One of the two main works we do at Cabrini Ministries is Health Care Outreach (the other is Care of Orphans and Vulnerable Children). We provide health care services to about 1000 patients a month.
Our health care program has received accolades for delivering high-level professional and comprehensive health care services to the St. Philip’s Mission community in Swaziland. Especially when dealing with illnesses like HIV/AIDS and TB, we believe highly organized comprehensive care with a lot of follow-up and monitoring is the only way to make progress.
Our health care services include several distinct but interrelated categories:
* HIV testing, counseling, and treatment (HCT); includes ARV, CD4 programs and counseling
* Prevention of mother-to-child transmission (PMTCT); in collaboration with St. Philip’s Clinic antenatal care program
* TB screening and treatment; treatment done in collaboration with St. Philip’s Clinic
* Community education and support groups
* Nutritional supplements for adults and infants
*HIV Testing, Counseling, and Treatment
We provide blood testing services and counseling for approximately 100 adults and children in our community per month. This includes a test to find out if someone has the HIV virus, following up with results, and providing counsel based on the results of the test. We also monitor the CD4 (or T-cell/ immune cell) counts for HIV+ people via blood tests. The CD4 count of an HIV+ person is what determines whether they need medication (antiretroviral drugs or ARVs) or if their immunity is strong enough that they do not need medication.
There are about 450 HIV+ people that we administer ARV medication to every month. The drugs are provided by The Global Fund to Fight AIDS, TB and Malaria. We keep detailed records for each patient in our health care program- this is very important in administering complicated treatment regimens like those for HIV and TB. About 10 new HIV+ patients per month have to go on ARV medication in our community.
*Prevention of Mother-to-Child Transmission (PMTCT)
One of our programs, in collaboration with St. Philip’s Clinic, is called the Strong Mother/Strong Baby Program. There is a very high infant and birth mother mortality rate here and this program aims to provide pre- and post-natal education and health care for mothers from a nurse/midwife team. There are about 100 mothers & infants in the program. HIV+ mothers can give birth to and raise HIV- babies, but steps must be taken, such as taking PMTCT medication during pregnancy, and avoiding breast-feeding. We provide testing, referrals, transportation to the hospital for medication, formula, education classes, bottles, soap, candles and matches for sterilization, and other services as needed.
photo by Luis Maximiano
*TB Screening and Treatment
Tuberculosis is the leading cause of death in Swaziland, because the HIV infection rate is so high. TB attacks people with compromised immune systems. We have begun to screen every HIV+ patient for TB with a sputum test. We administer medication to about 50 adults and children per month for TB.
*Community Education and Support Groups
We provide walk-in community health education sessions twice a week for about 30 people each session. At these sessions- usually led by a Swazi nurse or Swazi HIV+ health care staff member- we review basic disease and health care education for HIV/AIDS and TB. We also provide HIV education at our monthly staff meetings. Support groups have formed naturally among HIV/AIDS and TB patients in the community education sessions.
*Nutritional Supplements for Adult and Infant Health Care Patients
We provide about 800 dietary supplement packages per month to our health care patients. Malnourishment is a serious health problem here because of drought and the lack of economic opportunities. (Click to read more about the drought, climate change, and the food crisis in Swaziland: “Life in a Changing Climate” or “Food Crisis in Swaziland”.) We believe nutritional support is critical to comprehensive health care, especially because people cannot take medications or stay healthy and off of medications for HIV/AIDS and TB if they don’t have enough food. The nutritional packages contain such items as fruits and vegetables from our farm, Morvite (a vitamin powder mixed into a drink), and a corn/soy blend.
Delivery of Services
At our drop-in center at St. Philip’s Mission, staffed by nurses and assistants, we receive about 350 patients per month, for everything from HIV/AIDS and TB testing, treatment, care, and follow-up; to other, often secondary infections, such as skin infections, diarrhea and vomiting; and education and emotional and spiritual support.
For those too sick to come to us, we deliver the same services to them at their homesteads. We work very closely with the traditional system of the Rural Health Motivators (RHMs)- community members who are trained to diagnose people on homesteads and help get them to us for more care. Swaziland has a great shortage of trained doctors and nurses for all the people that need health care, so the RHM programme is a stopgap in place right now. We visit about 50 people on their homesteads with our mobile clinic and home-based care program.
To read about a typical home-based care visit, click on the post: A Visit to A Homestead.
Transportation to Hospital or Clinic
One reason why many people can’t access treatment for HIV or TB is the lack of transport to and from hospitals and clinics, which can be miles and miles away. We transport over 350 people a month to hospitals and clinics for the services they need there in Cabrini Ministries vehicles.
Healthy patients help staff with the farm harvest
What Our Health Care Program Means For Our Community
We suffer about 5 deaths per month, usually all from HIV/AIDS. This is a loss this community feels so deeply. But for 1000+ people a month, the health care program means receiving health care services they need, and sometimes means literally receiving life. The health care program is a ray of hope and healing that we feel and appreciate here.
Also, the people that we provide health care services to in the communities around us are also often intimately connected with the orphaned and vulnerable children at our hostel- such as being the immediate and extended family members and very close neighbors of the children. With both our health care and orphan care programs (and education and agriculture), we aim for a continuum of community health in all aspects of the word.