The NYU CFAR Team in Kenya:
A Nursing Perspective Without Borders

Maura Laverty, RN, Clinical Research Nurse Coordinator, reports on her experiences in Africa. Her first visit was in 1983 as part of a surgical team. In her most recent visit, she notes the difference in care when the focus is on HIV/AIDS.

This was different than the first time I was in Africa . That was in 1983, before HIV/ AIDS started to ravage the continent. At that time I was a young nurse, excited about joining a surgical team that was to spend a month in Nigeria . Because the practice of surgeons and surgical nurses is well-defined, we all knew what we had to do. You diagnose a tumor you remove the tumor. We deliver good post operative care and the patient goes home. Long days in the theater, but everyone knew their role, including me.

This time I was traveling with Infectious Disease physicians who specialize in HIV/AIDS. This disease has been my nursing specialty for the last 18 years. Kenya has one of the highest HIV infection rates in Africa . Even using conservative estimates, there are at least 1.8 million people infected. Without adequate resources to treat those infected, only the sickest get therapy and children are almost never considered for treatment.

We arrived in Mombasa for the first time in July 2003. At that time only 11,000 people were being treated with ARVs (anti-retroviral medications). Seeing first hand the consequences of this disease and the lack of significant American and European responses to the epidemic was devastating. It was hard to know how to step in and help.

Over the course of the last year, we have formed relationships with staff from 2 hospitals, one provincial hospital, Coast Province General Hospital and one private hospital, Bomu Clinic. We spoke with physicians, nurses, and administrators and began to develop a partnership where the two main goals would be to increase access to antiretroviral medications and to initiate operational research. The two protocols that were developed over the last year had major input from Kenyan clinicians and we hope that results from these protocols will change HIV/AIDS care for those infected in Kenya by providing additional or alternative ways of monitoring responses to ARVs so that the best possible treatment regimens can be determined.

The NYU CFAR team is returning to Mombasa in November to initiate these research protocols and to implement a program designed to speed up access to ARVs for both children and adults. As we work to implement these programs we will be training doctors, medical officers, nurses, data managers, and laboratory technicians who will ultimately be responsible for maintaining this effort. It is essential that all of these projects be sustainable so that Kenyans can continue providing care utilizing information gained through these collaborative research efforts.