Problems, problems…

I was supposed to be on clinic duty in Taiping yesterday, and today in Ipoh. But I couldn’t make it to Taiping yesterday as my uncle passed away on Monday and I had to rush to KL for his funeral. No problem about going for today’s Ipoh clinic though.

As usual, the moment I got to the specialist clinic, I headed straight to the doctor’s room to inform the nurse that I was already there and to ask if there were any new cases. The nurse told me there was one, and she told me that SN (the staff nurse we had been working with and had gone for a 6 months course during the second half of last year) was back. Immediately I went to the room next door and SN was there, talking to Wan, the orang asli lady whose son is under our sponsorship programme.

SN told me about an old client, Normi, who may need help. Normi had been referred to Buddies before (not during my duty though) but at that time the volunteers on duty didn’t assign her any buddy. My guess is there were 2 main problems back then – the volunteers on duty were non-Malays… and Normi speaks in Parit dialect, and in addition she has hearing problems as well.

So SN got Normi to see me at the counselling room. The counselling room by the way, had so many people today, definitely no privacy at all. Other than the usual pharmacists, there were also student pharmacists as well. It was noisier than usual, and with Normi’s hearing problems, I had to speak louder than usual, something I don’t usually do… at least not in the counselling room!

Normi is a single mother with 5 children. However only the youngest, a 14 year old girl, stays with her. The eldest is married, stays in another town. The other 3? They’re staying with their married eldest sister. I asked Normi if they’re working, but she herself was not sure if they were.  I asked how often they come back, and Normi said that only happens during Raya. With Normi herself not working, I asked if Normi had been getting any form of financial help from anyone. All she gets is Welfare Dept’s Bantuan Kanak-kanak of RM100 for her youngest daughter. She has to pay RM70 per month for her house rental. So what does she survive on? I asked if her children give her any money. Only when she asks them for money, she said.

When Normi’s husband was still alive, they used to get PPRT assistance. The house was under her name, while the land belonged to her father-in-law. According to her, after her husband and FIL died, her in-laws chased her out of the house. She claimed she “kena buat” and the numbness she feels on the left side of her body is also “buatan orang”.

Frankly, I don’t quite know what to think of this case. For someone who only gets RM100/month and has to pay RM70 for rental, she looked rather “bergaya”. There must be a reason all her children except for one prefer to stay elsewhere. She also said she came to the hospital with a “kawan”. I wonder what her children’s version of the story is like…

The next case referred to me was a prisoner’s case. He came handcuffed to a policeman, so whatever conversations I had with him, the policeman listened as well. There were no secrets though, I wasn’t discussing with him how to escape from prison… :), he is due to be released in March anyway. SN referred the case to me because this guy has 2 children, aged 11 and 7 who may need help. The children are now staying with their mother, his wife. The wife works as a cleaner, earning about RM400 – RM500 per month, and she has to pay RM170 for rental. Hmmm… I think I may need to pay a visit to assess this family’s needs. I’ve got the wife’s number, so I shall be calling her soon.

There were no further cases referred and it was still early. When I went to the doctor’s room to inform them that I was leaving, Dr Ker gave me the name and number of a new Taiping case. “You tak datang yesterday pun I ada case untuk you,” she said. I called the lady, and frankly I think she’d feel more comfortable speaking to a Chinese-speaking volunteer. I told her I’d get a Chinese volunteer to call her.

Since it was still early, I decided to visit Sofie at the ward. She had been warded since Thursday 2 weeks ago, and initially the doc thought it was  just due to dehydration as a result of ARV allergies (she’d vomit every time she tries to eat/drink anything). So rightfully she should have been discharged after 2 or 3 days. But after she fainted at the toilet in the ward, and the next day she had very high fever, they decided to do x-ray and scan.

When I got to Sofie’s bed, Saiful was there. Apparently he had not gone home ever since he started accompanying his mother at the hospital 2 weeks ago. Meaning he skipped school for the same length of time. I asked if he had informed his teacher.

“Mintak tolong kawan aje bagitau cikgu. Tapi hari tu kawan kata cikgu dah marah.”

Well, I’m a bit concerned too. I know of a girl who skipped school for a month to take care of her mother and ended up being expelled from school. I don’t want Saiful to go through the same thing, although he himself didn’t seem too bothered. I told Sofie to get her sister to call the school to inform them of Saiful’s situation. At least getting the news from an adult, hopefully the school teacher would be more understanding.

At first I wanted to suggest that the boys take turns to take care of Sofie at the hospital. But it was a women’s ward, and males are not supposed to stay overnight at the women’s wards. It was different for Saiful, because although 13, he looks like a 9 year old! Initially he even had problems getting in because the guards didn’t believe he was 13. But now, after 2 weeks, all the guards know him already.

