Okongo sets global trend
The innovative HIV treatment administered by the Okongo district hospital and the first of it is kind worldwide has been recognised by World Health Organisation (WHO) as a model for critical health service.
Emilia Mwalungama, 45, from Onghalulu in Okongo area gave her testimony during a handover ceremony of eight pre-fabricated dispensary buildings to be used as outreach clinics for antiretroviral treatment (ART) distribution centres.
This aim is to reach remote areas to complement the Okongo programme and the structures were donated by the United State of America President’s Emergency Plan for AIDS Relief (PEPFAR) on Wednesday.
Emilia, who is one of the beneficiaries of the Okongo outreach programme, revealed that she tested HIV-positive in November 2004 when her husband was sick for a long period. She said she was hopeless because community members discriminated against her for being HIV-positive.
“I started my treatment in April 2005 and my CD4 count was 283 at that time. It was not easy for me because that time Okongo district hospital was not administering ART,” she said.
“We had to go to Eenhana hospital which is over 90km away, and if there was nothing at Eenhana we had to go and look for them as far as Onandjokwe, Engela or Oshakati. We had to spend up to N$150 or more a day for transport alone.”
In 2006, the Okongo hospital started administering the ARTs and it was a huge relief to the transport burden.
“In 2007, the Okongo ART team realised that some patients were not taking their medication properly. They were skipping some days because they could not afford transport costs to get to the hospital. They decided to bring treatment to us deep in the villages that are far away and others that can only be accessed using four-wheel drive vehicles. Communities organised treatment centres in our villages,” Emilia stated.
HIV-negative children
“When the programme started in 2008, my viral load was 218. During 2009 and 2010 it dropped to below 100 and during 2012 and 2013 it dropped again to below 40. From 2014, my viral load could not be detected and neither could my husband’s. This means that when treatment was brought to us, we took it seriously as there was nothing to prevent us following our treatment. During that time I was on treatment, I gave birth to two children, one is nine and another one is three, and they are all HIV-negative.”
Emilia said that she continues taking her medication and as a chairperson of their treatment centre, she will continue to encourage other HIV-positive patients to follow her path. She said the main challenge now facing HIV-positive patients in rural areas is the issue of food shortages. She said people on ART need proper and healthy meals, but for many rural people this is a major challenge.
In 2007, the Okongo district hospital introduced a community medication outreach programme to take AR treatment to people in remote rural areas to reduce travelling costs and the distance they travel. The initiative was spearheaded by Sister Linea Hans. The programme has been described by beneficiaries and Ministry of Health and Social Services officials as a great achievement. Community members working with their traditional readers identified distribution centres.
It was announced during the handover ceremony that WHO recommended this approach of getting treatment to the people in remote areas to be used internationally.
The best
The American ambassador also announced that the Okongo strategy is the best alternative to reach the 90/90/90 goal that the Namibian government set, adding that their effort would be doubled so that the government can reach this goal. The Namibian government set the 90/90/90 goal target to become the first African country to identify 90% of all people who are HIV-positive, getting 90% of them onto lifesaving ART, and achieve viral suppression in 90% of the people taking ART.
At the donation event, the American ambassador to Namibia Thomas Daughton, in a speech read on his behalf, said Okongo is a true pioneer in the treatment of people living with HIV.
He congratulated Okongo for the innovative treatment programme and the care rendered to patients.
“Almost ten years ago when you started this programme, there were no guidelines about how to help people living with HIV in rural areas. Your guiding principle was simple: Offer the best care to your community in the most direct way. It was elegant and effective. Knowing that your patients were travelling for days at a time and at high cost just to get their lifesaving ART, you opened community-based medicine points to make it much easier for people with HIV to get their medication,” Daughton’s speech read.
‘Unique programme’
His speech also revealed that WHO has now recognised Okongo’s unique programme and has recommended using the approach at international health communities to make sure that patients get the best possible treatment especially for critical health services.
All 13 regional health directorates were represented during the handover ceremony so that they can take the Okongo model to their respective regions. Anne-Marie Nitschke, who represented the health ministry’s permanent secretary at the handover ceremony, told representatives that the decentralisation of services especially to rural areas throughout Namibia is one of the areas that need improvement.
“Ohangwena regional health directorate and Okongo community, government applauds you for this great achievement and I would like you to keep it up. You have proven innovative community engagement in the chronic care management of HIV as a sustainable approach that can produce favourable results. Other regions must also implement the same programme,” Nitschke said.
Daughton also said that the most important role the Okongo programme has achieved is helping to reduce the stigma of being HIV-positive.
“Results to your programme are very simple and clear. People living with HIV/Aids in Okongo, like Emilia who gave her testimony, have a better quality of life. We want to learn from your success as we work with the Namibian government to expand your innovation care model to other communities in Namibia,” he said.
“In effort to reach that all-important 90/90/90 target, the US government will fund an additional 431 critical health care and support positions in Namibia including doctors, nurses, clinical mentors, pharmacists and counselors. We will also provide 14 modular houses for healthcare workers and 18 vehicles to reach even more patients in rural areas. The eight new mobile clinic spaces are the first of 40 facilities that will be delivered to districts in Namibia that can benefit from the Okongo lesson.”
Okongo villages to receive the pre-fabricated clinics include Oshifitu, Oupili, Oshitishiwa, Onghalulu, Oshalumbu, Olukula, Onamihonga and Omutwewomunhu.
