Dr. Heimerl in Lusaka, Zambia

_This entry was written by John Heimerl, second-year Pediatrics resident at University of Minnesota and member of the Pediatric Global Health Track._

Greetings from Tiny Tim and Friends and Lusaka, Zambia!

**Me spending pool time with the children at the farm**

TTF, the partner organization I'm working with here in Zambia, was founded with a mission to identify, test and initiate HIV treatment to local Zambian children, with the goal of stabilizing them on their treatment before transferring them to the government HIV treatment clinic.

In addition to the medical aspect of their care, TTF also provides a large social component, with Zambian social workers on site to provide counseling and education, as well as a place for them to live for a time if they are in need of extra care.

I am now into my second week here in Zambia. Since arrival I have remained busy.

On my first day I caught up on some much needed sleep, after the 26+ hours of travel from Minnesota. I also walked from the Tiny Tim and Friends (TTF) farm to a local village, Grieps.

The village is just a twenty minute walk from modern houses with electric and plumbing, but lacked even the most basic western "necessities".

Their water came from a central well. Water is collected in buckets, cooking is done on open fire pits, and an entire family occupies a small, one-room house.

I had the opportunity to visit the local school. The headmaster took me from classroom to classroom, and I got wonderful greetings from each class.

One class was learning of world geography, another their mathematics factors.

**Some of the village children of Lusaka**

February 7 was my first real day at the TTF clinic.

I started seeing patients right away, with one of the Zambian clinical officers (equivalent to a U.S. physician assistant).

The patients were all HIV positive and in clinic for one of several reasons. Some were due for their anti-retro viral medication (ARVs) refills, others had acute problems like pneumonia, flu-like symptoms or fevers.

The clinic has an on-site lab and pharmacy. Any patient requiring a higher level of care is referred to a local hospital for further management.

Over the past few years, TTF has worked on ways to better meet their mission, partnering with other organizations to find children and caregivers to enroll into the program.

One such organization is Grass Roots Soccer (GRS), which receives funding from the Elton John Foundation. GRS provides HIV eduction to children in the surrounding Zambian compounds (slums) and uses soccer as a way to engage the children.

At the end of the multi-week training, TTF hosts a graduation--a music- and activity-filled event--where additional HIV-testing for children also happens, with parental/guardian permission.

Last Saturday, Lusaka celebrated World Condom Day. TTF tested 165 children and adults at one of the compounds.

Multiple other organizations also were on hand to provide HIV testing and to provide education on HIV prevention.

**TTF group at World Condom Day (WCD)**

TTF has also begun renting a 40-acre farm, with hopes of growing local produce to be sold at markets. In time the income generated from the farm will be used to sustain the program.

**The farm at Tiny Tim and Friends**

A boy named Paul joined us here at the farm last week.

Paul has been on HIV treatment for some time, but was recurrently sick. Though his mother has noted that his appetite has improved since he started HIV treatment, Paul's family has not been able to afford to make more than one meal a day. So Paul came to live at the farm. He has adapted well to life here, and we are convinced after 5 days that his skin molluscum has begun to improve.

**Paul in the pool, you can notice the extent of his molluscum**

You can learn more about TTF here.
Till next time,
John Heimerl

**Tim, Winford and Paul at the farm**