Thursday, September 4, 2008

Lack of Coordination

Sometimes I just want to scream. There is a certain organization working here (let's call them Org A) who runs over a dozen VCT (Voluntary Counselling and Testing for HIV) sites. Keeping in mind that care and support services to people who are HIV+ are extremely limited currently in Southern Sudan, this area happens to have an ART center (anti-retroviral therapy - drugs which slow down HIV's effect on a person's immune system). However, there had been no paediatric HIV programs anywhere in the area, or so they thought. At an HIV Partners Meeting a couple weeks ago, another organization (let's call them Org B) stated in a presentation that they were running a PMTCT program (this stands for Prevention of Mother to Child Transmission of HIV) at the same facility (a private hospital) where Org A was providing VCT services. The true definition of a PMTCT program is one that tests pregnant woman for HIV (called ANC testing) as well as the administration of Nevirapine, the drug that when administered in a single dose to both mother and child, reduces the rate of HIV transmission by almost 50%. Up until this point, the common knowledge was that there was no one administering Nevirapine in Southern Sudan, so all the pregnant women who test positive for HIV had to be referred to Uganda.

So the representation from Org A was quite surprised to hear that Org B was claiming to be running a true PMTCT program, in the same site as one of their own programs nonetheless. So after some inquiries on the part of Org A, it turns out that Org B was indeed administering Nevirapine, about 9 doses per month. The problem is, Org A didn't know about this, the heads of the org running the private hospital didn't know about this, the ART center in the area didn't know about this, the County AIDS Department didn't know about this, and the Ministry of Health at the County, State and National level didn't know about this. NO ONE did.

Any explanation I can think of for why Org B was not making this known does not hold water. If they were afraid the demand would be greater than their supply, then they should be screaming at donors and the Ministry of Health for more supplies. Org A told me that they would be able to find money for the drugs, it's just that they have no personnel trained on its administration. If that was the case, they could have bought the drugs for Org B. Had they known.

So what has happened is that dozens of HIV+ women each month were being referred to Uganda (when not many of these women even have ID cards let alone a passport) when the life-saving service they need is available in their same county and has been FOR A WHOLE YEAR.


There is enough that is difficult about working in Southern Sudan, but there is no excuse for this lack of coordination and partnership, especially from an organization who is always present at partners meetings, etc. It makes me ill.

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