There is a wonderful person named Za who works for AE and is usually working in the kitchen. She is 26 and has a beautiful two year old daughter! The other night we got into a long conversation, and she told me that her one wish in this world is to go on a plane. She asked me to describe everything about being on an airplane… what it looks like, feels like, sounds like… etc. She asked if airplanes had beds and if they gave you good food. She was drinking in each word I said, as if I was telling a little kid a bedtime story. It was kind of sad for me to explain it to her because flying on a plane is so normal for me. I have been doing it since I was in the womb- literally! I still love traveling and flying, but I would never consider it to be someone’s “wish.” There are so many things I take for granted!
Later on in the conversation she asked me how I can handle being a nurse and seeing all of the sick people. She asked if I had seen a dying person, and when I said “yes” she could not understand how I was able to do that and not cry all the time. I explained to her that I have to begin each day with the mindset that I did not get these people sick, and it is not my fault that they are sick… and I am here to help them in any way I can. All I can do is try my best to make them better, comfort the family, teach them, and advocate for them. If I can make a positive difference in someone’s life, then I have done my job. Za then asked me if people in America have diseases. I sat there speechless for a minute, just looking into her eyes and trying to decide how to answer her. I finally answered “yes” and mentioned that some people in America even have AIDS. She was absolutely shocked! And then with a painful expression she asked, “Have you ever seen someone with a disease?”
It was the night before my first clinical and I had no idea what the next day would entail. I knew it wouldn’t be anything like clinical in America. I have seen dying people, and people with “diseases,” but I have never seen the magnitude of suffering that Za was referring to. From the sound of her voice and look on her face, I knew she was speaking of a kind of suffering that was so much worse than I had ever seen or experienced. As I looked into her eyes, I knew the truthful answer was “no.” I told Za that I had seen sick people, but that I couldn’t give her a good enough answer until I had been to a clinic in SA. I knew she had been deeply impacted by “diseases” here… much more so than I will ever be.
After my first week in clinical, here are some things I have seen and learned:
· Nurses don’t wear gloves. The charge nurse actually said to me, “I think we have a pair somewhere around here…”
· Nurses do not wash their hands between patients… or wash their hands much at all. (Handwashing has been shown to greatly reduce the spread of hospital acquired infections/diseases).
· I spent all day Wednesday helping a nurse draw blood for people with HIV and AIDS. She never put a pair of gloves on her hands… not once. (Don’t worry, I had a fatty stash of gloves in my pocket, along with hand sanitizer).
· It is illegal for anyone to write that a person is HIV+ on their chart. The nurses have come up with codes to hide that they are notifying each other of the patients’ status.
· Many of the pregnant women- I’ve heard 60%- are HIV+. Often they do this on purpose, because the government will give them grants for being sick while pregnant or having a child under the age of 5.
· TB is very common here. The government gives people grants for having that, too. Some people try to get it, or sick people will sell their sputum to non-sick people, so that they can get money from the government.
· Up until a few years ago, it was illegal to claim that HIV caused AIDS.
· 80% of the Black population here still uses faith healers instead of medical science.
· Many of the women here are uneducated, and have to rely on men for their shelter and food. They are powerless, and do not have a say in how many sexual partners the men have, or whether or not they wear a condom.
· The clinic that I have been working at makes each person who volunteers for HIV testing go through pre-test counseling and post-test counseling. If they are HIV positive, they must attend “literacy classes” that teach them about HIV/AIDS, send in a sample of the sputum for TB testing, and the women must have a pap smear. After those steps have been completed, the clinic will continue to monitor their blood levels until they reach a CD4 count of less than 200, OR if they exhibit some of the illnesses that go along with stage 4 AIDS. Once a person meets the criteria, they are eligible for ARV’s (medication) and a government grant.
· Some people stop taking their ARV’s so that their CD4 count stays low- allowing them to continue receiving money from the government.
· When each person comes in, they are weighed. The baby scale has a piece of paper over it; the kind of paper you would see on a bed in a doctor’s office. This paper is not changed throughout the day. I don’t understand why they bother putting it there! All the babies are stripped down and set on the scale. All the different diaper rashes, dirty bottoms, sores, and Kaposi’s sarcoma are placed on that paper. Eeeeeek.
· The beds in the nurses’ offices have actual linens on them, and they are not changed between patients. I doubt they are changed frequently at all. Eeeeek again!
· Yvette and I found a needle from a syringe sticking out of the wall. We took a picture of it.
· I have seen the sickest babies I have ever seen in my life. I took one to the ER. It was the smallest 2 year old I have ever seen. It’s awful seeing young children with AIDS.
· Registered nurses are called Sisters.
· The clinics are free
· You have to be referred from a clinic to a hospital, or the hospital will not see you (unless it’s a true emergency).
· There are different levels of hospitals and you must be referred to each as well.
· I had a 21 year old pregnant patient who had just been told she was HIV+. She didn’t appear sad or devastated, like I would be if I were her. She had a paper in her hand from the clinic that had several questions on it. One of the questions was, “Do you have a will?” The next question was, “What is your backup plan for your children when you die?” Wow. I cannot imagine dealing with that at my age- and she was a year younger than me!
· On the way to clinical, Phillip teaches us Zulu phrases! Yvette and I spent the entire ride one day just trying to say “please” instead of “breast feeding.” I FINALLY got it! YES!
There is so much more I could write about the clinics, but this post is becoming a novel. I probably will write more as time goes on. I will try to take some pictures of it, too. It’s so strange- there are wild chickens, goats, and dogs wandering around outside the place! TIA.
xoxox
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