HIV Care and Nutrition Program (UKUN)

 
$2,680
$15,320
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Remaining
Oct 7, 2013

UKUN Volunteer Diary (Week 6)

My sixth week at UKUN was really busy with trip to Muhimbili Hospital, painting the office and Mariam’s hospital appointment as well as Captain’s showers and laundry.

On Monday we went to Muhimbili Hospital to Dar Es Salaam with three of our clients; Hamisi, Hadija and Sulemani. Charles organized a car and also drove half of the trip! We left at 06.30am and arrived to Dar Es Salaam 09.30AM. First I was dropped at CCTRB Hospital (Eye specialist hospital in Dar Es Salaam) with Hadija and her grandmother who had come with us to escort her too.  Then Charles drove to Muhimbili Hospital with Hamisi and Sulemani.

 First half of the day in Muhimbili was spent looking for his file and once they finally found it he was only given a new appointment to come back next month! We paid a lot of money (Debbie from UK sponsored it) for the car and it took two hours there and another two hours to get back and the patient were not even seen! Now we will have to find funding again for the second trip. Another patient Sulemani went there to be seen by surgical doctors as he is suffering from haemorrhoids that have grown very large. His trip was successful as he ended up being admitted for surgery so we left him there to Muhimbili. He has some family around Dar Es Salaam who will visit him and we informed his wife that he was admitted.

I went to CCTRB with Hadija, our blind lady. They told her she will never see again and there was nothing they could do as it had gone too far. She will have to come to terms with being a blind rest of her life. It was really sad. She has already been blind few yrs due to some pressure in her head. Perhaps it could be tumour but they said it was too late and no point to do a scan for her head, her sight was irreversible. Hadija was still smiling and her happy self as always. Her grandmother seemed more upset.  She does everything in the house so I want to give her lots of support in the house. I think she is scared what will happen to the rest of the family if something happens to her. I think she can live a long life if she keeps healthy like she has done!  We arrived back in Bagamoyo after sunset and dropped all patients back to their houses (except Sulemani who was admitted).

The rest of the week Tuesday till Friday we were cleaning and painting the new office with Mathilde and Sophia. We kept painting layers of white (on the top of the old blue) but it just never seemed to be covered! It looks better though and next week we will continue our hard, messy but fun work! We had some local boys to volunteers with the painting so we bought them a beer afterwoods at the local bar next to the office to say thank you!

Wednesday I took Mariam to Bagamoyo Hospital to have her CD4 checked. We picked her up with ‘TucTuc’ and one of her daughters came with us. It was all done in two hours and we took her home. Mariam seemed little uncomfortable on the trip back and when we arrived we noticed that she had had an accident and had her bowels open in the seat. We cleaned it and she was taken to shower at home. She was given ARVs enough to last her a month and I bought he mango juice to take them with.  I need to pick up her CD4 results in few days time.

Captain had two showers this week and was happy. I started funding Abdullah’s meals from sponsor money and need tlo sort some kind of system for this. He has already put on few kilos! Next week will be busy again finishing the painting and fitting new floors to the office.

Jun 17, 2013

UKUN Volunteer Diary (Week Five)

Inside UKUN Office
Inside UKUN Office

My fifth week was spent with moving to our new office and visits to Mariam and Mr Captain. I also got to know about one of UKUN’s long term client Mr Hamisi Tanga and his sister.

I arrived back from Dar Es Salaam on Tuesday as I spent Easter there (Sun /Mon). We moved to the new office on Wednesday. We hired removal van and Abdullah was also helping us and Charles really enjoyed the exercise! After two trips we were done. We had to put all the furniture to the second room of the building as the room we have rented needs cleaning and painting before we can move in. I can use some of my sponsor money for the paints and we can do it with my two new volunteer friends Mathilde and Sofie as they have experience of painting. They have decided to work with me and I could not be happier about that! We are planning to work on the new office from Monday next week.

Mariam had her appointment date for hospital for Friday but we did not take her as the CD4 machine is not working and that what she needed to have done. I will take her next week (if it is back on working!). I picked up more medications for her (ARVs) and for Abdullah.

