Global health: a strategy to Enhance patient care. Blantyre, Malawi. November 17 -21, 2014.
Cardiology, neurology, angiology, surgery, hepatology, radiology, infectious diseases, with particular attention to the epidemic of Ebola, but also common chronic diseases that are also increasing in sub-Saharan Africa and which are often ignored, undiagnosed and therefore untreated. All this was discussed in Blantyre, Malawi, thanks to a multi specialist course attended by doctors from Malawi, Tanzania, Kenya and Mozambique, organized by the Program Dream of the Community of Sant’Egidio in collaboration with GHT-Onlus (Global Health Telemedicine). DREAM, which is present in 10 African countries, treats 250,000 people with HIV / AIDS and has allowed to date about 26,000 children born healthy to HIV positive mothers. In Malawi there are 13 treatment centers, 3 laboratories and DREAM supports 24 maternity wards of the ministry of health with the vertical prevention program for HIV. In the tribune, a small group of Italian specialists: cardiologists, neurologists, infectious disease specialists, internists, hepatologists, dermatologists, angiologists and radiologists who have brought their knowledge and experience to 50 colleagues in sub-Saharan Africa. The inauguration was attended by the Mayor of Blantyre and by leaders of the Malawian Ministry of Health and the National AIDS Commission.
Thanks to the partnership between DREAM and GHT in this last year it was possible to install 8 Telemedicine Centers in Malawi, Tanzania and Mozambique; from these countries requests of teleconsultations come via web as well as reporting of ECG. The answers are quick and mostly simulate a diagnostic and treatment center in Europe.
From the Telemedicine Centers is sent a brief description of the patient’s medical history and his physical examination, electrocardiogram, the values of pressure, heart rate and blood oxygenation and, if necessary and possible, of his blood tests. The specialist on duty imagine a real patient before him and provides the required responses, taking into account the local limitations on the availability of diagnostic tools and drugs.
From the Telemedicine Centers the requests of teleconsultations were over 1200 in just a few months, creating a network that took “our” everyday knowledge and therapeutic habits very far.
At the end of the course, carried out also thanks to funds from GHT and CIS, two new Centers of Telemedicine will be inaugurated, one of which in Blantyre, funded by the non-profit organization “Nico the fruits of the grain” and the second in Balaka, always in Malawi, demonstrating that a new model of cooperation is possible, one of high-impact and low costs. A North/ South alliance, which opens the future to a better health system for Africa.
Last Monday saw the opening of the 14th edition of the DREAM Programme’s Panafrican Training Course. As usual, the course is divided into two sessions, one for activists (90 participants), and the other for doctors and paramedics with differing qualifications (90 participants).
The activists come from all over Malawi, while the other course participants, apart from those from Malawi, number many from Tanzania, Kenya and Nigeria. There is also a delegation of the Mozambique movement ‘Eu DREAM’ led by Ana Maria Muhai.
Among those enrolled in the course for biologists, lab technicians and nurses, the presence of a sizeable group of 25 people from the Malawi Ministry of Health and local hospitals such as the Queen Elizabeth Central Hospital and the Adventist Hospital, provide yet another example of collaboration between DREAM and the country’s health institutions.
During his cordial and affectionate greeting, the Papal Nuncio in Zambia and Malawi, Mons. Nicola Girasoli, underlined the fact that the Community of Saint Egidio is not in the habit of simply ‘doing’ but also shares in the condition of the poorest.
The course was officially inaugurated by Dr. Mary Shawa, the Principal Secretary for HIV, AIDS and Nutrition, and by other directors from the Ministry of Health responsible for diagnosis and the running of the laboratories. Dr. Mary Shawa spoke of the complementary role that DREAM has in the Government’s program of treatment for people with HIV/AIDS.
Among the participants was Vera Chirwa, the country’s most famous human rights activist, well-known also abroad for her work in favor of abolishing the death penalty.
And last but not least, representing the local authorities, the District Commissioner and District Health Officer made the appreciation that is felt for the work carried out by DREAM manifest both by their presence and through their speech.
One of the most touching moments of the ceremony was the speech by Dofa Namagowa, a Malawi activist in the DREAM program who spoke of the suffering she experienced as a seropositive woman but also of her happy encounter with the DREAM program during her pregnancy.
Mr. Elard Alumando, DREAM program Country Coordinator
H.E. Mons. N. Girasoli, Apostolic nunzio apostolico in Zambia and Malawi
Mrs Dofa Namagowa
DREAM program Activist
Dr Mary Shawa,
PS for HIV, AIDS nutrition, Office and President Cabinet
Government of Malawi
Dr Giuseppe Liotta
Community of Sant’Egidio, DREAM Program
The XIII course of Pan-African formation of the DREAM programme is under way in Maputo, Mozambique. The course, which is being held from 22 September to 1 October, is attended by doctors, nurses, pharmacists, coordinators and biologists from several African countries.
The 120 participants come from beyond Mozamique, from Guinea-Bissau, Democratic Republic of Congo, Gabon, Madagascar, Burkina Faso, the Republic of Guinea, Cameroon, Rwanda and Burundi.
Young biologists from Italy and Spain are also taking part in the course.
