This week was really hectic as it was my final week before departing Bagamoyo for two months. I said goodbyes to all clients and passed on my duties to volunteers; old and new. Cindy, Stefanie and William started this week and for Sarelle and me it was the final week. Charles also went on a leave for two weeks. Abdullah had a bad week with his health and Captain’s family got a new kitchen built.
On Monday I visited Mr Captain with Sarelle. He reported that his son had showered him the day before as he is on his school holidays and paid a visit to him. This was great news knowing that someone from his family had got involved in his care. I asked if he was coming again this week but Mr Captain said: ‘probably not’. We cleaned his room and took him outside for a while. Afternoon was spent in CCS (Cross Cultural Solutions) meeting where we received a new volunteer Cindy from the US. She is an experienced nurse and will make a great difference to people lives here in Bagamoyo even if it will be only two weeks stay.
On Tuesday Cindy joined our team and CCS provided us a minivan with a driver to visit patients so we can orientate all our volunteers to the clients efficiently. It was great to have a big team of volunteer together; me, Cindy, Sarelle, David and Charles. We visited Mariam, Captain, Amina and Hamisi. Patients were happy to see so many volunteers! Mariam’s physiological observations were within the normal range and her skin looked fine. Volunteers were taught about her weekly visits and to purchase her mango juice weekly. William arrived Tuesday afternoon and was introduced to the program. He will be taking over a lot of my duties after this week. Charles went on his leave Tuesday afternoon and we were left to our own devices but with instructions of each of our roles for the next two weeks. David our local volunteer took over testing and counselling at the office and Godfrey will be helping with home care and assisting at the office. Me, Cindy and Sarelle will be doing home visits and orientation to William as well as getting things ready for next week when I won’t be here.
On Wednesday Cindy was orientated to take over Mr Captain’s shower. He was happy about Cindy; he does not let many people to see his privates! We also visited Hamisi and bought him a nice red jacket that covers his enlarged male breast so that he will not feel embarrassed to walk in public places. He was so greatful and loved the coat! We also paid visit to Hadija and her family to introduce Cindy and William. They were OK themselves as usual and happy to see more volunteers joining us.
David took Abdullah to the hospital Wednesday morning as he had a toothache. They ended up removing the tooth completely and he came back with lots of antibiotics and pain relief. They also told Davis that Abdullah needed his Hb (Hemoglobalin) checked but this could not be done at the hospital as they were missing some important equipment in the laboratory! He should go back on ARVs (Antiretrovirals) as his TB treatment is finishing soon.
On Thursday morning we took Abdullah back to the hospital again and did an orientation to Cindy and William. Abdullah forgot to take his hospital card so they could not do his CD4 or check his TB medications. We had to take him to the private hospital St. Elizabeth to have his Hb ckecked. It was only 5.3, which is very low. I asked to have it done again but they refused. All of us were very surprised as he does not appear to be that weak or tired to have that low reading. We took Abdullah back to the doctors in Bagamoyo Hospital to tell them the results. It was frustrating as the nurses were telling us to come back tomorrow as he did not have his card. I told them we did not care about the card and he needed to be seen right away because he was very sick. After a while doctor came to see him. He was told to have iron deficiency anaemia. His diet has been really good for the past few months so the doctors are suspecting it could be worms. Hookworm can cause iron deficiency. He was put on worm medication and folic acid with iron syrup and iron rich diet. Cindy said he will need a lot of Vitamin C in addition to this for the iron to absorb. We should recheck his Hb next week again. We took him back to the office to rest and explained all his new medications to him and bought a bag of oranges for C vitamin. Doctors informed us that he cannot be started on ARVs until his Hb will come up to 7 or 8. Later that day I took William to Mariam’s house to introduce him to the family
Next morning (Friday) we; I, Cindy and a new volunteer Stefanie took him back there to have his CD4 checked. Stefanie joined us from CCS and she is also an experienced nurse from the US and will be a great asset to our team! After couple of hours of waiting it was done and we will get the results sometime next week. After this we joined the other volunteers at Mr Captain’s house. Abdullah wanted to join us too. They had been building a kitchen that Chanzi had designed to family since the morning. Unfortunate thing had also happened. I had given money to one of his family members to buy materials for the kitchen and Charles said he will be joining us to build it. He never came and obviously took our money so everything had to be purchased again! However the smile in Mr Captain’s face made me to forget all of that. There were all of us there; Sarelle (saying goodbyes), David, Godfrey, Cindy, Stefanie, William, Chanzi and our local friend Omari. It had been an on-going problem to our patient to have the kitchen outside his room. All the smoke had been going inside and him being vulnerable for chest infections. He often suffers from a bad chest. The family had not shifted the kitchen elsewhere even after several discussions with them so we thought the only way was to just come and build one ourselves. Sarelle wanted this to be done before she left so she got things moving. The kitchen was ready before midday and looks amazing! After that we built an exercise pole on his yard and stood Mr Captain against it. His limbs are very weak but volunteers will come few days a week to do physiotherapy so he can build his strength. We are not sure if he will ever walk again but at least we are hoping that he will build up enough strength to transfer independently from bed to chair. At last I washed his mosquito net and sheet and also said goodbyes, which was so sad. I will be returning after two months. The kitchen was a great finishing to the week and everyone left exhausted but happy.
