ESTHER SUPPORT SYSTEM

Partners who are present

Chronology

The ministerial arrangement that formalised the willingness to create hospital twinnings within the framework of cooperation between France and Cambodia was signed on August 20, 2002. The aim of this programme is to create reference centres for the comprehensive treatment of HIV/Aids by organizing and maintaining 2 active files of patients receiving ARV therapy at 2 sites: Calmette Hospital in Phnom Penh and the Provincial Hospital in Siem Reap.

This programme began in 2003 with an emphasis on:

§ Training of all of the key actors in the project for PLWHA treatment and care.

§ Reinforcement of medical equipment for the medical and biological monitoring of patients as well as the procurement of medicines (ARV and medicines for opportunistic infections).

§ Implication of the association network and community structure in the psychosocial support of patients and affected families with a rationale of comprehensive treatment and continuity of care for patients.

§ Implementation of monitoring and evaluation mechanisms that provide quality care and a good adherence to treatments.

In 2008, the ESTHER Initiative contributed to the treatment and care of 2,500 people including 1,854 receiving ARV therapy, 22,000 medical consultations performed by doctors at Calmette and Siem Reap Hospitals. 1,800 patients were monitored in therapeutic education consultations at Calmette and Siem Reap Hospitals. 3,000 people were monitored within the framework of a psychosocial structure at Calmette and Siem Reap Hospitals (a total of 6,247 since the setting up of this structure).

MAJOR ACTIVITIES IN 2008

§ Reinforcement of the capacities of those who provide care and support

- Training in Cambodia and in France of care providers, biologists and pharmacists in the treatment of HIV/Aids and opportunistic infections and in biological monitoring.

- Prescription and dispensing of ARV.

- Training in the diagnosis and treatment of opportunistic infections.

- Training of teaching doctors within the framework of a University Certificate "Comprehensive care of PLWHA and public health practices".

- Training of psychosocial counsellors at Siem Reap in partnership with SIDA Info Service.

§ Treatment of Opportunistic Infections (OI)

- Support for the treatment of OI at all sites supported by ESTHER: contribution to the supplying of medicines for the diagnosis and treatment of OI.

§ Therapeutic Education

- This activity is ensured at both sites by teams of doctors and nurses. All of the patients being treated have been able to benefit from these consultations.

§ Psychosocial support of patients

- Consultations are ensured by psychosocial counsellors who currently represent the link between patients, care providers (medical and paramedical) and mobilise resources in favour of patients within the framework of collaboration with existing association networks.

- Support for the lodging centre and for the partnership with the Vitey Chivit Association in Phnom Penh and with the NGO Caritas in Siem Reap to ensure the sustainability of care and support for PLWHA.

§ PMTCT/Paediatrics

- Consultations for pregnancy at risk (PAR), performed for pregnant women who have tested seropositive (set up since April 2003 in collaboration with the consultation team and the Maternity Ward at Calmette Hospital in order to limit mother-to-child transmission).

- Monitoring of a mother-child cohort (120 women infected with HIV monitored during their pregnancies and 120 children).

- Training in paediatrics: a second training session for the paediatric treatment of children living with HIV was organized in 2007. 24 paediatricians benefitted from this training.

§ Operational Research

- Collaboration with the ANRS within the framework of the CAMELIA Research Project which aims to determine the optimal moment to start ARV therapy against Aids when patients are being treated for tuberculosis.