Busy day at the clinic

I was on clinic duty again today. I went to my office first in the morning, and only left the office at 9.30 am to head to the GH. This time I didn't bother to go a few rounds around the hospital to get a parking space. I just went one round, and ended up parking my car at a proper parking lot, within walking distance from the hospital, but still considered quite far for those with knee problems or the likes. Thank God I don't have such problems... yet...

As I got to the specialist clinic, I noticed most of the hospital staff were wearing masks. Alamak... I forgot my mask! I left them in my car! I was too lazy to walk all the way back to the car park, so I thought, whaddaheck, I will just make sure I use the hand sanitizer which I always carry in my handbag. Then I remembered, hey, I did have one mask in my handbag!

Well, anyway, after leaving my things in the counseling room, I immediately headed to the doctor's room, to inform SN that I was already there, and also to pass her some ole-ole I got for her from Bali recently.

Things started quite slowly at first, but once the cases started coming, we (my team-mates and I) hardly had enough time to talk about anything else. All the cases referred to us today were guys...

CASE #1

The first was Ravi, a young chap in his thirties... married, has an 11 year old daughter, and his wife is now pregnant with their second child. So, what made him go for the HIV test? You see, the wife knew about his previous affair with another woman, and when she found out she was pregnant, somehow she got worried that her husband may have been infected by that woman, and as a result, she too may have been infected as well. As such, she requested for the HIV test herself. She felt a whole lot better when the results came out negative. She told the husband to also go for blood tests initially, but when the time came to take the results, she got scared and told Ravi not to get the test results. Ravi still went, found out he was infected, but have yet to inform his wife. She's due to deliver soon, and he didn't want her to feel depressed. I'm not sure if he is ever going to tell his wife about it now that his wife is confirmed negative, but I reminded him to at least practice safe sex.

CASE #2

The second case referred to us today was Hasan. He is about my age, married, and has 4 children, the youngest is a 10 year old. Hasan had to undergo an operation at a private clinic to remove his appendix a few months back and it was during the full blood tests done before his op that they found out about his HIV infection. They broke the news to him the day before his scheduled operation. He was so frustrated, he felt like jumping off the 3rd floor of the hospital, where he was warded. Then his wife came and he broke the news to her. I must say Hasan is one lucky chap - his wife gave him the much needed support and encouragement to carry on with life. She was definitely his pillar of strength. She told him straight in the face, "Yang nak terjun dari tingkat 3 tu apa faedahnya? Kalau mati terus satu hal le jugak. Kalau tak mati tapi cedera teruk, tak ke lagi susah nak jaga?" Hehehe... clever wife.

Hasan does feel better now, knowing that his wife supports him, and after speaking to SN and us Buddies, he knows there are many other people out there just like him, who continue to lead a normal life. However, he has yet to reach the 100% redha stage... and still has the "if only I didn't do that" thoughts coming to his mind from time to time. Yes, he regretted all his wrong doings. He wasn't faithful to his wife, and yet when he got infected with HIV, his wife is still there for him. His wife, by the way, has been tested negative, alhamdulillah.

CASE #3

After Hasan left the room, my colleague went out to call the next person, Ramli. Ramli came in with a young lady - I thought his wife at first (he was wearing a mask, and he looked quite young behind the mask - hmm... I wonder if I looked young behind the mask too... haha!). Then the young lady introduced herself as his daughter. I looked at Ramli's file, and saw that he's 43. Well, still young, and with a grown up daughter, he must have got married at quite a young age. The daughter who came with him just got married recently.

I then asked how he found out about his HIV infection, and almost choked when his daughter selamba-ly answered, "Sebenarnya masa ayah kawin nombor 4 baru-baru ni kena buat test HIV. Dari situlah dapat tau."

I hope behind my mask they didn't notice my terkejut beruk face. Whoa... in our contact report form which we have to fill up, there is one column for "Spouse's name". Duh, do I now have to change it to "Spouses Names"??

I asked if his family members, especially his wives all know about his HIV infection. Here goes...