I did some last orientation and job lists for William. Sarelle had organised medications and other things at the office so it will be easier to access things now. Her leaving will be big loss to us but she had a great impact here on her short visit. This week I and Chanzi also made a fundraising project for ‘Every Little Helps’ by selling his handmade shoes for friends and family. This turned out to be great success. Chanzi makes beautiful shoes from leather including nice decorations from colourful beads. £5 for each pair purchased will go to our home care clients. I will be taking these pairs to Europe next month. Some of our volunteers also ordered few pairs! We received 10 orders already this week and hope we will get some more.
Next week William will take charge on the ‘Every Little Helps’ sponsor money and report writing. They will still have great team of volunteers and the week after Charles will be returning. I will be in regular contact with all the team and come for a short visit in few weeks time. I will miss my clients and work so much, it has been my life for 16 weeks. I cannot wait to return!
This week was busy with home visits together with our new volunteer Sarelle.
On Tuesday Charles and Sarelle did visits to Semeni, Mariam and Amina to introduce them to Sarelle. Semeni who has been a client for many years was doing really well with her family. We used to visit her for physiotherapy when she got really weak. Now she is still doing fine and is able to walk independently. She also has a good support from her family. There were no changes with Mariam and we provided her mango juice and more gloves. Amina continued her walk with the zimmer frame and it appears that soon she will be strong enough to change the frame to a walking stick.
Mr Captain had two showers Wednesday and Friday. The same problems occurred again; no-one had been there to help him to the toilet so he was covered in faeces again. Friday I took him to his hospital appointment after giving him a full change and shower first. Doctors assessed his strength on his limbs and suggested to build a pole in his garden to do some physiothrerapy. They think he could be able to walk again and build more muscle to his legs if we did regular physiotherapy. We decided to make this plan for next week. We will be also building a new kitchen outside for his family to shift it away from outside of his room. His family was happy with this idea and Chanzi made a design for the new kitchen. With all the volunteers arriving next week also we made the plan to build it Thursday and Friday next week. His CD4 had dropped from 506 (last year May) to 384 so this was alarming and we need to build him up fast. Doctors also mentioned that he is lacking many vitamins and that is why his hands are week. The family do not cook many vegetables and he does not like the fruit I bring him. I took some multivitamins for him and he was also started on neuropathic medicine for a month to get more strength on his limbs. I hope these medicines together with better nutrition will help to increase his CD4 count. His new appointment was made to the end of the month to reassess. I hope something more can be done for his nutritional support but it is a complicated situation with the big stigma that exists in the family. His uncle sho lives next door is the traditional healer and has a lot of money and wives I have been told. I wish they would help Mr Captain more. It makes me so sad.
I, Sarelle and Chanzi took Abdullah to the beach on Wednesday but he was too afraid to swim. We found a volunteer who is a swimming teacher and she agreed to teach him next week! Abdullah was happy to hear that. Next week will be his last few injections and he will finish all his TB treatment. We need to look into getting him back to education. He is eating really well and acts like the boss at our office now. He has been sleeping in the office for a while now and his family has not been asking after him, which is really sad. He is continuing with his English lessons and likes to greet us now in English and telling us in English all the things he has eaten!
Chanzi visited Sulemani in Ocean Road Hospital in dar Es Salaam and took him water, juice and bread. He was doing fine and was still waiting to start his radiotherapy treatment.
