I started my first week at the Lewanika Hospital in Mongu by working at the HIV ART (antiretroviral therapy) clinic. When we first toured the hospital, I was astounded by the number of people that we saw at this clinic. After learning that Western Province has the highest rate of HIV in Zambia, and that this country has one of the highest rates in all of Africa, I knew that I wanted to get some first hand experience working with HIV patients. My first day at the clinic was easily one of the busiest shifts of my nursing career. I spent the day taking patients in and doing brief assessments on them. I easily saw at least 200 patients in 5 hours. The line up never seemed to end. We saw patients of all different backgrounds… kids as young as a few months old, to elderly patients, to people of various socioeconomic backgrounds and professions such as teachers and police officers. What I always thought was a disease that only affected those in lower socioeconomic areas I found holds no boundaries here in Zambia. My heart was with the little ones, those who are the most vulnerable who are affected by the illness. I had a conversation with a young adolescent girl about what she saw for herself in her life. She told me she wants to be a nurse some day. She had a warm smile and her eyes were full of optimism. A wall of sadness and hopelessness hit me at that moment because I knew that HIV may not allow her to live out that dream.
I have yet to have a patient with a positive HIV status in Canada. The difference between those living with HIV here and those back home is that those back home have privileges such as better access to healthcare professionals and consuming a more balanced diet. As well, opportunistic diseases don’t take a toll on us as much as they do here. We saw many prisoners at the clinic, handcuffed to one another and dressed in their bright orange attire. Many of them appeared very ill. As Jessica described, the conditions at the prison in Mongu are deplorable, and with diseases such as tuberculosis running rampant throughout the prison, you wonder how someone with HIV has any chance of surviving in such conditions. The stigma here is also very apparent, even at the clinic. It was rare to hear any of the nurses or doctors use the term “HIV”. They would often say things such as “patients on ART…” rather than “patients with HIV…”. I also learned that some people here, especially those from a higher socioeconomic background, are less likely to visit the clinic or even disclose their status because of the stigma here. Word spreads like wildfire in Mongu, and for some people they would rather suffer with the disease than have everybody in the village know of their positive status.
The hardest part for me is working with patients and knowing how much potential they would have in Canada. Not only was this apparent at the HIV clinic, but also throughout the hospital. One can’t help but think that if only they had a few more medical supplies here, or a bit more education around certain issues (such as how HIV can be prevented), then we wouldn’t see as many people unnecessarily suffering or passing away here.