Kapla ku pusing...

Some days I don't get any calls regarding my NGO work, some days the calls come in one after another.

Well, for the past 2 days, it seems most of the calls are regarding "my babies".

In my previous posting I mentioned about Baby K going for her heart op soon. Before she goes for her heart op, she was to undergo a minor dental surgery in Ipoh. Apparently it was done on Tuesday and the little girl was warded but Mrs K didn't call to inform me. My colleague was the one who informed me about it. When my colleague asked Mrs K why she didn't inform me about it, guess what she said?

"Tak beranilah kacau dia. Kak Zah tu garang." (in case you're wondering, no, nobody else calls me Kak Zah)

GARANG? MUAHAHA!!

Well, let it remain that way... I mean let her have that perception about me. With her history of trying to borrow money here and there, it's best if she thinks I'm garang. I think my earlier "lecture" to her about spending only on necessities must have had played a part.

We have not informed her that Buddies has approved a certain amount for her living expenses while in KL. I shall only give her the money nearer to the date. Knowing them, if they get the money now, they'd probably be spending it on other things and by the time they need to go to KL, they'd run out of money to even pay for their bus fares!

I met up with Anita and her baby yesterday. Kak Ana had brought them to Ipoh GH as Anita had defaulted the baby's earlier appointment (she went back to her home state then to get the necessary supporting documents for her IC). In addition to that, Kak Ana also just found out that Anita had finished her supply of ARV drugs and has not been taking her medication for more than 2 weeks already.

Not much problem with the baby as he was just supposed to get his blood tested to confirm that he is free from HIV. Tests so far showed that he is spared from the virus, but he will still be tested from time to time until he reaches 2 years of age.

But Anita kena sembur by SN for not being compliant with her ARV drugs. Hehehe... nasib badanlah... siapa suruh miss makan ubat...

That was yesterday. This morning a call came in from Anita's number. She then passed the call to Kak Ana who asked me about the boy's birth cert. Duh! She didn't know the boy's cert is not done yet! Kak Ana had actually brought Cek Mek and Anita's baby to the hospital for their immunisation and the nurses asked for the babies' birth certs.

After about half an hour or so, Kak Ana called again. This time to ask about Cek Mek. The nurses were asking for Cek Mek's immunisation card which according to them was supposed to have been given when the little girl was discharged from the hospital after birth. As far as I know, the only thing we got was a referral letter to transfer my Cek Mek's case to the hospital near Kak Ana's shelter home. I didn't dare confirm it though, as it was Puan Nur who took the baby and whatever documents from the pediatric ward when the little girl was discharged. I told the nurse (Kak Ana passed the phone to the nurse so she could speak direct to me) I'd have to confirm with Puan Nur and/or Sharifah first.

So yep, later this afternoon after 3 pm I called Puan Nur as I knew she usually finishes work at 3 pm. I didn't want to call Sharifah as I wasn't sure of her work shift. I didn't want to call her at work talking about her baby when her friends didn't even know she has one! Puan Nur didn't answer the phone. So I sent her a text message asking if there was any hospital card given when Cek Mek was discharged. She replied my message immediately saying there was no such thing given.

About 2 hours later another text message came from Puan Nur. She had checked with Sharifah and Sharifah confirmed that there was no immunisation card given. I decided to call Puan Nur's number. Sharifah answered the call... she just got home from work. Anyway, after confirming a few things, I told Sharifah that her baby has grown montel and is already beginning to recognise people. I told Sharifah to make it a point to visit her baby more often, otherwise the little girl may not feel comfortable with her own mother.

Before that, right after I sent a text message to Puan Nur, a call came in from a 03 number. I almost didn't answer as I thought it could be one of those telemarketing calls that have been irritating me a lot lately. But seeing that the number was not from central KL, I answered the call.

Thank goodness I did. The call came from an officer from JPN Putrajaya in response to the letter I sent earlier regarding Anita's MyKad. Yayyy, somebody's responded!

The lady told me to bring Anita to JPN Ipoh, fill in the necessary forms and submit together with the required supporting documents. She said by right there shouldn't have been any problems in the first place to get Anita's IC done (although her PR father cannot be contacted and her Singaporean mother is dead) but now that it is considered as late registration, there are additional documents we'd need to come up with. She asked why the IC was not done earlier... I couldn't really answer that. I've only known Anita just recently.

