MAURITANIA: Nouakchott gets its first HIV/AIDS test and treatment centre

NOUAKCHOTT, 3 December 2004 (IRIN) - Mauritania opened its first HIV/AIDs testing and treatment centre this week in the hope of improving early detection of the disease in this staunchly Islamic desert state where public discussion of AIDS has long been restrained by social taboos. Run by the French Red Cross, the new day care centre in the capital Nouakchott will offer HIV tests as well as treatment for those living with AIDS. The outpatient clinic will offer HIV-positive people free medical, psychologicial and welfare help as well as nutrition, all in the same place. "Now that we have the centre and the drugs required, doctors are going to do their best to produce early diagnoses," Abderrahmane ould Mohamedoune, who is the head doctor of the day care centre told IRIN. "A few months back some doctors were reluctant to test patients because there was no medicine available." The new centre will be manned by three Mauritanian doctors trained by the French Red Cross as well as a chemist, a biologist and a nurse. It will have a total staff of 15 and will offer seven day care beds. The treatment centre is one of 10 outpatient clinics for people living with AIDS being established by the French Red Cross throughout sub-Saharan Africa. The official HIV prevalence rate is extremely low in Mauritania - just 0.57 percent, compared to a West African average of around five percent. But given people's reluctance to talk openly about the disease, AIDS workers in the country suspect the real rate of infection is much higher. Furthermore, this poor arid nation of 2.8 million people is looking forward to an economic boom when oil, copper and gold exports start flowing next year. And there are fears that the social changes this will bring to a country that until recently consisted mainly of desert nomads, may provoke a sharp rise in the spread of HIV. "The problem must be tackled at its root as soon as there are warnings that the epidemic might spread," Marc Gentilini, the president of the French Red Cross, told IRIN at the inauguration of the new day centre. "Now is the best moment to attack the virus," he added. "It was a very good move for Mauritania, which has been even less affected than Senegal, to commit now to resolutely fighting the epidemic." Senegal, which borders Mauritania to the south, launched a free AIDS prevention and care programme several years ago that has had a considerable impact in curbing the spread of the pandemic. It is widely regarded as one of the best and most enlightened HIV/AIDS programmes in Africa. In 2003, around one percent of the population of Senegal, a mainly Muslim country like Mauritania, was infected with HIV. Houssein ould Sid’Ahmed, who runs an NGO called Espoir et Vie (Hope and Life), said many Mauritanians living with HIV/AIDS crossed the border for tests and treatment in order to escape from social discrimination directed against them in Mauritania. The opening of the new outpatient treatment centre in Nouakchott was "a dream I can barely believe," he said. Visitors will be offered pre- and post-testing counseling. People testing positive will be offered free treatment and follow-up tests as well as psychological and nutritional support from the medical team. "The outpatient treatment centre will enable us to hand out drugs in good conditions, avoid prescription mistakes and make sure that no HIV-resistant strains emerge because drugs have been prescribed in just any old way," Gentilini said. Medical staff at the centre told IRIN that its opening should encourage more people living with HIV/AIDS who, until now, were too ashamed to seek help, or who were too poor to pay for treatment, to come forward. Although the World Bank agreed to fund a US $20-million AIDS programme in Mauritania in July 2003, the country still has only two testing centres, one in the capital Nouakchott and the other in Kiffa, a large town in the south. World Bank money will be used to help finance the new outpatient treatment centre in Nouakchott. "Even though there are not many people undergoing treatment for HIV/AIDS in Mauritania, it is absolutely necessary to increase the amount of drugs on offer," Gentilini said. Around 50 patients began receiving antriretroviral (ARV) treatment free of charge following a first delivery of ARV drugs in June 2003. A further 39 people living with AIDS have been put on ARV treatment in Nouakchott since then. These specialist drugs improve the health of people living with AIDS and prolong their lives, but cannot cure them. Ould Mohamedoune told IRIN that 300 people living with HIV/AIDS had been registered as living with AIDS in Mauritania, of whom 138 lived in the capital. Their files had been handed to the new day care centre, he added. Up until now, Espoir et Vie and another local NGO, Stop Sida, had been administering ARV treatment as well as they could. They brought a specialist doctor in from Senegal to hold a two-day clinic every month, but he was unable to cope with the demand. "It was very difficult for the sick to have to turn up with 100 people and line up for hours to see a doctor in the office of an NGO," said ould Mohamedoune. "From now on their lives are going to change." Gentilini said a lack of proper care facilities and problems in distributing drugs were the main problems faced by medical staff and carers helping people living with HIV/AIDS in Mauritania, not a lack of money. "There are sufficient funds," he said. "What's lacking in Africa are facilities to look after the ill, to give them continued care, to evaluate results. There are not enough facilities capable of providing proper long-term care."