| I arrived at Logan Airport
in Boston Massachusetts, USA on 14th-4-2004. The journey
delayed of being issued with a wrong USA visa. The traveling
date was 1st-4-04 but delayed to 13th –4-04 when
I received the correct visa (USA) valid for one month.
This delay distorted the schedule of the whole program.
EXPECTATIONS:
- Give an accountability of the money sent by the
Greater Newbuyport/Bura
- Alliance (GNBA) USA to Saghaighu Dispensary for
construction of the Laboratory.
- Exchange education on all aspects pertaining to
HIV/AIDS.
- Pursue a course on Counseling Pre & Post HIV
testing
- Be updated on Medication of HIV/AIDS and test
- Enlightened on anything new in HIV/AIDS treatment
or vaccines
SCHEDULED ACTIVITIES:
- Worth- Women Empowerment on fighting against HIV/AIDS
- Tour of Anna Jaques Hospital
- Organized HIV/AIDS services integrating support
- Tour of Holy Family Hospital
- History of Greater Newburyport Bura Alliance (GNBA)
- Visit Serenity Supportive Housing in Topsfield,
MA for HIV/AIDS patients
- Meet with HIV/AIDS support group in Haverhill, MA
- Attended Seminar on Nutritional at Visiting Nurses
Association (VNA)
- Case Management Linked with HIV/AIDS
- Counseling on Testing at Beverly
- Training at Wilmington High School and Middle School
and Pingree High School
- Adolescent support Group (counseling at Beverly)
- Adolescent Group Training Techniques
- HIV/AIDS Home care with Mary (VNA)
- Counseling Techniques with psychologist Sheila Treiff
- Mother to child HIV Transmission and Prevention
at University of Massachusetts in Worchester.
- Visited Heifer Project International, Overlook Farm,
Rutland, MA
- Newburyport High and Middle Schools trainings
- HIV/AIDS Public Community Training at Newburyport
Savings Bank
- Tour and Training with member of staff at Boston
Living Center.
HOSPITAL TOURS
Universal Precautions:
The word no-one is negative with HIV has made all health
staffs apply the Universal precautions to protect against
HIV/AIDS. HIV is only tested in some hospitals on the
consent of the patient. There is no discrimination of
the patient because all are treated in the same way.
Confidentiality remains a good issue between the patient
and the Service Provider. If a patient is HIV positive
he is requested to know his own venue for case management
since there are so many case management areas.
Organized Oasis services integration support:
This is an association of Visiting Nurses who started
this organization to take care of the HIV/AIDS patient’s
needs. The doctor who diagnosed the patient refers the
patients or the patient may get the information from
the media, like radios, TV, journals or newspapers.
The patients are to produce the medical records and
the name of the doctors who diagnosed. The needs of
the patient are met psychologically, socially, financially
and physically
Departments in this Association cue:
Counseling:
- The patient is counseled when he/she is disturbed
in one-way or the other. From there the nurse might
determine if the patient is taking medications as
prescribed by the doctor.
- If the patient has developed some side-effects from
medications, he/she can be referred to the doctor
- If the patient is not having any money for food
and other necessities, a social worker is assigned
to go and buy the items for him/her.
- If the patient is neglected by relatives the VNA
assigns the patient to a supportive housing program
Nutrition:
- There is a department I the Oasis (the consortium
of all HIV/AIDS resources) in Danvers which deals
with nutrition education of the HIV/AIDS patients.
It is from this department that I was updated on the
issue that increased Vitamin A lowers mutation of
the virus in a pregnant woman. Thus this lessens the
risk of transmission to baby.
Housing:
Patients who are abandoned by relatives are taken care
in support houses where there are doctors, nurses and
social workers. When patients are there their medications
and needs are taken care of by the US Government. Most
of the patients in these houses have survived for more
than 10 years with HIV/AIDS using the “cocktail”
(combinations of antiviral and supportive medications)
treatment. This treatment is not a cure. It
suppresses the virus and prolongs life as long as medication
work and the body stays strong.
Emergency Adolescent Counseling:
This group starts from age 9 and 17. This group of
adolescents are place in an emergency residential program
for up to 45 days some of the following reasons:
- Children who have run away and are living in streets
- Drug abuse
- Mistreated at home by parents or relatives
- Sexual abuse
- Rebellious behavior at home or at school
The courses taught are:
- HIV/AIDS
- Education
- Income generating activities
- Anger management/proper social behavior
- Drug counseling
Counseling has enabled psychological stressed adolescents
to absorb the courses.
The family also has counseling to learn the problems
and help to solve them.
Some of the adolescents have gone back to families and
are living happily despite the factor of being dropped.
Some have gone to school to continue with their education.
Parents have gained courage and now can teach their
children about HIV/AIDS at home. HIV/AIDS is taught
in schools starting in Middle schools (ages 11-13) and
in secondary schools as part of their health courses.
Mother to Child HIV Transmission:
Dr. John Sullivan, professor of Virology at University
of Massachusetts Medical School, in Worcester, MA. taught
on subject of mother to child transmission of HIV during
birth. He is a medical doctor who is doing research
in Pumwani Hospital, in Nairobi, Kenyan. The idea of
giving all newborns 1 to 7 days old, Nevirapine (antiviral
medication) will reduce the infection of mother to child
whether the mother is positive or negative. Nevirapine
combined with two other drugs (efavirenza and delavirdine
drugs) making it a triple dose also works so well.