ILENI NANDJATO
Emilia Mwalungama, 45, from Onghalulu in Okongo area gave her testimony during a handover ceremony of eight pre-fabricated dispensary buildings to be used as outreach clinics for antiretroviral treatment (ART) distribution centres.
This aim is to reach remote areas to complement the Okongo programme and the structures were donated by the United State of America President’s Emergency Plan for AIDS Relief (PEPFAR) on Wednesday.
Emilia, who is one of the beneficiaries of the Okongo outreach programme, revealed that she tested HIV-positive in November 2004 when her husband was sick for a long period. She said she was hopeless because community members discriminated against her for being HIV-positive.
“I started my treatment in April 2005 and my CD4 count was 283 at that time. It was not easy for me because that time Okongo district hospital was not administering ART,” she said.
“We had to go to Eenhana hospital which is over 90km away, and if there was nothing at Eenhana we had to go and look for them as far as Onandjokwe, Engela or Oshakati. We had to spend up to N$150 or more a day for transport alone.”
In 2006, the Okongo hospital started administering the ARTs and it was a huge relief to the transport burden.
“In 2007, the Okongo ART team realised that some patients were not taking their medication properly. They were skipping some days because they could not afford transport costs to get to the hospital. They decided to bring treatment to us deep in the villages that are far away and others that can only be accessed using four-wheel drive vehicles. Communities organised treatment centres in our villages,” Emilia stated.
HIV-negative children
“When the programme started in 2008, my viral load was 218. During 2009 and 2010 it dropped to below 100 and during 2012 and 2013 it dropped again to below 40. From 2014, my viral load could not be detected and neither could my husband’s. This means that when treatment was brought to us, we took it seriously as there was nothing to prevent us following our treatment. During that time I was on treatment, I gave birth to two children, one is nine and another one is three, and they are all HIV-negative.”
Emilia said that she continues taking her medication and as a chairperson of their treatment centre, she will continue to encourage other HIV-positive patients to follow her path. She said the main challenge now facing HIV-positive patients in rural areas is the issue of food shortages. She said people on ART need proper and healthy meals, but for many rural people this is a major challenge.
In 2007, the Okongo district hospital introduced a community medication outreach programme to take AR treatment to people in remote rural areas to reduce travelling costs and the distance they travel. The initiative was spearheaded by Sister Linea Hans. The programme has been described by beneficiaries and Ministry of Health and Social Services officials as a great achievement. Community members working with their traditional readers identified distribution centres.
It was announced during the handover ceremony that WHO recommended this approach of getting treatment to the people in remote areas to be used internationally.
The best
The American ambassador also announced that the Okongo strategy is the best alternative to reach the 90/90/90 goal that the Namibian government set, adding that their effort would be doubled so that the government can reach this goal. The Namibian government set the 90/90/90 goal target to become the first African country to identify 90% of all people who are HIV-positive, getting 90% of them onto lifesaving ART, and achieve viral suppression in 90% of the people taking ART.
At the donation event, the American ambassador to Namibia Thomas Daughton, in a speech read on his behalf, said Okongo is a true pioneer in the treatment of people living with HIV.
He congratulated Okongo for the innovative treatment programme and the care rendered to patients.
“Almost ten years ago when you started this programme, there were no guidelines about how to help people living with HIV in rural areas. Your guiding principle was simple: Offer the best care to your community in the most direct way. It was elegant and effective. Knowing that your patients were travelling for days at a time and at high cost just to get their lifesaving ART, you opened community-based medicine points to make it much easier for people with HIV to get their medication,” Daughton’s speech read.
‘Unique programme’
His speech also revealed that WHO has now recognised Okongo’s unique programme and has recommended using the approach at international health communities to make sure that patients get the best possible treatment especially for critical health services.
All 13 regional health directorates were represented during the handover ceremony so that they can take the Okongo model to their respective regions. Anne-Marie Nitschke, who represented the health ministry’s permanent secretary at the handover ceremony, told representatives that the decentralisation of services especially to rural areas throughout Namibia is one of the areas that need improvement.
“Ohangwena regional health directorate and Okongo community, government applauds you for this great achievement and I would like you to keep it up. You have proven innovative community engagement in the chronic care management of HIV as a sustainable approach that can produce favourable results. Other regions must also implement the same programme,” Nitschke said.
Daughton also said that the most important role the Okongo programme has achieved is helping to reduce the stigma of being HIV-positive.
“Results to your programme are very simple and clear. People living with HIV/Aids in Okongo, like Emilia who gave her testimony, have a better quality of life. We want to learn from your success as we work with the Namibian government to expand your innovation care model to other communities in Namibia,” he said.
“In effort to reach that all-important 90/90/90 target, the US government will fund an additional 431 critical health care and support positions in Namibia including doctors, nurses, clinical mentors, pharmacists and counselors. We will also provide 14 modular houses for healthcare workers and 18 vehicles to reach even more patients in rural areas. The eight new mobile clinic spaces are the first of 40 facilities that will be delivered to districts in Namibia that can benefit from the Okongo lesson.”
Okongo villages to receive the pre-fabricated clinics include Oshifitu, Oupili, Oshitishiwa, Onghalulu, Oshalumbu, Olukula, Onamihonga and Omutwewomunhu.
ILENI NANDJATO
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