Noticing that it was too early for visiting hours, Saiful asked, “Macam mana makcik boleh masuk?” I showed him my pass. Definitely more “power” than his temporary pass… :)

As for Sofie, there were some equipments attached… drip… machine… I don’t know what the machine was for. Sofie herself was not able to tell me anything. She only said that further tests were done but results were not out yet.

After a while, I left Sofie, and told Saiful to come along with me downstairs so I could help top-up his mom’s phone credit. After 2 weeks in the hospital, they ran out of credit. They could top-up at the shop at the ground floor, but Saiful had to buy food at the hospital canteen and things aren’t cheap. After 2 weeks, they don’t have much cash in hand.

After paying to top-up their phone’s credit, I gave Saiful some extra cash for his lunch. Then I headed back to the HIV clinic to see the doctor, hoping to get more info regarding Sofie’s condition.

According to the doctor, the scan done showed “something” in Sofie’s brains, and so now they needed to do further tests to find out what exactly the “something” was. The doc did explain some things in medical terms which I can’t quite recall (I did badly for my science subjects in school!) but one thing she could confirm, Sofie may need to spend a lot more time at the hospital than anticipated.

Oh dear… I think I may need to visit the children at home without waiting for Sofie to be discharged.

I just hope that the “something” is not something dangerous…

 

More of this and that…

It has been more than a week since Sofie was hospitalised. Although I did tell her to call me once she’s discharged, until today I did not get any calls from her. Initially she was hospitalised (on Thursday 13th Feb) so she could be put on drips to enable her to get her energy back after the allergies caused by her ARV caused her to vomit every time she ate anything. She was supposed to be warded at the most for 4 days only.

But on Sunday, she fainted at the toilet in the ward, so the doctors decided to keep her at the hospital for another day.

I waited for her call, it never came. In the meantime I was busy with other matters so I didn’t call her to ask. But’s it’s already Sunday again, and so today I decided to send her a text message to ask if she was already home. Who knows, maybe she didn’t want to trouble me and decided to go back on her own.

It turned out that Sofie is still at the hospital. Last Monday she started getting feverish. The doctors decided to do further tests on her. The results of the tests are still pending.

Thank goodness Sofie’s sister is at home looking after the kids. But I think if Sofie doesn’t get discharged anytime soon, I may just drop by their house to see how they are doing.

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I was in KL yesterday, attending a cousin’s wedding. Quite a number of SMS came in, mostly my FB notifications. But one SMS came from Aina. Remember Aina and her husband Ali, the poor family I visited recently? Aina informed me that Ali had to be hospitalised at Taiping Hospital because “doktor suspek kuman masuk ke otak”. I told her I’ll be going to Taiping Hospital this coming Tuesday for my clinic duty.

This afternoon as I was about to have my lunch, a call came in from Aina. She was sobbing, telling me that Ali “dah nazak”. I wasn’t about to go all the way to Taiping Hospital to visit. Thank goodness we have a volunteer in Taiping Hospital and so after lunch I sent a message to the Taiping volunteer and asked her to check on Ali if she had the time.

The volunteer did go to see them and gave her number to Aina just in case. At least Aina knows who to contact in case she needed help or support.

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I thought I had settled all the fees/workbooks for the children under our sponsorship programme. Apparently Fuzi herself  thought her children’s school payments had all been settled. I have to say I was quite impressed that her children’s fees seemed the lowest compared to all the other children under the sponsorship programme. Well, it turned out, the earlier payment was only for exercise books etc they needed to buy from the school co-op before school reopened. Now the fees are all known and the total needed to pay for her 4 children’s schooling comes out to more than RM400.

So their fees aren’t the lowest after all…

This and that…

Remember the Orang Asli lady staying in an ulu kampong whom I never had the chance to visit as her house is not accessible by car? I finally got to see her personally… by chance! I was at the ID clinic to get some info from the nurse, and at the very same time there was a patient who came in to ask for an MC. Her appointment to see the doctor would be in 2 weeks time, and so usually they are required to come about 2 weeks earlier for their blood tests so that by the time they come for their appointments, the blood test results would be ready in their medical files.

I heard the nurse saying, “Ambil darah aje mana boleh bagi MC, *Wan!”

When I heard the name Wan (not real name, of course), I immediately figured that must be the Orang Asli whom I’ve been talking to by phone just a few days before to ask about her son’s schooling needs. I introduced myself to her, and immediately she responded with, “Oh, ni yang telefon saya hari tu ya?” Hopefully with that chance meet in the doctor’s room, after this she’d feel more comfortable talking to me. True enough, after that she started sending me info via SMS even without me having to ask.

