Most of the children playing in a bright red train carriage in an Angolan hospital are too young to know they have HIV.
They were infected by their mothers –something that can easily be prevented with treatment.
Bernardino Paediatric Hospital, in the South central African country’s capital, provides therapy for mothers and children living with HIV.
An estimated 190,000 people are living with the virus in Angola, including 110,000 women.
Staff in hospitals and clinics in 16 districts in Angola are being trained in preventing mother-to-child transmission and the United Nation Children’s Fund, Unicef is running country-wide education campaigns.
The idea is that if a pregnant woman goes to a clinic for an HIV test and finds that she has the virus, she will be referred for specialist treatment when she gives birth. With just a short course of anti-retroviral therapy, her child than has a much better chance of being born HIV-negative.
To support children already born with HIV, a special anti-retroviral treatment regime is needed and doctors have to have paediatric training to give it out. At Bernardino Hospital five fully qualified doctors are being trained to provide the treatment to children.
HIV activist Paulina visits families, giving advice and support to mothers with HIV. But because HIV is misunderstood in Angola, and the fear of stigma is real, Paulina’s own neighbours still do not know that she and her five-year-old boy are living with HIV. Many women in Angola are afraid even to take an HIV test.
Paulina works with them, giving support, and also receiving it. She feels lucky that her husband, who is also HIV-positive, is supportive. When their second son was born, Paulina had anti retro-viral treatment to prevent mother-to-child transmission, and her baby was born without the virus.
Paulina herself goes to a counselling and support session at Bernardino Hospital, where mothers share their experiences, giving each other emotional support and swapping tips. Like Paulina (not her real name) most of them can't talk to their neighbours or family about their status. The Hospital support group has helped Paulina. She says that she now sleeps well, knowing that the next day she will talk to her friends. “I don't have words to describe it,” she told Unicef, which backs the project. “The group has really changed my life.”
Across sub-Saharan Africa, the HIV rate varies between one and 25 per cent, according to the World Health Organisation.