BIPAI, along with adult ID and orthopedics are contracted through the Batswana (and yes, this is correct vs a Leanaism) Ministry of Health to conduct outreach clinics in remote areas around the country. We flew on a 10 seater bush plane funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) and headed out across the Kalahari desert to a city called Gantsi, near the Namibian border.
After arriving at the tiny airport we all headed to the regional hospital and on to our respective wards. From the pediatric HIV/AIDS side, we see the kids who are failing their ARV treatment that the local adult medical officers and physicians are not sure how to treat. In theory, we are supposed to be working hand in hand with the local medical personal to teach them, but in reality the medically complex patients just await the Baylor team’s arrival each month for their ongoing care.
We saw an actively suicidal patient, with a plan and no psychological support to leave her with. We met a twin teenage boy whose father murdered his mother after finding out she had infected him with HIV. The patient refuses treatment and is now failing second line treatment with few treatment options left if he decides to once again be compliant, so we suspended his treatment. His twin brother has refused therapy all together. To see the psychosocial implications of the disease, its stigma, and the abandonment issues these children face, even when taken care of by extended family is heart wrenching. Working in the capital there are lots of rural health care issues we don’t face that I was reminded of on this outreach trip. How can one take ARV’s if they have no cell phone or watch to remind them of the time? Even if a watch is suggested, are they going to be able to read it to know when to take the meds? No electricity and running water certainly compounds issues faced by immunocompromised children and families.
This was truly an amazing experience I will never forget. Looking forward to next weeks outreach adventure!