Mother to Child

On top of working at Bugando Hospital, a large portion of my work in Tanzania will involve helping to scale up the pediatric HIV care at district hospitals throughout the northwest region of the country. District hospitals, for the most part, are the first tier hospitals where most Tanzanians get their medical care. Cases that are complicated or need specialized treatment are sent to referral facilities like Bugando.

One of the district hospitals I’ve been assigned to is Magu District Hospital, which is about 50 km east of Mwanza. The plan is to visit Magu about twice a month, giving lectures to the medical staff and seeing patients with local doctors in the HIV clinic. Most people in Magu District are subsistence farmers.

Wednesday was my first time working with the medical staff at Magu. The HIV clinic opens at 9 AM, but many patients arrive much earlier, since care is given on a first come first serve basis even for those who have appointments that day. For many people, coming to the clinic is a full day event, since traveling back and forth from home to the clinic can take several hours.
I saw about 20 patients together with John, my Tanzanian colleague for the day. The patients included newborn babies exposed to HIV from their mothers, and HIV infected grandmothers caring for their infected grandchildren because the mothers had passed away.

A heart-breaking dilemma for many HIV infected mothers here is how to feed their baby. Breast milk is a vector for transmission of HIV from mother to child. But since the majority of families cannot afford infant formula, and handing out formula at places like Bugando is not sustainable, infected mothers have no choice but to continue breast feeding. Again, this magnifies how much harder life is for a poor woman living in a poor country.

Studies have shown the risk of mother to child transmission of HIV (without any intervention) ranges from 15-40%. In industrialized countries, where mothers are able to access antiretroviral medications easily during pregnancy/delivery and use infant formula, the rate is less than 2%.