HIV AIDS
2011 PATA Forum Botswana
Opening evening: The conference opened with one participant leading us in singing and dancing to a new “PATA” song written by a doctor from FACES clinic in Kenya, which set the tone for the conference. As in the past, key stakeholders were present including Dr. Jibril, head of HIV in the Ministry of Health, Botswana as well as Prof. Gabriel Ananbwani, head of Botswana Baylor clinic and the UNICEF lead for the region, Guillermo Marquez who gave keynote speeches. It ended with David Altschuler speaking about PATA and the work of One to One Children’s Fund and welcoming the 41 clinic teams from each region.
Plenary sessions
Day 1: This was the most medically focused of the 3 days. The presenters outlined developments in research and clinical work in discussing early infant care, which included discussing the relative merits of formula and breast feeding when mothers are HIV+ as well as the dosages of treatment children require when on breast milk and when they are weaned.
Key statistics...
- 1 in 4 children in need of ARVs are currently receiving them
- PATA affiliated clinics care for approximately 20% of HIV+ children
- If infants born with HIV can be put on ARVs before they are 12 weeks old, their mortality rate is reduced by 75%
- 50% of new infections are children and young people under 24
- In South Africa alone, there are almost 400,000 new infections each year
Day 2: This focused on the medical and psychological care of adolescent girls – which included considering the challenges of ‘ordinary’ adolescence, the link between depression, pregnancy and HIV/AIDS, teenage pregnancy and prevention.
Key statistics...
- 70% of HIV+ 15 to 24 year olds are girls and women
- 20% (and rapidly growing) of the HIV population are adolescents
- 20% of adolescents are HIV+
- HIV+ adolescents are much more likely to experience mental disorders
Day 3: These presentations focused on the voice of the child, palliative care (which included discussions about how to tell children they are dying) and work with Expert Patients. The final plenary was devoted to quality improvement and included a working team session on setting and measuring goals, leading into the final afternoon workshop where each team committed to goals and tasks for the next 3, 6 and 12 months, which will be monitored by PATA.
Almost without exception the presentations were incredibly clear. Of particular relevance to One to One Children Fund’s SMS Lifeline programme was a discussion about the way in which SMS text printers could be used to speed up the process between children being tested and learning their results.
Speakers corner: Each day teams presented a series of pre-prepared 5 minute presentations on work, in most cases, related to the theme of that day – though some of these were very rushed with people trying to pack too much in, on the whole they were very good and engaged each team at the forum.
Brain storming sessions: As with previous PATA forums each day participants had a chance to brainstorm the implications of what they had heard with members of the same discipline and later with the rest of their team with a view of considering what changes they would like to make to their current work. For example, many of the teams are focusing on making their services more adolescent friendly by instituting adolescent days only and extending clinic working hours to make sure that adolescent appointments can occur outside of school hours; clinic teams have also been inspired to develop more systematic transitioning programmes for adolescents so that they are supported in the transition from paediatric to adolescent care.
Expert Patients meeting: Myself, David, Victor Misume (another member of the PATA Steering Committee) and Roseanne Turner who is based in Cape Town at the PATA office and has been monitoring the Expert Patient programme, met supervisors of the Expert Patients to discuss the findings of Roseanne’s research, as well as to discuss the various ways in which EPs are being used and the challenges the supervisors and EPs face. In particular, we focussed on training and core competencies required by EPs as well as an appropriate Code of Conduct for all EPs.
Master classes: Once more this was a highlight – although it was incredibly hot, they were very well attended and focused on such issues as counselling skills and medical innovations in adolescent care, communication in the pharmacy, staff attitudes to adolescents and the application of a PATA toolkit for working with children.
Ending session: Facilitated by Shaffiq Essajee, this began with a brief outline of the key issues covered and the teams who had not spoken were invited to share their thoughts on the forum. Continuing the theme of the opening evening, most of them complemented what they said with a song. David concluded with some thoughts for the future and thanks for the various contributions.
Caring for the carers: A real highlight was that yoga sessions were held each morning and evening by 2 volunteers, Brain Bergman and Linda Codron – and as some plenary and speakers corner sessions were long on the 2nd and 3rd day, they were broken up with some yoga exercises.
Challenges: There are of course many challenges which were highlighted in plenary and group discussions, such as:
- the struggle of non-medical professionals for their voice to be heard
- the need for greater collaboration between paediatric care and prevention of mother to child transmission
- how to address sexual and reproductive health when employed by faith based organizations for whom discussions about sex are taboo.
Final Comments: In general my sense is that this was probably the best run and most relevant forum we have attended, and that despite the huge challenges of this work the participants were open and hungry to learn – with a real ‘can do’ attitude. The impact and “ripple effect” of PATA was clear to see. PATA is planning 10 local forums for 2012, and many of the teams that attended the forum have expressed an interest in holding a local forum in their area to spread the PATA effect by sharing what they learnt in Botswana.
Jenny Altschuler, Clinical Director
For more information on this Summit and future PATA Forums, as well
as to download materials used at our forums, please see the PATA website:
www.teampata.org
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