Neverapine capsules are rapidly absorbed in the body
tissues. Research has been done in Uganda and South
Africa with very positive results. Nevirapine causes
resistance as other antivirals do. Caregivers (all health
workers) should have a strong relationship with patients
so they can recognize signs of resistance and make recommendations
to their doctor to make changes in their regime.
Drugs are to suppress the HIV infection and not a cure.
When the patient is on the drugs, blood test are done
frequently to show that the virus is being suppressed
and in many cases the test will show no virus at all
in the blood. The “Cocktail” can extend
the life of AIDS patients for many years (10 or more)
until the body becomes resistant to the drugs.
During delivery the baby can catch the virus through
the eyes, mouth, or ears when passing through the birth
canal. All the strengths of the HIV respond to all antiretrovirals.
Doses for medications:
| Adult |
200mg |
| Child 2/12 to 8 yrs. |
7mg./1 kg |
| Newborns |
6 mgs start dose |
Side Effects:
- (+/- 1%) fever, myalgia, parestgesia,
- GI- abdominal cramps, diarrhea, hepatitis, increased
LFTs, nausea
- Skin- rash
- Hemologic- anemia, neuropenia
- CNS-headaches
Counseling Techniques and Skills by Psychologist Shelia
Triffe:
Effective Questioning-
- use of closed-ended phrases
- use of open-ended phrases to get detailed information
Active Listening:
- Technique involving communication without words.
Maintain this by eye contact or leaning forward.
With these technique the patient and Service Provider
will get a clear information that can help come to a
solution.
IMEC Packing of Equipment:
This is International Medical Equipment Collaborative.
Medical Equipment that is no longer used in hospitals
are collected and gathered in a warehouse. The equipment
is repaired if needed and then shipped to countries
where it is needed. Dispensaries in Bura have benefited
by getting forceps, blood pressure machines and microscopes.
We packed two containers for Pumwaini Hospital in Nairobi.
The containers had two delivery couches, two mattresses,
two wheel chairs, two drip stands, soaps and lotions.
IMEC is willing to ship some more equipment as per
the list which will come from the dispensaries in Bura
locations in Taita Taveta District of Kenya
Book Packing:
This is packing of books for Primary, secondary, colleges
and the Dispensaries. Bura location has benefited from
this project supported by GNBA. We packed books which
are waiting shipment.
Other Activities:
- Sunday worship in Christian Churches
- Watching Boston marathon whereby Kenyans won
- Computer training (basic)
- Visiting White Mountains in New Hampshire (saw snow
on ski mountain)
- Fundraising for GNBA HIV/AIDS Project-through an
Evening of African Food and Dance- Raised $1400.00
- Attended monthly meeting of GNBA
- Attended GNBA funding committee meeting
Contrasts:
- HIV/auds patients have a lot of “Cocktail”
medications at a cheaper price which are paid for
by the Government
- Most of the HIV/AIDS patients contract HIV through
I.V. drug use by sharing same unclean needle
- Testing is none by cheek swab
- This test is done by non=technical person
- Public disclosure of HIV patient is not allowed
with out patient’s permission and it usual only
those who need to know.
- Very many support sites for HIV/AIDS patients
- Results for the are gotten after a fortnight and
if positive no second is usually not done
Reported by Lady Mwambuin Mshote
08-05-04
nhr |
A
Visa Ordeal
in the words of Mrs. Lady Mwamburi Mshote
It
was late last year, 2003 when the Dispensary received
the application forms for HIV/AIDS Exchange Program
through the Greater Newburyport Bura Alliance Sister
Cities in Newburyport MA, USA. These forms were collected
and taken to the USA by Mary Mwazo.
-
In January 12th. 2004 MD. Glen Crawford, Norma Rushton
and Laurel Rushton visited Bura, hence Sughaighu Dispensary.
- On
16th January I received a letter from Laurel showing
that I was selected to be one of the participants
from Bura to USA. I waited for the formal letter in
order to start the procedures.
- On
26th February I took the formal letter to the District
Public Health Nurse and the District Medical Officer
of Health. They wrote a letter to the immigration
officer to secure a passport. At the same time they
recommended a letter for the travel clearance.
- On
1st March 2004 I took the letter to the Provincial
Medical Officer of health and Provincial Nursing Manager
at Mombasa. The Public Relation Officer recommended
it then be forwarded to the Health headquarters. I
had to go back for duties to wait processing of the
passport.
- On
8th March 2004, I collected the passport, then took
the letter to the Health headquarters on 12th March
2004
The
Chief nursing officer recommended hence the letter was
taken to the Permanent Secretary officer and I was recommended
for the program. Later Mr. Monaya, the Public Relations
Officer wrote the clearance for travel. I went to Nairobi
on 28th of March and on 29th was issued with the visa.
The same day traveled back home to wait travel. On 1st
of April, 2004 the sad news followed through the phone
from Joanne, coordinator of Star Travel Agency. She
told me that the consulate fro the US Embassy had issued
me with a wrong visa thus I had to wait forms to get
the correct visa issued. I had been issued a visitor’s
visa instead of and educational exchange visa (J-1).
I traveled on 8th of April to Nairobi to fill out the
correct forms but they had not arrived. The forms arrived
on the 13th of April and on the same day I traveled
to the USA. I arrive at Logan Airport in Boston, MA
on 14th at 9:30 P.M. |
