OkaZHI: Okanagan-Zambia Health Initiative

ART Clinic Week Four

This week we Caitlin R and Aryn were placed in the ART (antiretroviral therapy) Clinic at the hospital. This unit is strictly for HIV infected individuals and those to be tested. We spent the week moving through counseling, adherence, meeting with the clinical officer and all of the other stages a person who comes into the ART Clinic experiences. Up until this week we have seen few cases of infected people, only the positive clients on the hospital wards and a few in the clinics but never really noticed just how many people are living an HIV positive life within Mongu. Coming from Canada, having never seen an HIV patient, to working at the ART Clinic where they reach 18,000 plus individuals is mind blowing. Of all the positive clients only a few that we assessed and met with were in stage three of their disease, for the most part our clients were healthy and just coming to get their medication top up, you would never be able to tell these people were HIV positive by appearance alone. Due to the large number of clients each day, and the limited staff, we noticed conversation with most of the patients was quick and at times lacking in education. 
One of the gaps in the education that we noticed was regarding cervical screening for women. The women who were recently diagnosed had information sessions including cervical cancer screening and were sent to receive testing straight after their HIV status was determined. The cervical screening clinic opened at Lewanika in March of last year and has seen over 3,300 patients since! What an amazing job they have done – we can only imagine the number of women who have been positively impacted by this clinic! On the other end, we did notice that women who were diagnosed with HIV before March of last year were not being encouraged to attend the clinic as well as patients who tested negative for HIV. Women who are HIV positive have a higher chance of contracting HPV than someone who is HIV negative however it is still a very prevalent disease regardless of the HIV status. We thought that in addition to the topics mentioned in adherence, cervical screening could be added as top priority. Upon saying this, we made it our goal to mention this to each patient we met, as well as speak with the staff about the importance of educating women on this topic. The staff was receptive and recognized the need so hopefully enthusiasm will be continued! 
Working in this clinic allowed for us to practice in the cervical screening center where we both screened a number of patients ourselves which was an interesting experience finally being on the other end of this very routine procedure we have had many times back home. We also went through the circumcision clinic in which we supported a 13 year old boy brave enough to go through this procedure since he was educated to the reduced risk of contracting HIV and lessened chance of becoming a carrier for HPV after being circumcised.  It is unfortunate that they do not have the technology to circumcise infants and have to perform this procedure with boys over 5 for safety reasons. 
The highlight of our experience was working the pediatric day where all ages of children living with HIV came in for counseling and medication. We played many games with them and had a lot of fun, reminding them that they are still kids even though they have been dealt such a responsibility at such a young age we wanted them to know that its still important to have fun and live a normal life. The educators were great at empowering these kids as young as 2 and teaching them about their disease. It was tough to see these little ones diagnosed so early on in life but it was really eye opening to the reality here in Zambia.
We really enjoyed working in this clinic and understand just how important it is in Mongu  to screen people and have antiretrovirals available because the sooner the client is diagnosed they can start ART and live a healthy prolonged life.

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