Charles and previous volunteer Debbie told me about Mr Hamisi Tanga who has been UKUN’s client over 10 years now. He has been suffering from gynaecomastia (male breast enlargements) since 2008. I was told that it could be a side-effect from one of his ARV medication. He needs to go to Muhimbili hospital in Dar Es salaam to see specialist as this problem has become unbearable to him. I was told he used to go to Muhimbili regularly but due to lack of money he had stopped going and now he came to the office and showed Charles that the breast have grown even larger. He is too sick to use local transport and will need a taxi as a transport. At Muhimbili they need to find out which medications are causing this. Charles said he will need several visits, approximately one per month but does not know how long for. I could use my sponsor money to take him but the transport is not cheap (around £40 per trip) and if this will be on-going thing we will need more sponsors.

I visited Hadija and her family asI was supposed to be escorting her to CCTRB hospital in Dar to see eye specialist. However they told me they could not get the car now.

May 28, 2013

UKUN Volunteer Diary (Week Four)

Captain with Mathilde and Micu
Captain with Mathilde and Micu

My fouth week began badly as I was sick with bad stomach for three days. Once I got better I continued Mr Captain’s visits and got introduced to another family of UKUN’s clients by Charles. This was our last week also at the old UKUN office.

I visited family that all three generations are infected with HIV; grandmother, mother Hadija and her two children Mohamedi and Farida. Hadija is a very cheerful lady who has been blind for three years now. Doctors said this was due to pressure in her head. Her mother (the grandmother) looks after the household and she does it really well as far as I can see. She cooks and cleans and all the family appear really well looked after. They do not appear malnourished and are in very good spirits. Hadija hopes to go to see specialist in Dar Es Salaam Muhimbili Hospital to find out why she cannot see and if there is any treatment for her. She really hopes to be able to see again. The family told me that they have their cousin who can take them to Dar Es Salaam next week and want me to go with them. Both of Hadija’s HIV positive children appear well and go to school. I will visit this family weekly and give them support if they have any issues arising. At the moment they seem fine. I do worry for the grandmother as she is probably very worried what will happen to the family if she gets sick. She seems like a‘supergranny’!

Mr Captain was his usual self. He is eating well now and has already gained some ‘meat’ around his stomach.  My friend Chanzie visited from Dar Es Salaam and volunteered to give Mr Captain a shave and a haircut- he looks ten years younger now!

In the weekend we started packing UKUN’s old office with Abdullah to move into the new office next week. It is located in Old Huruma Dispensary and also near to town. We need to get sponsors for the rent so I need to take a lot of photos I have not seen the place as the landlord is away but Charles said it was very nice and easily accessible. I am looking forward to the new office and a new start.

At the weekend I also met two really nice girls Sofie and Mathilde from Denmark who were looking for volunteer work! They are staying here two more months. I will meet with them end of next week (they are going now to Zanzibar!) and hopefully we will work together.

May 28, 2013

Mr. Hamisi's visit to Muhimbili Hospital

Mr. Hamisi at MoH
Mr. Hamisi at MoH

 Today we took Hamisi one of our clients to Muhimbili Hospital in Dar Es Salaam. He has been suffering from gynaecomastia (male breast enlargements) since 2008. This could be side-effect from one of his ARVs (Antiretrovirals) and now the problem has become unbearable. His breasts have become very large and he is suffering from a lot of pain.

We started our trip at 6:30 am from our office in Bagamoyo where the driver picked us (Mathilde, Micu and Sofie) up from. After this we went to pick up our client Hamisi Tanga who lives in Bagamoyo town. We arrived at Muhimbili Hospital around 9:30 am. There were a lot of patients waiting for appointments, as Muhimbili is one of the biggest governmental hospitals located in the center of Dar Es Salaam. Hamisi is not really able to walk long distances so we got him a wheelchair from the hospital and pushed him to the new surgical building. We got our client registered and then waited for his file for an hour. After this we had to wait for him to see a doctor which took another hour. He was seen by a surgical specialist who took his full medical history. We discussed the possibilities for surgery which he said would be double mastectomy (removal of both breasts). He informed that it could be done at the governmental hospital, which would be a long wait and would cost around £40, or privately straight away at the cost of £600-£2000. Hamisi would now need to have his Hb and CD4 checked and have a x-ray done. The doctor also prescribed medication for his tremor which is another side-effect from his ARV-medication.

