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)

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