St. Louis Post-Dispatch Examines Partners in Health-Run Hospital in Rwanda That Addresses TB, Malaria, AIDS

The St. Louis Post-Dispatch on Sunday examined how a Partners in Health-operated hospital in Rwinkwavu, Rwanda, addresses HIV/AIDS, tuberculosis and malaria in the region. Because of the large numbers of people coinfected with at least two of the diseases, physicians at Rwinkwavu Hospital "suspect" coinfection in "almost everyone who comes for treatment," the Post-Dispatch reports. To ensure that patients adhere to treatment, the hospital employs local health workers to deliver medication to patients' homes daily. The hospital employs 280 staff members and 600 local health workers, who also "extend the eyes and ears of the hospital into every neighborhood," according to the Post-Dispatch. The hospital -- which includes eight buildings and four clinics -- provides care for an area that comprises 400,000 people, and some patients come from distant locations. It has laboratory, X-ray and pharmacy equipment and soon will have a full-service operating room, but it still needs certain diagnostic tools and specialty care facilities. The Bill & Melinda Gates Foundation is funding the creation of a medical training center. PIH aims to confront the three diseases "comprehensively" by creating not just a medical center "but also a de facto community for the region," the Post-Dispatch reports. For example, doctors and social workers at the hospital launched a program in which all infants born to HIV-positive mothers are provided with a regular supply of formula. Under the program, mothers are provided with a kerosene stove, a thermos, a bottle for boiling water and a pot to ensure that the infants are not fed using water from local wells, which can cause diarrhea. In addition, classes are held every Saturday for HIV-positive women and children to teach them about the virus and how their treatment works. PIH also seeks to combat the stigma surrounding the three diseases, and the doctors make causal physical contact with patients, the Post-Dispatch reports (Simonet, St. Louis Post-Dispatch, 8/13).