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HIV, VCT, AMREF free treatment

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We’ve had a few text messages from our HIV positive ex night watch man lately. Let’s call him Paul for now:

‘Good evening?for 2wks now im unwell,chest problem.im on medication,awaiting xray report done 10.08.08 To check tb or pneumonia.thanks. Paul’

It’s freezing here at the moment and I seem to remember him getting sick this time last year. Not really surprising when you are standing around outside all night in the cold. I sms’ed back to say that we were sorry to hear he’s sick and to let us know if we can help by paying for treatments or in any other way.
He texted:

‘Hi?im at hospital booking for 2lab tests both going for 4000 .xray report show –ve TB results & so Dr says it is pneumonia but has to tested in lab 4 certification.drugs will cost 2700 ,2wks full dose.just like the you treated me last year.weather is too cold for my chest .jul&august.’

I said that of course we can pay 7000/- for his treatments and we arranged to meet and hand over the cash later in the week. He receives free antiretroviral drugs from AMREF but must meet the cost of treating the recurrent ‘incidental’ illnesses suffered by him and his wife, himself. His wife seems to have been on the brink of death a couple of times but has miraculously come out of it.

Funnily enough, yesterday I’d invited a couple of friends around for tea at home and between being interrupted by twelve children and a fairly vicious dog fight that unexpectedly kicked off, the conversation turned to staff with HIV and AIDS. My friend said that her nanny had asked her recently;
‘Madam, what are we to do about my sick sister at home in Kakamega?’
It’s common to make a personal problem a joint one here and my friend knew that the lady in question was HIV positive. Whilst pondering this question, my friend suddenly noticed while driving about a VCT surgery in Karen. She went in and learned that they have a Tuesday clinic especially for the treatment of patients who are HIV positive. First the clinic will treat any incidental illnesses, sending patients off for free xrays, then providing the relevant drugs free of charge. Then, when the patient is recovered they check their HIV ‘count’ and provide antiretroviral drugs for those whose numbers are low enough:
‘Why doesn’t she get treated by the VCT clinic in Kakamega where she comes from?’ another asked;
‘Because, for some reason they charge for treatment up there’.
We could only speculate why this might be:
'It sounds like maybe someone somewhere is pocketing the cash?'

We also had a more general discussion about health, where someone piped up and said;
‘why do doctors and clinics here always say our staff have malaria? I thought that there was no malaria in Nairobi!’
Another chimed in to say that there is malaria in the slums of Nairobi and it is increasingly cropping up elsewhere amongst the city’s population. I said that I remembered a trainee doctor on placement in the government hospital in Dar es Salaam saying that all patients are routinely treated for malaria when they arrive at hospital. If that doesn’t work they are then treated for TB. If the patient is still alive after these two treatments, but not yet better, they will then carry out further tests to pinpoint a specific illness. The reason for this is that doctors’ resources are so over stretched that they save more lives with this blanket approach.

Well, my assignation with our ex night watch man was today and as luck would have it, it’s Tuesday, so I handed over the cash and we drove together straight to the VCT clinic to investigate. Paul said that it was an AMREF doctor stationed there. They do give out free drugs to HIV positive patents (if they have the right ones available at the clinic) and they can send patients for free xrays. Most often for chest xrays as this is a common problem.

This was good news, as his xrays seem to cost about £30 a go. Not that I resent forking out, but if some treatment is available free it seems crazy not to take it up.

Anyway, Paul also had a moan about his employers, they asked him why he kept being ill and he finally told them about his HIV status. His complaint was that they are making him do two weeks of night duty, then two weeks of day guarding. Paul complained that too many nights at work on the trot were making him ill, couldn’t they alternate, or do one week of nights, one week days? The employers said that they didn’t care about his HIV status, but he must do the shifts they give him or forfeit his job. Paul wanted to speak to the superiors at work but he said that his boss; ‘Prevented him’. Paul said to me; ‘Do they want me to die because of my work!’

Today my friend said that her nanny’s sister was found to have a bad case of TB in the neck, and my friend has offered to drive her into town to admit her to hospital. I wonder who will end up footing that bill?

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