Last week I spent my time at Lewanika Hospital in the ART (Anit-Retroviral Therapy) Clinic, which is a clinic focused on the treatment of HIV/AIDS. It's important to remember that the treatment of HIV is not a cure, but only a way to minimize symptoms and delay death for as long as possible. This of course is the same for HIV positive individuals back home, only the medications in North America are much more developed than they are here. To put this into perspective the ARV(anti-retroviral) medications that were used in Canada in the early 1990's were first introduced to Zambia in 2005. At first clients were responsible to pay for their medications which were very expensive and created a major barrier for people to receive treatment. In 2008 the Zambian government made ARV medications available at no cost to clients who met specific criteria. Since then there has been a steady increase in the number of people requiring the clinic's services.
The ART Clinic supports approximately 1800 HIV positive clients from Mongu and surrounding villages. This is an insanely large amount of people considering how small and understaffed the clinic is. Each weekday morning people are lined up outside the hospital waiting for the gates to open so that they can rush to the waiting room in the hope that they will be seen fairly quickly. One thing I found to be most frustrating was the lack of structure. Back home we book clinic appointments ahead of time to help ensure everyone is seen in a timely manner and to prevent overwhelming amounts of people showing up at one time. Here it is first come first serve. For those clients who remain in the waiting room at the end of the work day they are simply told to come back the next day. This might not sound so terrible at first, but once you learn how difficult or expensive it is for some people to travel to the clinic you begin to understand some of the challenges they encounter.
Even though I already knew there was a large HIV population in Zambia, it wasn't until I worked in the ART Clinic that it truly hit me. I was there when people came in for counselling because they were concerned that they may have been exposed to the virus. I witnessed people being tested and sat there with them for what felt like a lifetime while they waited to see whether or not a stripe appeared on the test strip. I was there when clients were told they tested positive, and I even delivered the news myself. This is something I never thought about doing when I first went into nursing, and it is something I will never forget. How do you tell a person that they have HIV, especially someone who is similar in age or a chid for that matter? I makes it even more difficult when you know that the medications used here are close to 30 years behind the ones used back home, and that the life expectancy for a person with HIV is much shorter here.
I guess my time in the ART Clinic was a big eye opener to the many inequities here.