DREAM: the dream started 12 years ago
In the month of February an important event is remembered: it was in February 2002 that the antiretroviral therapy was first introduced in the DREAM Center of Machava in Maputo, the first DREAM center of Mozambique and of the whole Africa. DREAM was born at a time when the antiretroviral therapy was already widespread in then western world but it still seemed a distant hope for Africa; no one believed at the possibility of treating the sick in Africa, the resignation, the sense of impossibility, the real difficulties of implementation in poor settings such as those in Africa made care in Africa only a distant dream. But the Community of Sant’Egidio was the first to pursue that dream and that is how the DREAM Program started. Since then, DREAM has offered the possibility of treating AIDS in Africa with the antiretroviral drugs that were introduced in the western world already in 1996, and have changed AIDS from a death sentence into a chronic disease with which it is possible to live. The intuition of DREAM was that of not precluding anyone the access to therapeutic standards of excellence, since the vast majority of HIV positive people lived and lives in countries in the developing world, where it was thought impossible the introduction of western treatment protocols.
The DREAM program has shown the opposite: it is possible to treat AIDS in Africa as confirmed by the tens of thousands of patients under therapy, with rates of adherence to treatment that are higher than those in the western world; it is demonstrated by the 23.500 children born healthy to HIV positive mothers, the more than 230.000 people assisted, the approximately 2.000 pregnancies followed currently, the over 1.500.000 people who have benefited from the program in 40 day hospital centers and through the 20 clinical laboratories in the 10 African countries where DREAM is present today.
Since the beginning of Dream Program, we believed that formation of sanitary staff was the most important aspect to improve assistance. During the years 2012-2015, the partnership between Dream Program and “Merck for mothers” will grant formation of local clinical and support staff, throughout the whole period of time. Thanks to Merck, there will be resources enough to continue forming new local personnel and to keep up-to-date the ones that already work with us. So we can involve more young women to work in their territory and in local communities.
That modest beginning in the outskirts of Maputo marked a turning point in the history of the treatment of AIDS: for the first time a program aimed at the care of HIV-positive patients and the elimination of the mother to child transmission had set foot in the African continent. A turning point that has also successfully demonstrated the feasibility of treatment in resource-limited settings. DREAM has created a model of AIDS care and prevention of the mother to child transmission of HIV in African contexts that up to today has achieved results never before attained in such sites. A reproducible model in Africa, in urban, semi-rural and rural areas, where approximately 70% of the global population affected by HIV/AIDS lives.
All this began right in Machava and it is here, in the “mother center” that on Saturday, February 1st, the twelfth anniversary of the DREAM Program was celebrated.
Doctors, nurses, activists who everyday in this “little house” next to the public hospital specialized in the treatment of tuberculosis take care of AIDS patients, started arriving already in the morning. Along with their many friends, old and new members of the “DREAM family”.
The story of the last 12 years lives in the words of Dr. Noorjehan Abdul Majid, the first physician of the DREAM Program in Mozambique who, in the hospital of Machava where she worked, in 2001 met the doctors of the Community. Recalling that period, Noorjehan tells about the pain of not being able to cure the TB patients that were entrusted to her and that died at a rate of 5-6 per day; the frustration of not being able to execute the HIV test because, despite knowing antiretrovirals, then it was not possible to use them in Mozambique; the discovery, after meeting with the embryonic DREAM Program, that 90% of her patients were HIV positive and died exactly because of the lack of proper care…
Since that February 2002, that dream pursued with such tenacity resulted in many stories of resurrection, return to a normal life and full of dreams for the future.
From the “little house” in Machava a long way has been covered, with the introduction of the vertical prevention protocol that has enabled thousands of children to be born healthy from HIV-positive mothers and then with the multiplication of the DREAM centers in Mozambique and up to 9 other African countries.
All this would not have been possible without the help and personal commitment of many, African and European allies, to change the future of a continent. The thought of all goes to Ana Maria Muhai, the first activist of the DREAM Program, for 10 years a tireless voice and face of so many patients, who recently passed away.
There are so many things that could be told and described, time passes quickly remembering these twelve years of struggle and success, passion and faith. But after the words, there is still a desire to be together, to celebrate through songs and dances and express joy and gratitude for a life and a new family that so many have found exactly in the hardest moments of their lives.
At the moment of parting the thank you to the Community of Sant’Egidio from Florentina, the first nurse to work in the program: “On behalf of all of us Mozambicans, thank you to the Community from the bottom of my heart …without DREAM what would have happened to us! Long live the great house of Machava! Long live DREAM! “