In this post, Chris Carter, a final-year medical student at the University of Birmingham, continues his series of blogs from a hospital in Botswana …
I promised yesterday to discuss transmission, and how education and awareness can play a part in its reduction. Outside of HIV/AIDS, the next most common illness that I have seen in Botswana is Pelvic Inflammatory Disease (PID). This is a sure indicator that sexually transmitted infections are a major problem in Botswana. Education is the major way in which PID can be tackled, via the prevention of unprotected intercourse and the subsequent sexually transmitted infections. However, across the patients that I have seen, many are not made fully aware of why they are unwell and many others seem not to appreciate the gravity of the problem. It is frustrating to see that it is clear just how much HIV/AIDS could easily be prevented.
Vertical transmission, from mother to baby, however, is treated far more successfully. Management plans are all over the hospital and antenatal testing for HIV is commonplace.
The availability of medical resources in the developing world has long been a talking point across the globe. Botswana is no stranger to shortages in medications and materials needed to run a safe hospital, as well as a continued lack of qualified staff. Anti-retroviral (ARV) medications have been a target of many charities for a long time and I am pleased to report that Botswana appears to have no problems in distributing free ARV’s to anyone who requires them.
At the hospital in Mahalapye, there is a dedicated clinic run every day to review patients with a HIV/AIDS diagnosis. This clinic provides patients with support and information, as well as routine blood tests to help monitor their disease. CD4 count and viral load are checked regularly, alongside other requisite tests – depending on the ARV’s being prescribed. Tablet counts are made as standard and any issues are discussed. On a number of occasions I have seen patients come to the clinic, visiting from another area in Botswana, who are running low on medication. The hospital in Mahalapye is able to prescribe ARVs to these patients, despite not being at their regular provider. This emphasised to me the importance that Botswana is placing on HIV/AIDS care.
In terms of diagnosis, Mahalapye hospital uses two separate rapid HIV tests. Each patient’s sample is tested on both forms of the test, and any invalid or positive results mean that repeat or confirmatory tests will be undertaken. This is an important way of ‘systematising’ testing – and will help control transmission.
I’ll write more in the coming days and weeks …