Today at the clinic...

Today being my clinic duty, I decided to go a bit early to arrange for Saiful's appointment with the eye specialist at the Ipoh GH. SN had told me earlier that there was no need for Saiful to personally come when seeking an appointment date.

After queuing at the "kaunter temujanji", when my turn came, the moment the nurse saw the referral letter I held in my hand, she said, "Oh, kes baru terus pergi bilik 6 dulu. Bawa pesakit sekali." Aduh, luckily there were only about 4 or 5 people in the queue in front of me earlier...

So no, couldn't fix an appointment for Saiful yet. Sofie will have to bring him along to Ipoh for that. Sofie is coming to Ipoh next week to get her supply of ARV, but Saiful will be having his school exams on the same day, so I guess, they will just have to wait until the school exams are over.

I then immediately headed to the HIV clinic to inform SN that I was already there if she wanted to refer any new cases. I needed to go off early today, so if the new cases could be referred earlier the better.

Because it was still quite early, my colleagues were not there at the counseling room yet when the first case was referred. I was quite concerned at first when the guy brought in was quite an elderly Chinese guy (sometimes these elderly ones would only speak in their mother tongue), but when I started speaking to him in Malay, he was quite conversant. Yes, maybe at certain points I had to repeat myself as he didn't quite understand what I was trying to ask him, but overall our conversation went rather smoothly and he too was quite open.

Anyway, this guy's a bachelor, never married and stays alone. He knew of his HIV infection 4 years ago after an accident, but since he felt okay then, he didn't see the need to get any treatment for his HIV. That was until a few months ago when he got TB, started getting weaker, and during the recent Raya holidays, he was so weak he couldn't even get up. And imagine he was staying all alone at home! But he managed to call his sister who stays with her son in another state, and due to his condition, the sister came to stay with him temporarily, at least until he gets a bit better. I promised to assign him one of our Chinese-speaking guys as his buddy.

By the time the second case was referred to us, both my colleagues were already there. SN brought in a couple - the wife pregnant. I was quite surprised when SN told me that the wife is due to deliver next week! Apparently, at the earlier stages of her pregnancy, HIV was not detected during the blood test. It was only during another very recent blood test that she was found to be HIV positive and that was when she was immediately referred to Ipoh GH, not only to the HIV clinic, but also to the O&G clinic.

After going through her file, I noticed that this is her second marriage. She has 2 children, aged 5 and 7, from an earlier marriage. Her first husband, an IVDU, died 3 years ago. One look and you'd conclude that she must have got HIV from her first husband. But if she really did get HIV from her first husband, then the window period (for her HIV infection) is long over and the presence of HIV should have been detected during her blood tests at the early stages of her pregnancy. But nope, it was only detected just recently. So, either she got it from her present husband (who has not been tested yet as of today) OR there were some errors in the result of the earlier test.

Due to the late detection, this lady had not been given any ARV drugs to help protect the baby. The c-sect is already due next week, let's hope there will not be another "Cek Mek" case of baby coming out earlier than scheduled c-sect.

Emotional-wise, I wasn't really sure if this couple had absorbed the whole thing. They didn't look shocked, they didn't look sad, they didn't look like they had accepted their fate either. They looked... BLANK! Maybe things haven't really sunk in yet. Asked if they needed a buddy, the husband said they didn't think so. But I still gave my number anyway and told them to call me if somehow suddenly they feel the need to talk.

There was supposed to be another new case today, but the person never turned up. But SN did want us to see Zali today. Remember Zali, the guy who's still on methadone treatment, whose wife dumped him and the kids as well? He's not working (I don't think anybody dares offer him a job when he's still on methadone) but needs to feed his 2 daughters. After the last time that I supplied him with some foodstuff, the hospital welfare unit did manage to get some assistance for him with the monthly provision of groceries etc, but that was only a temporary measure and I was told that the assistance will end soon.

I never got to see his wife. Neither did SN. Zali always said that his estranged wife refused to come to the hospital. When I offered to meet up with her outside where other people wouldn't suspect anything, Zali gave all sorts of excuses. When I asked for her number so I could speak to her myself, he'd always say, "Nantilah, biar saya cuba cakap dulu dengan dia." And recently, when SN asked him why not send the kids to his wife who's working and would at least be able to support them financially, he told SN that he was the one who refused to give the kids to their mother.

Maybe all the while it's not the wife who had refused to see us. Maybe Zali was the one who didn't want that to happen. He wouldn't even give us her phone number.

Well, even if that wasn't the case, I still feel that Zali is being very selfish. With his no-income and methadone-dependent status, I'm sure he knows pretty well he is not fit to take care of his children. The children deserves a better future. If his wife had attempted to bring matters to court to gain custody of the children, I'm quite sure she'd win hands down. But obviously she hasn't done that, or has she?

Anyway, Zali was supposed to come to the clinic today and I so wanted to talk things over with him for the children's sake, but he never turned up.

Maybe for the sake of the children, I should refer this case direct to the welfare department for their action...