MALI – Bamako – 16 October 2009 - Parents are supposed to outlive their children, or so thought the grandmothers sitting in the children's playroom at Gabriel Touré hospital in Bamako, capital of Mali. They had all lost their children to AIDS-related illnesses, and met each other when they brought their HIV-positive grandchildren on hospital visits.
"I borrow, I beg - what else can I do? I am the only one willing to take care of him," said Mouta Tounkara, 61, speaking of her orphaned grandson who started HIV treatment in January 2008.
Aminata Soumaoro told IRIN that when her daughter died three months into the pregnancy, the newborn girl barely survived, but not her gravely ill father. "I did not want to care for this premature child, but it is easier now because she is grown."
She pointed to the 9-year-old girl. "I already lost my daughter; I do not want to lose her as well." Soumaoro used to travel between villages selling charcoal but had switched to agriculture because of poor sales.
Up to 60 percent of the children receiving HIV treatment at the hospital had lost one or both parents and were often shuttled among caretakers, said Anta Koita, one of two full-time paediatricians specializing in HIV care.
"She is not good with the child's treatment. The viral load [the amount of HIV in the bloodstream] is still detectable after six years of [antiretroviral] treatment," Koita told IRIN.
"The too-busy caretaker, often a grandmother, struggles to accept her new responsibility. And even if the parents are alive, if they are not infected with HIV, they do not know the gravity of the situation and the importance of helping their children with the medical treatments."
Missing
Only half of the 935 children taking antiretrovirals (ARVs) show up regularly at the hospital for medical care. More than 280 of the hospital's paediatric HIV patients are listed as "missing", and more than 100 children living with HIV have died since 2002. "But this is only when we get formal notification - it is hard to know how many children we are losing to AIDS," said Koita.
Mali has 31 HIV treatment centres nationwide and 65 doctors trained to treat HIV paediatric patients. Paediatric HIV care became available in 2002, and since then Gabriel Touré hospital, the largest provider, has notified more than 3,000 families nationwide that their child is HIV positive.
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