HIV Program in Zambia Strengthens Early Childhood Development

At 9:00 on Thursday mornings, the ‘Survive and Thrive’ center at Mt. Makulu Pediatric Clinic in Linda, Zambia, begins to fill with mothers, babies, and young children. Colorful rugs are spread onto the floor, scattered with toys. The mothers and children form a wide circle on the rugs and begin to sing, talk, and play.

Survive and Thrive, funded by the Conrad Hilton Foundation and implemented by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), is aimed at strengthening early childhood development (ECD) in areas where children are severely affected by HIV.

Initially, Survive and Thrive focused solely on helping children with disabilities—a group that is often overlooked in the densely populated Linda Compound near Mt. Makulu. Survive and Thrive has now expanded to include services that prevent developmental delays in children.

Due to the heavy burden of HIV and other health issues in places like Linda, babies and young children are especially vulnerable to malnutrition, disease, neglect, and abuse. These vulnerabilities may, in turn, lead to developmental delays, which are made worse by the widely held belief that children with such problems should be hidden away.

“I’ve been seeing these children who have got some delays or maybe a disability. In our compound, they are kept indoors,” explains 33-year-old Mainess Haminda, the volunteer leader for Mt. Makulu’s Survive and Thrive program. “So if there is a child who has got this problem, [the parents] say no, this child is not to be shown to the people.”

The first challenge in helping these “invisible” children is to find them.

“For us as nurses, there is a manpower shortage,” says Darry Tembo, a midwife and the assistant nurse-in-charge at Mt. Makulu. “So for us, to capture those children from the community is very difficult.”

To remedy this challenge, EGPAF recruited a team of volunteers, most of whom were mothers themselves, to go into the community, find the affected families, and invite them to participate in Survive and Thrive. The volunteers were also trained to run the ECD programs—educating mothers about physiotherapy and proper nutrition, and preparing young children for school.

“All the programs are taught by the mothers,” says Darry. “By doing that, at least we could see the other mothers coming up. Even those children whom the mothers used to hide them in their homes, we could see them coming up. Even those children who are maybe HIV-positive, even those malnourished children, we could see them coming up.”

Twenty-nine-year-old Barbara and her 3-year-old son, Favour, are regulars at the Survive and Thrive early stimulation group. Favour sleeps in a sling on Barbara’s chest as she speaks; later, Favour wakes up, smiling and laughing with a slightly wobbly head.

“I learned about EGPAF through the volunteers who came to the compound,” Barbara says. Favour first started showing signs of developmental delays when he was nine months old, and up until recently he was not able sit up, hold things in his hands, or talk.

But now, Barbara says, “There’s a change, because when we come to physiotherapy we are learning things. “Favour can hold, and he can also say some of the words. He is still learning to balance his head and sit on his own.” Barbara’s hope for Favour is that he will soon learn to walk and be able to attend school.

Mt. Makulu staff has observed many positive outcomes from Survive and Thrive. “Our children have improved in terms of malnutrition,” Darry says. “Mothers in the compound used to be there until their children are very sick, and once they reached the clinic there was nothing we could do. Mothers now, at least they try to encourage each other in the compound, because they have been sensitized. For malnutrition, it has really worked.”

“I’m thanking EGPAF for the program that they’re doing,” says Mainess.