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Overcoming Language Barrier: Fighting against AIDS in Children

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Photo by Tom Greenwood

Nurses at Hatyai Hospital in the southern Songkla province of Thailand found difficulty in getting a life-and-death message across to a new mother. Communication became a hardship because the patient was a Burmese migrant worker, getting a low-paid job in a food-processing factory. Unfortunately, she couldn’t speak Thai, was diagnosed HIV positive, and just gave birth to a baby.

That’s just an example of language-barrier obstacle that the medical staff at Hatyai Hospital have to deal with constantly. Oxfam supported a team, whose members are community/religious leaders, local NGO staff, caregivers, and HIV-positive volunteers, to work with the hospital team to design a leaflet in Burmese language providing information about early HIV diagnosis and heath care for mothers and children infected by HIV.

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Early HIV diagnosis promotion poster in Burmese language placed on an information broad in the hospital.

“These posters and leaflets are very useful and help communicate with HIV-infected Burmese women. We are able to explain and give information to them about early HIV diagnosis, care for their infants, and care for mothers after giving birth,” said Boonpa Cheuypram, a nurse at Hatyai Hospital.

Hai Yai Hospital is one of 13 hospitals joining in the early HIV diagnosis and ARV treatment in children program that Oxfam gives support through a medical research team in Chiangmai, a northern province of Thailand. Since 2005, the program has provided HIV testing by using the new technique to over 800 children. For those who were diagnosed HIV positive and needed to start ARV therapy, they are now receiving the treatment and health-care services for free under the government’s health insurance system. However, there are a fraction of children who do not have access to the treatment because of their non-Thai status. Currently Oxfam is supporting the hospitals to give the treatment and care to these marginalized children.

One quarter of infants who are born to mothers living with HIV and AIDS are at risk from HIV infection unless the mothers and newly-born babies receive antiretroviral (ARV) treatment. The infection rate in children will reduce significantly down to 2-3% if a proper ARV therapy is given to both mothers and babies before and after childbirth. Yet, half of these babies remain in danger, contracting AIDS and needing ARV medication before their second birthday anniversary, whereas most of young children in Thailand receive HIV diagnosis at 18 months of age.

“It helps save lives of children whose mothers are HIV positive. The sooner we know if they’re infected by HIV, the faster we can start giving ARV medication to the babies,” said Sirirat Hammajitsagul, the field staff of Oxfam’s partner organization in Chiangmai.

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Dry-blood sample on filter paper is ready to be mailed to a lab for HIV test.
Photo by Tom Greenwood

With a new blood-testing technique for HIV infection, namely HIV DNA PCR, it makes a difference in the lives of both parents and children. Instead of waiting until 18 months old, the babies at the age of two months can receive a blood test for HIV. Unlike the HIV diagnosis that uses liquid blood, the new technique is very convenient. By simply dropping blood onto a piece of filter paper, leaving it to dry well and keeping the paper in a Zip-Lock plastic bag, the sample is then ready to be safely mailed to a lab for testing. The testing results will be sent back to the hospitals within one month. Whether positive or negative, the children need to have another blood test for confirmation not later than two months after the first examination.

Ultimately Oxfam wants to advocate for policy change in provision of early HIV diagnosis in newly-born children. By using this program as a model, Oxfam and the partner organization would like to dialogue with the Thai government to adopt the model and replicate the practice nationwide.

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