Abstract
The activities are described of an aid mission of Medecins du Monde (MDM) in the impoverished northern Tanzanian region of Kagera. The spread of AIDS in the region has been assisted by population upheaval the war with Uganda poor agricultural development and socioeconomic deterioration. HIV seroprevalence is estimated at 10% of the rural and 17-24% of the urban population. There were 4135 reported cases of AIDS in late 1992. A major objective of MDM is to enable the regional hospital in Bukoba and the rural dispensaries to provide better management of HIV symptoms and a better quality of life for patients and to reduce transmission. The pediatric service treats an average of 260 children monthly in 70 beds. 60% of child deaths are due to malaria and 16% to acute infantile diarrhea. MDM assistance to the pediatric service has included provision of drugs and treatment rooms development of a system of hygiene and sterilization and a unified record system and provision of treatment protocols and follow-up care for children with AIDS. The maternal-child health center diagnoses sexually transmitted diseases in pregnant women but is constrained from HIV testing by cultural and economic obstacles. Four rural dispensaries have been renovated and provided with drugs. A mobile MDM nurse-midwife provides health education and vaccination in distant localities. HIV testing is available at the regional hospital. Indications for blood transfusion have been limited and a pool of low-risk donors created in order to minimize the danger of transmission. Home-based care is provided to the HIV seropositive in order to reduce pressure on the hospital services. AIDS prevention efforts stress peer counseling and education. AIDS education is provided in bars by hostesses working with the hospital AIDS counselor and the MDM physician and free condoms are distributed. MDM has sought to cooperate closely with local health services so that activities will continue after the mission departs.
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