With the power and internet so unreliable last week the girls didn't get a chance to put their piece on the last blog post. Now we are back at Suubi and Chantelle is back in Australia we have finally been able to put their prospective of last week up. So here goes........
Hannah:
Last week we were fortunate enough to attend a HIV clinic at the government health centre where Richard (the clinical officer for Suubi) works in nearby town Kinoni. The session is held twice a month, and brings around 150 patients with HIV each day. They attend to have the progress of their HIV checked – that is to have any new opportunistic infections checked and treated, be prescribed more medication, and to pick up their supply of ARVs (antiretrovirals). It is a hectic day where Richard works from 8AM to 5PM with no break, seeing patient after patient. The people simply arrive and wait in line to be seen – some waiting many hours. They also travel great distances – for reason of need or, due to stigma in that they don’t want to be recognized attending a HIV clinic by others they know.
Though the clinic in Kinoni is seriously lacking in medical equipment when compared with one of similar size in Australia, it is of great benefit for the people. They can attend free of charge and all medications are free thanks to government funding (though not all medications are always available). A connecting lab means tests for malaria, HIV etc. can be done on the spot and the result used to determine the treatment which should go ahead.
I sat in with Richard seeing patients for an afternoon and the variety of diseases presenting secondary to a HIV infection was very interesting. There were upper respiratory tract infections, a scar due to herpes zoster, skin infections, urinary tract infections and even a woman was diagnosed with cancer of the cervix. Richard informed me that in the morning I missed a very interesting case of Kaposi’s Sarcoma – a cancer that forms large, ugly lumps on the skin.
It was saddening to see many HIV positive mothers bringing their children (also HIV positive) to the clinic, especially since transfer of HIV from mother to child during birth is avoidable. Shockingly, if HIV positive children are not treated early, 50% of them die before age 5. If treatment is commenced, 80% of them reach adulthood. The stigma associated with HIV is also an issue where, commonly men, do not accept treatment. The majority of the people attending the clinic were females. We learnt of one male patient who was tested to be HIV positive and commenced on treatment, but did not continue due to stigma. Months later he was extremely ill and thin, and according to Richard almost on his death bed. It took this level of ill health for him to accept treatment for HIV. Now, down the track, he is quite healthy and doing well.
It was wonderful to be able to gain an insight into HIV/AIDS in Uganda and what is being done to treat it.
Chantelle:
Well it’s great to be home, but I am missing Uganda already! No surprise
there, I guess it is hard returning home from anywhere after such a long
stay. They say it takes 30 days to break old habits and start news ones,
so after six weeks away it can become hard to adjust back to the “normal”
way of life. This morning I had a nice hot shower which was so enjoyable
when compared to using cold water in a bucket, but I felt really guilty
because whilst running the tap waiting for the water to get hot I wasted
more water than I have used to wash in the past week!
What I am really missing mostly about Uganda is waking up in the morning
hearing children already running around laughing and playing outside. I am
also missing the new friends I have made. I am missing Jane and Fatuma
from the house next door, and it seems strange to wake up without Ishmal’s
usual greeting of “good morning girl” not that he couldn’t remember my
name, he was just being smart.
Last week so much happened but I did not get a chance to write about
anything because the power was so unreliable. I wrote it down in my
journal instead, so now I can type it up and post my last blog.
Last Tuesday Drake returned to the clinic in Masaka for the third time.
All up, Drakes hospital visits have cost 140,000 shillings which is a huge
amount. This cost is only for consultations and medication, it does not
include the expensive cost of transport to get to Masaka each time. I
can’t imagine his family being able to pay for this easily. To put it into
perspective, 140,000 shillings is equivalent to two terms of school fee’s
for Namusoke Jane’s Secondary School, and her family is having trouble
paying only one term.
I think that Drake was excited to be returning to Masaka for the third
time. His toe was looking a lot better and was healing really well. The
infection was totally removed and it was looking good. I really don’t
think he was prepared for what was about to happen to him. Because the
infection was gone, it meant they could finally stitch the wound back
together. Unfortunately for him, this meant reopening the whole wound so
it was fresh again. Walking back into the room 5B for the third time Drake
look terrified. This time I think he was determined to withstand the pain
of the injections, probably encouraged by the last doctor’s comment of
“not being man enough”. What a horrible thing to say to a 14 yr old boy.
They gave him several injections of local anaesthetic and at one stage
Drake looked like he was going to faint, but he was okay. Helen leaned
over the bed in front to him so he could not see what was going on and she
talked to him about anything she could think of to keep his mind off the
pain. The doctor reopened the wound by ripping at it with tweezers and
then used a small blade to cut off all the edges around the wound to make
the edges raw and fresh again. Then they pulled all the skin back together
and put in five stitches. Drake did so well during the whole ordeal. He
asked us to take photo’s so we could show him after it was finished. Every
time he tried to look past Helen to see what the doctor was doing, he
almost passed out. Afterwards we tried to show him the photographs but it
just made him feel sick. I really hope everything heals okay, surely now
if he keeps it clean and stops infection everything should be fine.
