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!