Children's Home currently has sixty (60)
children living with the AIDS. Of this number only thirty-five (35)
are on Antiretrovirals (ARVs). The remaining twenty-five (25)
children still have relatively high CD4 count.
The eldest child
living with AIDS at Kasisi Children's Home is sixteen (16) years,
was brought at the age of three (3) months. As at that time,
not much about HIV/AIDS was known the only treatment this child used
to receive were different doses of Antibiotics. It was not until the
early 1990s, that the she took an HIV test and was found to be HIV
positive. Since then, the Home made a policy that all
new children accepted would be tested for HIV.
In 1994, a new wing of babies was opened with the vision of
providing total care, love, hope, and education to the children
living with AIDS. The house, called House of Hope, has a capacity of
twenty (20) beds for children aging from zero to three (0 - 3) years
old. For children from the age of four (4) years and above, there is
another wing called St. Martins house.
"Where from" of Children at Kasisi
The children at the Home come from all the different parts of
Zambia, and with varying reasons. There are families (extended,
spouses that have lost a partner) that due to extreme poverty, as
they do not have the strength or means necessary to bring up a baby,
and have had no recourse but to bring the babies to the Home.
Children also come
through other agencies. These are mostly social welfare department,
non-governmental organisations, police, victim support unit, and
"Children who are HIV
positive have no time limit of staying with us, which means they can
stay with us until death. With this type of children, family members
are often not willing or able to take care of them at home, so we
take care of them because of their status. In case relatives wish to
take them home, we allow them to do so. The problem we have had in
the past when discharging HIV positive children is that in all cases
the children we have discharged have come back in a very bad
condition - with sores all over the body, visible weight loss, etc.
This has discouraged us from discharging them, because it becomes a
great suffering for the child and later for the staff. We however
encourage the relatives to visit the children and take them home for
short periods of time. They are also advised on how to care for the
child at home, and to bring the child for treatment when early
symptoms of any opportunistic disease become visible."
The Present situation
Administration of Antiretrovirals (ARVs) at Kasisi Children's Home
started about four (4) years ago. The drugs were obtained
free-of-charge from the University Teaching Hospital (UTH) scheme.
The Home, however, had to meet the costs of CD4 count and
Liver Function Tests (LFTs).
Before the start of
administering Antiretrovirals (ARVs), all HIV+ children at the Home
were only treated for opportunistic diseases. The mortality was
high, with most children dying before the age of five. This was
because the drugs and tests were too expensive, and the Home did not
have a sustained Donor for purchase of drugs and hence, did not want
to run the risk of discontinuing treatment because of lack of funds.
The situation today,
is relatively better, but a lot of challenges still remain.
Today, the Home has
put in place several HIV/AIDS strategies, that mostly constitute
palliative care measures and counselling. A brief overview is
provided below of the measures presently in place at the Home, for
HIV/AIDS associated ailments, and indeed other ailments.
When the child is in pain, the simple measures like giving them
Paracetamol or Aspirin are administered whenever they are in pain.
In case this step fails, a progressively high dosage of pain killers
is used if pain persists. First, codeine is administered progressing
to morphine or ephedrine. These drugs are controlled and very
difficult to get. It is only doctors who can prescribe and
administer such drugs. Sadly, they are often needed when the doctor
is not around.
Where a child has no fever and no trace of blood in stool and the
diarrhoea is not severe, Oral Dehydration Salts (ORS) are provided,
and when a child becomes dehydrated with all those signs of
dehydration, intravenous feeding (IV) fluids are administered.
The type of food given is closely monitored until the diarrhoea has
run its course. The management of diarrhoea is easy when noticed
A lot of fluid intake is encouraged when this condition is observed.
However, this condition is not very common at the Home.
Nausea, Vomiting and Weight Loss
This is very common in children less than two (2) years old, and the
problem is mitigated by use of nasal gastric tubes for feeding. For
those above two (2) years old, a balanced diet is provided, and
where vomiting can not be controlled some anti-emetics are used.
Multivitamins are also provided too.
For this ailment the Home administers, gentian violet in the mouth
once a day for 2 3 days.
Fever can be a
sign of secondary infection, and usually efforts are made to
investigate and treat the underlying causes. The Home has often used Analgesics for symptomatic
always in stock and kept safely. All children are given drugs by
the sister-in-charge, through the office, usually twice a day.
"Actually it is encouraging and uplifting to see the joy these
children have as they come to get their drugs. Each one of them
knows which drug he/she takes, whenever it is a half tablet or a
full tablet and once you purposely try to pretend you have mixed up
in giving then they will always tell no! This is not my medicine.
The children living with
counselling from the early stages of their life onwards. This is
necessary, especially for older children, as it is very hard for
them to cope with being sick, having lost their parents or
relatives, being in a strange environment, and having to meet many
new people children as well as adults. The Home has trained counsellors
to help newcomers adjust, help them in their grief when they lose
friends or carers, or cope with illness.
in the dawn of Antiretrovirals (ARVs)
"It is brightening to see children who were at
one time dying now enjoying their life to the full and playing
with friends. Almost all of them have responded well to the
availability of ARVs at Kasisi Children's Home has to saved many lives. The
mortality has gone down compared to the previous years. In
addition, the time spent at the
hospital has also reduced, as children on ARVs seem to develop few or no
other complications. And indeed, the Home always has medical
volunteers at hand.
Noteworthy, is that
from the time the Home
started administering the ARVs, the children have not shown much
complications relating to their illness.
OUTLOOK & CHALLENGES
Children's Home has a positive outlook in its caring for children,
and in particular children living with HIV/AIDS. This more so
because over the years the Home has gathered a wealth of knowledge
and experiences. A wealth generated from times of no hope for
children living with HIV/AIDS, to times of hope in the dawn of
Although there has
not been much
intervention from the government, there has always been a wealth of
individuals in the medical field and other endeavours who have taken
it upon themselves to help the children living with HIV/AIDS, and
indeed to make the Home independent in HIV/AIDS testing.
successes in managing HIV/AIDS at Kasisi Children's Home, the Home's
overriding challenges of providing adequate nutrition and indeed
meeting the costs of administering such a huge institutions still