I want to tell you a story.
This is the story of Divin, a 4-years-old boy who I met a couple of years ago in Yangambi, on the North side of the Congo River.
Yangambi, a town of the Tshopo Province in the Democratic Republic of Congo (DRC), is connected with Kisangani through a 100 km unpaved road, rarely used in the rainy season, and difficult to use at all times of the year.
When I met Divin, he was just like every 4-years-old boy: plenty of energy, curiosity and dreams.
Divin’s mother, who is living with HIV, was afraid to test her unique son: what about their dreams and future in a hard-to-reach small community if he would have resulted positive to HIV?
I went to Yangambi with a few friends and colleagues of Caritas Congo ASBL, the DRC Caritas of the 165 national members’ Confederation of Caritas Internationalis. That visit – what we internally call “solidarity visit” – was meant to touch base with local health facilities run by the national HIV program, and to support them in increasing case-finding of children living with HIV, especially those aged 0-5.
Our goal was to replicate in Yangambi – as well as in Kisangani and other few villages around the Province’s Capital – the GRAIL Project, a successful program already implemented in Nigeria through Caritas Nigeria with the support of the UNAIDS and PEPFAR Faith Initiative.
GRAIL stands for Galvanizing Religious Actors for better Identification and Linkage to pediatric HIV. The idea was to leverage on the influence and respect of religious leaders within their own communities to eliminate stigma and discrimination towards children living with HIV and their families; and to engage them to serve as a bridge among identified health centers and the children presenting preliminary symptoms that could be linked to HIV.
Our intention was not to transform a priest or a nun into a medical doctor with a three-days training, but to build on their presence, network and relationship capital with those most in need in their faith communities and, if in need, immediately link them to health services.
Divin was one of the 1,800 children less-than-15 referred by one of the 127 trained religious leaders to the nearest health facility for HIV testing, together with an additional 30,000 adults.
He was among the 28 HIV-positive cases. But he was not among the 11 children immediately put on treatment, mainly because of lack of appropriate child-friendly ARVs combinations in the selected local health facility.
Divin’s mother was shocked. She lost all confidence in the public health system.
We were speechless too: GRAIL does not provide HIV testing nor treatment directly. Our role is to link children from a place of worship to the nearest health facility, but… How is it possible that children living with HIV have still challenges to access to life saving treatment?
Is Divin’s life not worth to live? Could we decide whether Divin would live or not?
Definitely not. We had to re-build the trust of Divin’s mother in the national health system, in our work, in her community, in her religious believes, in our humanity.
As soon as I realized what was happening, I immediately made a quick trip to Kinshasa, to speak with few friends at the PNMLS (Programme National Multi-Sectoriel pour la Lutte contre le SIDA, a sort of National Agency for the Control of AIDS).
The gap identified was the supply chain system: not enough optimal antiretrovirals for children were procured and purchased for that area. Luckily enough, Cordaid, another Caritas member and the DRC Global Fund Principal Recipient for HIV and TB, the entity in charge of ensuring a proper supply chain, addressed the issue: enough pediatric ARVs formulations soon arrived in Kisangani and then in Yangambi.
Divin was immediately put on treatment: he is now growing and developing well.
Over the past two years, religious leaders involved in the GRAIL Project in DRC and Nigeria have reached more than 60,000 women, men and children with age-appropriate HIV messaging. They referred over 22,000 children for HIV testing. 150 were diagnosed with HIV. They are now on life-saving treatment. Definitely, the best concrete and rewarding result of my work with FBOs engaged in public health.
Yet, what about the other missing children?
Stefano Nobile
Caritas Internationalis
Focal Point for Health and HIV
Stefano Nobile earned a Master Degree in International Relations at the University of Padova, Italy. He joined Caritas Internationalis in 2009, as Advocacy Officer and Focal Point for Health and HIV. His principal responsibility is to coordinate the response of the 168 national members of Caritas Internationalis to pediatric HIV and HIV-TB co-infection, Anti-Microbial Resistance, Non-Communicable Diseases as well as health emergencies preparedness and response. He represents health-related concerns of the members of the Caritas Confederation at international organizations, specialized agencies and other multi-lateral organizations, and advocates for global solutions inspired by person-centered approaches and the principles related to Integral Human Development.