Dr Tracy Evans-Gilbert

DR Tracy Evans-Gilbert has been changing the lives of newborns and children for 20 years, with a special interest in those stricken with the HIV virus.

“I have always had an interest in children,” the consultant paediatrician told All Woman. “I have an interest in public health but my passion is children with HIV. The unit I now work in falls under public health because it has to do with newborn survival.”

Dr Evans-Gilbert worked at the Bustamante Hospital for Children for 10 years before moving to the west end of the island to Cornwall Regional Hospital in 2005, where she is now the consultant paediatrician.

Born in Kingston, she attended Immaculate Conception High School then did her training in paediatrics at the University of the West Indies.

Her work with children with HIV started when she would visit the Jamaica AIDS Support, which was located opposite to her church at the time. But it was during her paediatric residency, when she did a paper that focused on HIV in Jamaican children, that she realised the extent of the problem.

She said the research was useful as at the time there was no report about HIV in Jamaican children.

“And so I went all around the island to every little hospital collecting data and published the first data on children who live with HIV in Jamaica. There were other physicians who had similar interest and we pretty much came together and we took on the challenge of taking care of kids with HIV.”

The report was compiled in 1998/9 and published in 2000.

Dr Evans-Gilbert explained that she has been working with children with HIV from the time drugs were unavailable to treat the condition and children would die since there was nothing that could be done for them.

“The children with HIV were primarily born during the period when the prevention programme was not yet established. In the early days, in the 90s, it was just hopeless. No drugs were available and the babies would come in with various conditions and antibiotics wouldn’t work. What you needed to do was get the virus out of their system and we saw the virus progressing and just felt helpless because there was just nothing we could do. And the inevitable was there; the baby was going to die and you couldn’t offer the mother any hope at all, so those things made me cry.”

She said during her residency in the late 90s she visited Toronto’s Hospital for Sick Children to learn how to best care for children with HIV.

“It was during the time when there was no free access to drugs. I recall bursting into tears on a ward round when one of the teens was throwing away medication. I thought, ‘My kids are dying and you’re wasting this precious commodity’. I saw HIV infected children grow to adolescence and get on with their lives and I wanted that for my kids too. I’m really happy it’s a reality now.

“I saw when drugs were available what a difference it made. The miraculous and wonderful thing is that I have seen the change to the point where they are now growing up and becoming adults,” she smiled.

As a result, Dr Evans-Gilbert has started a specialist HIV clinic at the Cornwall Regional Hospital, attending to the needs of children who are affected by HIV while also taking care of children at the Savanna-la-Mar Hospital as well. The oldest HIV ‘child to adult’ she now cares for at Cornwall Regional is 20 years old.

“We saw children who HIV affected their brains and they couldn’t walk, and they started walking after the medicines were available. There were a lot of babies who died because there was no medicine, so it’s just like a miracle. So I went from a paradigm of death to hope. Now we get funding from The Global Fund to get medication to help them survive. So now we give them hope.”

Dr Evans-Gilbert said there were two children at the Jamaica AIDS support back in 1995 and they were able to get medication for one of them.

“That one is still alive today and is cared for by the team at UWI. I did a clinic at an outreach hospital last week. Eight of the 11 children had undetectable virus in their blood. I’m so proud of the families. They may be HIV positive but they’ve chosen to live positively and the affected children are planning what they want to do when they grow up.”

She said it’s now rare to see new cases of children born with HIV due to the successful ‘prevention of mother-to-child transmission of HIV’ programme by the Ministry of Health and the Jamaica Perinatal Paediatrics and Adolescent AIDS programme.

The mother of two, a 15 and an 11 year old, said her work makes her realise the importance of parents communicating with their children.

“I have come to learn that communicating with your children to make it into adulthood without them harming themselves is so critical because that period is a time of risk taking and it’s a time when they think that they are invincible and you need to just walk them through adulthood without them causing themselves undue harm healthwise or otherwise. The adolescent age is very critical and I think a lot of parents are missing out on that interaction that they need to be giving at that time.

Dr Evans-Gilbert has been married for 20 years this year to a surgeon she met in medical school.