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Urgent need to protect babies from aids.

According to figures just released by the Ministry of Health and Social Services, the rate of HIV infection among pregnant women has increased dramatically in Katima Mulilo, and to a lesser extent in a number of other towns where routine testing takes place in Namibia.

Already two years ago, pregnant women in Katima Mulilo had the highest rate of HIV infection, with 33% testing positive during their fist antenatal visit to the hospital. Now this figure has shot up to 43%.

Babies born to HIV-positive women are at high risk of being infected with HIV by their mothers. However, this risk can be greatly reduced by the use of the medication Nevirapine.

How does mother-to-child transmission of HIV happen?

If a pregnant woman is HIV positive, it does not mean her baby will definitely be infected with the virus. Many healthy babies are born to HIV-positive mothers. However, babies can become infected with HIV by their mothers in the following ways:

A baby can become infected while it is in the uterus (womb) if the wall of the uterus is damaged through falling, violence, or through illnesses such as malaria and syphilis.

A baby can also become infected through the breast milk of the mother. It is therefore recommended that HIV-positive mothers use formula milk to feed their babies. If they cannot get formula milk, then they should breast feed for a short period of time and then wean the baby. While breastfeeding they should not give the baby any other food. As soon as the baby can take other food the mother should stop breastfeeding.

Finally, a baby can become infected during birth if the baby receives a wound during labour and the mother's infected blood enters the baby. It is therefore safer to have a caesarian birth if possible.

How does prevention work?

The medication Nevirapine can help to protect a baby from becoming infected during birth. The mother takes one dose of Nevirapine when her labour begins, and the baby receives one dose of Nevirapine within 72 hours of birth. Nevirapine reduces the risk of transmission of HIV from mother to baby during birth by 50%.

The Ministry of Health and Social Services has begun to enrol pregnant women who are HIV positive in a programme to receive Nevirapine treatment for themselves and their babies. The women receive counselling about Nevirapine and how to feed their babies. The Ministry also plans to provide both parents of these babies with anti-retroviral treatment when they become ill with Aids, so that they can live longer to look after their children.

However, the Prevention of Mother To Child Transmission Programme is only established in Windhoek and Oshakati, and only 250 women can enrol at each place for this programme. At present less than 300 women are enrolled altogether.

It seems that there is a lack of information and mobilisation for this programme, hindering women from joining and thereby having a chance to prevent their babies from illness and death in childhood. The figures just released reveal the urgency of extending the prevention programme to Katima Mulilo and other towns with high prevalence rates.

Providing Nevirapine only to women living in Windhoek and Oshakati is an obvious case of discrimination. The Namibian Constitution prohibits discrimination on any grounds. The Aids Law Unit of the Legal Assistance Centre has therefore stated at a number of public meetings that it is willing to assist pregnant HIV-positive women from anywhere in Namibia to challenge this discrimination in court.

Considering that the drug Nevirapine is available in Namibia; that it needs to be given only once to the mother and once to the baby, and costs little more than N$80 for each mother and child, we fail to understand why all pregnant HIV-positive women are not receiving this drug in our country. We see this to be inhumane, and draining the human and material resources of Namibia, as it is far more cost effective to provide medication to prevent infection than treatment to babies dying of Aids.

We need a nationwide Treatment Literacy Campaign to provide information on Aids treatment to all sectors of our society and build strong public support for the demand to "treat people now!"

For more information contact the Legal Assistance Centre, Aids Law Unit, Tel (061) 223356.
Rate of HIV infection among pregnant women in November 2002

Katima Mulilo 43%
Oshakati 30%
Grootfontein 30%
Windhoek 27%
Walvis Bay 25%
Swakopmund 16%
Keetmanshoop 16%
Gobabis 13%
Rehoboth 9%
Opuwo 9%


*olgens syfers wat onlangs deur die Ministerie van Gesondheid en Maatskaplike :Dienste bekend gestel is, het die koers van MIV infeksie onder swanger vroue in Katima Mulilo drasties gestyg. Die styging was nie so drasties in ander dorpe waar roetine toetsing by klinieke plaasvind nie.

Dringende behoefte om baba's teen Vigs te beskerm

Aireeds twee jaar gelede het swanger vroue in Katima Mulilo die hoogste infeksiekoers in die land gehad. Toe was die persentasie 33% en nou is dit 43%.

Baba's wat van MIV positiewe moeders gebore word het 'n groot kans om die virus deur hul ma's op te doen. Maar die risiko kan baie verminder word met die gebruik van medikasie soos Nevirapine.

