Your daily Selection of IRIN Africa PlusNews reports, 6/15/2005

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CONTENT:

1 - COTE D IVOIRE: MSF launches AIDS treatment programme in conflict hotspots

2 - SWAZILAND: Changing face of home-based hospice care

3 - UGANDA: Back condom use, Museveni urges Catholic leaders

1 - COTE D IVOIRE: MSF launches AIDS treatment programme in conflict hotspots

ABIDJAN, 15 June (PLUSNEWS) - Medecins Sans Frontieres(MSF) has announced plans

to start a treatment programme for people living with AIDS on both sides of the

frontline in the volatile west of Cote d'Ivoire.

Sloot, the head of MSF-Holland in Cote d'Ivoire, said the programme would

be based at hospitals in the rebel-held towns of Man and Danane and the

government-held town of Bin-Houye and would serve an estimated local population

of 500,000.

" We have completed the training of counsellors and we can begin testing as soon

as we have the go-ahead of Cote d'Ivoire's National Programme to Fight HIV/AIDS,

which is preparing a final assessment mission, " told IRIN.

" We have high hopes that we can start this summer, " he added.

The 'Wild West' of Cote d'Ivoire has remained prone to sporadic outbreaks of

violence, despite a two-year-old ceasefire that has brought a fragile truce to

most other areas of the country.

President t Gbagbo said last week that more than 100 people died in the

latest outbreak of tit-for-tat killings between Guere villagers and incomers

from other parts of Cote d'Ivoire near the town of Duekoue.

Most hospitals and health clinics in the west ceased to function shortly after

the civil war broke out in September 2002. Many of those that remain open rely

heavily on support from non-governmental organisations such as MSF.

There are no reliable figures of HIV prevalence in western Cote d'Ivoire, but a

study published by MSF in April revealed an " alarmingly high " incidence of

sexually transmitted diseases in the region.

The study reported that 20 percent of all patients at MSF clinics in the West

suffered from sexually transmitted diseases such as syphylis, gonorhea and

herpes and that 17 percent of all blood screened for transfusions tested HIV

positive.

" Even if we don't have reliable data, these numbers were high enough for us to

say: we have to do something, " Sloot said.

MSF's AIDS treatment programme would include voluntary testing, counselling and

the distribution of free antiretroviral (ARV) drugs to people who needed them,

he added.

The project will be run jointly by MSF Belgium, which operates the hospital in

Man, and MSF Holland, which works in Danane hospital and runs a mobile clinic

for villagers on both sides of the frontline.

Sloot said Danane hospital would be equipped with a special ward for people with

HIV/AIDS and tuberculosis (TB) - the most common disease associated with AIDS

patients.

" We are calling it a chronic diseases ward to avoid any stigmatisation, " he

said.

At present, ARV therapy, which can prolong the life of people living with AIDS,

is only available in the capital Abidjan.

There, patients have to pay a flat charge of 5,000 CFA (US $10) every three

months for subsidised drugs handed out by the government.

TB patients in western Cote d'Ivoire already receive free treatment which is

paid for by the government, Sloot said.

Cote d'Ivoire has the highest HIV prevalence rate in West Africa. It was

previously estimated by the government and international organisations and nine

percent of the adult population, but the latest figures from UNAIDS put it

slightly lower at seven percent.

[ENDS]

2 - SWAZILAND: Changing face of home-based hospice care

MBABANE, 15 June (PLUSNEWS) - AIDS has accelerated the death rate in Swaziland,

causing home-based hospice care to expand into an entire support system for

affected families.

" People now come to us as a resource to go for help when they have a terminally

ill family member, to help them cope with the burden, to help the patient, and

to help the whole family emotionally, spiritually and medically, " said Thulile

Dlamini-Msane, director of Hospice at Home, a care centre near the Matsapha

industrial estate outside Manzini in central Swaziland.

The country has the world's highest HIV prevalence rate, with 42.6 percent of

its adult population infected, according to the health ministry.

Fifteen years ago, hospice patients were primarily cancer victims; now a

substantial number are HIV positive.

