HIV Clinic

I spent the past week at work helping at the Comprehensive Care Clinic (CCC) for HIV positive patients at Msambweni District Hospital. The hospital has over 800 patients on anti-retroviral therapy and is quite busy testing new patients, counseling those taking drugs, and managing the overall health of the HIV positive population of the area. Nurse Theresa explained to me that stigma isn’t as bad as it was a few years ago, and real strides are being made, but that doesn’t mean it has disappeared completely. Patients who live an hour and a half away in Likoni sometimes get their care at Msambweni so that they won’t run into anyone they know. Some people even come all the way from the city of Mombasa, where there is a much higher availability of high-quality healthcare, to Msambweni so they can be seen in ‘privacy’. Msambweni is a very Muslim area, and it’s not uncommon to see women wearing a full burqa (my Mama even wears one when she goes to work!), but I noticed that there was a much higher proportion of women wearing their burqas at the CCC, and Theresa confirmed that many women seem to get ‘extra religious’ when it’s time to come to the HIV clinic and don the face-covering veil instead of their usual head covering so that they won’t be recognized.

One woman really caught my attention at clinic this week. An elderly woman weighing less than 70 pounds, she was bent over with the weight of the world on her back. Coughing and weak, she looked like the ‘before’ patient in documentaries about the miracle of ARV’s and AIDS therapy. I found out she wanted to switch to a different clinic, and the staff was perplexed. After finding out a little more, I learned that she thought she had tuberculosis, a common opportunistic infection that attacks AIDS patients. Judging by her cough I would assume that she was correct, but the hospital was telling her that she had had a negative TB test and would be sent away without treatment. After asking around a little more, I learned that the negative TB test had taken place last November. I flashed back to my days of leg infections and how it was often necessary to speak up to get the best care possible and was so amazed that this weak old woman at clinic all alone felt empowered enough to speak up. It worked; the staff couldn’t afford to test her again ‘so soon’ but agreed to start her on TB drugs based on her clinical diagnosis.

On Wednesdays and Fridays I’ve been going to the operating theatre to watch surgeries. My favorites have by far been the 2 C-sections I’ve witnessed—there’s just something about a new life being brought into the world that makes everything seem like it’s going to be okay. (This makes me really excited that I will be spending my last two weeks of the internship in the maternity ward!) One of the most interesting but also the hardest for me was watching an ORIF procedure—an Open Reduction with Internal Fixation of a broken leg, the same procedure I had done to put a rod and screws in my tibia after it shattered. I had to leave partway through the surgery when the doctor started cleaning up the fracture by pulling pieces of bone out with pliers… I’d just rather not know. There have also been gynecological surgeries to observe like cervical cancer stagings and tubal ligations, and plenty of general surgeries like hernias and abscesses. Overall I’m really enjoying my internship at the hospital and I’m being exposed to so many new and interesting things. I’m so glad it’s just barely halfway over now and I still have 3 more weeks of this!

My friend Emma and I before surgery