Dealing with HIV in Uganda
I know the exciting stuff these days is healthcare reform, but I happen to be in Uganda for a month, taking care of the female ward at Kisoro hospital.
I was recently called away from rounds for an urgent admission. I arrived to find a thin woman in her 50s, dressed in swaths of colorful fabric. She was carrying one of the little black plastic bags that people use to bring vegetables home from market. Before I could ask her anything she coughed, hard and wet. Then she spit a mouthful of bright red blood into the bag. She had a fever of 101F and had a big right side infiltrate. I didn’t need a laboratory to tell me this woman likely had TB.
This woman is a cardiac patient in the chronic care clinic. There are several pages of notes documenting her heart condition, which is known as endomycocardial fibrosis. She’s been seen by the legendary Jerry Paccione, who politely rebutted the previous resident’s opinion of hypertension with a “not likely” scribbled in the margin.
We talked for a while, and eventually I thought I had a pretty complete history. I started to finish up, and sent my mind back across the most likely diagnosis. Why did this woman get TB?
“Have you ever been tested for HIV?” I asked her.
The way her eyes went left and right, scanning for nosy ears, immediately told me the answer. I stepped forward so she could whisper, and motioned my translator to do the same. The words she muttered were barely audible.
“She has HIV,” my translator said.
I looked down at the five pages of “Chronic Care Management” notes I was holding. They went back as far as 2006, and she’d never mentioned the fact that she had HIV.
“Do you have a doctor taking care of your HIV?” I asked. She said she went to the HIV clinic in this hospital for her care.
So she wasn’t telling her heart doctor that she had HIV. And she wasn’t telling her HIV doctor that she had a heart condition. The two sets of doctors were a hundred yards away from each other, and for three years this duplicity had been maintained.
It makes me angry. I can’t help it. You don’t want to talk about HIV? You don’t want to bring it into the open? Fine. But other societies have been down this road before. I was just a kid when the HIV epidemic started in the U.S., but even I remember that Silence = Death.
(more about my time in Uganda at whougandabelieve.blogspot.com)
.We celebrate and A Major focus of the day on muslim Circumcision
Dear sir/madam
sochara
Greetings of the seson.
We have worked with homeless people.We handledled many problems of these people who are unprotected from all sides.including risk of STD and HIV/AIDS..etc.
We have been working with Muslim community for over five years and have identified saveral problems of this community.We want to draw your attention towards following factors:that have emerged after our prolonged work and study of of this commonity:-
1.Circumcision is a religious duty of a Muslim man.It is done as a ritual in the chidhood Mostly several children of an extended Muslim family are circumcised together. The person who perfom this task is usually a barber whoes only qualification is that his father, gradfather ,grand father great grandfather etc. had been doing it.Without observing any rules of hygiene he circumcises all the children with the same razor without even sterlizing it.To avoid titanus he even gives TT injections to these children, more often than not with the same needle .
2.Due to illiteracy community is less informed aboutt health issues.
3.Men of the cummnity usually go to othe parts of the country or abroad.They live away from their families for long durations, sometimes for years together.This makes them vulnerable.
4.Parda system and low status of women are another another important factors that makes the cummnity vulnerable to riks like STD,HIV/AIDS etc Men bring infections and pass the to women who usuallycan neither protest nor suggest any measure.Rights of a man to bring in upto four wives and get rid of his wife by uttering word ‘Talak’ three times keeps women in constant fear
5 As Muslims do not believe in family planning they are reluctan to use condoms which they percieve as a means to avoid pregnancy
6 Most Muslims go to quakes who usually practise medicine in Muslim neighbourhoods. These doctors give injections and even perform small surgeries including using their knives on women during childbirth
We want to work on larger plateform and share our experiences with other organisations
We request you to include the above mentioned researchwork of our orgnisation to be part your’s agenda .
Please find enclosed the profile of our organisation and help to us in this project.
Thanking you,
Yours sincerely
Saroj Khan
Gen-sec —Centre for Human Rights &Social Welfare.
50, Jawaher market Hasanpura police Chowki ,Jaipur ,Rajasthan-302006 INDIA
+91-0141-2222562, 09414253482, 09509783694
.We celebrate and A Major focus of the day on muslim Circumcision
Dear mem/sir
Greetings of the seson.
We have worked with homeless people.We handledled many problems of these people who are unprotected from all sides.including risk of STD and HIV/AIDS..etc.
We have been working with Muslim community for over five years and have identified saveral problems of this community.We want to draw your attention towards following factors:that have emerged after our prolonged work and study of of this commonity:-
1.Circumcision is a religious duty of a Muslim man.It is done as a ritual in the chidhood Mostly several children of an extended Muslim family are circumcised together. The person who perfom this task is usually a barber whoes only qualification is that his father, gradfather ,grand father great grandfather etc. had been doing it.Without observing any rules of hygiene he circumcises all the children with the same razor without even sterlizing it.To avoid titanus he even gives TT injections to these children, more often than not with the same needle .
2.Due to illiteracy community is less informed aboutt health issues.
3.Men of the cummnity usually go to othe parts of the country or abroad.They live away from their families for long durations, sometimes for years together.This makes them vulnerable.
4.Parda system and low status of women are another another important factors that makes the cummnity vulnerable to riks like STD,HIV/AIDS etc Men bring infections and pass the to women who usuallycan neither protest nor suggest any measure.Rights of a man to bring in upto four wives and get rid of his wife by uttering word ‘Talak’ three times keeps women in constant fear
5 As Muslims do not believe in family planning they are reluctan to use condoms which they percieve as a means to avoid pregnancy
6 Most Muslims go to quakes who usually practise medicine in Muslim neighbourhoods. These doctors give injections and even perform small surgeries including using their knives on women during childbirth
We want to work on larger plateform and share our experiences with other organisations
We request you to include the above mentioned researchwork of our orgnisation to be part your’s agenda .
Please find enclosed the profile of our organisation and help to us in this project.
Thanking you,
Yours sincerely
Saroj Khan
Gen-sec —Centre for Human Rights &Social Welfare.
50, Jawaher market Hasanpura police Chowki ,Jaipur ,Rajasthan-302006 INDIA
+91-0141-2222562, 09414253482, 09509783694