Whatever it is, the lady told me to register for the baby's birth cert first and not to worry about the mother's status or the citizenship of the baby. Just get the birth cert done. When Anita's case is settled, then we can apply to rectify the baby's birth cert to confirm his citizenship status.

My problem now is getting a supporting letter from someone who knows Anita and can confirm Anita's status. Who can I get from the list given by the JPN? Gurubesar? Anita tak sekolah. Ketua kampung? Aduh, Anita now stays at the shelter home... the ketua kampung there doesn't even know her.

We (that's Kak Ana and myself) will have to think of something. If a surat sumpah will do, then that's the easiest thing to do. Otherwise we may have to send Anita back to her hometown (in another state) again, and get her sister there to help her get the ketua kampung to sign the letter.

Ah well, at least I can start something already. But then again... aduh... kapla ku pusing...

Mother & baby to shelter home, another baby coming soon?

Right after I got back from Cameron Highlands on Sunday, I tried calling Puan Nur to get the latest updates. But my call didn't get through. So I called Sharifah - and was told that she was waiting for her mother to come to bring her to ward 6C to see the baby.

Later at night I tried calling Puan Nur again. This time I managed to speak to her. According to Puan Nur, they asked the nurses at ward 6C as to when they can send the baby back to the maternity ward to be with Sharifah. They told her that once Sharifah is confirmed to be discharged, then they will send the baby to the maternity ward.

Since Sharifah was supposed to go for her appointment at the combined clinic this afternoon, we thought there was a good chance she'd be discharged today - so we thought we could bring them to the flats first, and tomorrow we (as in myself and Sharifah's mother) will send both Sharifah and baby to the temporary shelter home. Apparently Puan Nur had already spoken to the lady in charge at the shelter home (I told her to call as my earlier arrangement was a bit different) to explain to her their latest decision not to give the baby away, and to ask if the lady would still accept Sharifah and the baby temporarily.

The lady not only accepted them both, she even offered Sharifah an admin job at the home if she was interested. That would be useful experience for Sharifah especially because she does intend to look for a job once she leaves the shelter home.

When I went to visit Sharifah today, she still wasn't sure when she'd be discharged.

"Doktor kat combined clinic kata apa?"

"Dia kata kalau tak dak apa-apa buleh balik. Tapi masa balik bilik ni tadi nurse tu kata doktor tu tak tulih apa-apa pun."

That meant Sharifah wasn't discharged today.

Puan Nur needs to go home on Tuesday by hook or by crook as she needs to attend to something on Wednesday, even if that means she has to take the night bus. But if Sharifah doesn't get discharged by tomorrow, then banyak susah lor. I will then have to take over as the mama again... aiyaiyai...

We needed to make plans but not knowing when Sharifah and baby would be discharged, it was difficult to plan. So I went over to the nurse counter, saw a few doctors there and asked them when Sharifah was expected to be discharged. The more senior doctor there asked if I was a social worker. I just said yes and I told them I needed to arrange to send both mother and baby to a shelter home. She then told me that Sharifah would be discharged tomorrow, and since there are so many things to arrange (Sharifah's next appointment, baby's next appointment, medication for the baby etc), most likely we could only take them out in the afternoon.

I told Sharifah to confirm with the doctors when they come for their rounds the next morning; and once she is confirmed to be discharged, to immediately inform both her mother and I. I also told Puan Nur to go to the hospital early if so, to help arrange whatever necessary. Since Sharifah doesn't have a husband, the best person to handle all the signing this and that would be her own mother. If I were the one having to do this and that, there would be probably loads of questions asked.

So Puan Nur is now at the flats, packing up, so by tomorrow afternoon, once we get Sharifah and the baby from the hospital, we will only drop by the flats to get all the luggage, then immediately drive off to the shelter home. After settling things at the shelter home, I need to rush back to Ipoh to send Puan Nur to the bus station so she can go home latest by tomorrow night.

Hopefully we can stick to the plan.

Just as I was updating my blog with this posting, a call came in from Asiah. Just to recap, Asiah got HIV from her first husband. She then remarried, as wife no.2 to an elderly man (elderly but still strong lah... not yet the ketaq-ketaq type). That was about 3 or 4 years ago.

