CBCHS shows continues commitment in partnering with the Regional Hospital Bamenda in the fight against HIV and AIDS to achieve epidemic
The Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome (HIV/AIDS) remains one of the most stigmatizing pandemics worldwide. The fight against HIV/AIDS remains one of the major points in the sustainable development agenda. Though great efforts have been implemented at different levels to limit the spread of HIV/AIDS, the incidence of HIV in the developing world and more precisely Sub-Saharan Africa (SSA) is still relatively high.
By the end of 2015, an estimated 36.7 million people were living with HIV/AIDS worldwide, with over two-thirds residing in sub-Saharan Africa, which includes Cameroon. Despite the recently reported drop in the prevalence of HIV in Cameroon from 5.5 to 4.3% over the last decade, it still remains amongst the highest in West and Central Africa.
To this effect, the Cameroon Baptist Convention Health Board CBCHS, which is an indigenous nonprofit organization founded more than 50 years ago with an underlying mission to provide care to all who need it as an expression of Christian love and equally to address both clinical and public health problems affecting individuals and communities in Cameroon in particular and in Africa at large, has sent some 35 medical personnel from the Centre Region of Cameroon to be incorporated in to the Day Care of the Bamenda Regional Hospital. The reception of these workers was done by the Director of the hospital, Dr. Nsame Denis in the presence of the medical adviser of the hospital, the General supervisor and the Assistant General supervisor, during a brief occasion to introduce the new personnel to other hospital staff. Welcoming the team from the center region, Dr. Denis reiterated that the issue of HIV/AIDS is an issue for everyone reason why the CBCHB who is a partner to the Regional Hospital and has a wealth of knowledge in handling issues of HIV/AIDS has decided to send these personnel made up of 2doctors, Dr.Chiabi Eugene and Fala Bede, 3nurses, 9 case managers, 7 index tracers who are present and have been committed to work, though others are yet to join.
In a brief unit overview, Dr. Mbuh Eyongetah Tabenyang the Coordinator for HIV Unit at the Bamenda Regional Hospital, indicated that the hospital day care has over 5600 clients both adults, children, pregnant women, youths and children who are closely assisted by a doctor, ward charge, pharmacist, 10 psychosocial workers and over 4 staff members. Dr. Mbuh said the Day Care as of now is functioning hitch-free but feels more elated with the support from CBCHS with the huge number of personnel coming in from the Centre Region. To him, this will only add to the goal of attaining the U.S. President's Emergency Plan for AIDS Relief’s (PEPFAR) goal of 95% 95% 95% for treatment by 2020 which holds that 95% of people living with HIV knowing their HIV status; 95% of people who know their status on treatment; and 95% of people on treatment with suppressed viral loads. From October 1st, the CBCHS requested for an engagement in direct health service and as at now, the Day Care of the Regional Hospital has a linkage level of 86% and most clients have had their viral loads suppressed, Dr. Mbuh added.
He further said “we have been working with these team for a week now and it has not been easy integrating 35 new people into an existing system but it has been in great experience as the nurses have been assisting in screening and consultations for biological monitoring for patients coming for their refills, they have been helping us in patient flow and we had to work to see how we can place the new nurses at the frontline of care at the treatment center which we have done so. We have integrated the case managers assigning them to the Assisted Partner Services APS, dividing the cohort into a cohort between 400-550 clients assigning a case manager to each cohort that will work with the Assisted Partner Services APS that was working the cohort before they came. The testing councilors one who is also a lab technician have been assigned to the entry points already at the OPD to replace the two Assisted Partner Services APS that were working there on shift and serve as councilors, others were assigned to the other entry points and also the lab. We have succeeded to work with the patient flow though it is not the best, but I believe as we are moving on many things will improved on. We have been talking with the clients to present the whole team so that they could be accepted for a smooth transfusion. We hope and believe that the team that has come, we are going to receive better results”.
Dr.Chiabi Eugene HIV Care and Treatment Physician one of the two doctors to head the team from Yaounde extended warm appreciation to the hospital administration and personnel of the Day Care for welcoming them and working with them as a team and also for the smooth integration process that has already taken place. Dr. Chiabi Eugene voiced that “the National Program for the fight against AIDS in conjunction with our Partners PEPFAR that is represented in the country by the center for disease control and Prevention CDC, has put the year 2020 as a landmark year for us to achieve epidemic control for HIV and this is a very ambitious target that when we look at figures that have to accompany all so that we get there, you agree with me that it entails a lot of work to be done in terms of injecting human resource and using it judiciously to meet u with objectives.
Permit me shed light on some of these figures, the country has been divided into for zones Northwest, Southwest, Centre and West and Northwest is in zone 1. Facilities have been recruited for this intensive recruitment of human resource based on the treatment current and the number of clients in the facility. It was realized that all over the country 90% of clients are found just in about 300 facilities in the country, it’s based on this kind of assessment that the country was divided and facilities chosen. For the Northwest Region, 30Facilities have actually been chosen and these are the facilities that carry at least 90% of the current number of clients that are in care and the Regional Hospital stands tall with a treatment current of over 5600 clients.
In order that we get our objectives attained, our partners thought that instead of having a huge treatment center like the Regional hospital with just one doctor, it is better that the number should actually be shared among more doctors, nurses, case managers to ensure effective health care delivery. the idea is any facility that has 2000 clients and above has at least once doctor and each doctor should be accountable for 2000 of those clients for effective follow up and its further broken down that for a cohort of 2000, 2nurses should be involved and each takes care of 1000 clients in the cohort. Under every nurse, we have 2 case managers who handle 500 clients each. All of this is so that clients get quality healthcare and for proper follow up.
Towards the end of last year and beginning of this year there was a serious problem of retention in the country and it is better we keep clients we already know are positive in care than to go looking for positive clients and losing those in care, that’s why the human resource targets issues on retention. When we look at the target, the Regional hospital has as target between now and the time we are expected to achieve epidemic control to test 30621 clients and with the limitations in the number of testing kids, there is need for the use of the screening tool which is a check list to know whether the client needs to be tested or not before testing is done so we don’t have to test one and the same people and the yield level in the facility is low but the prevalence rate keeps going up, reason why we have testing counselors at entry points. In order to achieve epidemic control, we will need to test them early enough, not waiting for them to get sick and come to the hospital before they get tested so that they don’t spread it to their partners and community. this will need a lot of contact tracing that’s why we have contact tracers in the team so that for every positive case that we have at the facility level, we are able to identify their sexual contacts for home testing or a convenient place where the contact may want to be tested and the more people are tested using this entry point contact tracing shows that the quality of testing that we are doing is efficient because not only are we getting the numbers, but we are preventing the level of transfusion in the community .
In this way, if it is implemented accordingly, we will have the right people tested and the yield will be appreciable. The expectation is that out of this 30621 that we are to test we should be able to identify 2531 positive cases. We are expected to test and have 765 positives out of the 2000+ that we are going to have in the course of the year from index testing. In other words index testing should contribute at least 30% of the total number of positives that we will have between now and September next year. The yield from index testing is expected to be 20% while the overall yield for testing for the Regional hospital is 8%. That is how daunting the task is for us and I wish to say that we are not coming here as CBC, we are integrating fully as staff of the hospital”.
The general supervisor Dr. Mrs Njini Rose cautioned the newly integrated on dress code and other management issues to ensure a smooth and convenient working environment.