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Tuesday 29 September 2015

Visiting a new client with multiple problems

When the nurse from Slim River Hospital called me last week to refer a case (which she felt needed help) to me, it was only 2 days before Raya Haji. While I’d usually call referred cases almost immediately, this time I decided to wait. Raya had always been family time for me, and so family comes first. Just because I’m not married doesn’t mean I don’t have a family. Then the weekend following Raya Haji, I was busy with other events.

So yesterday while I was on clinic duty at HRPB, I decided to call the referred client, Salmah. She sounded receptive enough, and so I asked if it was okay for me to visit her at home. It’s always easier to assess my clients via home visits, because some things cannot be assessed via phone calls. Their living condition… their body language… and things like that. In addition, gaining their trust is never easy if they’ve never met you before, so visiting them at home to meet them personally is always the better option, provided of course you get their permission first. We never visit any clients at home without their permission.

This morning I set off to visit Salmah. The address I got was simply a block __ at Taman _____. No road names whatsoever. After driving for roughly an hour and a half, I finally reached the said Taman. All I saw were terrace and semi-D houses, didn’t see any flats. So I stopped at the first mini-market I saw to ask, and I was told to drive straight ahead. And true enough, it wasn’t hard to find the low cost flats from there on.

The place didn’t look well kept by the developers. I saw many “untuk dilelong” signs at the various windows on various floors. I saw 2 boys running down the stairs when I walked up to the 3rd floor to find Salmah’s home (later I found out that the 2 boys were Salmah’s children).

As I was looking around for the unit number, the door to one home was open,with a lady holding a broom, sweeping. I looked at the unit number, it was the number I was looking for. “Salmah?” I asked the young lady. The moment she said yes, I introduced myself as the person from the NGO who called her yesterday.

Salmah has 4 boys with age ranging from 4 to 10 years old. 3 of them from her first husband, all classified as OKU. The number one boy is classified as a slow learner, number two with ADHD, and number 3 dumb. All 3 have to go to special schools. After their parent’s divorce, they had been staying with their father in another state, while Salmah moved to Perak to work. But their father kept going in and out of jail, and so the kids were passed to their paternal grandfather, who himself felt he didn’t have enough strength and energy to take care of the children.

When their divorce initially took place, it was an out-of-court divorce, and so there was no black and white. Both of them then remarried. No problem for the husband of course, but without formal divorce papers, Salmah ended up marrying an Indonesian guy (who works in Malaysia) and the marriage took place in Thailand. When they ended up getting a child, Salmah’s ex-husband was registered as the child’s father.

I thought there’d be problems with the youngest son’s birth cert, but as it turned out, it was the 3rd son who had problems with his birth cert. You see, Salmah’s second and third sons were born only about a year apart, and after giving birth to her 3rd son, her second son had to be warded for some accidental injury at home, and so Salmah spent most of her time with her 2nd son at the hospital. At that time she was also suffering from depression, and not being able to depend on her ex-husband, the 3rd son did not get registered and ended up without a birth cert until years later when his grandfather wanted to register the boy for school. By the time the grandfather went to the JPN to register the boy, divorce papers had already been filed but had yet to be finalised. The boy’s birth cert was only filled in with the boy’s and mother’s info, all other info in the birth cert was registered as “maklumat tidak diperolehi”.

Now Salmah wants to amend her 3rd son’s birth cert, and she has got all the necessary documents filled up and signed. Only problem now is that she needs to also submit the original copy of the birth cert. She has the photocopy, but the original copy, which was kept at his grandpa’s house, got burned during a minor fire which took place at the house some time ago. There shouldn’t be a problem getting a certified copy from JPN, right? Or at least that was what I thought. Salmah already tried that. But she was told that in this boy’s case, it wasn’t doable because of the incomplete info on the boy’s birth cert and in the system. Salmah was told to go to a lawyer to proceed. And from then on Salmah did not proceed further. She couldn’t afford a lawyer.

I don’t really know the whole story behind it, maybe Salmah misunderstood or maybe there were other options but the JPN officer suggested using the services of a lawyer instead just to make things easier. Since Salmah needs to go back to settle her children’s transfer of school, I suggested to her to sign a statement witnessed by a commissioner of oaths, indicating that the original birth cert was destroyed during a fire. Hopefully that will be enough for her to proceed in making amendments to her 3rd son’s birth cert.

Although Salmah’s present husband, an Indonesian doing odd jobs to make ends meet, doesn’t make much, all 4 children adore him. When the older 3 boys stayed with their father before, they never got any kind of love from him. He was angry most of the time, always scolding them. That was why he simply left them with their grandfather. Now that they have a fatherly figure to look up to, the boys are very happy with their stepfather.

Salmah knows she may need to work to earn extra income for the family, but after being diagnosed with HIV, she lost her confidence to face other people. She knew about her ex-husband’s HIV infection much earlier, but at that time, she was in denial and simply refused to get tested, telling herself that she couldn’t have been infected because she didn’t do anything wrong. It was only later, after she moved to Perak, when she was working at a factory, that she started getting ill and finally got warded and tested +ve for HIV. Salmah had to quit her job after the frequent medical leave she had to take. By then she had married her present husband, who, like her, initially refused to get tested, telling himself he couldn’t have been infected. That was until recently, when he finally got the courage to get tested, and he too was found to be HIV+. Both Salmah and her husband are on ARV medication now.

When I asked what’s stopping her from getting herself a job now, Salmah asked me back, “Boleh ke kak?” Apparently, she is of the impression that everyone will know of her HIV and everyone will look down on her. I gave her examples of my other clients who are currently working and Salmah seemed amused. I then asked if she was interested to start up a small business like selling nasi lemak and the likes. She told me she’d love to but she simply didn’t have any capital to start off her business. Her face lit when I told her that agencies like Baitulmal and JKM’s e-kasih do provide assistance to start off small businesses for the poor.

I had initially planned to spend just about half an hour at Salmah’s place. But when I got there, it was obvious she needed a listening ear and she needed encouragement. I ended up spending more than an hour there. Her spirits did seem somewhat lifted by the time I made a move. But I need to follow up on her from time to time to make sure her spirits do not die down.

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