Wife #1 (also mother to the daughter who accompanied Ramli): She knows, but has yet to go for testing. 4 children with this wife... all grown up and all know about his HIV.

Wife #2: Also 4 children with this wife, the youngest is 4. All the children are staying with him. I was quite concerned about the 4 year old, but I told them to just get the wife to go for testing, if she's negative, then no need to worry about the kids. The problem is, while the children are with him, the family doesn't know the whereabouts of the wife now. As such, they are unable to get her to go for testing.

Wife #3: No children. It is believed Ramli got HIV from this wife. The wife, a foreigner from a country north of Malaysia, was infected by her earlier husband, but did not inform Ramli about it. She just mentioned she had TB. And she died of TB. Habis cerita.

Wife #4: Of course she knows lah, it was during the mandatory pre-marital testing that Ramli found out he was HIV +ve. But she still married him anyway despite the HIV and the 3 earlier wives...

CASE #4

Three people came into the room when we called for Shamsudin: A young chap in his early thirties, and a couple in their sixties. As I figured, they were his parents.

It was the father who did more of the talking, insisting he already knew about the few things I mentioned, and insisting to know about the results of the latest blood test. I told him he should talk to the doctor about the blood test results, and that we Buddies were there more for the counseling session. The mother was more... well... motherly lah kan. She was the one who had been taking care of Shamsudin, making sure he took his medication (he was on pre-HAART) on time. When I asked how Shamsudin was at home, whether he felt depressed or anything like that, the father said no. "Takdelah, dia nampak okay je", said the father. The mother's answer was more acceptable... "Kadang-kadang elok je dia gurau dengan adik-beradik dia. Tapi kadang-kadang dia termenung." At this point, the father said, "Dia orang ni suka berahsia dengan saya." I'm not surprised...

Shamsudin himself didn't say a word. I was beginning to wonder if he could even speak! But I did suspect that he didn't feel comfortable pouring out his feelings in front of his parents, especially his father.

Finally at one point, when the father was still doing most of the talking, cutting me out whenever I said anything, Shamsudin blurted out, "Persatuan ni ada tak tempat tinggal untuk pesakit macam saya ni?"

Finally! He then started to open up, saying that he needs to see for himself HIV infected people who has succeeded in life. And he ended up crying. Gosh! He must have kept so much inside him. From what I saw, although his family did not shun him, and tried their best to give him all the encouragement (including his father - although his style may not be suitable to Shamsudin's emotional needs), he probably felt inferior at home. He probably even felt as though he was a nuisance and a useless son no matter what his family told him.

Well, there are no shelter homes in Perak specifically for HIV cases, but since Shamsudin is an ex-IVDU, I intend to refer him to Perak's Persatuan Pengasih. They do have a home in Ipoh with all the much needed activities including motivational ceramahs, and they do accept HIV cases. His parents agreed that maybe he needed to stay with "those in the same boat" to boost his confidence.

I didn't have Pengasih's phone number with me off hand, but I promised Shamsudin and his parents I'd get the number for them.

CASE #5

Well, SN didn't really refer this case for counseling purpose. She just wanted to find out if we could help out Moorthy, who needs a place to stay. Moorthy wasn't even sent to the counseling room. He was unable to walk and was actually on a hospital bed which was pushed to the HIV clinic. So we had to go to the doctor's room to see him.

Now, helping Moorthy is not as simple as finding him a place to stay. Other than no longer in touch with any family members, Moorthy cannot fend for himself.

He had an accident some time ago, and all these while had been staying at the hospital ward in another town. He was brought to Ipoh GH for the HIV case and he is also scheduled for an operation in October. Operation? Both his legs will need to be amputated. Which means, whichever home he is sent to, will need to have people who will be able to take care of him as he will be dependent on others even to move around. The hospital had informed welfare department and officers from the welfare department came. But the moment they found out he had HIV, that was it. None of the gomen shelter homes seem to accept HIV cases, be it for children, for the elderly, or for OKU cases.

Sigh...