By Eliza Petrow
An encounter with “swine flu mania” in China proves to PATS Co-Founder Eliza Petrow that the government is more than capable of monitoring and controlling a widespread health threat. She notes that such competence would be well directed towards providing treatment support for China’s HIV-positive population.
Last month I flew to China on behalf of PATS (Pediatric HIV/AIDS Treatment Support), an NGO providing medical support to HIV-positive children living in the central region of the country. While on my way to China to help with one public health crisis, I was stymied by another: H1N1, better known as the swine flu.
Some thought I was overdoing it by wearing a mask the entire 13-hour flight and taking my temperature hourly. But then the flight crew announced that before we could disembark, Chinese CDC staff in HAZMAT suits would board the plane and “hold a gun to our heads” (a rough English translation for taking temperatures with a thermometer gun). Anyone with a fever would be detained and tested for swine flu, while anyone within three rows of a confirmed case would be tracked down the next day, along with their taxi driver, and taken to quarantine hotels for 7 days. As the HAZMAT suited staff came through the aisles pointing their thermometer guns, I was relieved that no one within three rows – and no one in my group – had a fever. Mission accomplished.
Or so I thought.
We exited the plane and celebrated our freedom, stepping onto the 100 degree tarmac. As we went through customs, the infrared heat sensor picked up my elevated external body temperature. In less than 5 seconds, I was whisked to a separate room. The thermometer stuck under my hot, sweaty armpit read 98.8, slightly up from my initial plane temperature reading. No amount of explaining or pleading would save me from being whisked away in an ambulance to a quarantine hospital, an hour away.
As I sat in my quarantine cell, it all seemed so surreal. I had he comforts of a nice hotel—a flat screen TV, AC, amenities such as flip flops, soap and a washcloth. Meanwhile, my HAZ-mates, as I called them, communicated with me in Chinese through a speaker, lest they got exposed to my 0.2 degree “fever” (my temperature had stabilized at 98.6 once I cooled down). As I sat there anxiously wondering if I would be there all week, I asked myself – Is it possible to harness some of these resources and this remarkable organization to help China’s HIV-positive children?
As the co-founder of PATS, I often see HIV-positive children -- many living with elderly caretakers in isolated rural areas -- provided with free medication, but without the support necessary to adhere to such a strict treatment regimen. The result is drug resistance and countless deaths.
The central government has understandably focused on the critical first step of rolling out treatment. But given the challenges of sustained treatment, efforts must also focus on providing ongoing care and adherence support at the local level.
Compared with controlling swine flu outbreaks, this should be quite straightforward. The location of the patients is known, so there is no need to track them down. HIV/AIDS is not transmissible through casual contact, so expensive HAZMAT suits are not required, and the children’s disease and treatment have been determined, so highly educated workers are unnecessary.
The Chinese government has clearly demonstrated that it can tackle health problems. Now we need to think about how the central government can work with provincial and local governments to better support the great work they have already done in rolling out treatment. PATS offers one possible model of care, and we welcome the opportunity to engage with partners at all governmental levels. Coordinated efforts, much like those employed to control the swine flu, can ensure that HIV-positive children receive both the treatment AND care that they need in order to thrive.
Promoting treatment support in China:
Eliza Petrow is the co-founder and director of PATS and is the program director at the Izumi Foundation in Boston.