HIV Care and Nutrition Program (UKUN)

 The past three weeks were busy here at Bagamoyo running a home based care for HIV patients. We had no volunteers this time so I was very happy for my bicycle that was a gift from a previous volunteer. I continued to support our current clients with home visits and acted as an advocate on their hospital visits. We did get a new volunteer for the office; a local young man who is doing testing and counselling with Charles.

Updates on some of our clients;

Patient RMD:

RMD who is suffering from Tuberculosis in addition to his HIV infection was finally started on ARVs (treatment for HIV). He had been too weak before with low haemoglobin and it had been a long process taking almost two months to get him stronger. He had lost 3kg few weeks ago but appeared healthier last week. I continue home visits one to two per week for nutritional support as he is still very underweight. I bring porridge and peanut butter sandwiches. He does not have feelings of nausea anymore and did not want more anti-sickness tablets. On the last visit he seemed a little happy as he has finally started his HIV treatment and the future looks brighter.  His brother (lives together with him and a sister) is building their house much more modern now and hopefully Ramadhani will get a room there too with proper walls and a roof!

M & E:

I was busy with our new family of three. They have a three year old daughter E who is suffering from TB in addition to her HIV that she got from her mother at birth. Her mother M has also been suffering from couching but all TB sputum sample have gone back negative. She also had Penicillin injections prescribed for couple of days that she was due to have at a clinic nearby her house. When I delivered her TB results to her house she reported that she only had one of those injections (out of the three) because after the nurse had injected her into her arm/wrist it had gone swollen and red. I thought it was suppose to be intramuscular injection and not given to a hand so I was a little confused. Her cough was much improved though and she was on Septrin (antibiotic). On her next appointment she requested to start on ARVs but they told her ‘next time’ or’ tomorrow’. She is already almost five months pregnant now and should be on HIV treatment. According to the new guidelines in Tanzania women should start ARVs from the first months of pregnancy.

E had her TB appointment and received more medications. She appears fine and parents report she is eating well now as she was very underweight only 7.5kg few weeks ago. We will re-weigh her soon. I have visited this family twice a week and bring porridge and peanut butter sandwiches to E. Patient M's hand is not swollen anymore. I wrote a letter to the doctors to start her on ARVs as I will not be in Bagamoyo for her hospital appointment next Monday. I will visit her on Tuesday and see how it went. She really needs to be on this treatment but things just don’t run that smoothly here L so we just have to make them run.

Patient Z & her children:

I have been visiting this family regularly. Z, our HIV positive young lady with four children (one HIV positive: Dotto 8 year old) has been gaining weight for the past two months and getting closer to her healthy weight now. She also had vaginal discharge and was prescribed Fluconazole. She also takes Septrin but is not on ARVs due to poor adherence in the past. She recently suffered from PCP (pneumonia common with HIV clients) but has recovered. The family’s problem is poverty; they have no income and live with their mother who is not very keen to help. We have been supporting them with basic nutrition for few months whenever we can. I went for a meeting at the house with the grandmother and took Chanzi to translate. I wanted to discuss schooling for the children. She reported that none of the children have ever gone to school. They are aged 14, 8 and 4. I am not sure of the age of the middle brother who is deaf and makes jewellery of shells that he sells on the beach. He possibly has some mental health problems as he has been sexually touching his mother and his four year old sister Mariam for a while. Charles said this has been reported to the police. Their grandmother appeared happy about the children going to school. I organized a meeting for pre-school (African Child Care Centre) for Mariam where I will take her next week. After that we will look into the school for the other two boys. I asked them if they wanted to go to school and they were very keen. Next I will have to find sponsorship for the school fees. Mariam’s school will be 25 000Tsh ($16) per month that includes breakfast and lunch plus uniform 10 000Tsh ($6.5).

Patient Z came to our office earlier this week and asked money for food. Then she told us she had some maize in her house from a farm. We gave her 2000Tsh ($1.3) to get it grained in a machine and the family will have plenty of maize to eat for a while!

New client: Patient E

Patient E attended to our office and complained of lump to her left breast and was terrified of having a breast cancer. She has been diagnosed with HIV. She said that she had been to various doctors in Bagamoyo but no-one wanted to take any action and had told her to go to Dar Es Salaam. This problem had started two weeks before. We had a look at the breast and the ‘lump’ appeared more like a small blister with puss and blood inside. We planned to take her to hospital in Dar two days later but fortunately one doctor friend of Charles came by and invited her into his clinic at Muhimbili Hospital in Dar. She attended the clinic next day and her lump was cut open and the puss taken out. We are waiting her to visit us for the feedback.

Patient ABD:

Our orphan boy who started school in Dar Es Salaam last January had a week holiday and came to Bagamoyo. He was happy to see his friends here. He complained that he had still not started English lessons at GOIG School only making carpets. I contacted the school and they promised to have English lessons from next term (March). Abdallah has become grown up and more independent. He appears in good health and is taking his medications (ARVs) without prompting.

We also ordered soya powder to give to patients for extra protein. It also contains calcium, potassium and vitamin A, B1, B2 and B5. It is suppose help for high blood pressure and be excellent nutrition for pregnant women. It can be added to any cooking e.g. porridge or tea so it is easy for the patients to use.