The COVID pandemic has rocked the world, destabilizing it socially and economically. We have witnessed that global health systems have collapsed, in addition to adequately or not responding to the real challenge that Ecuador has been facing since on March 16 the Special Operations Committee (COE) imposed mandatory social isolation, including the National Emergency Declaration issued by the Presidency of the Republic and restrictions on the mobility of citizens through the curfew.
Ecuador joined the global proposal of: “Stay at Home”, in a scenario, in which the country faces a deep economic crisis, in the health sector, growth in poverty levels, among other structural causes that affect in a different way to the different productive and social strata, all this aggravated by the systematic and endemic prevailing corruption, the same that is most evident in times of crisis.
Kimirina, honoring her own name, to face the health emergency, has kept her human contingent and her community work focused through horizontal coordination, for this the management, technical, knowledge-scientific and territory manager team, They defined an emergency action plan, to address as a priority the needs for prevention and care services for key populations and people in human mobility living with HIV.
The suspension of prevention services involved the redesign and adoption of a community support and guidance system on HIV care and treatment services, aimed at:
- Ensure and support the adherence processes related to the link to health services of people living with HIV affected by the suspension of medical appointments on behalf of COVID-19, and coordination with the Comprehensive Care Units of the MSP for their access to treatment, providing adequate information, including people in international human mobility passing through, residents and nationals.
- Ensure the adherence of users of the PrEP program and support regarding Post-Exposure Prophylaxis to HIV in emergencies and the establishment of the mechanism to send the medication to places of residence.
- Ensure medical care in PrEP, PEP, to users in human mobility and national and other aspects related to sexual health, particularly on STIs, migrating from face-to-face care to remote medical service or telemedicine, with this approaching as closely as possible possible our services to the communities.
All services were adjusted to the needs presented by social isolation and restrictions related to the free movement of people within cities, city closures including the closure of roads, including the curfew from 2:00 p.m. to 05H00.
Our operations are carried out in close coordination and cooperation with other key national actors, such as the Ministry of Public Health, organizations with work on migration, as well as with the fundamental support of international entities for Kimirina's work, such as the Coalition Plus, the Cooperation Agency French, the French Embassy to respond to HIV in the context of the health emergency in the face of the COVID-19 pandemic.
We have attended and provided support services to users of organizations with work in human mobility related to health issues, provision of ARV medications through coordination with the UAIS, which due to the situation of COVID-19 forced into social isolation had to temporarily stay in the country.
The community services network located in Quito, Santa Elena, Esmeraldas, Santo Domingo, Portoviejo, Machala and Guayaquil through telework, remained operational, following up and attending to user demands with information, reference to care services, link to other institutional and community service providers.
We make references and counter references to the local UAIs where antiretroviral deliveries were dispensed, we coordinate with Zonal, District and Territory Coordinators, establishing the mechanisms for the closest access to treatment for PLWHA, according to the need of users and we continue to making arrangements with the 22 UAIs to provide adequate information to users from different parts of the country at the National Level to their patients on the measures to follow for the withdrawal of drugs.
During all this time of social isolation from March 17, 2020 to date, from Quito and Guayaquil, we remain active and coordinate with other members of the service network the delivery of PrEP, and TARV to users in human mobility in temporary residence in Ecuador, bringing them to their places of residence and we are in the preparation and adaptation phase to face the new normality and thus maintain our community commitment in the response to HIV, working together for the same purpose.
Author: Tito Esparza Quintana*
*Tito Esparza Quintana: He is a graduate in education and an expert in community HIV education. He is the coordinator of the Community Services for HIV Testing and Counseling of the Kimirina Corporation of the city of Guayaquil-Ecuador