Mama Kabeho: The Perspective of an EGPAF Research Nurse in Rwanda
Ramatoulie Jallow and Sushant Mukherjee
Petronille Musengente is a research nurse working for the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) in Kigali, Rwanda. She enrolls eligible HIV-positive pregnant mothers in a prevention of mother-to-child transmission of HIV (PMTCT) study at the Rwampara Health Center and follows up with the mother-baby pairs, monitoring their health. Musengente’s work is part of the U.S. Agency for International Development (USAID)-funded Kabeho study — officially titled Kigali Antiretroviral and Breast-Feeding Assessment for the Elimination of HIV.
Kabeho is the Kinyarwanda word used to wish someone a long life, so it is a fitting name for this evaluation of Option B+, which recommends enrolling all HIV-positive pregnant women and lactating mother on lifelong antiretroviral treatment. In 2013, the World Health Organization (WHO) rolled out these new guidelines, and research nurses like Musengente are gathering data to establish a baseline of Option B+ outcomes in a low-resource setting. Kabeho’s objective is to determine HIV-free survival of infants enrolled in Option B+ at 18 and 24 months of life. The study will also look at factors which contributed to positive health outcomes of Option B+.
The Rwampara Health Center is one of the 14 health centers around Kigali, Rwanda, participating in Kabeho. In total, 608 mother-baby pairs are enrolled in the study; Musengente oversees 47 of them. Musengente brings several years of experience in maternal and child health to her role as a researcher. Her perspective is sharpened by her previous work as a midwife and as a PMTCT nurse. Musengente’s job is made easier by the fact that she enjoys an excellent rapport with the study participants. Because of her compassionate and cheerful nature, some of the participants fondly call her Mama Kabeho.
Kabeho provides a safe space
The Kabeho Study is completely voluntary and participants do not receive an incentive when they choose to participate. One might then wonder how Musengente is able to get her participants to patiently wait for their appointments with her.
“I don’t have a strategy,” says Musengente. “It is essentially the welcome and how you interact with the women — remembering their names and showing them that you are genuinely interested in them.”
Not only does Musengente ensure a safe space for the women to talk about their daily lives, she also shows a genuine interest in the women and their children. “At times, the women feel like they can trust me more so than the people who provide them with health services. This is because the health staff is very busy and does not have a lot of time to spend with the women like I do,” Musengente explains
Musengente thinks that her rapport with the participants can also be partly attributed to the fact that she is also a mother.
“It helps tremendously. I treat the children in the Kabeho study like my own children!” Musengente exclaims. “When the mothers bring in their child, I carry the child in my arms and at times embrace the child. Often, when the baby cries, I try to calm the baby first before I collect information or do whatever it is that I have to do.”
“Given that the study is an observational study, it is sometimes challenging,” Musengente notes. She explains that research nurses are not allowed to intervene in the services being provided at the health center, merely observe.
Kabeho mothers pay it forward
Participants don’t receive any actual incentives to be enrolled in Kabeho, except perhaps the most compelling incentive of all — Kabeho, to wish someone else a long life. The philosophy of Kabeho moves many women to open up as they discuss what a day in their life is like, as mothers, wives, and women. Their voices become an important gift that will not only make a difference in the lives of their own children, but to many future children who will one day be part of an AIDS-free generation.
Musengente appreciates the value of this gift, so she engages attentively with the mothers and their children, seeing them as more than numbers, but as members of her family. Perhaps the title of Mama Kabeho is not just an affectionate nickname. Perhaps Musengente is Mama Kabeho because she is a listener and a confidante to these pioneering women.
This article is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The contents are the responsibility of the Elizabeth Glaser Pediatric AIDS Foundation and do not necessarily reflect the views of USAID or the United States government.