Charles wanted to involve one of Captain’s family members to help to shower him while I will be gone (July & August) but the person had gone away. Once Charles come back from his holidays beginning of August I hope he will find the person to assist Mr Captain. For now it will be our American volunteers together with our local volunteers.
Next week there are two new volunteers joining our team; Cindy for two weeks who is a registered nurse in USA and William for six weeks who is a medical student and from USA too. It will be nice to have a big team. Our local volunteers Davis and Godfrey continued to practice on HIV testing and counselling. They are also willing to help with home visits and will be translating when the American volunteers arrive.
Charles will go to visit his mum and on holiday next week Tuesday for two weeks and it will be my last week with UKUN also. We will have a lot of orientation and organizing to do for the new volunteers!
This week was a sad and busy week for me, the girls and our patients. We visited all clients and girls said goodbyes. We also did another trip to Muhimbili Hospital.
Monday and Thursday was spent with Mr Captain with showers and laundry. He also got a new mattress; bigger one and better quality. On Thursday we went to visit Amina and Hamisi Tanga first and girls said goodbyes. After that it was Mr Captain’s turn. After showering him we took him for a walk in his wheelchair. We went with him to visit Hadija and her family who live nearby and girls said goodbyes there. Mr Captain was happy to see Hadija. Then we took him for a goodbye lunch in a local restaurant. He was very happy but had no appetite to eat much. Girls found it hard to say goodbyes and promised to come back before the end of the year.
Girls spent a lot of time this week with Abdullah. They have created such a special friendship with him now and I am sure Abdullah will also miss them so much. On Wednesday we went to join Abdullah to a HIV children’s group BaoBao, which is run by great local volunteers George and Bernard and they often get other foreign volunteers to work with them. Most of the children were much younger than Abdullah who is 17 years of age and he was not joining in fully. This could have just been due to nerves as the both leaders said. We played ball games and had snacks with them after. This group meets every Wednesday afternoon for few hours and Saturdays for the full day 9am till 5pm. They have activities like games, exercises, life skills, counselling and days at the beach or swimming pool. On Saturday we went with him and the group to swimming pool in a nice hotel and spent the whole day there. Abdullah does not know how to swim and he had so many teachers there. He really enjoyed this day and all the children got ‘chips mayai’ (chips- omelette) to eat and were so happy!
On Wednesday there was a meeting here at UKUN with local home- care volunteers, which Charles attended. We had organized them to come here with their supervisor. They are not active anymore and most are lacking motivation and supplies. I wanted to take some of the burden away and work together with them. Charles asked for their ‘bed-ridden’ patients but they said all the patients need to be reassessed for their needs before they can give us information. They promised to come back on Friday for another meeting having to have reassessed the patients, however they cancelled it. I will go next week to the hospital to find the supervisor again, mama Kizunga.
On Friday I and Sophie took Sulemani back to Muhimbili Hospital in Dar Es Salaam to get his biopsy results. Last week they told us they were not ready and asked to come on this day. We left again early at 6.30am with the same driver Ally as last time. Unfortunately we received the same news again that the results were still not ready! I got little angry with the doctors as we had come from really far twice and spent a lot of time and money for the car. One of the doctors then organized to get the results that had to come from a different hospital in Dar. We waited about an hour and then they told me Sulemani has carcinoma (cancer) in situ in his bottom. I was told not to tell the patient yet but come back next week to admit him to the hospital. He will need a surgery or maybe radiotherapy. This was really sad news but at least it was now found and we could start treating it. Doctors think it can be detected early and he will be fine. I have to call back on Monday to get the date to go there.
On Sunday we had a leaving meal with Charles and Abdullah and the girls in town. We followed this with ice cream bar for deserts! I hope Mathilde and Sophie will be back soon, it will be extremely difficult to find as wonderful hard- working volunteers as they are!
Next week I will have things to sort out in home visits and I won’t have volunteers with me. There is also another trip to Muhimbili and meetings with Hannah to look at UKUN’s future plans, structure and funding options.
Beginning of this week I was in Dar to pay the rent. Poor Sofie got sick so I and Mathilde continued with the home visits. Tuesday morning I met our new landlord and paid the rent for UKUN for six months as it was agreed. We got one month free due to our renovation work. Unfortunately I only received a receipt as the landlord Omari did not have contract for us. I asked him to provide me one, which I will pick up on my next visit to Dar.
