For people living with HIV (PLHIV), antiretroviral therapy (ART) offers hope for a longer, healthier life, but that hope is predicated on adherence to treatment. HIV is a difficult disease often made worse by the burden of stigma and discrimination. This combination makes adherence a challenge, particularly for those who don’t have access to adequate social support services.

With support from the US President’s Emergency Plan for AIDS Relief (PEPFAR), Debre Berhan Referral Hospital in Ethiopia has been working with Elmhurst Hospital Center in New York City since 2007 to improve medical and psychosocial care for HIV patients, first at Debre Berhan and, more recently, at two rural feeder hospitals in Mehal Meda and Enat.

Recalling how things were before the twinning partnership began, Mr. Sharew Engidasewu, a nurse at Debre Berhan, explains, “The stigma surrounding HIV/AIDS was high and our staff did not fully address the physical and emotional ramifications of the disease.”

Noting that care provided to PLHIV was far from optimal at that time, he remembers how amazed he was to see American nurses chatting and dining with their HIV patients during his first professional exchange at Elmhurst. “The Elmhurst nurses knew the science behind HIV/AIDS, so they were not afraid to sit and dine with these patients. Their humanitarianism and respect for their patients forever changed me,” he says.

In New York, Engidasewu received training in HIV care and ART counseling, working closely with his Elmhurst counterparts. The quality of care he witnessed ignited his own desire to improve services at Debre Berhan. “I was determined to change the way HIV-related care was provided at Debre Berhan,” he says, explaining that he was particularly concerned with erasing the stigma surrounding HIV/AIDS.

Since then, partners have worked to improve both the quality and scope of care and support provided to PLWH. Debre Berhan social services and nursing staff have attended psychosocial care and supervision trainings conducted by experts from Addis Ababa University School of Social Work, which used a curriculum developed through another PEPFAR-supported twinning partnership.

Afterward, Debre Berhan’s psychiatric nurse and social worker met with Elmhurst experts, who stressed the need to build greater professional rapport and reinforce the importance of proactive consultation between the two departments. The ongoing training, mentoring, and exposure to best practices through professional exchanges has played a pivotal role in building the institutional and human resource capacity needed for Debre Berhan to provide comprehensive, client-centered HIV treatment, care, and support services.

“All HIV patients want to be treated with care and dignity,” Mr. Engidasewu concludes. “That is the way we provide services here at Debre Berhan Hospital and this service upgrade has everything to do with what we saw at Elmhurst Hospital Center.”


“All HIV patients want to be treated with care and dignity. That is the way we provide service for them here at Debre Berhan Referral Hospital, and this service upgrade has everything to do with what we saw at Elmhurst Hospital Center.” — Debre Berhan Referral Hospital Nurse Sharew Engidasewu (pictured at right above in the baseball cap).