Kigali Letter June 2015

Dear all

The rainy season has ended in Kigali and the weather is dry and warm. Many colleagues here have friends and neighbors who are housing those who’ve come from Burundi. Thousands from Burundi also live in terrible conditions in camps 2 hours from Kigali. Travel and business has been disrupted between the two countries. It’s unsettling politically as well for Rwandans, as President Kagame has come out against the Burundi President remaining in office. At the same time there are pressures to change the constitution here in Rwanda for Kagame to remain after his term ends in 2017.

I want to thank those who have already responded to the recent WE-ACTx mailing and donated to our “Spring to Successful Schooling Campaign.” WE-ACTx clinic staff have been busy assessing children and families to best direct our resources to most effectively address their problems. We have learned much from these assessments about the challenges facing children and their families. Many young patients have had interruptions in their schooling (because of being ill, not having school fees, or various parental difficulties) and are therefore uncomfortably much older than other students in their grades. Others are unable to receive their grades and report cards simply because they cannot present their school fees. A significant number (nearly 20%) of those who are mothers report they trade sex for money in order to feed their families. And housing continues to be a problem for many families.

We have learned that it is particularly important and rewarding to support those in school with disabilities, as well as encourage young women and men to try to go to vocational schools and the university. Our collaboration with Musicians Without Borders has resulted in trained Youth Music Leaders who lead all of the children’s activities in WE-ACTx and annual summer camp. In the last few months these Music Leaders have also been hired at nursery schools, church programs, and schools. These new jobs will make a big difference in their lives and those of the young children they will teach. Below, animated Leontine leads the young school children in singing and clapping.


weactx June Kigali Letter


Our clinic is continuing its efforts to improve adherence to antiretroviral medication so that our patients will have viral suppression (undetectable viral load by laboratory tests) and live long and healthy lives. Wonderfully, 90% of patients in WE-ACTx over 30 who are on antiretroviral medications have viral loads that are undetectable! Unfortunately, younger patients are not doing as well– only 75% have undetectable viral load levels. Many of these younger patients were born with HIV and thus have had the disease much longer, and have had longer periods without effective medications. They have more resistant virus and need more attention and better therapeutic options, some of which are becoming available here in Kigali.

We have also analyzed the new patients coming into WE-ACTx in the past 2 years. Of 100 patients without any previous care, 1 in 5 have a diagnosis of full blown AIDS with low CD4 < 200 (marker of advanced disease). More efforts are needed to bring people into care earlier. Many of you may have seen the publicity about the recently stopped large global study showing that earlier start of treatment results in longer and healthier lives for people with HIV.

WE-ACTx For Hope (the local organization who now owns and runs the clinic) has been recognized as a program which delivers high quality care in Rwanda. The Minister of Health/Rwanda CDC has just allocated funds to support several nurse, lab and data manager positions this year (and hopefully these will continue) in acknowledgement of this work. This support increases the stability and sustainability of the clinic in Kigali and speaks to the importance of local governance and responsibility.

Summer always brings interns and new projects to WE-ACTx. The income generation programs are gaining traction with help from our partner Manos de Madres newly hired staff and an intern from Tufts Fletcher graduate program. Also this month, a graduate student in psychology from Boston University is working with the KIP research team to learn about coping strategies of HIV infected older youth. Two college students are joining soon and will help staff work on clinic programs, the summer camp, and educational efforts.

I was lucky to be in Kigali this year again for the WE-ACTx celebration of Day of the African Child. The day is a giant party for children who are patients at the clinic and their families. Over 1200 people came, played, enjoyed the park, watched wonderful dancing, singing, drumming, and theatre, organized by the peer parents and youth leaders and ate a big buffet lunch.


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It was truly beautiful to see so many healthy and talented young people. Representatives of the WE-ACTx Board, the Rwandan Biomedical Center of the Ministry of Health, and other visitors joined in the festivities and were overcome by the enthusiasm, strength and joy of the youngsters.


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I wish you all could have also enjoyed watching the youth perform traditional dance, modern dance, hip hop, and sing together. We have seen these youngsters grow up over 10 years and continue to be amazed at how strong, creative, and hopeful they are. Thanks for your support in keeping WE-ACTx going.

In appreciation,

Women's Equity in Access to Care & Treatment