Whilst in Dar Sophie got sick with diarrhoea and Mathilde took Mr Captain to his hospital appointment and showered him alone. He had again had an accident with bowels. Poor Mathilde with her little Kiswahili managed so well at the hospital and had a big job alone to shower him and do his laundry. Mr Captain had his CD4 checked and will be told results on his next appointment. He was told it is chronic diarrhoea that is very common on patients on ARV medication. We gave him ‘pampers’ but he thought to use it as a toilet so we had to discontinue this! Sophie was better by the end of the week and all the team was back together.
On Wednesday we visited Mariam and bought her more juice, gloves and disinfectant. She also needed more Septrin, which I asked Charles to take there. Mariam appeared fine. After that we visited Amina for physiotherapy who is doing well and Mr Captain who had had no diarrhoea that day!
On Thursday we went to Muhimbili once again with Hamisi to get his fit status for surgery and Sulemani to get his biopsy results. This time it was me, Mathilde and a local friend Omari to come as a translator. We found a new driver Ally who is also works at the Bagamoyo Hospital. This time the trip was not too long; we left to Dar at 6.30am and came back to Bagamoyo before sunset time. Sulemani was seen first and he only got told that his results were not ready and that he should return next week Friday, not good! Hamisi got really good news; he was told that he was fit for the surgery (double mastectomy). Not only that, he got a date for his surgery and only just over two months wait. He needs to be admitted to Muhimbili on 6th of August 2013 and they will operate on the 9th. Hamisi and we were so happy. On our way back home we bought lunch for everyone; rice, ugali, fish and beans. We booked Ally for the next week’s trip to Muhimbili with Sulemani and he only wants to charge us the petrol money and nothing extra so we have another volunteer now!
Abdullah finally got his injections for TB from Bagamoyo Hospital. He needs to have still half of the injections from the total of 56. There was a three week gap, which is not good for the adherence and resistance.
We continued writing weekly reports and wrote separate reports of the Muhimbili trips and the office opening party. It is hard to sit in front of the laptop for hours in this heat but we go to do our work in Poa Poa restaurant, which has good fans and serves lovely iced coffee!
Next week is the final week of the musketeers Sophie and Mathilde so we have a lot of organizing to do.
This week was busy with organizing opening party for Wednesday and several visits to Mr Captain.
Charles had gone to the villages around Bagamoyo with people who had come to audit and assess UKUN’s previous projects. I and the girls together with local volunteer Ally organized opening party for Wednesday. We also had so many of our friends (local guys/volunteers) to help us with the preparation; gardening, cleaning, decoration and entertainment, which was music with drums and guitar. We had refreshments and snacks and free condoms. We had at least 20 local people (outsiders) to visit plus all friends and friends of friend's as well as our client Hadija our client. Ally took charge of the party and did the opening speech. After this we had questions and answer time with locals and it was also a great success. It was better to have someone local to do it in Kiswahili to reach to all the locals. Abdullah got to do the ceremony of cutting the robe. We finished sunset time and had a celebration beer with all the volunteers after in a local bar.
Unfortunately Mr Captain suffered from diarrhoea half of the week so we ended up showering him five times and doing his saturated laundry. It was hard work with the girls and Mr Captain felt so ashamed. He got some medication and it got resolved by the end of the week.
We visited Amina to do some physiotherapy and she is doing great.
We are planning to find a local nurse to take charge of the home care whilst I am not here in July and August. We could not get hold of the numbers we were given by Tarek and plan to visit the hospital for this next week. We have a volunteer coming from CCS (Cross Cultural Solutions) beginning of next month for three weeks and another one called William, who is coming end of June for six weeks. Our Facebook page ‘Every Little Helps’ is a great success. We have 150 likes now and more sponsor money coming in for the patients. We keep putting pictures and updates up of our daily work. The girls are really good with the camera!
Mariam had her appointment on Monday but I did not take her as there were no changes with her condition and she appeared fine. Her blood pressure was good, 115/80. I and her daughter went to collect more ARVs from the hospital for her and the doctor asked us to bring the patient next month 05.06.2013 to be reviewed.
Next week I will go to Dar to pay the rent for six months for the new office. Tarek has received sponsor money for this from America.
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