Infinite Hope: 7 May: New Wheels and Getting Started

Wednesday, May 16, 2007

7 May: New Wheels and Getting Started

7 May 2007

I feel I’ve really gotten started into the Emangweni community over the last week. The most exciting development is of course getting a new bakkie (pick-up truck)! I borrowed Sofi’s a couple of times over the past few weeks, but it’s been SUCH a blessing to not have to worry about the roads I drive on to get to meetings, to visit patients. And of course, having the capacity to transport patients regularly is exciting! The Home-Based Caregivers have been thrilled to see the snazzy new car, and know that it’s dedicated to helping them assist the sick and orphans in their community. It has a door-type canopy that is ideal for getting people in, and transporting lots of people in the back.

I have continued to meet with the various groups of home-based caregivers throughout Amangwe, and they continue to bring up difficult cases that seem to be stuck. In Tatane I went with the HBC to visit a 46 year old HIV+ man who had virtually been abandoned as a child by his mother, and thus has never had a birth certificate or an ID. He was not allowed to do a CD4 test to check his immune system strength because of this, thus ARV treatment (Anti-retroviral drug cocktail is the life-saving life-long treatment for AIDS) remains out of his reach. (This is actually against the law, as it has recently been changed to allow access to free treatment to all needing it, regardless of their documentation status.) I’ll be working with the ARV clinic at Estcourt Hospital on this one, as this is certainly the first case like this of many. Today, in fact, while sitting at the Injisuthi Clinic waiting for a patient to give blood for the CD4 test, I saw how all the HIV+ maternity cases were not allowed to get their CD4 count taken if they didn’t have their ID on them, much less if they didn’t even have one. I know that Sofi has worked out a system through Emmaus Hospital to get these sick patients without ID documents on ARVs anyhow, so I’m confident there’s a way forward.

Later in the week at HBC meetings in Mandabeni, they had called a sick patient, and the grandmother of orphans in to receive assistance. The sick mother lives entirely alone with her teenaged children and has no family to support her and no income. She is suffering from what appears to be a repeat case of TB, as well as being HIV+. I organized to take her in to get a CD4 count taken (again – the blood sample was wasted the first time), and take the TB sputum test. I took her in together with another patient from Mqedandaba needing to start TB treatment, and do the CD4 count. After one false-start at the clinic, and nearly being turned away the second time (because of lack of transport of blood samples to the hospital the first day and, because the VCT counselor was away, and then the blood sample bottles ran out), both patients gave blood for their CD4 counts today. Additionally, Xoli and I did home visits in KwaVala and Ngunjini to a 47 year old bed-ridden stroke-patient, a patient on ARVs (who was having very bad urinary blockages – we called the ambulance and he died the next day in the hospital), and a patient who was unwilling to reveal any health information to the HBC volunteers, but who committed to get tested.

Today I met with the social workers whose office is adjacent to the Injasuthi clinic, and who work under an NGO called (Amangwe) Child Welfare South Africa. I have been aware over the past three years of the tremendous turnover of social workers in Amangwe, and the tremendous backlog that has been created as a result. I spoke with them about these challenges of the past, and current mismanagement that has 60 cases of orphaned families waiting for over five months for the superior to sign off on before they go to court. As a result, these 60 families who are caring for from 1-4 orphans continue to be withheld foster care income to care for the orphaned children. At the social workers’ request, I committed to contact their superiors to follow-up on the gross negligence. Additionally, we made a plan to utilise the HBC and community health workers to assist them in contacting the applicants (from 2003 to the present) in areas that the HBC are working to check that their situation remains the same. The HBC will help contact the applicants in their areas, and I will help transport them to the Social Workers to save time in the process of checking up on their details and status to reopen the untended cases. I’m happy to see there is a potential way out of this big social welfare mess in Amangwe – a way to really help orphans in the area. And maybe a way to encourage the social workers into sticking around longer if their working conditions (ie. Less of a backlog) improve. Time will tell.

Join me in Praying for the Amangwe Community

Praise God for the land granted us and the new building that we’ve managed to put up!
Pray for an end to the stigma and denial surrounding HIV/AIDS in the Amangwe community – For courageous local people to come forward and openly talk about the huge devastation of AIDS in their community.
Pray for God’s provision and equipping of Thembalethu as we move forward in the work God has called us to do.
Pray for health, provision and hope for the many sick adults and orphaned children in Sub-Saharan Africa.
Pray for provision and wisdom as we move forward to establish Thembalethu Care Centre as a place of hope and love in the midst of Amangwe Tribal Area.
Pray for the HBC mommas that they would continue to be encouraged by God’s word and the fellowship of other believers to continue to deepen in their faith journeys.
Pray that God would build up strong, godly Christian leaders for the Amangwe community.

Jargon Buster

Adherence Training - The required three-module (three day) training given to HIV+ people who are on their way to accessing ART. The three modules cover topics including basic HIV, healthy living with HIV, and ARV adherence. The focus of the third module is to emphasize the need for the patient to takes his/her ARV medication according to the prescribed schedule.

AIDS - Acquired Immune Deficiency Syndrome; starts out as HIV, then becomes AIDS as the immune system damage becomes evident and opportunistic infections arise. document.

ARV(s) - Anti-retroviral(s) the multi-drug cocktail of treatment for AIDS that converts it from a terminal to chronic condition.

CD4 count- The measure of immune system strength through a blood test. If below 200, the patient can access ARVs immediately, if above 200, the patient must watch their health closely, and recheck their CD4 regularly.

Drug Resistance - Poor adherence to ART can lead to a public-health emergency where HIV virus mutates to develop a strain resistant to the positive effects of the treatment.

Gogo - [Zulu] grandmother

HBC - Home-Based Care, a grassroots network of (mostly) mommas who voluntarily look after the sick and orphaned in their community. With good training, they can be the eyes of the community to identify possible HIV/AIDS patients, motivate and assist them in receiving support and treatment. They also have the potential of remaining life-long treatment supporters of their patients on ARVs to ensure good adherence to the treatment.

HIV - Human Immuno-deficiency Virus, a virus that attacks the immune system of a person. It often lives in the body of an infected person for years before it shows any symptoms.

Opportunistic Infections - Infections that take advantage of the body's weak immune system. Some of the most common in South Africa are tuberculosis, meningitis, pneumonia, and oral thrush.

TB - Tuberculosis, is a disease most commonly infecting the lungs, and the number-one killer of HIV+ people. TB has been around for centuries and today infects one-third of the world’s population, killing almost two million people a year.