" In May, in the Manzini region, we had 1,000 patients; in June, the number had

dropped to 800, as some of them had died because of AIDS-related illnesses - but

we will be at 1,000 soon, because new patients always replace the old, " said

Jabulani Gamedze, a senior nurse at the hospice.

From what began as a centre serving a few rural homesteads, Hospice at Home has

grown into a nationwide network, with nurses located in all four of Swaziland's

regions.

Well-funded by a host of international donors, Hospice at Home's headquarters

has a care centre where patients whose caregivers are at work during the day can

rest and receive meals and medicine.

" My dream is to open a night-care facility - this would free families to attend

night-time prayer vigils before funerals, or take trips and much-needed breaks

from the 24/7 task of tending their terminally ill relatives, who would be

staying with us temporarily, " said Dlamini-Msane.

Institutionalising the terminally ill is anathema in a country where family

bonds are strong, and people prefer to spend their last moments at home.

" Most patients say: when they die, they want to be at home with their families, "

said Gamedze. " We treat the whole family - everyone must be prepared for death.

The first time nurses visit a homestead, they spend many hours getting to know

the situation there - the food, the relatives, the material needs; much of what

we do is counselling. "

To make patients feel more comfortable, hospice nurses do not wear uniforms,

while their role has grown from that of dispensing medication to being experts

in palliative care, specialising in managing pain.

" Through the years, our care has been in total response to patients' needs.

Caregivers of AIDS patients told us they feared getting infected through bodily

secretions and, indeed, some of them were getting infected. Now our donors are

providing adult diapers, rubber gloves and other essentials, " said

Dlamini-Msane.

An initial rapid response HIV test is administered in the patient's home, and if

the results suggest an infection, the standard blood test is conducted at

hospice headquarters in Matsapha.

Hospice care now also emphasises disease prevention among other family members.

" When a patient is HIV positive, we encourage the spouse and caregivers to get

tested, " said a nurse at the Matsapha daycare centre.

" We administer to the patients' spiritual needs, encouraging them use religion

or make contact with their ancestors, " said Gamedze. " The entire family is

counselled, and we work on their emotional needs in the face of death. "

[ENDS]

3 - UGANDA: Back condom use, Museveni urges Catholic leaders

KAMPALA, 15 June (PLUSNEWS) - Ugandan President Yoweri Museveni has called on

the Catholic Church to drop its opposition to the use of condoms as they are one

of the primary ways of fighting the spread of HIV/AIDS.

" If the church is really interested in having its followers live, it should back

the use of condoms to save church members from AIDS, " Museveni said on Saturday

when he closed a conference of Catholic bishops from 10 sub-Sahara African

countries.

He said, " This is not to support immorality, but to recognise the weakness of

those we live with and help them to live a healthy life. "

The 10-day congress debated the impact of HIV/AIDS in sub-Saharan Africa, the

world's worst affected region, where an estimated 25.4 million people are living

with the disease.

Two bishops attending the meetings had told reporters earlier that the church

would not accept condom use or financial aid from atheist NGOs to fight

HIV/AIDS.

" Condoms are an artificial birth control method, and the church is against birth

control, " Bishop Banzi from Tanzania told a news conference in Mukono,

22 km east of the capital, Kampala.

Museveni's comments came in the wake of criticism by human rights groups, who

maintained that his government was abandoning condoms as a means to fight

HIV/AIDS in favour of " abstinence only " programmes.

" Uganda is gradually removing condoms from its HIV/AIDS strategy, and the

consequences could be fatal, " Tony Tate, a researcher for the New York-based

Human Rights Watch, said in March.

Museveni said the church also should instil morals in the region's youth, as

this would mitigate the spread of HIV.

In their final message, the bishops commended efforts to control the HIV/AIDS

pandemic, specifically the work of governments and other institutions that

encourage abstinence and fidelity.

" We are greatly alarmed by the magnitude of HIV/AIDS, its origin, causes, spread

and consequences, " the assembly added.

Uganda has won accolades for its fight against the pandemic, which has brought

HIV prevalence rates down from over 20 percent in the 1980s to about six percent

in 2004. The country has used a strategy popularly known as " ABC " , or

" Abstinence, Be faithful and use Condoms " , to fight the disease.

[ENDS]

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