HIV treatment is ‘my passion’ he says

The children at Cyril Ross Nursery Home, Tunapuna, call Dr Nosa Omo-Igbinomwanhia, “Daddy Nosa” and his arrival is greeted with smiles and hugs. He has been part of their lives the past five years, on-call round the clock. He is not only their physician but a surrogate father very much like the other workers they have adopted. Hearing Dr Nosa speak about his work in HIV treatment, the listener is immediately struck by his enthusiasm. “This is my passion,” he said with a smile during an interview at the nursery. He does not blame those health care workers who, five years ago stigmatised and discriminated against patients who were HIV positive. “They were ignorant and did not know much about the disease. They don’t do that these days because of enlightenment.” He recalled the case of a 13-year-old girl who was placed in a room by herself and the louvres closed although there was no fan to provide cool air. “They thought it was spread by air,” Dr Nosa said.

When a nebuliser (mask through which oxygen is given to asthmatic patients) was used on a child with HIV it was not used on any other child. Years ago Dr Nosa had to call staff from Cyril Ross to feed the children warded at the hospital. He would like to see more doctors trained to treat patients with HIV/AIDS. He can “count on one hand” the doctors involved in treatment. There is a great deal of work to be done in reducing stigma and discrimination. Sometimes he wants to refer clients from the Medical Research Foundation (where he was reassigned last August) to Port-of-Spain General Hospital but they are reluctant to go. Still, Dr Nosa maintains that things have improved from five years ago. It was “by chance” that Dr Nosa got into HIV/AIDS treatment. He was working in Paediatric Surgery at Eric Williams Medical Sciences Complex, Mt Hope,  September 1998 when two children were brought to the Paediatric department for treatment. Dr Nosa noticed they were left on trollies for a long time and curiosity made him ask about their condition. He found out both girls were HIV positive and residents of Cyril Ross Nursery.

He found out from the girls’ caregiver that the facility had one doctor, Dr David John, who visited once in a while because he was based in the United States. He heard that children who fell ill when Dr John was not around were taken to Mt Hope. Dr Nosa offered his service and left his telephone number with staff from the facility. “I just knew that AIDS is a medical problem and there are medical things I can do.” Dr John contacted him some time later, but had reservations about his commitment to the task ahead. In January 1999, he started at Cyril Ross. At the time he did not have a car and had to travel from Mt Hope on the bus route and walk to the nursery. He admitted that his first visit to the Nursery was a shock because he realised that the children were not on antiretroviral therapy. “They just bathe the children, give them food and anyone that dies they call the funeral home.” Most of the staff has been working at the facility since 1997. Dr Nosa thought if they could handle the situation although they did not know much about the disease then he could too.

Dr Nosa said he used to feel very helpless treating patients with HIV/AIDS when he worked at the “big Government hospital” in Nigeria. They wanted to be “saved” and he could not help them. It was like that when he first started at Cyril Ross, but he decided to give hope. He would treat any illness the children contracted because of their compromised immune system. “I thought ‘let me reduce the amount of time they spend in hospital’.”

When any of the children were dying there was always someone with them to attend to their needs. Dr Nosa decided they should have the best care before they passed away. Antiretroviral treatment began in 1999 through donations from US-based Hope Alive and medicine purchased by Pour L’Innocence. The Health Ministry began supplying medicine to Cyril Ross in 2002 and pays for CD4 tests done at the Caribbean Epidemiology Centre. Highly Active Antiretroviral Treatment (HAART) has been successful in reducing the HIV viral load in the children to undetectable levels in the blood. “This is good, it tells us there is less likelihood for them to be sick.” There have been no deaths at Cyril Ross in the past two and a half years. Tests are done on children at 18 months and five years. If medication is started later than 18 months then the doctor must know how much of the combination of ARVs to administer.

“HIV needs specialised training especially in drug combinations. Dr Nosa said it is important medication begins early. He tries to seize every opportunity to learn more about treatment and the latest developments even if it means giving up his vacation to attend conferences in Uganda, Montreal, Barcelona.  Trips abroad have been sponsored by the organisers when the papers he submitted to present at conferences were accepted. Dr Nosa has also received training in Paediatric HIV in Newark, New Jersey at the University of Medicine and Dentistry which he described as “the best training in the world.” He visits the facility every year to update his knowledge. Dr Nosa’s along with Dr Jeffery Edwards were the only two Caribbean consultants involved in a the Commonwealth Secretariat three-day training workshop “Strengthening Capacity for Care and Treatment of HIV in the Caribbean” held in Tobago for Caribbean doctors. He also is a volunteer lecturer for a course on Clinical Pharmacology and HIV for final year pharmacy students. The only salary Dr Nosa receives is from the North West Regional Health Authority.  His other work is done on his own time. Maybe his name suggests something of his character Nosa means “What God said is the way” and Igbinomwanhia means “the struggle of everybody.”