On Wednesday we went to visit Regional College in Kinoni. Regional College
is a boarding school for secondary students. It was really interesting to
see the difference between this school and St Teresa’s school in the
village. This school did not have much better facilities, but it clearly
had better quality teachers. So it should, as the cost of fee’s for a day
student per term was 50,000 shillings more.
The teachers appeared to know their students better. They walked around
the classroom making sure that each student had completed the work set for
that lesson, and whilst there was still a lot of dictation it was a lot
better explained instead of just copied. I am glad I was able to see the
comparison between these two secondary schools to recognise a truer
representation of Uganda’s teaching style.
On Thursday we went to the Kinoni Government Clinic where Richard (suubi’s
new clinical officer) works. Once a month he administers drugs to patients
with HIV/AIDS. On this particular day Richard saw 140 patients. We were
allowed to sit in his office with him for 2 ½ hours whilst he assessed
patients. Some were diagnosed ages ago and were at different stages of the
disease and some were diagnosed positive on that day. Richard wrote the
prescriptions to administer drugs for people depending on their particular
stage of the disease. He also assessed different skin infections, growth
and other problems associated with HIV/AIDS.
During the short time we were there, one person was newly diagnosed with
AIDS. The patient did not react in the way I was expecting, one typical of
Australians when they realise they have just been diagnosed with a
terminal illness. The woman looked upset and was a little shaken but she
was not crying or emotionally distressed. The only reason she came to the
clinic for a check up was because her friend told her she should come
after her last born child died for no reason at the age of 1. After being
diagnosed, Richard asked her if she had anything strange on her body which
was abnormal and she exposed her breasts which had a strange skin problem.
Richard said it was caused by AIDS and this put her straight up to a stage
3 patient.
There was another man that had only been diagnosed last month. He still
looked shaken and a little shocked. Patients must return once a month to
see if they have moved up or down a stage, alter medication and check
their general body condition. Some patients travel a very long way to
visit because they are too ashamed to visit a clinic closer to their home
village. Some people may not know they have AIDS and they would rather
keep it a secret from their friends and even family.
We met a patient named Jovia who appeared to be about 60 years old, but
later we found out she is only 46. When she first walked in I thought “Wow
she is looking really good, for someone with AIDS”. She had such a
beautiful face and a smile that is so bright and welcoming. She was only
diagnosed with HIV earlier this year but she is sure she caught it at
least nineteen years ago, which was the last time she was sexually active
with her late husband. Jovia told Richard that she is feeling great and
the medication is working really well. The only complaint she had is that
she has some pain in her ovaries, and pain when urinating. Richard was
concerned by this because AIDS in women can cause cervical cancer and it
can also cause urinary track infections. Either way, he sent her to the
midwife for an internal examination. She returned about an hour later with
the test results. Jovia has cervical cancer. Once again, this patient did
not really seem fazed by the fact that she now has a second terminal
illness. She simply took it in her stride and excepted that this is now
the way that it is. Richard said Jovia could go to Kampala and receive
costly chemo therapy, but the reality is, at her age she is mostly likely
going to return home and except her fate.
I have so many stories to tell just from our short visit. I can’t image
being in Richards position and listening to every persons case, learning
their stories of living HIV/AIDS positive. I think by far the most hardest
part of the day was seeing small children, babies as young as two months
old who were diagnosed positive. Richard said that if left undiagnosed
only 50% of children will live past the age of 5. But if diagnosed and
treated early at least 80% will live to adulthood. I guess on a positive
note the children we saw were at least receiving treatment, but looking
through the HIV/AIDS Treatment Record books I was saddened to see so many.
'Digging out the jiggers'
Before I left Lubanda on Friday afternoon, Ishmal told me to go and wash
my feet so he could inspect for Jigga’s, a local bug which comes out of
the dirt and burrows into you feet. I said “ I don’t have any Jigga’s, my
feet are fine” but he insisted on checking because if I return to
Australia with one in my foot it is very costly to have it surgically
removed. So I washed my feet and sat on the grass whilst Ishmal checked my
feet over. Sure enough he found one! In my left big toe, burrowed under my
toenail. He dug it out with a small pin and afterwards I was so grateful
that he had checked because I did not want to return to Australia with
that in my foot!

Alex watched on as Ishmael dug the jigger out of Chantelle's foot.
I was sad as I was leaving Lubanda Village, even more so when flying away
from Uganda airport. But all good things must come to an end, and I am so
great full for being able to be part of this experience and immerse myself
in the Ugandan culture in the small rural village of Lubanda. Hopefully
one year I will be able to return again, but for now I have many fond
memories and photographs to keep me happy.
Chantelle :-)
Comments