WHEN Mildmay Hospital opened its doors in the late 1980s to care
for patients with HIV, it was intended to be run as a hospice.
Patients, largely white gay men, came to the hospital for
end-of-life care.
Twenty five years later, with rapid advances in medication and
subsequent life-expectancy for people with HIV, the patients who
come to Mildmay now come for rehabilitation, with three quarters of
them returning home afterwards to live independently.
The hospital now specialises in treating the neurological
problems that can come with late stages of the disease, and is the
only hospital in Europe dedicated to the rehabilitation of people
with HIV-related brain disorders.
Despite improvements in medication and awareness, HIV is still
one of the fastest growing serious health conditions in the UK,
with about 7000 new cases every year. Up to 100,000 people are
living with HIV in Britain, although about a quarter are thought to
be unaware that they have the disease.
THE profile of the patients who come into the hospital has also
changed in the past quarter of a century, the executive director of
Mildmay, Ross White, says. "Now, two-thirds of patients who come to
us are heterosexual, a large proportion of whom are from overseas,
places like sub-Saharan Africa. We can treat very young patients -
18-plus - who were born HIV positive; but more and more are older
people living with HIV.
"They tend to have motor problems and cognitive issues, as well
as behavioural problems. They get 'blue-lighted' in to us from an
acute hospital, and we focus on getting them to back to health from
a seriously ill state."
Mildmay remains a Christian hospital: its motto is "Life in all
its fullness", and the care it provides is holistic: spiritual, as
well as physical. Its money may now come from referrals from the
NHS, as well as charitable donations, but in ethos it is true to
its founder, the Revd William Pennefather.
The Vicar of nearby St Jude's, Pennefather developed a number of
projects known collectively as Mildmay Institutions, providing
spiritual guidance and care for the sick. But it was the 1866
cholera epidemic that established the nursing service for which it
became famous. Two of the Mildmay deaconesses volunteered to go
into some of the worst slums in London, where even the police
feared to enter, to care for the sick and their dependents.
THE first Mission Hospital was established in a disused
warehouse near to Shoreditch Church. It consisted of 27 beds, in
three wards, one doctor, three nurses, and five deaconesses in
training.
In 1892, Mildmay Mission Hospital opened, becoming a part of the
NHS in 1948, but, as a hospital with fewer than 200 beds, it was
regarded as uneconomic, and was closed down in 1982. Six years
later, after campaigning, it reopened to care for patients with
HIV.
Another new chapter in Mildmay's history will open next year,
with the completion of its new hospital building on the site of the
demolished Victorian building. The new hospital will provide 26
beds for inpatients, with specialist rehabilitation as well as a
centre for outreach work in the community, and training
facilities.
MILDMAY has also expanded its reach overseas, and has large
testing and treatment projects in Uganda and Kenya.
It was approached by the Ugandan government to set up a
programme. Since then, it has grown to be the biggest HIV care and
treatment provider in central Uganda. Currently, about 45,200
people receive care and support from Mildmay Uganda every year.
The work is supported financially by the government of the
United States - the last Bush administration pumped billions of
dollars into testing and treating HIV AIDS in Africa.
Mildmay's Kenyan project works with those who are marginalised
and cannot access treatment, whether they are orphaned children or
prisoners. But some projects in countries such as Rwanda have had
to close, owing to lack of funding.
"When Mildmay began in the slums of Shoreditch, it was working
with orphans, sex workers, and itinerant workers," Mr White says.
"Now our work has spread to other parts of the globe; but we are
still working with the same marginalised people."