Die Ministerie van Gesondheid het al begin om MIV-positiewe swanger vroue in 'n program op te neem waarin hulle en hul baba's Nevirapine ontvang. Die vroue ontvang terseiftertyd berading oor die medikasie asook oor hoe om hul baba's te voed. Die Ministerie is ook besig met planne ten einde beide ouers van sulke baba's van medikasie te voorsien wanneer hulle siek word as gevoig van Vigs, sodat hulle langer kan leef om na hul kinders om te sien.

Die Voorkoming van Moeder na Kind Oordragingsprogram is egter tans slegs in Windhoek en Oshakati van stapel gestuur. Slegs 250 vroue kan in elke sentrum onderskeidelik opgeneem word. Huidig neem gesamentlik net 285 mense deel aan die program.

Dit wil voorkom asof daar 'n tekort aan inligting en deursigtelikheid is aangaande die program. Dit verhoed vroue om daaraan deel te neem en daardeur 'n kans te he om te voorkom dat baba's gebore word bloot om siekte en dood tegemoet te gaan.

Ons behoort te vra: waarom is dit slegs vroue woonagtig in Windhoek en Oshakati wat tans Nevirapine ontvang? Dit is 'n duidelike kwessie van diskriminasie. Die Vigs Regseenheid (Aids Law Unit) van die Regshulpsentrum (Legal Assistance Centre) is daarom bereid om swanger MIV-positiewe vroue van enige plek in Namibie, wat hierdie diskriminasie in die hof wil beveg by te staan.

Terwyl ons vir die regering wag om die bogenoemde program aan alle Namibiese vroue beskikbaar te stel, moet ons die volgende in gedagte hou ter voorkoming van moeder na kind oordrag van MIV en Vigs.

Wanneer 'n swanger vrou MIV positief is, beteken dit nie noodwendig dat haar baba ook met die virus besmet is nie. Baie MIV-positiewe moeders skenk geboorte aan gesonde baba's.

Maar baba's kan die MIV virus van hul ma's opdoen op die volgende maniere:

* 'n Baba kan besmet raak terwyl dit in die baarmoeder is as die wande van die baarmoeder beskadig is, byvoorbeeld deur 'n val, as gevoig van geweld, of deur siektes soos malaria en sifilis.

* 'n Baba kan besmet word deur moedersmelk. Daarom word dit aanbeveel dat MIV-positiewe moeders formule melk gebruik om hul baba's te voed. As hulle nie formule melk kan bekom nie, moet hulle net vir 'n kort periode borsvoed en dan die kind speen. Terwyl die babanog geborsvoed word moet die baba nie ander kos gegee word nie. Sodra die baba ander kos kan inneem moet hulle borsvoeding staak.

* 'n Baba kan gedurende geboorte besmet raak as die baba gedurende kraam 'n wond opdoen en die moeder se bloed die liggaam van die baba binnegaan. Daarom is dit veiliger om 'n keisersnee te he, indien moontlik.

Nevirapine kan die baba tydens geboorte beskerm. Die moeder neem een dosis Nevirapine wanneer die kraamproses begin, en die baba ontvang een dosis Nevirapine binne 72 ure na geboorte. Die gebruik van Nevirapine verminder die risiko van oordraging van moeder na baba gedurende geboorte met 50%.

As mens in ag neem dat Nevirapine in Namibie beskikbaar is, dat dit net een keer aan die moeder en een keer aan die baba toegedien moet word, en dat dit nie veel meer as N$80,00 vir elke moeder en kind kos nie, kan ons nie verstaan waarom dit nie vir elke MIV-positiewe swanger vrou in ons land beskikbaar is nie. Ons beskou dit as onmenslik, en uitputtend op die menslike en materiele hulpbronne van Namibie. Dit is tog by verre meer koste effektief om behandeling te verskaf wat infeksie voorkom as om behandeling te verskaf aan baba's wat besig is om aan Vigs te sterf.
Die koers van MIV infeksie onder swanger vroue in Namibie in November
2002 is as volg:

Katima Mulilo 43%
Oshakati 30%
Grootfontein 30%
Windhoek 27%
Walvisbaai 25%
Swakopmund 16%
Keetmanshoop 16%
Gobabis 13%
Rehoboth 9%
Opuwo 9%


*[Text unreadable in original source]
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Publication:Sister Namibia
Geographic Code:6NAMI
Date:Oct 1, 2002
Words:1498
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