BAMENDA, CAMEROON – Even before he was 2, Paul was constantly sick. His aunt, Maggie, who has cared for him since his mother died of HIV-related tuberculosis, suspected the baby might have HIV, but she didn’t want to believe it. How would she care for the child, she wondered, and how would she protect her other children?
“He falls sick every week,” says Maggie, a 43-year-old single mother of three who asked that she and her nephew go by pseudonyms for fear of retribution.
In early June, Maggie took Paul, then 20 months old, to Cameroon Baptist Convention Health Services in Bamenda, the capital of Cameroon’s Northwest region. There, medical staff asked to screen the baby for HIV.
“I was counseled, very well, on the importance of having my boy screened for HIV, and I thought it was the best option to do,” she says.
The results came back: Paul is HIV-positive.
“I felt bad, really bad,” Maggie says. “I could not imagine what wrong a little boy his age would have done to deserve such deadly diseases.”
Paul is among an estimated 58,000 children under 14 living with HIV in Cameroon, according to 2014 U.N. numbers. In 2013, just 6 percent of Cameroonian children with HIV had access to antiretroviral treatment, UNAIDS reports.
That’s far lower than the already-dismal treatment rate of just 23 percent of the estimated 3.2 million HIV-positive children around the world – the number noted in a 2014 World Health Organization report.
Cameroon Baptist Convention Health Services in June launched its portion of the Accelerated Children’s HIV/AIDS Treatment Initiative, or ACT, which aims to identify and treat more HIV-positive children in Cameroon, says Dr. Pascal Atanga, a pediatric adviser for the project.
Cameroon is one if nine countries selected to participate in the ACT program, which is funded by the U.S. President’s Emergency Plan for AIDS Relief and the Children’s Investment Fund Foundation. The $200 million program aims to provide treatment for 300,000 HIV-positive children in those nine countries, which include Democratic Republic of Congo, Kenya, Lesotho, Malawi, Mozambique, Tanzania, Zambia and Zimbabwe, along with Cameroon.
Under ACT, children have access to specialized treatment, play areas and support groups, as well as age-appropriate counseling, Atanga says.
HIV-positive children are less likely to be diagnosed than adults, Atanga says, because they must rely on adults to provide them with access to testing, counseling and treatment.
That’s especially true of children whose parents have died due to HIV, says Dr. Gladys Tayong, the regional chief of reproductive health and prevention of mother-to-child transmission of HIV in the Northwest regional delegation of the Ministry of Public Health.
Many of those children don’t have close adult supervision, and they suffer from symptoms for longer than adults, she says.
The ACT program is working with 63 health facilities, each of which treats at least five pediatric patients a month, in Cameroon’s Northwest region, Atanga says. Every child who visits one of those health facilities, regardless of the reason for the visit, receives a free HIV screening. The program also partners with community organizations to identify children who are constantly sick or whose parents might have died due to HIV.
The project aims to place 11,260 children on antiretroviral drugs, commonly called ARVs, before it concludes in 2016, Atanga says.
Atanga and others with the program hope to overcome the stigma that keeps adults from having at-risk children tested for HIV.
Some adults try to treat sick children with medication from illegal or unauthorized pharmacies, which are sometimes run by people with no medical knowledge, says Vitalis Keng, a northwest regional monitoring and evaluation supervisor for mother-to-child HIV transmissions for the Cameroon Baptist Convention. The practice has left HIV-infected children suffering in their homes, without proper care. The adults who care for chronically ill children often fear learning they are HIV-positive, thinking they would surely suffer and die if they are infected, he says.
Bernadette Ngwa, a hairdresser and a single mother of three, says she’s scared to be screened for HIV, let alone to have her children screened. She was tested seven years ago when she was pregnant with her last child because the test was required, she says. The result was negative. But she says she wouldn’t even want to know her child’s HIV status.
“If my child is diagnosed positive, I think I will die before she dies,” she says. “I am praying that they remain negative for their entire childhood because I will never take the courage to take them for screening.”
Counselors play a critical role in children’s health, Atanga says.
“They have to use their skills to convince caregivers to have their children screened,” he says.
So far, he says, program counselors have persuaded “almost all” parents and guardians to allow their children to be screened.
Severine Tankeu says a neighbor advised her to have her late sister’s chronically sick baby girl screened for HIV.
“When she talked to me about it, I took it really personal,” says Tankeu, a seamstress and cloth vendor. “I was so annoyed to the point where I asked her whether she was insinuating that my sister died of HIV.”
Tankeu eventually took the girl to a health facility partnering with ACT. She heard stories of children who were born with HIV but are living normal, fulfilling lives. Her niece was tested and does not have HIV, Tankeu says. And if her test had come back positive, Tankeu says the counseling she received through the ACT program helped her realize that treatment is available.
“HIV/AIDS is not a death sentence,” she says.
Maggie, the woman who was afraid to have her nephew tested for HIV, says she’s glad she now knows his status because she can get him the treatment he needs. Ever since he started taking antiretroviral drugs, she says, he’s doing fine.
“He is hardly sick now,” she says. “He is looking stronger and healthier.”
