Projekte

Nachfolgend Projektvorschlag und Situationsbeschreibung zur Bekämpfung der Folgen von AIDS in Lesotho:
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ROTARY CLUB/S HIV LABORATORY CARE

BACKGROUND

Lesotho is highly burdened with HIV infected patients.

Thanks to goodness, the medications for HIV are currently available for free. Access to treatment is almost within walking distance to all who seriously wish to prolong their lives. There is a Test and Treat campaign going on in every corner in Lesotho. This means, many people are tested and immediately put on treatment. There is a workplace HIV testing campaign currently going on, so that people working in the factories who previously did not have the time to access HIV testing are now having it done at their work place during their break times.

Almost all these HIV testing and treating is carried on by many NGOs parading in Lesotho. The government of Lesotho has the desire to support the program by providing laboratory services to the patients. Unfortunately, the sheer number of patients and the challenging infrastructure and staffing of the government hospitals has become a stumbling block to the well intended progress of the project. Sadly, many patients go on treatment for months without proper laboratory investigations. Side effects of the ARVs are not picked or picked very late. There are many instances of patients having complications to their livers, kidneys and bone marrow presenting with late complications and death of liver and kidney failures and severe anemia requiring blood transfusion. And to make matters worse with the high percentage of infections getting blood for transfusion is getting more difficult than finding gold.

From 2009 to 2014, ALAFA an NGO, provided a comprehensive care for HIV clothing factory workers in Maputsoe and Maseru. About 5,000 factory workers and family were enrolled in the program and doctors in the private practice, including myself, were contracted to provide the medical care for them. Jesse Polyclinic was contracted to provide the supporting laboratory service to the patients. To the surprise of the doubting Thomases, we achieved a zero HIV infection in the children born to the HIV positive mothers and reduced the death rate among the factory workers to the surprise of the factory managers. Unfortunately as many good things come to an end quicker than we hope they run out of funds and closed. The burden of looking after the patients was left on the contracted doctors who due the humanitarian reasons have continued to look after those patients.

The challenge faced is laboratory backup. The government of Lesotho promised to take over the program but implementation of the promise has not happened.

The Club would like to take on that good work ALAFA has left and provide a laboratory service to the HIV patients in the factories and others if funds allow.

The basic needs to monitor the progress of people on HAART are;

1. ALT to monitor the liver health
2. Creatinine to monitor the kidney
3. Full blood count to monitor the bone marrow’s function
4. CD4 to monitor immunological recovery
5. Viral load count to monitor the effectiveness of the anti- retrovirals.
6. Other tests like cholesterol, triglycerides, urea, amylase, GGT, blood glucose, pregnancy tests, urine protein test may become necessary in some of the patients.

The plan is to provide the basic laboratory service to support the ongoing HIV care in the factories and any other patients we will deem in need.

We intend going for laboratory equipment rental which has the big advantage of no heavy initial cash investment and also putting the much needed and expensive repairs on the company renting the equipment. The equipment is replaced if non functional, which if we have purchased would mean buying a new machine or the program coming to an abrupt end.

Currently it cost about R 3,500 to R5000.00 per month for rental.

The average cost of the tests

We may be able to push the cost down if we run many samples, as the companies renting the machines charge the cost of reagents according the volumes purchased.

These tests are done every 6 months from the onset of treatment and when patient is stable once a year.

The laboratory technician/s will need some stipend of R5000.00 to R6000.00 a month.

This is the initial sketch which we can develop as we go.