St. Mary's

The hospital of the week was St. Mary's. A super old, semi-subsidized hospital which seems to be run by extremely compassionate, well organized individuals who are doing great things with the limited resources available. The first day I spent in the HIV ward where the halls were exploding with people waiting for care. A fellow CFHIer, Chris, and I spent the day bouncing between two doctors, seeing HIV+ patients mostly in stages 1-3 (out of a possible 4). They were in the hospital to be treated for the opportunistic diseases/infections that jump in once the immune system is weakened. I had my first look at tuburculosis, oral thrush (a rash in the mouth), severe cases of herpes, and genital warts.

The medical information was absolutely fascinating, and as I overlooked the crowd it swirled in my head along with the thought that these people have been handed their death sentence. Unless something random jumps in, they know how they will die, and have more than likely seen very vividly the process in full. A granny came into the office. She had nursed her son until his death and in so doing, had incurred the disease. Now his children would nurse their granny to her death. The doctor turned to us and repeatedly said, 'this woman is not supposed to be a statistic.'

There is so much ignorance here about the disease - and at all levels. It was only a few years ago that the department of health acknowledged that it was HIV that caused AIDS. It is especially within the Zulu culture that there is much misunderstanding about the disease, and they are very resistant to attempts to educate them. They would rather hold to their cultural beliefs and traditional healer's remedies, even though they are dying. This didn't make much sense to me until one of the CFHI doctors reminded me that only 20 years ago, these beliefs were all that they had. Apartheid really screwed things up.

Anyway, the second day I was in a unit called PMTCT (preventing mother to child transmission). It was nuts it was so gripping. Seeing babies all day, some positive, some not. Most not thriving, but some doing okay. I worked with a 62 year old white woman who had gone to school at a black college and had recently adopted 2 black children. She had 44 years of nursing exerience and talked my ear off all day. I took pages of notes. Then today we did home visits in the Valley of 1000 Hills. It was a gorgeous area, and we walked all day through a hillside village that had a mix of huts and small houses made of stone, mud, cinderblock, sticks, etc. We were checking on the HIV+ patients of St. Mary's in this particular village to make sure they were taking their ARV's and were doing okay. One woman told us that she couldn't take her meds because she had no food. Another had no money to get back to the hospital to get her son tested. I guess it was pretty typical, but still sad.

For the next two weeks we will be in rural clinics, so there will be no internet. We have heard though that they are very understaffed and we will be put to work, not just observing. So here we go... it should be interesting!