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NSKK NEWSLETTER distributed by
The Nippon Sei Ko Kai
(Anglican Episcopal Church in Japan)
Kiwoko Hospital in Uganda and Nippon Sei Ko Kai (NSKK)
JAPAN 051028-2
October 28, 2005

[The Nippon Sei Ko Kai - Japan] NSKK has been supporting Kiwoko Hospital in Ruero, Uganda since 2004 for the purpose of treatment of HIV/AIDS and contributing to the crusade against HIV/AIDS.

A Japanese doctor, Dr. Eiko Kitagawa, who operates and works as a medical doctor at the Hospital, has reported the recent situation of the Hospital, which is introduced as below.

Visiting medical practice for HIV-positive children has been continuously done and well progressed by the financial support from NSKK.

1. Free distribution of ARVs (anti-retroviral drug) has now been available.

Use of ARVs makes it possible to prevent from progressing HIV infection and to delay the manifestation of AIDS. Eventually, HIV-positive patients are able to maintain their health for a considerable length of time. For a long time, however, these patients were unable to obtain the drug because the drug must be taken daily for life, and furthermore, it is extremely expensive.

Reportedly there are 4 million HIV-infected patients worldwide, of whom 2.5 million patients are in Sub-Sahara area. In order to help these patients, there is a worldwide aid-project through which free-ARVs or inexpensive ARVs made in India have now been distributed to the patients.

Since April 2004, some of the HIV-positive patients who live in Kampala, Capital of Uganda, have been given ARVs through the good-will contribution from other countries. However, no ARVs were delivered to patients in such a small village like Kiwoko. In 2005, the Government has decided to deliver free-ARVs to Kiwoko Hospital for the use of 40 adult patients and 15 pediatric patients Daily dosage of ARVsf for children is determined by bodyweight of the children. ARVsf is normally administered in a form of syrup, which is extremely difficult to obtain, and we are just waiting for the arrival of the syrup from the Government.

ARVs for adult patients have already been available, and medical practice for adult HIV-positive patients has started since February this year. After giving medical practices several times, ARVs are given to the patients.

Time of starting ARVs administration is decided when the number of certain lymphocytes(so called CD4) has apparently decreased to a certain degree, which is caused by HIV infection. However, CD4 test costs about ¥2000 in Japanese Yen, which is quite expensive. Because of this, it is not possible to conduct free CD4 test within the Hospital budget. Therefore, the cost of CD4 test for children is covered by the fund of Visiting Medical Practice to HIV-positive children,

2. How to find HIV-positive adults/children

There is an inter-religious organization, called Inter Religious Council of Uganda or IRCU, which consists of protestant, catholic, Greek orthodox as well as Muslims. Due to the fund for Visiting Medical Practice to HIV-positive children raised by IRCU, it is now possible for HIV-positive children, who are newly found in places where no medical budge is available, to give free medical practices at medical clinic, transportation expense to Kiwoko Hospital as well as to distribute food to poor families. However, the Visiting Medical Practice to HIV-positive children Fund was used only to find new HIV-positive patients among the inhabitants who live out of the region, and no more services can be provided with the budget. Accordingly, other services are provided by part of the fund raised by NSKK.

3. Current situation of HIV-positive children

It has been possible to a certain degree to prolong the life of these children by giving free visiting medical practice, food supply and free medical treatment at the clinic and in the Hospital. However, there have still been some children for whom ARVs cannot be used, thus their life expectancy is not optimistic. Most of the HIV-positive children lost their parents, and they are brought up by their grand-parents or relatives. However, some of them are not necessarily well taken care of. These children can hardly go to school or some of them stay home all day long, or in some cases they are forced to help their guardians with the domestic chores including driving cows.

In order to improve the quality of life of the HIV-positive children whose life-expectancy is not long, we have decided to offer school fee to 12 HIV-positive children who are subjected to visiting medical practice. This has been achieved by the fund raised by NSKK, as mentioned above. Annual fee per child for this scheme is US$90, which covers school fee, text books, school uniform and shoes etc.

There is a boy named Kato, who is one of our visiting patients. His parents died of AIDS, and he is now living with his grand-mother and his twin-brother Wasuwa.(In Uganda, when twins are born, the first boy is named Wasuwa and the second one Kato; whereas the first girl is named Babirye and the second one Nakato). Kato is now 10 years old, but HIV-infection has retarded his growth, looking like only 7-year old or so. His brother Wasuwa is HIV-negative, and is a tall and vigorous boy.

Kato has received our visiting medical practice since 2002. Because of early treatment and well-nutritive food, he has been relatively progressing favorably. In January this year, however, he got pneumonia and was given treatment in the Hospital. He has recovered and was discharged from the Hospital. When we visited him in February, he was found to have recurrence of pneumonia. His elderly grand-mother did not give him medicine regularly or pay no attention to the sanitary condition. Furthermore, Kato’s immune state has dropped considerably; these factors caused to recur pneumonia. Kato is now in the hospital to receive medical treatment on pneumonia, lung tuberculosis and meningitis. His condition is well improving, but the lung murmur has still been heard. When he would be able to receive ARVs, his immune state will be improved and he will get well alright.

One of the male doctors who works at pediatric department is greatly concerned about Kato, saying “I feel that Kato is my own brother”. I was so impressed by his words. Some medical doctors in developing countries often have special awareness that they are belonging to the privileged class, and used to be less sympathetic towards the patients. However, as visiting medical practice has started and the doctor has regularly visited Kato, his mind has changed to become affectionate towards Kato. We are hoping that if such occasions as directly contacting patients are increased, it will be possible to give warm and heartfelt care and services towards patients by doctors from their own country, so that there will be no need to dispatch medical doctors from developed countries such as Japan.

Members of the English Version of NSKK Newsletter, Summer 2005 are: as follows:
Rev. Kazuya Takeuchi, Ms. Kazuko Takeda, Ms. Toshiko Yoshimura.
Editor-in-Chief: Hajime Suzuki