So, why did Asiah call me?

"Kak, hari tu saya tengok dah dua bulan tak dapat period saya pergi check kat klinik. Depa kata saya pregnant. Macam mana boleh jadi macam ni kak?" (eh, eh, tanya kita pulak macam mana boleh jadi macam tu... dia yang buat kerja, bukan kita!)

"Laahai, tak pakai kondom ke?"

"Pakai, tak tau macam mana boleh lekat le pulak. Ni suami saya kira suruh saya gi cuci, buang kandungan ni. Dia takut nanti budak ni dapat HIV."

I explained to her about all the precautions that can be taken etc. That was what she thought too, but she wasn't confident enough to explain it to her husband.

"Terima kasih kak, dah cakap dengan akak ni lega sikit rasanya."

Oh boy, I thought I was done with the pregnant cases for time being after Sharifah gave birth. Now comes another one??? I haven't even finished dealing with Sharifah's case. Maybe I should just be a midwife... a diving midwife. (bidan terjun daa!)

Oh well, at least for this new pregnancy case, the baby has a father.

Is it possible?

During the Q&A session of the talk I gave last week, the boys were the ones who mostly stood up to ask questions, while the girls preferred to ask me privately – both before and after the talk.

One of the questions asked before the talk started while I was chatting with the organizing committee was whether it was possible for a baby not getting infected if the mother has HIV. You see, they had watched this one Malay drama on TV and in that drama, although the mother was diagnosed HIV+ during her pregnancy, the baby, when born, was spared from the virus. So, they were wondering if such a thing was logical.

Another girl was asking if it would be better for pregnant HIV infected women to opt for abortion.

Obviously many still think that pregnant HIV+ women are sure to give birth to HIV+ babies.

So I told them about the necessary precautions that need to be taken to minimize the chances of infection – the pregnant mothers are to be given AZT (a type of drug to help suppress the virus), delivery must be caesarian and not normal delivery, and the mothers must not breastfeed the babies. And I told them about the HIV positive ladies I personally know who ALL gave birth to HIV negative children. (There’s Zainab, Fuzi, Yah, Sha, Zana, Anita, Ani…)

Usually, cases where the babies get infected are when the mothers’ HIV infection is not known during pregnancy. Most of the cases of infected children that I know of are those older than 7 years of age. I’m not sure, but probably at that time, pregnant women were not tested for HIV. Nuri and Lily only knew about their HIV when their youngest born were already 5 or 6 years old. It was definitely heartbreaking for them to find out that their children became victims as well.

Or there may also be cases where the mothers don’t go for proper check-ups during their pregnancy and as such their HIV status are not known. Zana almost fell into this category – it was an out-of-wedlock pregnancy and she didn’t want people to know about her pregnancy. Even the doctors at the HIV clinic were unaware of her pregnancy as she wore loose clothing to hide her pregnancy. It was only when she was chased out of her house that she had to seek my help to find a shelter home for her, and upon my insistence that she’d better tell me the whole truth if she wanted me to help her, that she finally admitted she was pregnant. And it was right on time too. She gave birth just 2 months later – to twins! (and nobody noticed her pregnancy earlier!)

Of course there may also be unfortunate cases like Fuzi’s 4th child, Ijam. Although her youngest child Iwan was spared from the virus, Ijam was not as lucky. When Fuzi went through all the tests during her pregnancy with Ijam, her HIV test came out negative. How could that be? My unprofessional guess is, the tests were done during the window period and as such, the HIV antibodies were not detected then.

And while we’re into the topic of the possibilities of babies getting infected from their mothers, we must remember that while chances are high that the babies would be infected if the necessary precautions are not taken, there is still that small possibility that even without taking the said precautions, the child would be spared. And there are indeed lucky ones out there who are spared.

Rose, for example, found out about her HIV infection only after her husband died, and only after she gave birth to her youngest son through normal delivery. Worse still, Rose had been breastfeeding him for almost a month. But yes, the lucky boy was spared. He is 12 this year and is free from the virus.

So folks, just because a mother’s HIV positive, don’t assume the child would be positive too. Just because a husband’s HIV positive, don’t assume the wife would be positive too.

The important thing is to learn the facts – don’t assume.

ASS-U-ME

The word doesn’t look so nice either… :)