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Monday, 10 February 2014

When a child is deprived of treatment…

I was on clinic duty again today. Nowadays I no longer worry about parking at the hospital as I no longer drive my car there. All I have to do is drive to the velodrome, park my car there and get a ride in the shuttle van provided by the hospital for free.

When I got to the hospital, I was told by the nurse that there’d be 2 new cases to be referred to Buddies today.

The first case referred was that of a young guy in his twenties, very skinny and with a CD4 of only 4. He looked like he had given up hope. But he was accompanied by his sister, who seemed very supportive of him and from what I was told, his father and a few other siblings also knew of his condition and they were all supportive as well. Hopefully with the kind of support that he is getting, he will adhere to all his treatments and get better soon.

After I handed over the guy’s file back to the nurses, the staff nurse came to the counselling room to ask me to stay on a wee bit longer if possible although the other new case she had wanted to refer to me wasn’t there yet. The new case was that of a 13 year old girl and the staff nurse thought the family needs the support of Buddies. I was told that the girl’s HIV status had not been disclosed to the family yet.

I waited and waited, nobody was referred. By 12.30 pm I went over to the doctor’s room to see the staff nurse to find out if I should wait any longer. The staff nurse had just got off the phone with the mother of the 13 year old girl. The mother, who had given all sorts of excuses before this (this was the 3rd time the nurse set up an appointment for the girl, she defaulted all 3 times), said she wasn’t feeling well and thus, decided not to bring her daughter for the appointment. When the nurse told her that they needed to inform them of the girl’s ailment, the mother said she already knew what the girl has. By the sound of it, the mother must have known all along that she (the mother) too had been infected by her late husband but simply never bothered to get treatment.

From what the staff nurse told me, the girl’s father had been a patient at the ID clinic before but he too always defaulted his appointments. He died a few years ago. The mother however, never went to the ID clinic to get tested.

Our main concern is, the 13 year old hiv+ girl has a younger sibling aged 5 who has not been tested.

We’re not really sure why the mother didn’t bother to bring her child for treatment. If she wasn’t bothered about her own wellbeing, she should at least give her daughter a chance to get proper treatment. But she could have problems of her own. Being a single mother to 7 children is definitely not easy. Maybe she has financial problems and couldn’t afford the transport to bring her child to the hospital?

My worry is that she may think those with HIV don’t have much hope, and thus, there’s no point getting treatment at the hospital.

For the moment there’s not much I can do. Buddies don’t have the authority to simply go to the homes of PLHIVs without their permission. But I do believe health inspectors have the right to visit them at home if they don’t come for their hospital appointments. From my conversation with the doctor and the staff nurse today, I understand that would be their next course of action.

I told the nurse to just give me a call anytime whenever she needs me to help out with this case.