More realities of AIDS...

Today I worked in the outpatient HIV clinic at Lewanika Hospital. I have been doing so much reading about HIV because I have been feeling like I know nothing about the disease, nevermind how to care for patients with this condition. In the most topics that I have taught my students the one underlying condition is AIDS. It really has completely changed how a nurse practices here. So I thought it would be a good experience to come to the HIV clinic here in Mongu, and see how they manage HIV patients.

The total population of Zambia is approximately 10.9 million. As of 2003 it was found that 1.1 million Zambians were living with HIV/AIDS. So basically that means about 10% of the population is HIV positive, but the scary thing about this statistic is that it is wrong. For many reasons, we know there are way more people with the disease that have not been counted in this statistic.

I walked in to the clinic at about 8am to find it absolutely packed with people, there was no room to even move. They put me immediately to work. My role was to be the first contact with the HIV patients, and begin their assessment with the usual vital signs (Temp, Blood Pressure, Pulse, Respirations and Weight). I did this for 75 patients…75!! I was processing people of all ages with HIV, from small babies, to children, teenagers, young adults, and the middle aged. Most people I screened seemed to be quite healthy, but did pick up on a few seriously ill patients. It only took me a few minutes to get a routine going, reminded me of my West Africa nursing days when we screened patients in prenatal clinics. In my usual nursing style I was multitasking to the extreme. At one point I had about three kids going, and then a line of prisoners (from our local jail) came in all handcuffed together that I needed to see. Nurses are masters of efficiency. I was also holding all the babies so their mothers could be weighed to monitor weight loss. As usual all the babies would play with my hair! My ears hurt at the end of the day from having the stethoscope stuck in them all morning.

As I was seeing all these patients, again the reality of AIDS here in Zambia struck me. I just never seem to get used to the idea that all these people are dying needlessly. This disease is 100% preventable, at if properly controlled with medication can become a chronic illness. Even with my experience here in Africa I still feel like someone with HIV in Canada is somehow different. In Canada they all can access medications that allow them to live 10 to 20 years. Here all I see on the medical floor is person after person dying in their 20’s and 30’s. At some point I found myself thinking, all of the people in this room will be dead in less than 10 years. Then I looked at women who were there with their babies and thought who is going to care for their children when they die? Another thing that just broke my heart was seeing the pediatric HIV patients. These children are so innocent, how is it fair that they have to deal with the burden of this disease?

At the end of the day I was beat. I asked the nurses who work at the clinic how often they run the clinic here..thinking in my head that they probably just do it once a week. Nope I was wrong, they do this everyday. Everyday this clinic is FULL of people coming for HIV care. All the nurses kept asking if I would start working here because they are short staffed, and overworked with the amount of patients. Can’t promise anything but you know I will be back next week. Ok time to end it on a good note, here is a quote from a book I am reading about AIDS.

‘The images and descriptions of AIDS are too often morbid and extremely bleak, and while we should never underestimate the seriousness and potential devastation of this disease, we must also not forget the human side. The aspect of HIV/AIDS has brought out the very best in people, and there are many courageous stories about people affected by the disease, and the relationship that have been deepened and enriched through caring, understanding and compassion’

Jessica