Clinic chat

I have actually been working, too. Although it is a beautiful thing to have weekends and nights off. The last couple of weeks we have been splitting time between working in the clinic in Mbabane and going on outreach trips. Baylor is currently involved in 21 outreach sites throughout the country. The docs go out just for the day. The sites are anywhere from 30 minutes to 1:30-2 hours away. Each site is situated in a local health care clinic and our role at each varies. Baylor is trying to move away from this to more satellite clinics, which will be little baylor clinics through out the country. Two such clinics are currently in construction in Manzini and Hlathikhulu. I think I may be spending a lot more time at Hlathikhulu once it is open. I have really enjoyed the outreach. While it definately has its frustrations, I feel like I am working more within the system and going out to the areas where people really have very little access or it costs them a lot to make it to Mbabane.



I am also getting exposed to how the culture influences the transmission and treatment of HIV. Last week at Piggs Peak, a northwest town, we saw a mother and her 17 month old son. The mom despite knowing that her CD4 cells, the cells that help protect you from infection and the cells that HIV attacks, were low enough that she should start treatment still refused. She initially told us that her husband was still sleeping around and refused to where a condom when with her. She has four children that he supports and does not feel she is able to leave. When we explained that the medications could still help her, the story then changed. Her husband is not ready to even be tested or consider that he has HIV. She has heard that after taking the medications for a while the virus can develop resistance to those medications, which is true. She fears that if she takes these medications and her husband does not that she will pass the resistant virus to him and he will be the worse for it. As the nurse who was translating for us put it, she is literally willing to die for this man. It seems the practice of official plural marriage is less common than in the past, but it does still occur. A firefighter that died in the fires last weekend was stated in the newspaper to have left three wives and multiple children. It also seems that men often still have multiple relationships if not official marraiges. Women when they marry join the husband's family on their homestead. Traditionally, when the husband dies his brother then takes over the role of husband/provider. I met an educated woman who is a school teacher the other day who was in tears talking about her husbands brother, but still did not see a way out. She now had a child with this brother.

On the good side, there are many children who are stable on the medications and doing well. I have had a couple parents compare how well the children are doing now to how sick they were when they came in.