A Beacon of Hope in Côte d’Ivoire
By Beatrice Karanja
Nairobi, Kenya
May 21, 2008

In an unassuming building in the midst of a crowded street in downtown Abidjan, Côte d'Ivoire, lies a haven of hope and peace amongst the chaos and despair that surrounds it. Squeezed in by tin shacks blasting the latest local sounds and rickety stalls displaying their wares — everything from plastic combs to electric kettles — is the Sainte Therese de l’enfant Jesus medical center.

Sainte Therese de l’enfant Jesus medical center

The streets of Koumassi

The center, which receives around 50 patients a day — 75 percent of whom are children — caters to the surrounding neighborhood of Koumassi. Koumassi is one of Abidjan’s poorest areas, which means that the people who live there do not have the choice of where to go for quality medical care.

One of the country’s largest general referral hospitals is only two kilometers from Sainte Therese de l’enfant Jesus medical center, but way out of the economic reach of most families in Koumassi. Many of Koumassi’s inhabitants are migrant workers or unemployed and the meager earnings that they get from small businesses, or from any menial work that they can find, cannot support them in accessing higher-end health care.

Dr. Cedric Sakalia consults with a patient in the center.

Walking through the gate of Sainte Therese de l’enfant Jesus medical center made me understand why Koumassi residents look to this beacon of hope. Run by a small team of doctors and nurses and a couple of Catholic nuns, the clinic receives the majority of its support from the Elizabeth Glaser Pediatric AIDS Foundation and other partners. The center addresses key maternal health issues, including prevention of mother-to-child transmission of HIV and HIV care and treatment. From the onset of every visit and as part of all pre-natal checks, patients are given the choice to undertake HIV testing and counseling. More often than not, the choice to test is accepted.

Côte d'Ivoire is a country slowly turning its back on its difficult past — a past of conflict and war. The previous period of stability has been destroyed by two coups (1999 and 2001) and a civil war since 2002, which has hampered the country’s economic development. All of this is evident in the poverty levels in areas like Koumassi. The country has one of the highest HIV/AIDS prevalence rates in West Africa at 4.7 percent. About 74,000 children under 14 are living with AIDS and 450,000 children under 17 have been orphaned by the disease.

Côte d'Ivoire used to have one of the best health systems in West Africa, but the fighting in 2002 prompted thousands of doctors, nurses, and pharmacists to leave or become unemployed. However, many of the health staff are beginning to return and clinics are re-opening. Aid from international donors has permitted the successful re-opening of 86 percent of health centers in the north, where the fighting was worst.

Côte d’Ivoire is one of 15 focus countries receiving support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); these countries collectively represent approximately 50 percent of HIV infections worldwide. Since PEPFAR’s inception in 2004, Côte d’Ivoire has received $200 million to support comprehensive national and international initiatives focusing on HIV/AIDS prevention, treatment, and care programs.

The Sainte Therese de l’enfant Jesus medical center is one of these initiatives. With over 400 patients on treatment and several women’s support groups operating in the center, its reach is immense. The buzz in the clinic is a testimony to this. Women and children fill the benches that hug the walls of this small clinic.

Dr. Cedric Sakalia, the chief doctor at the clinic, is far from daunted with the task at hand. “When I see children who are born HIV-negative to mothers who are HIV-positive, it makes me feel good,” the doctor said. “The challenges that we face in terms of human resources and scaling up our work take the back-seat role when things like that happen. It is then that we realize that we are doing the best that we can and all that we can. It is not easy, but when you see results like that, it is all worth the efforts.”

The Foundation also provides the center with technical support in training staff. The center is on track to becoming a center of excellence for training of health care workers, and it is unique in offering HIV testing to pregnant women during labor.

Dr. Sakalia is set on improving the quality of care and eventually catering to more patients. He believes that this will be possible with further support from the Elizabeth Glaser Pediatric AIDS Foundation and others.

This unassuming two-story building will hopefully become more than a haven of peace and hope — it will become a refuge and a shining light for others to follow.

Beatrice (right) with Dr. Sakalia

Beatrice Karanja joined the Foundation in January 2008 as the regoinal communications officer for Africa, based in Nairobi, Kenya. She has extensive experience working in the region as a journalist for international broadcasters such as the BBC and Reuters, and as an information officer for international organizations such as UNICEF. Beatrice recently visited Côte d’Ivoire on a learning and fact-finding mission.