital. The center is supported by AIDSRelief, a Catholic Relief Services-led consortium funded through the President's Emergency Plan for AIDS Relief to bring lifesaving HIV care and treatment to hundreds of thousands of people.

At Bunyina, Rose and Glandwell learned how to prevent their baby from getting HIV, and Rose started special antiretroviral treatment.

'Not the End of Your Life'

The services the Bunyina Center provided to Rose and Glandwell during her pregnancy with their now 3-year-old son are among others made available through the AIDSRelief consortium. Bunyina also trains volunteers to do home visits and check on those who have HIV to ensure that they adhere to their medicine regimen. Volunteers can also treat people for minor illnesses. "The home-based care must continue," explains Glandwell, who has benefited from the program. "It has really helped us, because volunteers come to our home and we want them to continue because they help us."

Built in 2007 with funds from CRS and AIDSRelief Zambia, Bunyina combines critical HIV and AIDS services, including HIV testing and treatment, client counseling, lab analysis and financial and medical record management. With 11 satellite clinics throughout the center's service area, and more than 80 trained volunteers to deliver home-based care, Bunyina has become a lifesaving hub for the dozens of communities it serves.

"We are very grateful for what AIDSRelief has done," says Claudia Caracciolo, the only doctor at Chikuni Hospital. "We especially recognize that, without AIDSRelief, our work in HIV and AIDS and our ability to provide good services would not be possible." For example, through the provision of electricity, which is part of the AIDSRelief support the clinic receives, "we have improved the quality of care of our [antiretroviral therapy] program," says Dr. Caracciolo.

To date, AIDSRelief has brought lifesaving care and treatment to more than 600,000 people in 10 countries since it began operating in 2003.

Claudia Caracciolo with Rose Muleya

Rose Muleya, right, who receives HIV care and treatment at Chikuni Hospital, an AIDSRelief site in Zambia, shows doctor Claudia Caracciolo the book she keeps to track her antiretroviral treatment regimen. Photo by Kim Pozniak/CRS

"At the center of every program is a patient, and AIDSRelief has built the capacity for qualified staff, and also volunteers to provide good quality care," Dr. Caracciolo explains. Currently, more than 2,200 people are enrolled in the AIDSRelief program at the Bunyina Center, and more than 1,400 of them are receiving antiretroviral treatment.

"Bunyina Center has helped me a lot, and it's the only place where I can go and get help," says Glandwell. "The help we get there gives us courage that HIV is not the end of your life. We're not afraid of HIV because of Bunyina Center."

Living Testaments to Success

The aim of the AIDSRelief project is to provide treatment models to local partners so that they can provide high-quality and durable care and treatment to clients. Through Chikuni Hospital, AIDSRelief, in cooperation with local faith-based institutions such as the Churches Health Association of Zambia (CHAZ), currently delivers HIV care and treatment to more than 40,000 Zambians in 18 facilities throughout the country.

As mandated by PEPFAR, one local group is assuming ownership of the AIDSRelief program. This means that CHAZ will eventually manage PEFPAR funds to implement HIV care and treatment throughout Zambia.

"We felt that we were the appropriate organization that this program would be transitioned to," says Karen Sichinga, CHAZ's executive director. "We felt that, in terms of sustainability, we were better placed than any other nongovernmental organization in this country, and that we had a moral responsibility that such programs would continue for the benefit of the Zambian people."

Over the next 5 years, CHAZ will take on the different functions of AIDSRelief, including HIV care and treatment. CHAZ is already managing the warehouse, where antiretroviral medicines are stored. "We are equal partners, and aiming for one goal helped us to be where we are today," says Sichinga of the relationship between CHAZ and the AIDSRelief consortium.

Rose and Glandwell are living testaments to the success of the project. Grateful for their health, they are dedicated to adhering to their medications and spreading the word about the lessons they learned at Chikuni Hospital's Bunyina Center.

"We now help our friends and tell them that HIV is not the end," says Glandwell. "We tell them life will continue, if you follow the rules."

Kim Pozniak is a CRS communications officer covering sub-Saharan Africa. She is based in Baltimore, Maryland.

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