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 CNS Story:

ZAMBIA-HEALTH Aug-6-2012 (810 words) xxxi

Health workers key in limiting spread of malaria, AIDS in Zambia

By Chris Herlinger
Catholic News Service

MUMBWA, Zambia (CNS) -- With about 1,200 physicians serving a population of 13 million, fighting the likes of malaria, tuberculosis, HIV and AIDS in Zambia is no easy task.

Recognizing the challenges, Zambian officials and church leaders have created a countrywide network of community health workers and counselors, many of whom have experience living with the diseases and coping with their troublesome symptoms. Working where physicians rarely are seen, the workers and their solid connections to the faith community are Zambia's front line in a battle to control the spread of highly contagious diseases.

The network includes thousands of such workers. The Rev. Kennedy Ilunga, a Pentecostal pastor who serves as district health coordination officer for the country's Central province, said their governing principle is simple: "I help because I've been helped."

Rev. Ilunga works in tandem with the Churches Health Association of Zambia, a joint Catholic and Protestant health network. CHAZ's network of community health centers, clinics and hospitals works in nine of Zambia's provinces and in nine Catholic dioceses.

Addressing a meeting of the Africa Congress for Catholic Nurses June 26 in Lusaka, the Zambian capital, Dr. Joseph Kasonde, the country's health minister, praised efforts by church-based institutions to extend their reach. Noting that Catholic health institutions account for about two-thirds of Zambia's health care system in rural areas, Kasonde expressed his appreciation for the work of church-based health care in local communities to reduce the spread of infectious diseases.

Rev. Ilunga's work includes overseeing six health workers in an anti-malaria campaign. The workers distributed mosquito netting and conducted blood tests to determine who had the disease. In one round of tests, seven residents of a small village were negative and two were positive. While not bad, the low infection rate can be attributed to the winter season in the Southern Hemisphere.

"With God's help, we'll get there. By 2015, we should see malaria down to zero," Rev. Ilunga said.

The urgency to address malaria exists because the disease continues to be Zambia's top killer. The country's health officials estimate that malaria claims the lives of nearly two in 10 children under the age of 5.

The concern about malaria also is linked to the fight against AIDS because those who become infected with mosquito-borne disease and who already are HIV-positive are at greater risk for additional health problems, Rev. Ilunga said. The connection between HIV and malaria is particularly critical because Zambia has the world's sixth-highest rate of HIV infections.

Observers do not have to look far to find health workers making the connection. The workers have turned to peer counseling to explain prevention efforts to limit the spread of both diseases.

One focus has been the promotion of male circumcision. The practice has proven effective because the male foreskin has been proven highly susceptible to HIV infections, according to medical authorities. A recent report by the World Health Organization noted that male circumcision reduces by 60 percent the risk of female-to-male sexual transmission of HIV, the virus that causes AIDS.

Zambian officials would like to have 80 percent of HIV-negative men -- nearly 2 million overall -- circumcised by 2015, according to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is helping fund the effort. The goal presents a major challenge because during the last five years there have been just 170,000 circumcisions in Zambia.

At the Nangoma Mission Hospital, a Catholic-supported institution in the Central province, a group of men who recently had been circumcised and are working as community health workers said they are spreading the word among their peers about the need for the procedure. They are telling other men that circumcision can reduce HIV infection in men, and possibly can reduce some dangers such as cervical cancer for women.

The suggestions come with caveats.

"Circumcision alone is not the (sole) solution to prevent HIV transmission," community health worker Fred Mbewe, 25, said of the procedure which is usually performed in about a half hour.

He and others who have undergone the procedure encourage peers not to fear the operation or the rumors that physical sensation is lessened afterward. The main concern, Mbewe said, is that men must abstain from sexual intercourse for six weeks after the operation. "Most do complain about that," he said.

Kristie Mikus coordinates the Zambian portion of the U.S. government's international AIDS program, known as the President's Emergency Plan for AIDS Relief, or PEPFAR. The program has funded a number of initiatives, including male circumcision, in Zambia.

In an interview at the U.S. Embassy in Lusaka, Mikus said ultimately the spread of HIV infections must be addressed in local communities and that programs emphasizing peer support and counseling can be the most effective means of doing so.

"In the end," she said, "it's about local capacity: for local people to lead and manage and take control of HIV and AID efforts."

- - -

Editor's Note: More information about the Churches Health Association of Zambia can be found online at www. chaz.org.zm/.

END


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