Images courtesy of Ella Mack | www.ellamackphotos.com
“African Services Committee Ethiopia represents a true grassroots community-based response to community need — serving the most destitute mothers and their children,” says ASC Founder and Co-Executive Director, Asfaha Hadera. “We were the first services to start free HIV testing and counseling in 2003.“
African Services Committee Ethiopia’s three grassroots health and community development centers provide a free one-stop service to the most marginalized segments of the community who find it difficult to get medical and social support, particularly integrated support, from larger institutions. ASC’s institutional strength is in its integrated, free community-based clinics and community development centers, providing health services and prevention and treatment commodities for the most destitute. We have fully integrated sexual and reproductive health and family planning and child nutrition with HIV and TB testing and treatment.
Today, ASC Ethiopia provides more than 20,000 children, women, and men with HIV and TB testing and treatment each year, nutrition for over 7,000, reproductive health for over 6,000, new shoes for nearly 17,000, and income-generating support for nearly 100 families. Since 2003 we have provided free HIV and TB clinical services to nearly 200,000 of the most marginalized and educated approximately 1,000,000 people in HIV prevention.
At the outset, ASC was providing more than 10 percent of the HIV testing for the entire country of Ethiopia. Over time, as the Global Fund to Fight AIDS, TB, and Malaria and the US PEPFAR programs began to make ART freely available in Ethiopia, ASC Ethiopia became the country’s trusted third community-based ART treatment site, and we scaled up our in-house laboratories and diagnostic facilities to serve patients with HIV, tuberculosis, sexually-transmitted infections, and malnutrition. We built up our capacity to provide nutrition, reproductive health and family planning and income-generating projects for poor HIV households, and we opened additional clinics in Kombolcha, Mekele, Zeway, and Hawassa. We sustained our free integrated clinic services through grants and subcontracts.
African Services' innovative approach to HIV testing and care begins at our clinics, located in the open-air markets that are the center of commercial and social activity in Ethiopia. Working in the heart of the community, we have aggressively reached out to underserved populations and engaged those at most risk for HIV in prevention education and condom distribution. Our expansion to Ethiopia's rural areas is an extension of our innovative effort to eliminate barriers to care by delivering services directly to the people who need them most.
ASC is in an ideal position to begin providing additional services, such as cervical cancer screening. “Cervical cancer screening would be enormously relevant for ASC Ethiopia because of the huge risk of cervical cancer among poor women in Ethiopia -- especially commercial sex workers and HIV positive women,” said Dr. Fitsume Kibret, supervising physician at ASC Ethiopia’s Henry van Ameringen Health and Community Development Center in Addis Ababa. ASC’s Zeway and Mekele clinics have also started rapid testing and treatment for malaria.
Together with rapid HIV testing, that is entirely free and confidential, African Services has made real strides in normalizing testing and easing the stigma of HIV, thereby ultimately curbing its spread.
Through our HIV education and prevention outreach program, African Services has reached over 1,000,000 people in HIV prevention people with essential information on HIV/AIDS transmission, STIs and reproductive health. Our outreach team is in the community each day, conducting formal and informal educational sessions at open markets, cafes and bars, businesses, universities, garages and driving schools, police stations, parks, and the operational areas of commercial sex workers.
Referrals for free and confidential HIV testing has brought thousands of people, from all walks of life, to African Services clinics. With both knowledge and tangible solutions, individuals gain the ability to combat HIV transmission and reduce the effects of stigma.
African Services has provided HIV counseling and testing to over 200,000 people since 2003. Our clinics are located in large, populous market areas, visited by 10,000 people each day. We provide free and confidential rapid testing with results in about 20 minutes. Over twice as many people have used ASC's testing services than the original estimate over a period of three years.
Our public education and prevention programs provide information on the risks of HIV/AIDS transmission and risk-reduction practices. Our outreach workers conduct educational sessions at local businesses and open markets, colleges and universities, garages and driving school, police stations, parks and open markets, and the operational areas of commercial sex workers. We have educated more than 1,000,000 people about prevention measures, protection against STIs, and reproductive health, and encouraged many of them to utilize ASC's free services. With both knowledge and tangible solutions, individuals gain the ability to combat transmission of the virus and reduce the effects of the stigma associated with it.
We provide free condoms for our clients, and to date, have distributed more than 2.5 million condoms. Each week, our Shola Market outreach workers provide nearly 100 free condoms to each of the hundreds of commercial sex workers in the market.
In the fall of 2010 African Services’ — in collaboration with the Ethiopian Federal Ministry of Health—received its first shipment of AIDS medicines and diagnostics supplies making ASC one of the first independent community-based treatment sites in Ethiopia. Both the Shola Market and Mekele clinics are now able to treat patients diagnosed HIV positive on-site instead of making referrals to other health centers. This development allows us to provide the entire range of HIV prevention, testing & treatment services for the hundreds of clients we see each day.
In 2005, African Services became the first Ethiopian NGO to offer CD4 testing service. At our Shola Market (Addis Ababa) and Mekele sites, ASC offers CD4 testing free of charge to HIV positive clients who cannot afford to pay; and at the $5.00 cost of test reagents for those who can contribute.
We provide vitamin supplements for each of our positive clients, helping them get the nutrition they need to boost their immune systems. We supply daily multi-vitamins, as well as Vitamins C and E. Our clients come to our sites for refills each month.
African Services has been providing rapid HIV testing to children over 18 months of age since 2004. To date, we have diagnosed over 200 HIV positive children, most of who have been referred to our partner organizations for further clinical evaluation, treatment, care, and support. In January 2007, ASC hired a pediatric nurse to examine children monthly and meet with their families to ensure they are receiving the proper medical treatment and adequate nutrition. African Services also supplies these families with vitamin supplements to support the necessary nutrition for healthy immune systems.
African Services implemented a reproductive health program at both the Shola sites in June 2006 and since have expanded this service to all five of our cinics. Our reproductive health nurses have seen over 15,000 clients for reproductive health counseling. We also offer oral and injectible contraceptives. As part of our counseling process, we refer women to appropriate hospitals and health clinics for antenatal care, ART, and pMTCT.
African Services provides practical attachment for counselors being trained in VCT. To date, we have provided training for over 200 counselors.