Earlier this week, I wrote about realities of childbirth in rural Ethiopia, of seeing a woman in agonizing labor, a woman suffering from obstetric fistula, and the dream of another young woman, Zanab, of becoming a fistula doctor. In Part II, of my report from Ethiopia, I take you back to the same place, the Adet Health Center, 40 kilometers from the city of Bahir Dar to tell you about how this community is responding to HIV/AIDS.

As the second most populous nation in Africa, Ethiopia struggles to meet the needs of its nearly 80 million citizens. Today, about one million Ethiopians, including more than 90,000 children younger than 15, are living with HIV. The vast majority of children living with HIV—90% globally—contracted the virus from their mothers either in utero, during childbirth, or through breastfeeding. Preventing this type of infection, known as mother-to-child HIV transmission or vertical transmission, requires that women have access to primary HIV prevention but also breastfeeding alternatives and antiretroviral therapy during pregnancy, which is 95% effective in protecting an unborn child or newborn baby from being infected. In Ethiopia, however, as many as 66,000 pregnant women living with HIV do not have access to this essential treatment.

At the Adet Health Center, I visited a support group for women living with HIV. In a small building down a small, muddy path from the health center, I find four women talking and laughing, their babies by their sides. One woman is preparing a coffee ceremony; two are spinning cotton using what looks like a spinning top. The fourth woman is attending to her very energetic baby. These women are here for a meeting of a local women’s support group, which provides these women with an opportunity to discuss the realities of their lives with HIV, including how they:   

• Disclose their HIV status to partners and others
• Deal with stigma and discrimination
• Adhere to guidance for preventing mother-to-child HIV transmission, including antiretroviral therapy
• Use alternative infant feeding options
• Prevent unintended pregnancies
• Practice safer sex and living positively
• Seek nutritional support and skills training to support themselves.

I am told that two of the women are new and have come to learn more about the group. They are considering joining. All of these women are living with HIV, but they look healthy, as do their babies. They are some of the lucky ones: they are on antiretroviral therapy (ARVs).  We chat for awhile and then go to the next room to meet the nurses administering the ARVs. The nurses’ office has a wall filled with patients’ files, some of whom are on ARVs and others are not yet on the drugs. In this clinic, there are 544 patients receiving these life-saving medications. The nurses tell me with confidence that the adherence rate for staying on the medication is high, about 95%. They also tell that there are more than 1,000 patients waiting to be put on treatment. Finally, the conversation turns to the heavy demand for Preventive Care Packages. The staff tells me they have already distributed all of these kits and are in need of more of them. The kits, which contain things like bed nets, water purification tablets, a jerry can, condoms, and de-worming tablets, are especially important for people living with HIV because they help protect people with compromised immune systems from dangerous opportunistic infections. I nod my head, thinking about how we can get them more of what they need. Before I leave, I duck back in on the women’s support group to look at these smiling women. I am proud to know that IntraHealth has played a role in making a difference in their lives, and I think about the others in this community who are still in need.