Doctor creates book to teach HIV-positive children in Africa about disease

At a Baylor College of Medicine clinic in Lesotho, Southern Africa, counselors use crudely drawn flashcards to tell children a story of a virus that attacks little soldiers.

But the virus has an Achilles' heel: frequent doses of medicine.

Adhering to a strict medicinal routine makes all the difference to the thousands of HIV-positive children in Lesotho and there's a way to get that message across without even uttering the disease's name.

Dr. Robert "Bobby" Ricketts III, a Baylor College of Medicine resident who spent a year working at a Lesotho HIV clinic, is taking more than $30,000 worth of donations, from a fully funded Kickstarter campaign, to enhance how the story is told. He crafted an idea - and an artist has drawn up sketches - to create a book called "Our Little Soldiers" that clinics and parents can use as a teaching tool.

"Talking to children about them being infected by HIV - it's a very delicate, tricky topic," said Ricketts, who grew up in Carroll County, "because you need to convince the child that they have something that they need to take these medicines for, but HIV - even in these countries - imports a tremendous stigma."

So, doctors typically won't tell young children that they are HIV-positive.

Instead, they'll use a story to explain the disease to the child: They have a virus that hurts their "little soldiers," (code for a specific immune cell), doctors and counselors will tell the child. These little soldiers are important to protect them from the virus. And taking medication at the appropriate time helps keep these soldiers healthy.

But with medication can come harsh side effects, such as nausea, vomiting and fatigue. Thus, getting children to take their medicine - especially when they feel fine - poses many challenges. Missing two or three doses per month can have a damaging effect, Ricketts said.

"You have to get these kids to buy into that taking this medication every day is important," he said.

If a child comes into the clinic with HIV, adherence counselors will take about a month to educate the family about the importance of taking the right medicine at the appropriate time. Ricketts has a vision: Instead of using the little soldiers flashcards, counselors will be able to read the book to the child and parents, who will then be able to take it home with them.

"I'm really trying not to reinvent the wheel because the analogy works so well over here," he said.

Ricketts, who has just finished up his year in Africa, hopes to have the book made by July. An artist has already produced some images for the project that is already funded.

With Kickstarter, the fundraiser only receives the money if its project reaches its monetary goal. Ricketts' goal was $9,000, and he netted more than triple that amount, with a total of $30,745 from 119 backers, according to the "Our Little Soldiers" Kickstarter website.

His mother, Mary Ricketts, was in Africa with him when he learned his Kickstarter campaign was funded. The money pledged was holding steady at $8,000 and jumped to $28,000 in one day from a husband and wife donor. He was floored.

"That was a wonderful moment," she said.

The excess funds are likely going to be used to produce the book in different languages so that it can be sent to other areas in Africa, Ricketts said.

Non-compliance with medication is an issue that is widespread, even in the United States, said Ricketts' father, Dr. Robert Ricketts Jr., who is an adult cardiologist in Carroll. It's a problem that he sees in his own practice with adults and knows has been difficult for Ricketts, who only works with children.

"Getting a child who feels good to take medicine, especially when he doesn't even understand how he's sick, is challenging," the elder Ricketts said. "This is a very concrete, real project that's going to help people."