WFP's nutrition support programme for malnourished people living with HIV in the region of Bouaké, central Côte d'Ivoire, runs for six months. After this, the patient is normally expected to grow out of malnutrition and regain his or her ability to lead an active life. However, many patients are so poor and vulnerable that they cannot be discharged.
Abidjan – Attimi, 44, has been on the programme since 2007. "We just cannot discharge her and most of the other patients," says Koué Bi Marius César, the coordinator of Renaissance Santé Bouaké, the local NGO that WFP is partnering with to deliver nutrition support to malnourished people living with HIV. "If we discharge them after six months, they will immediately fall victim again to malnutrition. Worse, they will go hungry as most have nothing at all.”
The redeeming power of food
Until about two years ago, WFP was able -- thanks to adequate funding from generous donors -- to provide Attimi, and 300 other people living with HIV in Bouake, with enough food for them and their families. The monthly ration - typically for a family of five - consists of 24 kg of cereals, 7,5 kg of pulses, 5 litres of oil and 15 kg of Super Cereal– a fortified blend of corn and soya flour that is used to prevent malnutrition.
"There was a time when I was so well-fed and strong that I was oblivious to my HIV condition," says Attimi, who first found out about her HIV condition in 2003. "I was not worried. I didn't have to think about my disease. I used to bring home lots of food every month. My family used to eat well and were content. This is why they were so understanding and kind to me. It's as if they didn’t mind that I had HIV."
Through this full family ration, WFP and its local partner Renaissance Santé Bouaké, made sure that the patients got the right quantity and quality of nutrition support they needed to accompany their anti-retroviral treatment and live an active, healthy life. The full family ration was a safeguard against the patient having to give up much of their food to the rest of the family and going hungry as a result.
Many families seemed to hold no prejudice and have no resentment against their HIV positive relatives. They seemed tolerant and even supportive. The secret? It's the redeeming power of food! The full family food ration has helped remove the stigma surrounding HIV.
Medicines on empty stomachs
Not any longer. Financial constraints have forced WFP to scale back its nutrition support programme to people living with HIV in Côte d'Ivoire. Instead of a full family ration, the patients now receive a reduced individual ration of 7 kg of Super Cereal and less than a litre of oil per month.
"That's too little," complains Attimi who has to share out the food with 11 other members of her family and has often no choice but to take her anti-retroviral medicines on an empty stomach. "Today I had nothing to eat all day. Neither did my 8-year-old daughter. People in the community are fed up with me asking them for food. But what can I do? My husband has been unemployed since he had all his fingers cut off in an accident at the textile factory where he used to work. Today I had to borrow money to be able to pay for transport coming up here.”
At 3.4 per cent, the prevalence of HIV in Cote d'Ivoire is the highest in West Africa. WFP's aim for 2013 is to support over 5,500 Ivorians like Attimi. However, the level of assistance WFP will be able to give to these vulnerable people will depend on the level of funding it will receive for its nutrition support programme.
Attimi is only too well aware that help cannot continue indefinitely. "I know that there comes inevitably a time when your benefactor will tell you the truth,'" she says.
"But what we need from WFP now is to restore the full family ration for a while until we can find some work and start relying on ourselves. We don't want to live on hand-outs. My hope is to get just enough support so I can start a small trade. I want my daughter to go to school and build a future for herself.”