Program of Extending the Network of “Sunflower” Day Care Clinics

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• Program of Extending the Network of “Sunflower”…

The program for scaling up the “Sunflower” Day Clinics Network was launched in 1991 and concluded in December 2008, being currently integrates into the public health system.

Partners:

• The Ministry of Health;
• The National Institute for Infectious Diseases “Prof. Dr. Matei Bals” of Bucharest;
• The Hospital for Infectious Diseases of Constanta;
• The Clinical Hospital for Infectious Diseases of Brasov;
• No. 3 Hospital for Infectious Diseases of Craiova;
• The “Saint Parascheva” Hospital for Infectious Diseases of Galati;
• The County General Hospital of Bacau;
• The Emergency Hospital of Petrosani;
• The County General Hospital of Giurgiu;
• The Clinical Hospital for Infectious Diseases of Cluj;
• The County General Hospital of Dambovita;
• The County Emergency Hospital of Suceava;
• The “Dr. Victor Babes” Clinical Hospital for Infectious Diseases of Timisoara;
• The “Louis Turcanu” Emergency Children Hospital of Timisoara;
• The County General Hospital of Braila;
• The County General Hospital of Slatina;
• The Municipal General Hospital of Medias;
• The County General Hospital of Resita;

The program was financed by The Global Fund to Fight AIDS, Tuberculosis and Malaria and Fondazione Franco Moschino (for the program of scaling up the Day Clinics Network to 16 day clinics). The network also benefited in time from the support of various sponsors such as Elton John AIDS Foundation and Mercury Phoenix Trust. As far as the psychosocial assistance component, it as financed by Franco Moschino Foundation through Romanian Angel Appeal.

Starting with February 2006, the services have been take over by the Ministry of Health and integrated into the national public health network.

HISTORY OF THE PROGRAM

At the beginning of the ’90s, Romania was facing an unprecedented situation: a large number of HIV people, especially children, and overcrowded hospitals, with old equipment and lacking specialized staff.

Long-term hospitalization for investigations, diagnosis and treatment exposed the children to intercurent infections while breaking, in many cases, the relation with the family. Thus, in 1990 and 1991, a large number of HIV positive children died in hospitals or were left abandoned by their families.

Aware of these deficiencies, Romanian Angel Appeal revolutionized the care system for HIV positive children and young people by creating a multidisciplinary model that combined medical care with social, psychological and educational services: the “Sunflower” Day Clinic.

Romanian Angel Appeal opened the first day clinic for HIV positive children in Romania in 1991, at Constanta. Currently there are 16 such day clinics at national level, in Bacau, Brasov, Bucharest, Constanta, Craiova, Galati, Petrosani, Giurgiu, Cluj, Timisoara, Targoviste, Suceava, Braila, Resita, Medias si Slatina, all brought together in a network for information, experience exchange and mutual help.

Program objectives:

• To improve the care given to HIV positive children and their families by providing medical, social and psycho-educational services within the “Sunflower-Smile” Day Clinics;
• To speed up the access to antiretroviral therapy and to monitor the quality of care provided to HIV positive children;
• To stimulate the collaboration between professionals and the quality increase of services through experience exchange and access to up to date information.

Activities carried out during the project:

• For the children, coming to the day clinic means not only investigations, diagnosis treatment and discussions with the psychologist and social worker but also moments of relaxation in a friendly environment. At the same time, the parents benefit from a close collaboration with the team, receiving useful information on how to care for their child.
• Every activity developed in the day clinic is adapted to the real needs of the beneficiaries. The evolution of each patient registered at the day clinics was followed carefully, both from a medical stand and from a social and psychological one.
• The social assistance includes drawing up psycho-social charts, developing individual family support plans for abandon prevention, social counseling and family support, especially single-parent families, counseling for school and social integration, counseling for crises situations.
• The activity of the psychological care service includes pre-test and post-test counseling, counseling concerning confidentiality, psychological evaluation of the child and parents for proper therapy prescription, observing child’s possible psychological disorders etc.

Results:

Thanks to the financing received from the Global Fund, Romanian Angel Appeal managed to scale up the number of day clinics for patients with HIV/AIDS from 8 to 16 in just two years (2004 – 2006). Thus, almost half of the people living with HIV/AIDS who receive therapy currently have access to specialized medical care and integrated social and psychological assistance, both for them and for their families.

Romanian Angel Appeal renovated and equipped the locations where day clinics were set up (provided to the foundation by the partner hospitals in the program), selected, hired and trained social workers and psychologists and integrated this staff into the medical teams. Thus we can say that, in 16 counties in Romania, the case management and HIV patient approach is now a multidisciplinary one.

Apart from basic service implementation, RAA also provided the necessary means to continuously provide quality services and to give the staff the opportunity to improve their qualifications through training courses, manuals and specialized books, conferences and workshops.

At the “Sunflower” Day Clinics set up by Romanian Angel Appeal, the children and teenagers find not only specialized care and support but also a pleasant and useful way of spending time between medical check-ups, investigations or counseling sessions.

The attitude of the staff towards the patients, the group meetings with peer educators or the access to the forum especially designed for them make the monthly visits a pleasant and awaited event.

Below, testimonials from the children, patients of day clinic:

“Mr. Gabi (psycho-pedagogue – Day Clinic in Bacau) held meetings with the children before and talked about condoms.” “I’ve always enjoyed our meetings and discussions.” – Corina, 15, Bacau

“If I were to give a mark from 1 to 10, I would give them 11. I found support in them.” “Gabi is gentle, Angela (psychologist – Day Clinic Bacau) is nice, the nurses as well.” – Matei, 17, Bacau

“When I got here and I saw how they treat you, I couldn’t believe it! They explain what happens to you. I fell very well here.” “There are people that you can tell by their face that they are grumpy, bitter. It’s something else when you see a smiling face all lit up.” – Ioana, 18, Galati;

“The children come to take part in the sessions organized at the clinic, for instance the sessions on sexuality, on illness and treatment etc” – mother of an HIV positive young woman, Galati;

“They come for the pleasure of talking” – mother of an HIV positive young man, Galati;

“They treat us very well, give us advice every time.” – mother of an HIV positive young woman, Bacau;

“Three months ago I told my boyfriend about my diagnosis. And then I came to Gabi (the psycho-pedagogue) and I was very thrilled. And it helped as I took a weight off my shoulders.” – Alina, 16, Bacau.