HIV and AIDS

My latest travels 2 weeks ago took me to Goli, Uganda where World Concern has a small clinic run by Sister Kim, a Korean Missionary who has been living among and serving the community for 25 years.

The clinic serves a population of roughly 8,000 people in the district and considers not only the physical needs of the clients but also the spiritual needs-in fact it’s  not uncommon for Sister Kim to be seen making rounds to pray for people’s various ailments .

I spent the week in Goli visiting the clinic and community activities. The work of WC also includes a prison ministry where Miss Kim and a local team visit a nearby prison on a weekly basis to care and minister for the prisoners.

Goli village is a few minutes from the border of Congo (DRC), and a very beautiful little corner of the world it is too. My first impression was that generally people were relatively healthy in Goli- no obvious bloated bellies, scabies, dull complexions or anemia- something I am always looking out for.

I wasn’t there long before a group of men, women, and children all living with HIV, came to greet me at the clinic after they had heard that the HIV person was coming to visit. I was touched but also rather hoping that they weren’t all waiting with great expectation and anticipation of what I could do for them.

Goli clinic has a somewhat regular counseling and testing department, with over 1800 people tested this year alone. People who test positive are offered Cotrimoxazole, an antibiotic for prevention of Opportunistic Infections. If they are pregnant they are given Nevirapine at the time of delivery- pretty basic stuff.

What I found difficult to understand was that there were no Anti-Retrovirals available to people with the infection. The local Ministry of Health has an inconsistent supply and hasn’t brought it out to the most rural areas of the country.  I would expect this in rural Somalia perhaps but surely not in a country like Uganda which is known for it’s efforts to combat HIV and AIDS ? Surely there is something that can be done about this thinks I.

When I am in the field I like to recapture my love of public health and what it is to be a midwife to women.  I put myself on call for any deliveries- thinking my chances were pretty slim as most women in rural Africa don’t come to a clinic to deliver. That said the Goli clinic has seen an impressive 126% increase in deliveries over the last year.  

Within just a few hours I was called to the clinic to deliver a beautiful baby boy named Andre with his mother Miriam. The Ugandan nurse was concerned that I wasn’t double gloved- as if double gloving would have added much further protection against HIV. I thought that was the least of our problems-I was more concerned that if this first time mum was in obstructed labour or  began haemorrhaging- we had no drugs, no IV’s, no sheets to stem the bleeding, no emergency transport to the nearest health facility 50kms away over bumpy dirt roads. Fortunately for all of us, it was a beautiful delivery. 

My follow-up is to see what can be done about drugs. For now our Korean WC sister humbly takes what funds she receives and drives the 8 hours to Kampala to purchase drugs herself every month. Unfortunately if ARVs are available on the market they will be out of sight in terms of cost.