It's amazing how quickly routine sets in. The new norm is now a wake up call at around 5am from the neighboring mosque followed by a half-conscious tracking of the lizards/vermin activity in the ceiling above my bed. I check my personal email from the comfort of bed and wait for the generator to roll to life. After a cold bucket bath (the cool water is still a welcome, even though we are in winter) I greet a smattering of the 11 collective expats on our compound for toast and Nutella/peanut butter/or whatever other condiment has managed to find its way into our cupboards. Coffee is a treat we’ve had consistently but has to be brought in from the capital (a 1 hour flight and 1 hour drive away); fortunately with the recent turnover of expats there has been an uninterrupted supply. The early risers start the 10 min walk over to the Primary Health Centre (PHC) while the rest of us pile into a car to drive over. Early mornings and late days are the best times to walk… choosing to walk back and forth from the MSF base and PHC in the scorching midday sun is an amateur move I only needed to make once.
After a brief meeting of all PHC staff we head to our posts. I head over to the ANC area where up to 80 pregnant women gather daily to be weighed, palpated (which means to have you stomach squished and prodded by the midwives until they can estimate the size of the fetus, and how far along in the pregnancy you are), and as of the end of September, tested for HIV.
Antenatal Care (ANC) has been growing and now averaging around 1000 women/month here at the PHC. The PMTCT program started up at the end of August to great acceptance. Thanks to huge efforts of previous MSF expats and national staff working in the community to spread the message and purpose of HIV testing in pregnant women, HIV testing uptake has been beyond expectations. HIV prevalence in Nigeria has been documented to be around 3% according to UNAIDS 2008 data, and therefore including a PMTCT (Prevention of Mother To Child Transmission) package in any ANC program has been strongly advocated for.
The program has now been running for about 2 months and there’s close to 100% uptake from the women. The midwives and nurses keep commenting that the women in the community really do want to know their status.
Anna is my partner in crime…she’s our PMTCT counselor and national staff, who is constantly going above and beyond her role to support the positive women in the community. She has such a gentle spirit about her as she counsels the women through the potentially tough road ahead. And I’m just beginning to have a glimpse into what that entails.