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MSF in China, 2009
Field Staff: 42
Reason for Intervention:
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China’s Ministry of Health estimates that 740,000 people in the country were living with HIV/AIDS by the end of 2009. Although less than one per cent of the overall population is infected, the minister warned that the disease is threatening to become a serious epidemic among high risk groups. Stigma and discrimination against people living with HIV remains strong in China, and this deters people from being tested. Where the condition remains undiagnosed, there is a far greater risk that it will be spread.
HIV treatment and care
Testing for and treatment of HIV/AIDS is officially free under Chinese health policy, but in practice hospitals and clinics often charge for the treatment of opportunistic infections associated with the disease. As a result, no matter how urgently some people need help, if they cannot pay they simply cannot access treatment.
Since 2003, MSF has been operating an HIV/AIDS center with the Guangxi Public Health Bureau in Nanning. The center provides confidential care and treatment focusing particularly on vulnerable groups such as injecting drug users, commercial sex workers, men who have sex with men, and migrant workers. The outpatient clinic provides treatment free of charge and MSF pays for patients who need to be admitted.
In 2009, more than 1,000 people living with HIV/AIDS were under MSF care at the clinic, 900 receiving first-line antiretroviral therapy (ART), and 27 receiving second-line therapy, which is needed when a patient develops a resistance to the original treatment. Teams performed over 8,500 consultations. MSF also worked with the center for Disease Control to set up voluntary counseling and testing centers in the city. Of the 4,300 people who used centers in 2009, 147 tested positive for HIV.
The Nanning project will be handed over to Chinese authorities in October 2010.
Post disaster mental health
In May 2008 there was an earthquake of magnitude 8 near Chengdu in Sichuan province, southwest China. Some 80,000 people were killed, ten million made homeless and vast numbers were left mentally traumatized. Working with the Chinese Academy of Science and the Crisis Intervention center, MSF provided psychological care for survivors, and trained mental-health workers from November 2008 to August 2009. Teams conducted home visits and established five counseling centers in Mianzhu and Beichuan, two of the worst affected areas. Patients received between six and 20 consultations to help them to recover.
Chen, a 35-year-old patient at the MSF clinic in Nanning, tested positive for HIV in 2006. The news was devastating. ‘When I found out, I felt that life had no meaning and I had no idea what to do next,’ he said. After his diagnosis, Chen was referred to the MSF center. ‘The counselor helped me to think a lot more positively. He explained that HIV is not a disease than takes your life immediately and that if you adhere to the treatment, you can live for years.’ Only one trusted friend knows about Chen’s HIV status. ‘There is more information about HIV/AIDS available these days, he explained. ‘Things are improving, but there is still a long way to go before discrimination will be eliminated.’
MSF has worked in China since 1988.