Increasing focus on paediatric care

A joint effort by local health authorities, aid agencies and a major pharmaceutical company is expected to improve paediatric care in Swaziland. With four out of 10 pregnant women testing positive for HIV, adequate healthcare for children has become a priority as the government grapples with climbing infection rates. The high cost of drugs and lack of trained medical staff were seen as the main reasons for the ongoing neglect of child health in this tiny landlocked country of just over a million people: Swaziland has just four paediatricians. "Up to this time we've had very little attention given to paediatrics," UN Children's Fund (UNICEF) Country Representative, Alan Brody, told PlusNews. Global pharmaceutical company Bristol-Myers Squibb is paying for the construction of a US $2 million paediatric centre in the capital, Mbabane. Run by the Baylor Medical College in the United States and modelled on one already in operation in Gaborone, Botswana, the facility is due to open by year's end. The Swazi government has committed itself to providing anti-AIDS drugs. "That was the biggest question in Botswana: 'Will people come?' But people answered with their feet - 3,200 patients tested in the first months of operation," said John DaMonti, president of the Bristol-Myers Squibb Foundation, which has financed more than 170 health-related developmental projects in sub-Saharan Africa under its 'Secure the Future' programme. The centre will feature a large outpatient clinic, procedure rooms, a pharmacy, laboratory and conference centre and offices. Psychological, social and child-life services will be provided, along with comprehensive primary and HIV/AIDS speciality care. "In addition to caring for children, the centre will be used for training healthcare professionals and seeking to add to the body of knowledge about the vulnerable population of Swazi children, especially those with HIV/AIDS," said Ministry of Health and Social Welfare Principal Secretary John Kunene. A pilot project to test the feasibility of a paediatric centre focusing on AIDS mitigation was launched in October 2003 and around 15,000 people have been assisted. Programme director Busi Bhembe noted that Nevirapine, commonly used to prevent mother-to-child transmission of the virus, had proven effective. "The mothers are trained on dosages and times to administer the drugs. They understand that [in some cases] the children will have to use the ARVs for the rest of their lives," she explained. Doris Dlamini, one of the participants, told PlusNews: "I am HIV positive, but my baby is negative. I am happy with the support I got from the pregnant women programme, because I believe it helped save my baby. I fear what might have happened to her if I did not get on the drug [programme] then." Brody explained that the drop in the cost of antiretroviral drugs had made it "economically feasible" to treat children, but noted: "We are just starting - there needs to be programmes in place." At a sod-turning ceremony for the centre, Prime Minister Themba Dlamini said: "Because of AIDS, we have lost some of the progress we made in healthcare since independence: we are at the crossroads with orphans and vulnerable children; the problem is compounded by poverty."