A day at the clinic

It has been quite a long while since I was last on clinic duty. The last time, if I remember correctly, was in November last year. Even SN was pleasantly surprised to see me this morning - she probably thought I had opted out of the Buddies HIV Clinic team.

I got to the hospital rather early today, and when I got to the room for support group, to my surprise the room seemed rather crowded. Usually we (the support group) would have to share the room with the pharmacists for HIV clinic, who'd be giving detailed explanation to the patients on their medication.

Today we also had another group, albeit a smaller group, of pharmacists giving advice to heart patients about their medication.

In addition to the above, there was also a group of pharmaceutical students doing their attachment - also in the same room.

Wow! So many people in the same room - and to think that we're supposed to talk to the patients in private, confidentially! Thank goodness it was a rather a large room - so I could still have the heart to heart talk with the patients - by getting them to sit right beside me and lowering my voice when talking to them. Besides, the others in the room were busy doing their own thing - I doubt they heard our conversation. We've brought this matter up before (about the need for privacy especially when talking to newly diagnosed HIV patients who may not want to talk when there are so many people around), but the hospital simply doesn't have any more rooms to spare.

Anyway, I got the duty roster for this year's clinic duty last week during our Board Meeting. We still have 3 groups - 2 groups consisting of 2 volunteers each, while the 3rd group, that's my group, has 3 volunteers. Waaa... I'm so lucky to have 3 in the group, huh? Not exactly. You see, the other 2 in my group are both new volunteers, still under training, and so for the time being, I still have to do all the talking while they observe. But I did get one of them to write down the patient's details in our contact report based on the medical file given to us. Today was their first ever clinic duty, so there are still lots of things for them to learn.

We had 3 cases referred to us today. The first case was a Malay-speaking Thai Muslim lady, Aminah, who has been working in Malaysia for more than 2 years. She got divorced about 4 years ago, and has no child.

Aminah came to Malaysia with a friend to work. Late last year she had to do a medical check up to renew her work permit and that was when she found out she was HIV infected. When I asked her what she knew about HIV, she admitted she didn't know much. Her concern was if her condition would in any way affect colleagues and customers at her workplace. She seemed relieved when I told her she wouldn't harm the others if she continued working there.

Aminah seemed rather calm and while she agreed to be assigned a buddy, I don't think she'd be much of a problem to the buddy assigned to her. The only worry is, the friend whom she's staying with, doesn't know she has HIV although this very same friend accompanied her to the hospital. Aminah may need our help later on when and if the friend begins to suspect something.

The second case referred to us was a young pregnant lady, Jayanthi. When I looked through her file, I got a shock when I saw her age. Oh my goodness, she's only 17!! She got married last year at the age of 16! Yeah, so my late grandma got married at the age of 13, but that was 83 years ago!

Jayanthi got pregnant recently and that was when she found out about her HIV. She does look rather mature for age. If I had not looked at her medical file, I would have thought she was in her early 20's.

Like Aminah, Jayanthi too seemed rather calm. Well yeah, she admitted sometimes she still feels angry and confused, but still, she remained calm and could even laugh when I talked to her today. She's definitely more mature than some of the older ladies I've handled before.

Jayanthi however, wasn't too sure if she wanted a buddy. Probably she needs to talk it over with her husband first. I gave her our brochure, told her to think things over, and to call us whenever she feels like talking to someone about it.

After Jayanthi left the room, we waited a while but no other cases were referred to us. So I went over to the doctor's room to see SN and find out if there were any more new cases. There was supposed to be one more new case, a single mother, but that lady didn't turn up for her appointment.

However, there was one old case which had never been referred to us before. There's this lady whom SN thought may need our help and since she was at the clinic today (she didn't have any appointment but needed to see the doctor), SN figured she might as well let me talk to this lady.

Before calling the lady, Nora, to see me, SN briefed me about Nora's background. Nora, a young lady in her 20's, is a divorcee. She has been admitted to a mental hospital before and seemed to be a very very stubborn lady. Her family could accept her HIV, but due to her stubbornness, they don't seem to get along very well. Nora used to stay with her parents, but later moved out to a town outside Perak, and stayed with a male friend.

Nora had actually been on medication before, but stopped going for follow-ups at the hospital when she moved out of Perak. Now she's back in Ipoh, and back on medication. She's still not staying with her parents though, instead she's staying with another male friend. When I spoke to Nora, she just mentioned she was staying with a friend, without mentioning if the friend was male or female. I didn't ask much though. This was our first meet, and I didn't want to dig too much.

I did ask Nora how she initially found out about her HIV. Apparently it was during her pregnancy with her youngest child 7 years ago that she found out she was HIV positive. And according to Nora, her 2 older children, aged 11 and 10, are staying with their father, her ex-husband, who has since remarried. The youngest one is staying with Nora's mother.

I think I may need to speak to Nora's mother to find out what Nora's problem really is. Nora reminds me so much of Zana, the problematic young woman I had handled earlier. The difference is, in Zana's case, her parents had disowned her. In Nora's case, the parents are still willing to talk.

As I got home today and wanted to touch up a bit on the contact reports, I realised something. Nora is 24 years of age. If she really has a child who is already 11, that means she gave birth to the child when she was 13. Younger than Jayanthi!!

But, but, but... SN did mention about Nora's earlier mental problems - could Nora have just created the story? Maybe she was like Zana, who tells a different story to someone and another story to someone else? Or was it because of her early pregnancy that she needed psychiatric help?

Alamak, right now I'm the one who's confused...