HIV and Poverty
Categories : Africa, Medicine, Missions, Travel, Uganda |
Another hectic day in the clinic today - much of the same stuff - otherwise treatable chronic diseases compounded by poverty. Many of these would be eminently more manageable back home - diabetes, hypertension, arthritis, epilepsy - but the people here just cannot afford ongoing treatment. And the backbreaking hand to mouth, one day at a time lifestyle contributes to it - men, women, and children all do their share of the physical work required for these rural households to survive. And this is in a beautiful, fertile land where there is plenty of rain and plants and crops and animals can thrive. Imagine what the more desolate, inhospitable areas of northern Uganda and much of the rest of Africa must be like.
But as is well known, the current number one scourge of Africa is HIV/AIDS - a more serious disease, but nevertheless one which is quite treatable with modern medications. My first patient of the day was a lady I had seen late the day before and ordered an HIV test on. I had to break the news to her of the positive result, encourage her to travel to the city to seek treatment in a public hospital clinic, and to arrange for her husband and 5 children to be tested. The husband will hopefully be coming to see us tomorrow. As for the children, they apparently live far distant from here, with another relative, and she could not envisage being able to get them either to us or to the city HIV clinic. In fact it is doubtful whether she can make it there herself. Probably only about 50km away, but a vast distance for someone with no form of transportation and no money.
Another patient was a lady who previously had had a positive test, but had not accessed any treatment. It transpired that the reason for this was that she was newly married and was afraid to tell her husband the result. She was looking for a way to access the treatment without him finding out, an even more tricky proposition. We encouraged her to tell him so he and the children could be tested but didn’t have much hope of her actually doing so. Another person, maybe even a whole family, who may die unnecesarily from this disease.
HIV is not the killer here - it is poverty and ignorance. The treatments themselves are not that expensive - the UNAIDS program supplies large quantities of anti-HIV drugs and Uganda now even has their own factory to manufacture them. It is the lack of infrastructure and the difficulty in getting the drugs out to the people outside of the cities who need them that kills. Like all problems in Africa, it is one to which there is no easy solution….
