HIV and AIDS, here such a common problem that I did not have written much about ... which must be completed.
On the day of my arrival in Libreville fell me the many posters that to make aware and educate on the disease. The PNL (National lutte contre le sida program) is working here with a 3-point slogan: 1 abstinence, 2 fidélité mutuelle, 3 préservatif. Since the first two points of access for the majority of Gabonese ere not, must be in practice probably begin before the same point in three.
In our HIV-positive patients for the prize en charge each open a special file, which is usually my job. In addition to the hard data such as laboratory values, personal data, and disease-indexing diseases and the risk factors discussed in each case - very few of these patients have ever used in her life Präservatif.
As an HIV-positive patient with Justin in the consultation did not know what a Präservatif, had never seen one and we demonstrated it to her, was with me exceeded the limit.
the Internet I found a fairly explicit Series, which explains the use of condoms for men. In large format prints I hung them up in the clinic, which initially provoked a small minor scandals at the Department's employees - I think it was rather out of duty, at least I was then asked by some to Flyers to them her "children" to show (resp. to read himself). As already hinted, the image series, I also reproduced as flyers, which has since rest in my office. The other two internal medicine although they are not, but at least are within reach in order to make risk patients. I do not care: I have been distributed to the 80 list - and thus perhaps prevent some infections. Also on the latent lack of condoms for selling and dispensing has not changed much. The few hundred that I brought from Switzerland, were shortly after my arrival to leave. As an educational center for sexually transmitted diseases, it is actually quite embarrassing and negligent, if not even more condoms is available here for the few responsible ones, they are now. Well, it is unfortunately not the only thing missing in here. We have just two example toxoplasmosis patients for whom there is simply no more medication. Even worse, the replacement drug is considered.
Despite the educational posters exist here in Gabon as everywhere in Africa a lot of stories and attitudes to AIDS. Many claim to traditional Practices (traditional medicine practitioners) can cure AIDS and consequently many HIV-positive patients are simply not in the controls because they receive treatment instead of somewhere in the boonies of a healer. They usually appear shortly before dying in a hospital setting but again - some with CD4 counts of 4 .. (500 above normal). Justin was of course on - both because it makes helpless and partly because it the reputation of the hospital course, not just better if people come here just to die, and then blame the hospital to their death.
more frequent, however, that a positive result, patients simply do not believe, do not accept it, it negligieren, and therefore also refuse any further treatment and disappear en brousse - probably further to infect an entire series. "A whole range of other" less because of the mostly elderly couples occurring polygamy, because more loyalty with many Gabonese is more of a foreign word. As Guillaume had said "comme chaqu'un a plusieures chaqu'unes et plusieurs chaqu'une a chaqu'uns ...". But there are also quite good patient when, unfortunately, more likely in the minority. Just today I had a pretty hefty conversation, in the morning hours I had a patient with herpes zoster (shingles) of the left upper side of the face. Because such a common occurrence in patients Immunkomprimitierten, I suggested him to take an HIV test (unfortunately a rather expensive test: 8,500 CFA, almost 15 CHF): the result was positive. I told him the result and the disease, and he seemed to understand well, even asking questions - a good sign. And he also asked me for his wife, perhaps even a positive one. I tried to encourage him to make it to tell her, offered him, they hereinzubitten and the whole thing both to explain again. He was afraid she was too fragile to prästieren to the result. And in my experience such people accepted it is usually the result anyway, affecting even the partner so that this treatment breaks off - at first very insightful patients, I have unfortunately already experienced this. After much hesitation, the patient came in, his wife and I explained the whole thing again. They barely reacted, but was willing to get tested. Was hurt, disappointed. Although I viewed the people, not the when, why, by whom look to the infection, as it currently does not have much, I can imagine what the result to the personal relationship between the two states. The result will be there on Monday, unfortunately I already almost certain to be read as it is.
few days ago, I compiled the statistics of the seropositive patients hospitalized in 2006. There were just 100 in the seropositive patients hospitalized Kopp - with many that you forgot to write some more secure. A few weeks ago I presented a statistic from 2004 - 2006 all together positive and negative tests of the entire hospital - Justin she needed to get the anti-retroviral drugs, for which he regularly has to personally go to Libreville.
are now all the drugs for free, already a significant achievement. However, all the tests in advance, which are necessary for treatment, paid for by the patient / patient (approximately 20,000 - 60,000 CFA) - an impossibility for many. The therapy would indeed be free, but the beginning of such a fail at the hurdle of the necessary investigations.
Next Wednesday is my turn to give a talk related I would like to introduce the statistics of the coupling, with a Rappel on HIV / AIDS - not a few of hospital employees are seropositive. On this occasion I would also like to take a new HIV information leaflets in the round, the old one of the many "copies of a copy of" barely legible. Guillaume, the young Gabonese of the studio des Arts et d'expression leads me to provide the illustrations, let's see obs works. Because, unfortunately, the stage will soon come to an end, time is always far too brief and be prepared with the presentation even more scarce, so I also apologize right here for my more rare items in the blog. And incidentally, the wife of my zoster patients was seronegative. Although in the first 3 months after a second test, a certain result, I was pleased the extraordinary.
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