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Aids Awareness and Education – Exchange Reports

Fulgence Lady Mary

Mrs. Lady Mwamburi Mshote

REPORT OF GREATER NEWBURYPORT/BURA ALLIANCE
HIV/AIDS EXCHANGE PROGRAM
FROM 13TH-4-04 TO 9TH-5-04

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
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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.