FAQ

The actual North Star was used by travellers for navigation, guidance and reassurance. The name is meant to evoke safe travel to distant lands.

Experience from a similar project in South Africa showed that people were reluctant to go an “AIDS clinic” or “AIDS project” due to the stigma associated with an AIDS diagnosis. North Star’s health services are broader than HIV and provide a more comprehensive package to the individual. By keeping the health services broad, the clinic staff are able to treat people for a variety of ailments and build their trust while doing so, which is important factor in the decision to get tested for HIV

North Star currently operates 22 wellness centres in 10 countries throughout East and Southern Africa. There are plans to roll out 29 mobile units throughout Southern Africa beginning next year. New wellness centres are planned along the transport corridors in West Africa. Countries in which North Star currently has wellness centres include: Kenya, Malawi, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe,

This cost varies by country but on average it’s about US$ 95k / € 75k to set-up and run an RWC for one year.

North Star captures data on all visitors to its centres through a software programme called COMETS, developed with the help of ORTEC, one of North Star’s core partners. COMETS (Corridor Medical Transfer System) is a client health registration and ‘passport’ system. It serves as an electronic health passport for mobile clients, provides daily information on each RWC’s performance, and gives an overview of the health care landscape along transport corridors and at the regional level.

North Star shares its (non-personalised) COMETS data with the District Ministry of Health in the country where a wellness centre is operational. While COMETS is still relatively new, it has already contributed substantially by enabling a deeper understanding of epidemiological patterns and trends through the collection of data essential to both the growth and operations of our RWCs, as well as to the building of capacity within National Health systems. North Star is making COMETS available to other public and humanitarian organisations. The more COMETS is used, the easier it will be for people on the move to have reliable access to health services.

For health problems that are beyond North Star’s capability, clients are referred to local facilities that have been previously identified. These facilities are frequently local or district hospitals. Scoping out the best referral centre in the area is part of the situation analysis that is undertaken before North Star establishes an RWC.

No, North Star does not share this information with employers, under any circumstances.

COMETS has multiple encryption levels built into the system and very few people have access to the personally identified data – even if the computers are stolen, there is no way to match results and individuals. Personalised patient data are normally stored for a maximum of 48 hours on any given clinic computer.

Each RWC sees approximately 35-45 people per day for clinical visits. RWCs can easily see up to four times that number for outreach and counselling sessions.

Tough to say as there is almost no reliable information on the exact numbers of the target populations in question (e.g. sex workers and community members). We are working to calculate it for truck drivers, but even these numbers are hard to get. However, we estimate that roughly 100 RWCs are needed to cover 85% of commercial cross-border traffic in sub- Saharan Africa. This is based on a 2007 study done for us by Maplecroft using data from multiple sources including ILO, IOM and national Road Transport Associations.

Low at the moment, something like 4%, but I’ll have to check. STIs are around 12-15% for truckers. Given the HIV prevalence in the countries we operate in (which ranges from over 25% to 4%) and the spotty consistency with which we test, it may be a bit higher or lower.

Studies have shown that long-distance truck drivers (in some places) have twice the HIV prevalence compared with the general population. Among sex workers, it is even higher. For example, in Malawi’s capital city, studies have shown that around 70% of the sex workers are HIV positive.

Yes, a short survey was recently conducted in six of the wellness centres in Kenya. Of the 78 respondents, the vast majority found the services to be useful although they specifically requested that educational materials be made available in Swahili and that recreational activities be added so that more people would be inclined to come to the wellness centre.

North Star adheres to the World Health Organization (WHO) Essential Drugs list. Antibiotics are included in that list.

Some medicines are donated in some countries, while in others they are not; it depends on the country. Ideally, the government would provide all drugs to North Star free of charge but in some cases we have to purchase them on the local market.

Clinical officers are more qualified than nurses.

Rapid test allows for results to be known in as little as 15-20 minutes.

We refer them to local treatment facilities following pre-arranged protocols. North Star will start offering adherence counselling and detection of opportunistic infections for those on HIV medications, called antiretrovirals (ARVs), as our first steps to providing ARV treatment. That is our goal for corridors where we have established sufficient coverage. Kenya will most likely be the first country as we have seven centres on the northern corridor (Mombasa to Kampala).

Some of the barriers currently include the need to ensure referrals to quality health services and patient follow-up, adequate training of qualified staff to conduct effective adherence counselling, and an uninterrupted and affordable supply chain of ARVs.

Pulmonary tuberculosis (TB) is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs. TB is the most common opportunistic infection in people living with HIV. North Star addresses both HIV and TB through behaviour change communication and health education on site. In addition, in conjunction with UNAIDS and KNCV (a TB center of expertise), North Star developed a specific TB Smart Card with information on TB prevention, HIV prevention, treatment and healthy living. North Star is collaborating with WHO and the National TB committees in Kenya and Uganda on a pilot project to introduce the new rapid TB testing technology into the RWCs, called GeneXpert. A joint funding proposal is in the works.

North Star consulted a UNAIDS TB specialist who advised on infection control. This resulted in the redesign of North Star’s wellness centres, including adding more windows to achieve cross-ventilation.

Rapid tests are available allowing results to be known within minutes.

We don’t currently have much of a role in harm reduction as it’s not a big issue among our target groups. However, Mombasa port is one area where there is likely sexual overlapping between truck drivers, sex workers and IDUs. Alcohol abuse is a problem and we do offer counselling and education programmes on that topic. If we were to move into the CIS and Eastern Europe, it would become more of an issue as there is evidence that truckers in that part of the world do have injecting drug users (IDU) among them.

To date, we have had no criticism or interference from faith-based organizations in any location. North Star takes a human rights and public health approach to the provision of services. Condoms and HIV/STI prevention education are offered not in isolation but as part of a broader health package. The fact that North Star primarily targets mobile adult men and women engaged in sex work may help to reduce potential criticism.