We split up in three; Mathilde went to the pharmacy, Micu went to register with the new appointment and Sofie stayed with Hamisi to wait for his blood-test to be done. This took about two hours. After this we went to the x-ray which took full three hours because they lost his file in between! The x-ray was never reviewed because the doctor had gone home. Therefore we brought the x-ray pictures home, so it can be taken to his next appointment which is in two weeks time, 16/5 2013. At the next appointment they will inform us whether he will be fit for surgery, this will depend on the CD4 and Hb results. Finally we were done, just before sunset (6 pm) and driver picked us up at Muhimbili. Unfortunately we were stuck in the traffic in Dar Es Salaam and got home around 10 pm all exhausted and tired.   

May 20, 2013

UKUN Volunteer Diary (Week three)

Mariam
Mariam

This week I continued my home care duties and visited new clients. I bought Mr. Captain a sheet, a mattress, towels and a new mosquito net. I also made a plan to buy him extra snacks to start building him up. His family only gives him one small meal per day. I am also giving him money for his daily porridge he can have for breakfast (150Tsh/day-10c/day).

Charles also took me to see two other clients. On Wednesday we visited Mariam, a 57 year old HIV positive who had a stroke 5 yrs ago. She does not speak or walk but can do some facial expressions like smile and nodding. Mariam has stage 4 AIDS now so the care for her is palliative to keep her comfortable.  None of her daughters are positive or the grandchildren. 

Mariam appeared to be itchy all over and has small skin lesions/small cuts also all over her body and looked very uncomfortable. I gave her Piriton tablets and cream to help with itchiness. She lives in a house with her four beautiful daughters and some of them have children too. They all look after Mariam and it seems to me that stigma does not exist in her household, which makes me so happy. Mariam’s husband died two months ago and she has not been taking her HIV medication ever since because no one was buying her Mango juice. Her husband used to do and she will only take her ARVs with that. I guess it is too expensive for the family to buy so I will provide it for her from my sponsor money. She had not seen a doctor for 15 months so we took her to the hospital CTC centre on Friday. Her sister is a nurse in Bagamoyo hospital so it surprises me that she was not taken to be seen before this. The doctor was angry with Mariam’s daughter who came with us to the hospital. She had to have adherence counselling, get new appointment for CD4 check and she got new medications (ARVs).

A malnutrition is an issue but I have not figured it out yet as I need to see more. There is a problem especially with Mr Captain. He is malnourished you can see that. His family says they give food but Captain tell it is very little and sometimes nothing at all. He is not able to cook for himself. If I give the family porridge ingredients to cook, they want it for the whole family. We are not here to feed them all and all his family appear well nourished. He gets cup of porridge now daily. He does not like the family to see that we give money but Charles and volunteers in the past have had several meetings with the family and explained to the family that we are only giving him little money for porridge and that we are here for extra support and not to replace the family support. I take him extra things in every visit e.g. bread, cakes and bananas and water for drinking. Last week I asked him what he likes and he said he likes rice. His family only give him half portion of ugali (maize meal) a day.

He asked if I could buy some rice and his sister will cook it (she lives outside and is the one who gives/cooks ugali or whatever the family eats). I suggested buying half a kilo. Captain did not like this and said he would rather eat with the family and I should buy one kilo. I did this and they had the meal on Saturday so I do not know a solution for this. For sure we cannot keep buying the family food but how do we feed 'just' Captain as he relies on them? I did explain to him last week this is a problem.

Abdullah is also very underweight; only 35kg. He reports that he does not get food at home and that his auntie once tried to poison him! Charles buys him meals when he comes to the office. The stories never seem to end.

He appears to be a clever boy and knows computers. I want to help him by giving him money (from my sponsor money) to start a small business. He used to share a business with a friend. He wants to sell some food stuff in his street like ugali flour, sugar etc. He says that is where the good money is. We are going to find out now the costs for these items from the wholesale shop. He seemed very happy. Now he has been confirmed with TB and I went to the hospital with him to be trained to give injections to him daily for 54 for days so he does not need to walk to the hospital every day.

Abdullah’s housing situation is also a disaster. He does not want me and Charles to have a meeting with his auntie and the chief of the street (I was told by Charles this would normally be the procedure) because it will cause more conflict and bad atmosphere at his family. We have to respect his wishes but how can we find a solution to this? Maybe the small business could be a start to a better future. When I mentioned about it his face really lit up!

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Map of HIV Care and Nutrition Program (UKUN)