Aid in Action
A Burundian Doctor’s Dream
Hoping for a vaccine to prevent AIDS
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Friday, June 12, 2009
Photo: Kimberly Wylie, USAID/East Africa
A USAID-supported physician is improving health systems and building the capacity of health providers at a busy referral lab and hospital. The result is growing demand—a sign of confidence in the HIV/AIDS prevention, testing, counseling and treatment services.
Dr. Jean Bosco Nsengiyumva is a 34 year old medical doctor working in Burundi’s Kirundo public hospital. Dr. Nsengiyumva helps to prevent and treat HIV/AIDS and knows that to gain the confidence of patients, he must provide good services.
Kirundo hospital is four hours north of the capital city along a main highway: two-lanes that wrap precariously around undulating hills, through misty banana plantations, climb past verdant tea terraces and culminate in highland coffee country. Dr. Nsengiyumva works with USAID’s Regional Outreach Addressing AIDS (ROADS) activity, and meets a critical need for well trained physicians in rural health facilities.
HIV prevalence in much of Burundi is about 2.9%. But in some groups-- internally displaced, uniformed corps including policemen, mobile drivers--prevalence rates rise and among commercial sex workers soar to 38%. Asked what accounts for these differences, the physician points to polygamy and grinding poverty as factors influencing local behavior.
With USAID and implementing partner Family Health International support and technical assistance, Dr. Nsengiyumva ensures that HIV/AIDS health systems and supplies are functioning and well stocked. He trains health providers in drug protocols and insures that medical files are complete and confidential. In the hospital’s laboratory, Dr. Nsengiyumva points to a centrifuge machine donated by USAID and
explains in rapid French its importance for thorough blood work-up.
The spotless lab also boasts one of only three functioning Facscount (CD4 Count) machines in Burundi, all gifts from the American people. This delicate but unassuming device determines the degree to which HIV has infected the cells—crucial for defining treatment. Dr. Nsengiyumva argues that because these services are offered in a high-prevalence area, Kirundo Hospital has become one of Burundi’s leading referral labs for HIV and AIDS: “People here used to go to traditional medical doctors. Now they come by word of mouth to the hospital and they even bring their neighbors.”
Dr. Nsengiyumva is an optimist with a positive outlook and affirms, “People see that they get help here. Being HIV positive isn’t a death sentence.”
Referring to what’s most difficult about his job, he concedes that taking care of people who have a chronic disease like HIV/AIDS is taxing. “The most important thing is for people to take their treatment.” He pauses and urges, “If they don’t, we’ll encounter resistance to medicines, and the situation will get much worse.” But his optimistic side wins and he muses that one day, there might be a vaccine to prevent AIDS, and in the mean time, he adds, if those who are living positively take their medicine and eat nutritious foods, “They can live just like everyone else.”