Differences faded when a group of African health care leaders, visiting Madison as part of the Mandela Washington Fellowship for Young African Leaders, sat down this summer to talk about HIV/AIDS challenges with their University of Wisconsin-Madison counterparts.
Sharing a table in the UW-Madison Health Science Learning Center, they realized the issues they face with HIV/AIDS know no boundaries. Physicians, nurses, midwives and social workers from Kenya, Lesotho, Nigeria, Botswana, Uganda and Wisconsin recognized each other’s questions.
- What do you do when a patient has taken so many pills for so long that she refuses to take any more?
- When do you tell a child who was born with the virus that he is HIV-positive?
- Stigma is alive and well everywhere: How do you help patients know who to tell and when to remain silent?
Although they come from two continents with vastly different resources, each group can
claim the same rate of success—measured by the number of patients whose HIV is enough under control that no virus can be detected. About 30 percent of U.S. patients reach that zero viral load; about 30 percent of African patients reach the goal.
“We are practicing in a different way, but at the end of the day, we have the same goal. We’re looking to an HIV-free future.”—Susan Mmalane, Botswana
“We are practicing in a different way, but, at the end of the day, we have the same goal,” says Susan Mmalane, an HIV/AIDS prevention and care officer for the Botswana Red Cross Society in Dukwi Refugee Camp. “We’re looking to an HIV-free future.” Of the 2,600 refugees who came from across Africa, 10 percent are children who fled war zones, many of them arriving alone. Mmalane supervises volunteers, counsel patients and works with an HIV support group. She would like to establish an HIV/AIDS club for the children living with the virus, so they can give each other hope.
“We tend to think we’d be so much better,” says Susan Gold, a UW Health HIV nurse who has worked in and led UW-Madison global health field courses to east Africa since 2003. “But (the results are) about the same because there are so many barriers to care all over the world. It doesn’t matter what country you live in, HIV has huge effects, economically, politically, socially. We’re all in this together. (The meeting) was an affirmation that the fight goes on.” Gold also founded Talking Health Out Loud, a mobile platform that gives teens a safe place to ask questions about HIV and sexuality.
The HIV/AIDS meeting brought together Africans and Wisconsinites who are on the front lines of prevention and care. It was the sort of intimate, personal discussion that can only take place when participants are in the same room sharing the same concerns.
The African health leaders were among 25 scholars who spent six weeks in Madison in summer 2016 as part of the larger, national program sponsored by the U.S. Department of State. The Mandela Washington Fellowship for Young African Leaders is the flagship program of the Young African Leaders Initiative. The UW African Studies Program hosted the scholars, and the Global Health Institute organized several academic sessions for them, covering climate change and health, quality improvement, immunizations, designing cities for the future and HIV/AIDS.
“There’s so much we can learn from people who do similar work to what we do, and who do it in resource limited areas,” says James Conway, a UW physician specializing in pediatric infectious disease who organized the meeting. He’s also the UW-Madison Global Health Institute associate director of health sciences and has worked around the world to improve access to vaccinations.
“As things get tighter in the United States, we realize we need to be more efficient,” Conway says. “One of the most efficient things you can see is how people manage health challenges in resource-challenged settings.
Bringing people together so they see their challenges are the same makes them more likely to work together. Sitting together as they did in Madison lets them break down what needs to be done and share how they are taking those steps.
“If we share experiences and collaborate, we have better results.”—Femi Adebola, Nigeria
“Communication is always a two-way thing,” says Babafemi “Femi” Adebola, a Nigerian emergency room physician who also leads corporate services at HiDoctor-Nigeria, a mobile platform that provides free access to health information and medical consultation. “If we share experiences and collaborate, we have better results. If something works somewhere, we can pick something that we can implement in our own place.”
Nigeria has youth-friendly HIV centers that don’t look like clinics and teens are often reluctant to move to adult care. With four doctors for every 100,000 people, physicians can’t spend a lot of time on helping with the transition. Adebola was inspired to see newer drugs available in Madison that will decrease the number of pills and quantities of medicine needed to control HIV. He was surprised to learn that, even in the United States, people also might travel hundreds of miles to access care. “It felt that Africa was not so much left behind,” he says. “The world needs to work more on access to care and funding for vulnerable groups.”
Kenyan physician Sicily Mburu works in HIV/AIDs prevention and care and founded
@AIDSnomore to get information to teens and young people through social media. With more than 1 million HIV cases in the country and a surge of teens and children born with the virus, she struggles with how soon to let children know they have HIV. She also engages with young HIV-positive moms on how to breastfeed and safely wean their babies.
“We have made connections and have networks to come back and talk to,” she says of her UW-Madison colleagues. “This is not a one-time deal. We will continue to share our knowledge with our countries and come back to our mentors at UW.”
By Ann Grauvogl/ October 5, 2016