One Nurse Makes a Difference at Lira Regional Referral Hospital-Early Infant Diagnosis Care Point

Dorothy Ejang, commonly known as ‘Sister Dorothy’, is a registered nurse providing frontline paediatric HIV care and treatment at Lira Regional Referral Hospital’s Early Infant Diagnosis (EID) care point. The EID care point serves HIV-exposed children (babies born to HIV-infected women) from birth up to 18 months of age, when the baby is either referred to anti-retroviral therapy if HIV-positive or discharged if HIV-negative.
 
Sister Dorothy has been instrumental in the set-up and management of the EID unit at the hospital since 2011. Her typical day is busy, given the setting—Lira is a public healthcare facility which serves as a referral site for all cases and clients from lower facilities. The Lira EID care point enrolls about 47 HIV-exposed infants per month and Dorothy is the only qualified nurse managing the unit’s activities.
Dorothy begins her day at 7:30am. She rides a bicycle from her home, which is 2km away from the hospital, and by 8:00am, she starts attending to the mothers and caregivers of HIV-exposed infants. She attends to at least 40 mothers and babies per day. Her work also involves a lot of documentation due to use of multiple tools such as exposed infant register, infant cards, appointment book, HIV client cards for mothers and dispensing log book—used in monitoring the status of exposed infants. Due to her commitment and dedication to serving the community, Dorothy has become a source of hope and inspiration to mothers.
 
I first met Sister Dorothy on the 26th of February 2013. When I came to Lira Hospital EID care point, she welcomed me and attended to me. During the session, I opened up to her about my fears and burden of being a positive mother with a positive baby. When the test results for my baby came back negative, Sister Dorothy encouraged me to keep all scheduled appointments and breastfeed exclusively for six months to increase chances of the baby remaining HIV-negative. That day, I went back home with hope and a commitment to honor the appointments. I kept all my appointments and in May 2014, Samuel was confirmed to be HIV-free. I am grateful to Sister Dorothy for the advice, counselling and encouragement she gave me,” said Betty (not her real name), an HIV-positive mother.
In addition, Sister Dorothy encourages mothers to always keep scheduled appointments, take medication and give their babies prescribed drugs at the right time, in the right doses, following the right frequency as prescribed by the nurse.
 
In April 2012, the USAID-funded Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) project, with funding from PEPFAR, allocated a volunteer to the EID care point to assist Sister Dorothy in providing EID services. The project also supports comprehensive HIV prevention, care and treatment activities at Lira Hospital. At the care point, Sister Dorothy has provided on-job training to the volunteer who complements her work to effectively attend to the clients.
Sister Dorothy mentored me in performing measurements, documenting EID activities and outcomes, assessing nutrition status and, most importantly, in creating a conducive environment to provide the best care possible to mothers, their babies and other caregivers. I feel valued because of the responsibility entrusted to me by Sister Dorothy. She supervises and guides me and is always available for consultation,” said Esther, a volunteer at the EID care point who is supported through PEPFAR funding by the USAID/SUSTAIN project.
 
By 3pm, all mothers and their babies have been seen and Dorothy and Esther remain behind to update the registers and the appointment book. Through their teamwork, the duo has managed to attend to mother-baby pairs even with additional documentation work and activities that were added after the introduction of the mother-baby care point in May 2014, where mother-baby pairs receive same day appointments and services. The rate of HIV-exposed infants at Lira RRH with HIV-positive results after 18 months has significantly dropped from 8.3% in 2012 to 2.6% by September 2014, moving closer to virtual elimination of mother-to-child transmission of HIV.
 
Written by; Julian Natukunda, Communications Specialist; Dr. Cordelia Katureebe, PMTCT-Paediatric Technical Advisor with contributions from Jessica Ziegler, Knowledge Management Specialist at URC