Firstly, I would like to thank the Community of Saint Egidio for giving me this opportunity to speak today on behalf of my fellow HIV activist; this is rare opportunity to stand in front thy delegates, for this am very thankful.
To begin with, my name is Jennie Mphande, born 34 years ago and a widow. I have a 14 year old daughter and I keep other 5 relatives .I got married in 1992 .My husband became sick towards the end 2000.We went to MACRO in January 2001 and we were both tested positive, unfortunately my husband died in 2004 of pneumonia.
Things started getting tough for me after his death, I had to move to the house he bought though not completely built. Towards the end of 2005, I got very sick which lead to my own dismissal from my work as a teacher in a certain private school. I knew even I become better, the owner will fire me.
I stayed at home without any thing to do and was being admitted in the hospital frequently and thought I will die, Especially when the best friend to my husband came with the advice and I quote: Why cant you go back to your home village you are just wasting your time living in town without a job and moreover you don’t have money, children are suffering, just sell your house, nowadays if the husband die next is the wife”Mlamu, umenewo ndi mtengano”
My neighbor, who happens to be a dream client was concerned with my sickness and advised me if we could go together to DREAM centre. It was my first time to hear about DREAM. When we arrived at DREAM I realize there was still hope for me. I still remember the warm welcome I received from an Italian dream staff, who asked me, how do you like your new family? And I answered what family? She said Dream. It is very good but I am not sure if it’s real. What do you mean? She continued, I said I have never seen this beautiful hospital just being offered to HIV patients.
The next appointment was that I was offered a job as an activist. Dream has been a blessing from God because when I came, the people were and are still eager to understand my HIV situation.
To work as an HIV activist has been my happiest moment. Dream has saved my life physically and socially, I am strong and able to take care of my family. Now I am contributing to save the lives of other patient’s am always happy to work with Dream and let the world know that we are children of God, who love and care for each other and that being HIV its not a death sentence, but the beginning of new life with a dream.
My gratitude will forever go to the community of Saint Egidio who trained me as V.C.T Counselor. My work is carried out in some antenatal units of the health centre. It is aimed at testing the pregnant women, preventing mother to child transmission. And after, the women are brought to the centre where are treated according to the protocol of dream. Throughout pregnancy, the contact with the dream is opportunity because women are encouraged to do a test with advice, encouragement and assurance they will receive treatment and in hope that they will have a health child free of HIV, often without support of the husband who might be dead, absent of work and many reasons.
My work is challenging especially to women who understand what dream is, when I talk to them and prefer coming to our center and get the therapy but they meet many hindrances like;
1. when they disclose their status to the husband some are divorced.
2. some are accused of bringing the virus into their marriage
3. some refuse to be tested in fear of their husband
4. some even stop taking the ARV therapy in fear of their husband this may result to poor adh
An unusual type of class was held in recent weeks in DREAM centres in several African countries where the programme is operational: a proper “cookery class”.
The lessons brought to you by the photos on this page were held at the centre of Manga Chingussura, in Beira, in Mozambique, in November 2007, and they saw the participation of dozens of mothers, whose children were born on the DREAM programme of mother-to-child prevention of HIV infection.
The idea of organizing meetings to explain the basic principles of child nutrition, and to accompany mothers through the initial weaning phases, grew from the realization that many children, although they were born free of AIDS thanks to antiretroviral therapy given to pregnant women, nonetheless presented malnutrition problems. Their growth could actually be compromised because of inadequate weaning or nutrition.
So an idea emerged, to gather mothers followed up by DREAM whose children were in the weaning phase, in order to help them concretely, to give them the information making up the core of solid nutritional education.
They gathered as if at school, but theirs was an unusual teacher’s desk.
Yes, because instead of books and copybooks, there were pans, milk, sugar, different types of flour and fresh fruit! Thus, a highly useful theoretical and practical class was held, about how the women should wean their children and ensure their healthy growth.
They learned what the most adequate diet for children in their first two years of life should be. Attention was drawn to inappropriate customs related to food, with a view to changing them. Hygiene norms to follow while preparing feeding bottles and baby food were illustrated.
Further, there were practical demonstrations about the preparation and cooking of baby food. Members of staff from various centres and mothers clustered around stoves, pans and flours and cooked together. They prepared tasty baby foods: with cooked vegetables and sauces as main ingredients, with ground nuts and rice flour, with added sugar and milk, and fresh fruit, mangoes, papaya and banana.
Many of the women who turned up for the lesson in Beira came on foot, carrying their babies on their backs.
Rita Laura was one of them.
We got to know her when she was pregnant with her second child. She lost her first six days after he was born. In the meantime, she learned she was HIV-positive when she took a test at the public maternity clinic. She was desperate and longed to save her second child at least.
Rita Laura turned up happily for the “cookery class”.
She came with Florencio, who was born healthy thanks to DREAM, a sweet and lively boy, only he was a bit weakly. The baby food about to be prepared that day was just what he needed…
But for the mother, for Rita Laura, this meeting was more significant and precious than a good meal. It was another way of winning over resignation, to hope and have faith.
In fact, Rita Laura – like many other mothers – started to realize that, even if she was very poor, there was a lot she could do to help her son. She discovered that triumphing over the serious problem of malnutrition wasn&r