Monday, April 5, 2010

HIV Clinic and Tb Paranoia

April 1

Hailey was sick today so it was just I going to the hospital. I had no idea where to go but I eventually ended up in the adult HIV clinic. As I walked through the clinic, I looked throughout the waiting area at the patients. There were men and women who looked deathly sick and there were beautiful well-put together women and men with smiles on their faces. One would never know that they were infected with HIV/AIDS. I started in the pill counting area where patients would come in and have their pills checked to see if they were adhering to their regimens. This is very very important because if they default and don’t to take their ARVs (anti-retrovirals) then the virus has the ability to build a resistance to the drugs. Once the virus builds its resistance, the drugs no longer work and the virus eventually kills the person or it’s passed on to other people. I encountered my first frustration of the day at the pill counting. Since the influx of patients is so great and the technology is not up to date, when the pill counters inputted their names into the computer, it felt like half of them came up with no hits. She said that it takes time for the people to input patients into the computer. I remembered one woman who was so nice and beautiful, and didn’t have a medical record for two months. Whenever they encountered this problem, they simply just put the file off to the side and continue to work on the next one or send them on a wild goose chase. I then met with Dr. Omar and spent the day with her. She begins the initiation process of HIV treatment and does check ups on patients. I saw a variety of patients and came face-to-face with HIV’s best friend, tuberculosis. We were told to put specialized masks on and sit by a fan so that nothing could touch us…hopefully. This lady came in with this whopping cough and sat down by us. It was here where I felt instantly paranoid about my surroundings. I sure don’t want Tb, especially when there are drug resistant strains out there. From then, I started to notice that everyone in the waiting room was coughing. I couldn’t tell the different between who was regularly coughing and who was infected with Tb.

More patients continued to file in, including a newly diagnosed man with a CD4 count of 4. To put it in perspective, a patient with full-blown AIDS has a CD4 count of 200 or less. When he left, Dr. Omar turned to me and said, “I can’t believe he’s still alive”. Another patient walked in, it was the same woman that had not been inputted into the system for two months. She was asking about when the new pills would be coming in. South Africa recently revamped their HIV drug program (since the current pills had severe side effects) and planned to start administering the new drug the following day (April 1st). Dr. Omar turned to her and told her that the new pills simply haven’t come in and probably won’t for a couple of months. What was worse was that this woman wasn’t responding to her current treatment anymore. Essentially, she is in a race against time and the government to get these new pills otherwise she will probably die in these next few months. She then turned to me and smiled with the same smile I had seen in waiting and pill counting rooms and said “I am going to be praying every night that I don’t get sick and that these pills come in soon. My son is getting married in Cape Town next month, I am so excited and hope I can make it”. I just smiled back and had one of those moments where you know you’ll never that person for as long as you live.

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