Mission to Maua #8

(Blogmaster's note: Computer problems have prevented my posting these materials form the Boes until today. My apologies to all.)

As the world observes thirty years of the onset of AIDS, I am impressed with the way Maua Methodist Hospital has expanded its ministry to help AIDS victims and the survivors.  Two-thirds of the 33.3 million people with HIV live in sub-Saharan Africa.   Maua Hospital is addressing the AIDS problem in a comprehensive way, including preventive education in schools, on-going medical help for AIDS patients, and support for AIDS orphans. (Six thousand children become orphans per day due to the AIDS pandemic in Africa.)

This week I had the opportunity to accompany the Palliative Care team to see HIV/AIDS patients who have a difficult time traveling to Maua Hospital.  We went to a remote rural area where fifty patients had appointments for medical checks and medications.  Several were waiting when we arrived. 

 The Palliative Care team consisted of a nurse, two clinical officers (roughly equivalent to a physicians assistant, but with more training and more autonomy), pharmacy technician, and a woman to keep track of the records and the fees. Each patient had to pay the small health insurance fee, have vital signs taken by the nurse, then go into the next room to see one of the two clinical officers.  There, the CO would take the patient’s history, discuss their treatment, do any necessary exam, then write a prescription for the medications needed to keep the patient stable.  The patient would present the prescription to the pharmacy technician and pick up enough medication to last until the next month or next appointment.

The patients ranged from a 73 year old to a three day old.  It was heart-breaking for me to see the children come with their mothers  - both mother and child with AIDS.  A three-year-old toddler, a five year old, ten year old – all there with AIDS.  I asked the nurse what their future was and he said it was a bright future as long as they faithfully took their meds.  However, he feared that international donors will eventually withdraw or decrease funding.  Should that happen, there would be no way for the Kenya government or the patients to afford the life-saving medicines.

The three-year-old became fascinated with my hands while waiting for his grandmother.  He turned my hands over, then over again, ran his fingers over my hands, and just stared at me.  We laughed because we figured that he had never seen white skin before and he wanted to see if my hands were white on both sides.

The CO spent a lot of time with a 14 year old boy who had not been coming on a regular basis because his grandmother was unable or unwilling to bring him.  So the CO worked with the boy teaching him to be responsible for his own treatment and clinic visits.  The boy seemed very shy and I hope he is able to shoulder this life-saving burden.

The hopeful sign of the day was the three day old baby.  The mother had had prenatal care and the required HIV test.  Because she was HIV positive, she was given Nevirepine in order to prevent transmission of the virus to the baby.  The baby would also be given Nevirepine for a few months, but here was a healthy baby because of the mother’s preventive care.

Some patients showed up without an appointment; others who had appointments didn’t show up at all.  Some patients won’t follow doctor’s orders, such as the woman who wouldn’t give up drinking alcohol, others get mixed up on how many pills to take. The nurse said that more women than men are patients because men don’t want to know their HIV status.

After giving efficient, compassionate care to fifty patients, the team was tired and we packed up the records and medicines, loaded them into the truck, and headed back to Maua Hospital.  AIDS patients had been able to get treatment at this “mobile clinic”  without having to spend the time, energy, and money to travel to Maua.
The Palliative Care program is another way that Maua Methodist Hospital is reaching out to patients, providing care otherwise unavailable.

I also had the privilege of going with the director of Community Health to a food distribution for grandmothers taking care of their orphaned grandchildren.  Food prices are increasing and these grandmothers have no source of income, so they welcome the food distributed through the AIDS Orphans program.  This time we were only able to give out maize; bean prices are too high to be included.  But it was nice to see the sixty women singing and dancing in anticipation of receiving the food, see the distribution, then watch the women slowly walk back toward their homes.

 Through the Palliative Care effort combined with the Giving Hope and AIDS Orphans programs, Maua Hospital is helping both the AIDS victims and the AIDS family survivors.