“Working with HIV positive children has really opened my eyes to the strength and perseverance of children. Being diagnosed with HIV is a big challenge in any person's life. You can imagine how it is for a 10-year-old who is too young to understand why him, and is still at that developmental stage were he is still trying to find his place amongst his peers. I have seen children become depressed, angry, isolated and have complete mistrust and low self-esteem. Helping children has been the biggest challenge in my life and has proven to be the most fruitful work I have ever done.”
- Bakani Johnson, Social Worker


Summary

BIPAI Botswana started its adolescent clinic in 2005 with 23 teenagers. The adolescent population has continued to grow and by the end of 2010 included more than 600 teenagers.
 
Based on age-stratification data collected from a representative sub-section of our client population, the average age of our pediatric patients is just over 9 years old. In the next few years, when our 8- to 10-year-olds reach adolescence, the age makeup of our patient population will shift dramatically toward the teen years. By 2011, a conservative nationwide estimate of Botswana's teen ARV needs indicates that nearly 4,000 adolescents will need ARVs. In addition to medical treatment, these teens require specialized care and support to help them overcome the hurdles of puberty and adolescence.
 
Because BIPAI Botswana’s teen population is growing rapidly, psychosocial services is heavily involved in the center’s teen services. Successful care and treatment of HIV+ adolescents can be significantly different from that of young children, so the Botswana program acquired land near its main building for an adolescent center. It will be built when funds permit.
 
Our staff teaches and encourages self-care skills that go beyond the disease and symptom to focus on living a positive life. Camp Hope is probably the center’s most popular program for self-esteem-building.
 
HIV-infected children have complex health needs and their psychological and social needs are no different. BIPAI Botswana’s psychosocial department treats families in need of psychosocial intervention, using a multidisciplinary team of psychologists and social workers. Their physician, nurse, or the pharmacy may refer a client to psychosocial services.
 
This center will provide teens with medical care, the extra psychosocial support and education they need and help them transition to adult care, in addition to relieving space constraints at the center of excellence. Learn more about BIPAI Botswana’s programs for teens.
 
Psychosocial services also supports the center’s in-reach and outreach programs. These efforts result in better adherence and happier families. Learn more about in-reach and outreach in Botswana.

Adolescent Forum

In 2009 we implemented a bimonthly adolescent forum. A social worker and/or psychologist leads staff through the cases of challenging adolescent patients, with a focus on those dealing with psychosocial issues. Programmatic updates on Teen Club and other adolescent-focused initiatives are also covered. 
 
The forum is attended by a variety of healthcare providers with an interest in adolescent issues such as physicians, nurses, psychologists, social workers and auxiliary staff. Through the adolescent forum and other innovative interventions, we strive to build the capacity of our staff to provide our adolescent patients with the highest possible standard of care.

Teen Club

Teen Club is a peer support group intervention for HIV-positive adolescents between 13 and 19. The mission of Teen Club is "to empower HIV-positive adolescents to build positive relationships, improve their self-esteem and acquire life skills through peer mentorship, adult role-modeling and structured activities, ultimately leading to improved clinical and mental health outcomes as well as a healthy transition into adulthood." 
 
In addition to our Botswana COE (Gaborone) site, Teen Club operates in 5 satellite sites throughout Botswana, reaching more than 400 teens, in partnership with local NGOs and ARV hospitals, in these locations:
  • Francistown: Light & Courage Centre Trust, Nyangabgwe Referral Hospital (formed October 2008) 
  • Molepolole: Hope Worldwide Botswana, Scottish Livingstone Hospital (formed November 2008) 
  • Mochudi: Stepping Stones International, Deborah Retief Memorial Hospital (formed September 2008) 
  • Mahalapye: Mothers' Union Orphan Care Centre, Mahalapye District Hospital (formed May 2009) 
  • Maun: Bana Ba Letsatsi, Letsholathebe District Hospital (formed November 2009) 
Partnering with NGOs and healthcare partners at the local level has allowed the Botswana-Baylor COE to decentralize its psychosocial care and support interventions for adolescents, namely Teen Club, to various towns and villages throughout Botswana. 
 
The aforementioned initiatives would not have been possible without the generous financial support of our two primary donors, Barclays Bank and UNICEF Botswana. For more information, including our life skills curricula and toolkits, you can visit our website at botswanateenclub.wordpress.com.

Camp Hope

Camp Hope has been part of the BIPAI Botswana since 2005. Camp Hope strives to give each child the opportunity to normalize their social experiences and improve their outlook on life. In addition, Camp Hope endeavors to improve the ARV adherence of the children through Directly Observed Therapy (DOT).
 
In 2009, the 5-day overnight camp was hosted at Maru-a-Pula School for 50 vulnerable children ages 10-12.
 
Campers are chosen from the clinic population, with a strong preference for those in challenging psychosocial situations or who have significant problems with medication adherence.
 
More than 30 adults volunteer for Camp Hope and are a mix of center staff, community volunteers and qualified staff from community-based organizations. Activities include cooking and nutrition, character development, arts and crafts, dancing, sports, board games and talent shows. In addition, a feelings and emotions session is led by a social worker to help the children draw and discuss their feelings in a safe and comforting environment.
 
Since 2009, teen leaders from Teen Club have been involved as counselors and members of the leadership committee for Camp Hope. The teen counselors bring an unmistakable energy to each day's activities and also serve as role models and mentors for younger campers, particularly through their reinforcement of maintaining good ARV adherence.
 
Camp Hope receives generous support from Barclays Bank, UNICEF Botswana, Seabelo's Express, Maruapula Secondary School and Mokolodi Nature Reserve.