Wednesday, March 07, 2012

Village of Hope 2

See the previous post for a story of the morning visit to Village of Hope with Eliya.

Shortly before 4:00 p.m. that same Monday, I was again on the way to Village of Hope, now with Dave Hanson, my friend from Portland, Tiffanee Wright and Mama Jafeti, Eliya’s principal caregivers at Grace and Healing Ministry of Dodoma (GHMD), and Lauren Hall, an American pediatric nurse from Pennsylvania, who is volunteering at GHMD as part of a graduate studies practicum.

Father Vincent Boselli
We had the extraordinary good fortune that our tour guide was Father Vincent Boselli, an Italian priest, who with Sister Rosario and the order of Roman Catholic sisters of which she is a member, founded Village of Hope 10 years ago as a refuge for HIV+ orphans. Father Boselli has lived and worked in Tanzania 40 years, which includes the onset of the AIDS epidemic 30 years ago, and clearly cares intensely for the children he serves and all aspects of the most current AIDS treatment.

Dave Hanson and an infant get close.
He led us first to the infant nursery where babies live after coming to Village of Hope until they are old enough to join a family. We then moved around the orphanage, which shelters 150 children in family groups of about a dozen children with a father/mother team. All are HIV+, and those whose CD-4 count has dropped to 200 or less are in closely-monitored treatment with ARV medications. 

As we walked with Father Vincent and listened to his vivid description of Village of Hope, admiring the beauty of his close, personal contact with the children whom he knew by name, we were constantly surrounded by those children, usually with one or two attached to our hands.

Lauren and Mama Jefeti with a child
Village of Hope also includes a primary and a secondary school, a school of nursing, a small hospital for children who are seriously ill, which we did not see, and the clinic which we had visited earlier, open to the community for AIDS treatment.

A important part of our visit for me was the opportunity to interview Father Vincent about Village of Hope and the treatment protocol used there, with Eliya’s prognosis and treatment in my mind. Father Vincent gave us a mini-course in AIDS treatment from his overflowing knowledge and experience and his urgency to provide the finest treatment possible, beyond limitations of money and access. He has been involved with this tragic disease since the early days when people began to appear with a strange, unnamed disease, always fatal, in the early 1980s. Not until the early 1990s was the disease recognized in children, since death came because of other diseases, later to be called opportunistic diseases that take advantage of a weakened immune system.

Tiffanee with Victoria,  a Lahash sponsored child
 now living at Village of Hope. When Victoria's first CD-4
count was tested, it came up six.
We learned about the importance of CD-4 counts that determine the number of T-cells, an indication of the progress of the disease toward full-blown AIDS. That borderline number in much of Africa is 200 (usually much higher in America). When a child’s T-cell count falls to that number, ARV treatment begins with baseline drugs now available in Tanzania from the government at no charge.

Father Vincent went on to describe viral-load testing as an essential next step in determining the effectiveness of treatment. Early on, Village of Hope provided the only viral-load testing in Tanzania. He explained that at first, he was forced to fight for awareness of the value of this test, an expensive procedure requiring costly equipment and skilled technicians Because of the long-standing connection of Village of Hope and the Pope’s hospital in Rome, Village of Hope acquired the needed equipment, but budgets have not been sufficient to provide a full-time technician, which is the reason Eliya must wait until April for his viral-load test. Then, a volunteer technician will arrive from Rome at Village of Hope for a month of constant viral-load testing. Six months later, another technician will arrive for another month. Lauren reminded us all that in American viral-load testing is usually a quarterly procedure.
A child responds to Tiffanee's words and touch.

A viral-load test, Father Vincent explained, provides information about how well the ARV medications are functioning and will show drug resistance. If it were determined, for example, that Eliya was taking his medication regularly but his condition still deteriorated, he has possibly developed drug resistance. Then the task is to determine which part of a three-medicine cocktail is failing and to find a a second-level drug. At that point, problems develop in procurement of advanced drugs from the government. Usually those drugs are more costly, and the government is caught in the bind of restrictive budgets and need to balance the need to expand treatment to more first-level HIV+ persons or to provide more costly drugs to those who have become resistant. Father Vincent described his determined battle to acquire those advanced drugs for the benefit of the children he serves. We listened to a man who is surely an unstoppable advocate for people living with AIDS, determined that they shall go on living.

I then asked, “How is it possible that your patients get free ARV treatment at any level?” His immediate answer: “The Global Fund,” referring to The Global Fund for AIDS, Malaria and Tuberculosis, founded in 2002 and now the main financier of programs to fight AIDS. It was an answer I expected as a result of my work with Bread for the World. Treatment like what Village of Hope was freely providing (although with the untiring efforts of Father Vincent) came from a world-wide fund largely provided by governments, with the USA being the largest donor. Thus, I was hearing, my tax dollars have been directly connected to Eliya’s treatment. Were he an American, his insurance company (or state and federal subsidies) would provide around $1000.00/month for drugs that Eliya receives at no cost. Of course, Eliya and millions like him have no money to pay for medication. His Lahash sponsors pledge $25.00/month for his care, which includes a portion of his food needs, clothing, and school fees; few sponsors could pay the full cost of his medications. Without government subsidies (and government agreements with international drug companies) HIV/AIDS victims would die, as they did, inevitably, in the past.

Children with Mama Jafeti
We talked about the threat that cutbacks in contributions to the Global Fund imply. Such threats are real in Europe and America, related to the economic downturn. Father Vincent sees a direct connection between reduced funding and deaths of AIDS sufferers, and he uses the word “immoral” vehemently. He is a veteran of battles to provide adequate treatment and knows well that he may lose his battles in an era of declining funding.

I was thrilled to be able to assure Father Vincent that he did not battle alone. In America there are battalions of caring people who write letters to their senators and representatives, urging that they work to maintain a circle of protection around programs that make up the U.S. contribution to poverty-focused development assistance, including the Global Fund, PEPFAR, and other programs aimed at reduction of disease, malnutrition, and poverty. I described to him how such programs are at grave risk in the current political climate but guaranteed to him that many in America share his concern and will work very hard to support the efforts of courageous advocates for vulnerable children. He seemed truly grateful for that assurance.

I came from that interview with an enormous sense of gratitude for Father Vincent and Village of Hope and for the resources provided there for the best possible treatment of Eliya and others living with HIV. I felt even more determined that the story must be told at home and more Americans be convinced that the circle of protection is absolutely essential.

I had renewed hope that my prayer beads are still effective.

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