Tuesday, August 9, 2011

The forgotten elderly

In many societies the elderly often get "forgotten' or ignored, this can be true in developing countries in Africa also. My friend Reverend Samuel Mahulu who I have been working closely with at the HIV clinic pointed this out to me Many organizations are getting funding for HIV, TB and malaria and children and orphans get lots of attention- as they need to, but when it comes to the elderly, they are often neglected, by their own society and the world as a whole.In Uganda there is no social security system, and most people have struggled just to make ends meet so they do not have any money saved for old age. Many of the elderly's grown children have left the village to find work in the city and are struggling themselves with caring for their own families, there is often no money left over to send home to the aging parents. Or worse, the children have died from HIV or some other disease and have abandoned the grandchildren in the village with the grandparents. As these grandparents age, there is often no one to look after their needs. As they age some of these people are really having difficulty just maintaining their daily basic needs such as food and water. As their physical health fails they are no longer able to go to the well to get water, or gather firewood ,or plant a garden. These are basic survival needs in rural villages in Africa,
They may have no one to help them or to visit them . They are unable to maintain their physical homes and their health.Reverend Muhulu and his church have started an wonderful organization in their church and want to expand the program to the whole community, then all of Uganda and even beyond.
It is called the African Development Association for the Elderly, their goal is to link youth and neighbors to the elderly that are unable to care for themselves. They have already begun visits to the elderly within their community and are assisting 30 people that are unable to provide for themselves. The organization has linked some generous neighbors with some of the elderly who will provide meals and firewood and water. They also have built some small dwellings for elderly who have had no where to live. They want to be able to build the organization to buy rain water catchment tanks, repair homes, (many homes have leaking roofs, holes in walls, no bedding and are infested with rats ,mice and bedbugs). They want to provide basic health care for these people, and transport to the clinic as needed. There goals are to improve the living conditions, health and sociailization of these people. These goals are lofty for a poor church organization, whose members may only be able to donate 20 cents a month towards the project, but they are committed, organized and caring towards these elders, where governments and even the elders own families lack compassion. I was very impressed with these folks and the love they showed towards these old people who are truly suffering. It is another area in which many people are having a difficult time.

Friday, August 5, 2011

Some more random entries from my journal

July 8th-Outreach clinic in Makindye suburb. The outreach team goes to several different suburbs once a month and distributes ARV medications to patients near that area. Out reach is done so that patients who are healthy and adhering to their ARV treatment do not have to travel into the main clinic to pick up their medications. Patients are only given a 2 or 3 month supply of medications to monitor their adherence to the medicine regimen and also assess patients for side effects. Patients may have to travel and then wait several hours to pick up their medications at the main clinic. Outreach was started in an effort to provide shorter wait times and less travel times for those patients who are staying healthy and adhering to their medicine regimen. It is a great service to the patients. A doctor, nurse, counselor and volunteer travel to each outpatient clinic. (7.5 hrs)

July 11th- Worked in TB tent with Dora. TB tent provides treatment for all patients with TB at Mengo hospital, even the patients that do not have HIV. Many patients who do have TB also have HIV, TB is an opportunistic infection of those with HIV. The TB treatment is an 8 month course of medication. Patients must come in each month to pick up their meds, adherence to themedication regimen is monitored. If patients are not responding to the initial treatment after 2 months the medications are changed. Response to the meds is monitored by a sputum test and/ or a chest x-ray. The clinic has volunteers in the community (usually another HIV patient from the clinic) who check in with the new TB patients and help them to make sure they are taking their medications. (5 hrs)

July 16th – Attended children’s support group for HIV+ children and their caregivers. Approximately 60 children attended. This group gives caregivers a chance to get together to discuss issues and problems they may be facing caring for an HIV+ child. The children separate from the adults and it gives the children an opportunity to play, laugh, sing and dance. The adolescents break off from the younger children and meet with counselors and share about difficulties they me be facing. Mengo nursing staff and counselors are there to offer support. (4 hrs)
July 13th - Worked at PMTCT prevention of mother to child transmission clinic. This clinic provides prenatal HIV testing of all pregnant women All of the women are required to attend an education class on HIV prior to testing. Each woman coming in for prenatal care will be tested for HIV, if a woman tests positive she is then followed by the PMTCT clinic. PMTCT will continue to educate the woman and place her and the infant on ARV’s during antenatal labor and delivery and if the woman is breastfeeding. When the woman starts her ARV’s will depend on the CD4 count. The clinic will continue to follow up and test the infant every 3 months for 1 and ½ years to monitor if the child converts to a positive HIV status. Infants may initially test positive due to the mothers antibodies that are passed through the placenta, but the child may end up being negative, which is why they are monitored for 1 and ½ years. Infants may also acquire the virus through breastfeeding, so the mother and infant may both be taking ARV’s when she is breastfeeding. It is recommended that the women only breastfeed for the first 6 months and then wean the child quickly. (7.5 hrs)