Another round of clinic duty

What? Clinic duty again on 2 consecutive days? Whoa… never before!

On Tuesday I was on clinic duty at Taiping Hospital. Wednesday I was on clinic duty again, at my “regular” place… Ipoh GH. With 2 new volunteers able to join clinic duty, and the trainees in my old team already confirmed and ready to handle cases on their own without my supervision, we now have additional teams.

Even the nurse was surprised to see me this morning. I told her from now on, there should be volunteers every Wednesdays, except on the 5th Wednesdays of each month, if any. However I told the nurse that in the event HIV clinics on any Wednesdays are cancelled for whatever reason, to please call and inform me about it so that our volunteers will not have to go through all the trouble of finding a parking space at the hospital only to find out clinic was cancelled!

The nurse had told me earlier that a 15 year old HIV+ girl would be coming for her appointment yesterday. Dr Ker too had requested that I meet this girl to assess her needs. But so far no such luck and I was hoping to meet her and talk to her when she comes for her appointment.

Meanwhile there were 2 new cases yesterday. When the first one was referred to me, my fellow volunteers had not arrived yet. The new volunteer was having a hard time finding a parking spot, while the other one was simply… late!

No problem, I might as well just talk to this lady alone. The lady, 35 years of age, originated from Thailand but had married a Malaysian since 15 years ago. My problem yesterday was, this lady speaks very little Malay (and I mean VERY little) and  Mandarin while I can only speak Malay and English. So imagine I had to speak to her in the simplest Malay possible.

“Sudah berapa lama tahu you ada ini sakit?”

*she nodded*

“Sekarang you sudah memang makan ubat ka?”

*she nodded*

“Sudah berapa tahun you mula makan ubat?”

*she nodded*

MAAAKK! TOLOOONGG!!

But eventually I did manage to understand bits and pieces of her background (I think!). She had been diagnosed with HIV when she was still in Thailand and had been taking medication since before she came to Malaysia and married a Malaysian Chinese. She never went for any follow-ups in Malaysia but was still continuing taking her medication by getting a friend to buy the medication in Thailand. It’s cheaper there. Besides, earlier on she did not have any Malaysian IC yet, and as such getting treatment in Malaysian government hospitals would mean she’d have to pay. I couldn’t get an answer on whether her husband knew about her HIV status when they first got married, but after she was finally referred to the Ipoh HIV clinic, her husband was called for blood tests and results showed that he was negative.

So how was she finally referred to the HIV clinic in Ipoh? Now that she has got herself a Malaysian IC, she went to the eye specialist since she had some problem with her right eye. The specialist then asked her if she had any other illness, and so she just told the doctor that she had HIV. When the doctor found out that this lady had not been going for follow-ups ever since she moved to Malaysia, a referral letter was immediately given to her. That was how she finally ended up getting an appointment at the HIV clinic. She even brought a bottle of her medication which she got from Thailand. I told her to make sure she showed them to the doctor as it is important for the doctor to know all these facts.

She seemed to be doing fine, both financially and emotionally, and no kids to worry about; so no buddies were assigned to her. I just gave her our brochure and told her to call the hotline number if she ever needs our help.

My other 2 colleagues arrived after I was done with the Thai lady. We just sat there and chatted. After a while, there were still no new cases referred. Even the 15 year old girl I was hoping to see was nowhere to be seen.

I decided to go over to the other side to see if there were any of my clients there for their appointment. I saw 2 familiar ladies sitting beside each other having a good chat – Maria and Zainab. Yep, Zainab, the one whose house I went to visit last Saturday but she was at work. The moment she saw me, she immediately got up, hugged me, kissed my cheeks and said, “Rindu kat akak, lamanya tak jumpa!” She and her family even missed our Family Day because I couldn’t get hold of her.

When I saw the nurse coming out to give an appointment slip to one of the patients, I went to her to ask if there were any more new cases. She said there was one more; so okay, I went back to our room and waited there.

The next case referred to us was a guy, Loges, an ex-IVDU. I let my colleague speak to him in Tamil while I jotted down his particulars in our contact report. But I noticed his Bahasa wasn’t too bad, so I joined in the conversation. I asked if he was still taking drugs.

Loges: “Tada la kak, sudah laaaama tada ambil. Lepas keluar Serenti saya sudah tada ambil dadah lagi.”

Me; “Bila you keluar Pusat Serenti?”

Loges: “Bulan anam itu hari.”

Duh… just 2 months ago and he said sudah lama?

I browsed through his file and I noticed that he had been taking drugs since he was 12 years old! Wow! No wonder he said it had been some time since he last took drugs. He’s 35 now, and so after over 20 years of being addicted to drugs, surely it’s not easy for him to get used to life without them.

Although he is not working (he used to work with a government agency, but after being caught for drugs, he was expelled), and his wife too had stopped working after marrying him, he now lives with his parents. His parents are old, with income coming only from his father’s pension. So how do they survive? His youngest brother and his wife also stay in the same house. It’s his brother supporting the whole family. According to Loges, he doesn’t have any problem with his brother, but it’s the brother’s wife who had been complaining about having to support Loges and wife.

Now Loges wants to move out of the house so he can live on his own, but how on earth is he supposed to support himself and his wife when he is not working? I asked if he had been looking around for jobs, but he said of late he had not been feeling too well. As a matter of fact, both he and his wife had been diagnosed HIV+ since 2007 but both of them had not been going for any follow-up anywhere. Loges himself only decided to see the doctor after he started feeling weak. He coaxed his wife to go along with him to the hospital, but his wife simply refused as she still feels okay.

Yesterday was Loges’ first appointment with the doctor, and already he was asking the doctor for a report in his favour to withdraw his EPF for permanent disability. Ahh… no wonder lah he finally decided to go for hospital appointments… it’s $$$$$$ that he wants!

Well, yesterday he found out that it’s not easy to get the doctor’s letter for EPF purposes. He is not yet in that critical stage where he is no longer capable to work at all. No doubt he is presently feeling weak, but once he goes on medication and if he strictly complies with it, he should be able to improve. I told him to just stick to whatever the doctor advises him to do, get himself better first, and then try to figure out something to generate some income for him. If he withdraws his EPF now, he’d probably finish it very soon. Maybe even get back to drugs, who knows. Then by the time he really becomes incapable to work, he’d have nothing left.

He did still ask for a referral letter from a doctor just to say that he has HIV. I think he wants to use the letter to get sympathy. I’ve seen/heard people doing that. I’m not sure if Loges too will be doing that with the small note he got from the doctor saying that he was HIV+. But he also wants to use the letter in case he gets caught by the police/AADK for not reporting after being released from Pusat Serenti.

Let’s see if Loges will be compliant with his appointments/medication.

Anyway, the 15 year old girl I was hoping to meet, did not show up until the end of the clinic. Sigh. That wasn’t the first time the guardians didn’t bring her for her appointment. I’m not sure if it’s the guardian who’s not bothered, or the girl herself refused to come. I never had the chance to speak to her personally, so it’s rather difficult to assess.

Hopefully one of these days, I will still get the chance to meet her.