The Oblates have a growing missionary presence in Kenya and are engaged in community health and education programs. In addition, through our corporate social responsibility work, the US JPIC office has been engaging with the management of Merck & Co., Inc on HIV/AIDS issues, especially in developing countries. The following reflects a new and interesting approach to HIV/AIDS prevention and treatment on the ground in Africa.

A STRIKING IDEA WITH A BIG FUTURE IN THE FIGHT AGAINST HIV/AIDS IN AFRICA.

From: HIV@MSD - Merck & Co., Inc. October 2007 Newsletter. http://www.hiv-msd.info

KENYA’S  CENTRAL HIGHLANDS: A small village perched 2,200 meters up the slopes of the Great Rift Valley. Outside from various neighboring countries, as well as Kenyans, come to Kijabe, or "Place of the Wind" in the Masai language, for many reasons. Some come to sample the healing and medicinal qualities of its hot springs, others because it is a well known treatment center for the migrant Masai populations, or still others come to enroll in the famous 100-year-old Rift Valley Academy, Africa's largest American Christian school.

But in recent years, Kijabe has been making a name for itself for an entirely different reason. Its hospital, the Africa Inland Church Kijabe Hospital (AIC Kijabe Hospital), is developing an innovative and potentially very exciting approach to HIV/AIDS care and treatment in the community. The approach consists of training community members, mostly HIV patients themselves, in key aspects of HIV management, in order to enable doctors to reach patients at an earlier stage of the illness.

It is cost-effective for the health system as the patients play the basic role of doctors within the community. It is also effective for the community because the patients themselves benefit from the successful outcome of the hospital HIV/AIDS program. Experience has shown that hiring Community Health Workers (CHWs) who are not patients is not effective because they move to other positions when offered.

The idea was put forward by a local HIV-positive man three years ago, and since then Kijabe Hospital has now trained more than 300 patients as community health workers.

The impact of Kijabe Hospital is not negligible. Created in 1959, it now has the biggest catchment area in Africa. It reaches a population of over one million and serves 100,000 patients a year. At least one third of the hospital's in-patients are HIV positive, as are the people attending the Voluntary Counseling and Testing services.

The approach has had encouraging results so far in ensuring that patients adhere to treatment. The hospital is considering adapting this model to catch other diseases early on, especially those leading to mother and child mortality. The next step might be to replicate this model elsewhere in Kenya, and why not across Africa.