HIV Clinic- June 20

 Tuesday June 20 

We lost power in the middle of the night but Roland our coordinator was able to turn it back on.

Today was the dedicated HIV clinic day that took place in one of the outpatient rooms. Dr. Mensah, a doctor from Guyana, was the doctor running it. There were two other people in the room mainly doing paperwork and nurses came in and out. Dr. Mensah only speaks English so the nurse would have to sometimes translate for the patient. 

The patients would come in and usually, it was a child and mother, the kids who were in today ranged from 4 years old to 14. Usually both the mother and child were HIV positive. The doctor mainly checked in with them about their meds and did a basic assessment. She would ask the kids how they’re doing in school and encouraged some to study harder. She would ask the moms if they’re married or have a boyfriend and if they’re using family planning. She would also ask if they’ve told their partner of their status; some said no and she would question that.  

The kids would go out to get their blood tested after being seen. The doctor would write a prescription of their meds; one type of med is running low so she had to switch some patients to the other type. The patients were supposed to bring in their medication bottles to show how much they had left; but several had too many bottles left to have been taking them correctly, either they didn’t know they were supposed to be taking multiple a day or were skipping days.

It seems like most of the kids did not know exactly what condition they had. One 14yo girl came in with her grandmother and from her leftover meds, the doctor knew she wasn’t taking them all. She bluntly asked “do you know what’s wrong with you?” and the patient did not know her condition. The nurse argued with the grandmother about telling the girl what her condition is but the grandmother said that the girl would be sad if she knew so they didn’t want to tell her. 

Of course, I have to wonder if the patients suspect what they have since they are taking medication every day and kids are usually smarter than parents think. Definitely some teens around this age are sexually active and birth control is stigmatized so I can definitely see why the doctors and nurses question if the patient knows and want the family to tell the patient about their status. 

They never actually used the term HIV in any of the visits and there was no signage about this being HIV clinic day. 

The patients come about every 3-6 months depending on each individual patient. One mother brought in her young daughter a month early because she said that was when she had funds to pay for the medicine and she couldn’t wait or the money would be used up. 

Ghanaian national health insurance does not cover HIV antiretroviral drugs, although the website does say they cover “HIV/AIDS symptomatic treatment for opportunistic infections.” 

One article says that “Number of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%”. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326618/

They screen mothers for HIV during prenatal care and if the mother is positive, they start the baby on medication pretty soon after birth. Of course, this is only for mothers who are actually getting prenatal care. 

At one point about 10 University of Ghana medical students came into the very small room. They gave the doctor a patient history of a small child with a cough and they spent about 45 minutes going through all the diagnosis stuff and assessment steps and decided it was pneumonia. 

We left and got lunch at the hospital. I had chicken and rice but one of my peers was given banku and okra stew, a more traditional meal. I tried some of it, the banku tasted like sourdough and had a pasty consistency (it is made of corn and cassava). The okra stew was slimy and wasn’t my favorite but I’m glad I tried it. I didn’t get a picture but here’s a picture from google. 

I got antibiotics from a local pharmacy because I’ve been having lots of stomach issues (as have many of my peers). I then went to the gym with two of my peers (one of whom is also an athlete, a runner from Princeton). The view from the top of the gym was nice and breezy. 

Then we went home then went out to dinner for another of my roommate’s birthdays. We went to Bella Afrik which we went to on one of our first days with Dr. Charles. I had great homemade pasta with bacon and a pistachio cream sauce and they gave us free shots of Ghana's version of fireball which was very spicy. We shared a salad which was also nice because greens aren't as common here and fresh produce can be risky for bacteria. 

For our car ride on the way there, our Bolt driver didn't end the ride on the app when we got out and kept driving around which charged me for more. I was able to submit a refund request which they gave me quickly which was good. We then went home and had cake that our program coordinator got from a fancy bakery then went to bed.