HIV Care and Nutrition Program (UKUN)

 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.