Both mothers are well, their babies plump, pink, wrinkled; one asleep, the other nuzzling at his mother’s breast, already hungry.
Mingende is run by the National Catholic Health Services – Papua New Guinea. They run nearly a third of all the health services in the country.
The four nurses on duty in this labour ward have stitched, set up drips, sterilised, weighed, cleaned up blood, administered antibiotics, painkillers, vaccines, checked temperatures, and urged a mother to “Push! Push strong! Bebi blong yu bai kam klostu!” (Push! Keep pushing! Your baby is nearly here!).
And this is all before most people have breakfast.
Far from the bustle of the delivery room, another mother sits with her nine-month old daughter. They were admitted to the hospital’s paediatric ward a few days before.
The baby’s cry is weak and from head to toe she is covered with abscesses—in some places her skin has come completely away and her flesh is raw and exposed. Her mother finds it difficult to hold her, comfort her. The mother’s eyes are anxious. She blinks away tears.
In the next few minutes the baby will undergo a dry blood spot test to check if she has HIV.
Sister Eileen Alalo is the Coordinator of Mingende Hospital’s Prevention of Mother to Child Transmission (PMCT) service.
“The baby has severe diarrhoea, and a number of other complications. She isn’t responding to any of the antibiotics she was given. And the nurses noticed that her mother was also presenting with a couple of infections,” she says.
“They’ve already done the voluntary counselling with the mother, and a test, and the results came back positive. It will take two weeks before we know the baby’s status, but in the meantime we’re going to start them both on antiretroviral therapy.”
The baby has a 50-50 chance of surviving. The hospital has had 11 similar referral cases since 2006. Out of the 11, eight babies are well and on treatment. Had their mothers tested for HIV in pregnancy and received preventative treatment, the babies could well have escaped infection.
The Catholics’ sizeable HIV program is run by the Catholic HIV/AIDS Services Inc and supported by AusAID. Last year CHASI tested over 11,000 pregnant women at the 14 of their antenatal care facilities that offer prevention of mother to child services.
Pregnant woman who test positive are started on a short course of anti-retroviral treatment and their babies are also given some of the medication after birth. Those women whose immune systems are already weakened by the virus are continued on lifelong antiretroviral therapy.
So far at Mingende, 62 babies born to HIV positive mothers given the anti-retroviral drugs have found to be free of HIV.
One of those babies was born to Marjorie just over two years ago. She found out her positive status when she attended the antenatal clinic when she was three months pregnant. She went onto the preventative short-course straight away.
“Nau bebi blong mi i bikpla pinis. Em stat long toktok na wokabout. Em i no sik. Mi save lukim em na hamamas tru. Nau mi bel ken, mi laikim seken bebi blong mi bai no inap sik tu.” (My baby’s big now. She’s starting to talk and walk. She doesn’t get sick. I look at her and I’m so happy. Now I’m pregnant again and I want this baby to be well too.)
Fortunately for Marjorie she was in the 23% of pregnant women in PNG who are offered an HIV test during antenatal care, and in a facility that also provided drugs to prevent transmission from HIV positive mothers to their babies.
To help more women like Marjorie, Australia is supporting the Government of PNG and their civil society partners PNG Health and HIV Capacity Development and Service Delivery to increase the number of facilities which offer HIV positive pregnant women testing and treatment.
There is still a long way to go to meet the global goal of zero infants born with HIV, but the Catholic HIV/AIDS Services have made a good start.
Anna Awasa worked for AusAID focusing on media and communications for the HIV program from 2010-12. She is now media and communications advisor on the LNG Project.