6.10.2006
What the HIV clinic is like
I spent several days this week at one of the better “Patient Support Centers” in Western Kenya. They are called that because other places have found that calling it an “HIV clinic” deters people from coming. Supported by the government and several NGOs, this particular clinic offers free medications including multivitamins, treatment for opportunistic infections, and as of June 6, antiretrovirals. The place has been recently refurbished and the waiting room is private. So this is one of the better places around for people with HIV to go for care.
But the atmosphere can be grim. People who are coming for follow-up visits often look unhapphy and anxious not to be seen, even if they are still healthy. Many of the people at the clinic are arriving for the first time—they have been admitted in the ward for some illness and the doctor recommended they be tested, or they had a persistent cough and have now been diagnosed with TB and HIV on the same day. Or, for the women I am trying to learn about, they came to the hospital for a routine prenatal visit and now their world has been shattered. All of these people have the shell-shocked and sheepish expressions of people that have just been thrown into a stigmatized group and handed what is still a death sentence at the same time. The people who come in sick are the worst, they are ashamed of their ill health, and some of them look like they expect to die. They register at the front desk and then they wait to see the doctor. Since the patients are many and the doctor is only one, they wait a long time.
But this clinic has a program of peer escorters--HIV infected volunteers at the clinic to show people where the lab is, to accompany people who have just been diagnosed, and to help with routine tasks like opening files. There is also a long-term Japanese volunteer who speaks Swahili (which, oddly, she and I used as our common language). These volunteers and the nurses maintain a banter that is noisy and cheerful, and make the clinic seem like more of an ordinary, lively place and not as much a house of death.
Then, too, there are patients like the baby I saw, her face covered with sores, her eye swollen shut and too lethargic to fuss, and no one could laugh when they saw her.
But the atmosphere can be grim. People who are coming for follow-up visits often look unhapphy and anxious not to be seen, even if they are still healthy. Many of the people at the clinic are arriving for the first time—they have been admitted in the ward for some illness and the doctor recommended they be tested, or they had a persistent cough and have now been diagnosed with TB and HIV on the same day. Or, for the women I am trying to learn about, they came to the hospital for a routine prenatal visit and now their world has been shattered. All of these people have the shell-shocked and sheepish expressions of people that have just been thrown into a stigmatized group and handed what is still a death sentence at the same time. The people who come in sick are the worst, they are ashamed of their ill health, and some of them look like they expect to die. They register at the front desk and then they wait to see the doctor. Since the patients are many and the doctor is only one, they wait a long time.
But this clinic has a program of peer escorters--HIV infected volunteers at the clinic to show people where the lab is, to accompany people who have just been diagnosed, and to help with routine tasks like opening files. There is also a long-term Japanese volunteer who speaks Swahili (which, oddly, she and I used as our common language). These volunteers and the nurses maintain a banter that is noisy and cheerful, and make the clinic seem like more of an ordinary, lively place and not as much a house of death.
Then, too, there are patients like the baby I saw, her face covered with sores, her eye swollen shut and too lethargic to fuss, and no one could laugh when they saw her.
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