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South Africa Tackles Prevention of Mother-to-Child HIV Transmission

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Lisa Schlein

Around 70,000 babies are born with HIV in South Africa every year. It is one of the main contributors to the country's high infant mortality rate.   In a hopeful sign, programs aimed at preventing the transmission of HIV from mother-to-child are meeting with success.  One such program is part of a community-based project called Total Control of the Epidemic (TCE).

Total Control of the Epidemic was started in Denmark in 1977 by the organization, Humana People to People.  TCE provides care and support to entire communities heavily affected by HIV and AIDS.

The program has been operating in South Africa for eight years and has reached more than three million people in five of the country's nine provinces.  

PEPFAR, the U.S. President's Emergency Plan for AIDS Relief and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria are the main contributors.

Corp commander of the TCE program in Ilembe Province, Ruth Makembe, says one of the goals of the program is to make sure people know their HIV status.

"If they are positive, they should know where to go and get support-in clinics or hospitals where they can get medication," said Makembe.  "If they are negative, we encourage them to stay negative for the rest of their lives.  We are also saying that they have to change their sexual behavior."  

The program employs locals as field officers for a period of three years.  Each one works with 2,000 people.  The field officers go from house-to-house, person-to person to get each individual to become active in the fight against HIV/AIDS.

A group of women welcome visitors to Ndulinde clinic, a child and maternal health clinic in Ilembe. They are wearing red t-shirts and red berets with the TCE logo, identifying them as field officers.

Troop commander, Ntsoaki Motaung, says the song warns women not to give into the sexual demands of men.

"You want everything.  I give you my hand, I give you my breast-and then this one, you can't get it," said Motaung.

Pregnant women and mothers, holding their babies, are sitting on two long benches waiting to see a nurse.  The clinic specializes in the prevention of Mother-to-Child Transmission of HIV.

At the clinic, HIV-positive pregnant women receive the necessary medication and care to give birth to a child free of HIV.  

"My name is Mbali Mhlongo, I'm 25 years old…I'm eight months pregnant," said Mhlongo.  

Mhlongo has three children and is pregnant with her fourth.  She says she got tested for HIV after she became pregnant because she saw that her boyfriend was sick and she got worried.  She says she is HIV-positive.

"I came to take my treatment for the baby and to see how the baby is feeling," she added.  "How he is kicking and all that stuff and I do everything what they say I must do.  When they are giving us a treatment, they say it is for the baby, to protect the baby."  

Mhlongo says she is feeling well except she is tired because she has to walk a long distance to get to the clinic.

Nonhlanhla Masuku, 23, welcomes visitors to her home, a one-room mud hut with a thatched roof.  She lives alone here with her three-year-old son and six-week-old baby.  

The house is situated in a poor rural area of Kwazulu Natal.  There are few neighbors and the distances to the water well, to the clinic, to the school are long.

Masuku tells the visitors and the field officer accompanying them that she got herself tested and is HIV-positive.  But, she says, she does not yet know whether her baby has been infected.

"She is saying she got the medication for the baby immediately after she delivered and, I think she is talking about AZT because she said they gave her to use that medicine for seven days," explained a field officer.

Six weeks after the baby's birth, a mother, who is enrolled in the treatment program, has to bring her baby to the clinic for injections against childhood illnesses, such as measles and polio.  

Yogan Pillay is acting director of the National Department of Health that oversees the HIV/AIDS and TB epidemics in South Africa.  He says the baby's HIV status is checked at the same time.

"And we're finding that fewer children are being born HIV positive to HIV positive moms," he noted.  "Our target for 2011 is 5 percent.  The national average at the moment is heading towards 7 percent."

Pillay says he has seen significant improvement and is sure the target of five percent transmission rate will be reached.  While this is good, he says the ultimate aim is to completely eliminate mother-to-child transmission of HIV.

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