Uganda 2012

So, yesterday… well as every other Wednesday, it was HIV clinic day. Therefore once we all got ready and had breakfast (which consisted of a boiled egg, a banana and some millet porridge), we headed to the clinic to lend our services. This time though, I actually got to work the clinic instead of pre-natal care. I didn’t expect just the students to be running the clinic pretty much though! Liz(one of the 4th year medical students), Robert(a 1st year medical student from a different university who had been a clinical officer for 6 years previous), Nicole and I got told to go into one room and start seeing patients. There were soo many patients to be seen, it seemed like an impossible task! I would say well over 200 people were waiting to be seen when we arrived. Hence, we got to it right away! Liz was the only one who could speak the local language so she spoke to the patients, while I wrote the notes in their books/charts plus I documented their medications on their HIV enrolment sheets. After a couple of patients, we seemed to get into a type of rhythm, as most patients who come in, just come in to get a refill on their medications. However, there is the odd patient who comes in with a complication as a result of their HIV status. For example, we had one female patient come in, and even before we had called her in, one of the intake nurses warned us that she was a suspected TB patient as well. TB is an opportunistic infection that is seen in high number of HIV patients. Therefore, to give us some sort of protection, we left the doors and windows open, and tried to stay a safe distance away from the patient, as TB is very contagious. When the patient came in, she was wearing a scarf, and as soon as she removed her scarf, it was evident as to why she had kept it on. Every lymph node in her face and neck was extremely enlarged, along with the ones along her collarbone. You did not even need to touch her to notice them, but when you did feel them they were very hard and immobile. Because of her lymph nodes, we referred her to another hospital to get a TB test and a biopsy of her lymph nodes. She also had signs of HPV that we referred her to get looked at and treated at the other hospital.
One thing that amazes me about the people of this area, is their ability to persevere through what seems like anything. This was exemplifies when we had a male patient who came in for a refill of his ART’s and when we looked at his CD4 count, it was only 7! To try and put some perspective on this, normally a healthy, HIV-negative individual should have between 600 and 1200. So it was amazing to me that this man was talking to us, let alone standing!
By the end of our morning shift at the HIV clinic, I knew how to treat basically anyone who came in as HIV positive, given their CD4 count, including dosages and number of days. In Uganda, however, they do not place anyone one ART’s (anti-retroviral treatment) until their CD4 count is below 250, which is lower than the recommendation that people below 350 should begin ART’s to prevent opportunistic infections. Although ART’s are free to HIV positive patients in Uganda, which is extremely helpful as the people cannot afford most medications.
Working in the clinic took us right up until lunch, after which we were all going to work on our sections of the group project. Nicole and I were delegated to stay at the health centre and look over records, partially because of my messed up foot, but also partially because we cannot speak the local language, and therefore would most likely not be able to participate in the community survey. The rest of the group, as I have just mentioned, headed out to Nyakahama village to survey the people about sanitation and HIV/AIDS. Nicole and I headed to the District Health Office to retrieve the latest records on the prevalence of HIV in the district, but when we got there we were informed that the person in charge of those records was doing an outreach program that day, and that we should check back in the morning. Since the rest of our group was already gone to the community, and there was nothing else that really could be done at that moment, Nicole and I decided to take advantage of the yet again beautiful day, and read outside on the grass while listening to music.
After supper, a bunch of the guys wanted to go to a local bar to watch the Euro Cup, and said that we should come too, so Nicole, Stephan and I decided to go. I’m not a huge soccer fan though, so Patience and I basically just went to relax and have a beer. After the first game was done, David and Julius asked Patience and I to go to a different bar, as none of us were huge soccer fans, so we went there and had a beer as well. It was actually pretty fun! We compared university experiences, where I found out that the students here seem to like a good time just as much as we Saskatchewan students do. David also said that he is interested in practicing pharmacy in Canada for a few years when he is done! I told him that he had better buy some warm clothes now if that’s what he wanted to do! Haha Overall, it was a fun night and I am glad I decided to go out and have some fun with the other students!
Today, Nicole and I were supposed to try and get the records again from the office, but the guy in charge was again out of the office. Instead of just sitting around doing nothing while the other students were out doing community surveying again though, we worked on making some posters and putting some finishing touches on other things our group has started, so I think we accomplished quite a bit!
Anyways, I am now off to a group meeting, so I shall write again soon!
Have a good day! :)