Anyway, I asked her why she didn’t simply take leave from work. “Tak boleh kak, majikan saya strict. Nanti kena buang kerja.”

Ah, another of those no-annual-leave employers, huh?

Wan promised she’d inform me about her son’s school fees, workbooks etc as soon as she gets the chance to go to her son’s school to get the details. Ever since Wan started working, she has been staying in town with a group of friends, while her son stays with Wan’s mother back in the Orang Asli kampong. She only goes back on weekends. I asked if her kampong house is accessible by car. “Boleh kak, tapi kereta yang tinggi lah.” (she meant 4-wheel drive)

OK, so going in my Kenari is out of the question.

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Yesterday I went with a fellow volunteer to visit Nalini’s family. Remember Nalini, the 15 year old HIV positive orphan? When I suggested to the aunt earlier that since the girl has stopped schooling, then maybe she should go for a short course or something – at least to equip her with some skills which she may use for her future. Although Nalini now stays with her aunt, the aunt was the one who suggested that for the first visit, we should go to the grandma’s home so we could discuss the matter with the whole family. She promised she’d bring Nalini back to the grandma’s home for the meet.

Nalini’s assigned buddy then arranged for the meet to be held yesterday. Initially we were supposed to fetch Nalini and her aunt and then proceed to the grandma’s house. Later however, the aunt told my colleague that they’d be at the grandma’s house from morning, so there was no need for us to fetch her at her house.

So off we went, and when we reached the grandma’s kampong, we called Nalini’s aunt, as promised. Although the calls were initially not answered, the aunt finally returned our call. When told that we were already at the kampong, she said she’d call her brother to come and fetch us.

After a while, the brother. Nalini’s uncle, came on a motorbike. We followed him to the grandma’s home, expecting to whole family there, including Nalini and her aunt.

Greeting us at the door was the grandma. No sign of Nalini, no sign of the aunt. The uncle then called someone, I assume the aunt, shouting at the person. At first the conversation was in Tamil, I didn’t understand the details, but he was obviously angry as he was shouting. Later on he spoke a few words in Malay, I guess to make me understand, calling the other person on the line as “bodoh” and the likes. Apparently they didn’t know heads or tails what our visit was about. Nalini’s aunt just told them that there were people coming to discuss about the girl. Problem was, she should have been there as well, together with Nalini, but she didn’t do as she had promised. So both the grandma and uncle were upset and angry. Thank goodness they didn’t vent out their anger at us instead.

Although the grandma just sat there for a while and then went to the back and then out, the uncle did sit down to talk to us. We told him that our main purpose is to get their permission to arrange for something for Nalini so that she’d have a better future. The grandma did mention earlier (before she got up and left us) that she didn’t mind Nalini going for a course if it was nearby. The uncle told us to ask Nalini personally, and if she herself agrees, then they wouldn’t object.

Oh well, we didn’t expect the drama that took place, but at least basically we got their permission to arrange something for Nalini, provided Nalini herself agrees. So I told my colleague to meet up with Nalini, and if possible to talk to her alone, to be sure that whatever she says is not in any way influenced by anybody. No point arranging something for her but she ends up not taking advantage of the help given.

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When I went to visit to Sofie on Friday, she did mention she’d probably be warded for 2 or 3 days. I told her to give me a call once she’s discharged so that she doesn’t have to go up and down the bus to get home.

This morning, I decided to call her around 11 am to check if she had been discharged. Saiful answered the call, “Belum keluar lagi makcik!”

He then passed the phone to Sofie. According to Sofie, on Sunday, the doctors did mention that there was a possibility she’d be discharged on Monday. However the same evening, she fainted when she was in the toilet. The nurses had to carry her back to her bed. So when the doctors did their rounds this morning, there was no mention about discharge.

Saiful missed another day of school today, and looks like he will miss at least another day tomorrow.

I sure hope Sofie will get better soon, so she can go home and Saiful will not need to miss another day of school.

 

Updates from the hospital…

I was relaxing at home yesterday when a text message came in on my hand phone. It came from Sofie’s number, but was actually sent by one of her children…

“Ck fzh mama kne thn wat dkt hsptl ipoh..”

It was already 6.40 pm then, and so I decided to wait until today to visit her.

I do have the special pass from the hospital so I don’t have to wait until visiting hours to visit her. But I didn’t want to go too early in the morning as during those hours the doctors were probably doing their rounds or she may have been brought elsewhere for tests etc. I decided to settle some other businesses earlier in the morning, went to the bank, went to the center, then only 10.40 am I went to the hospital. Having my car parked nearer to the Specialist Clinic, I figured I might as well drop by the ID clinic first to see the nurse before visiting Sofie in the ward. At least to get a better picture of what was wrong with Sofie as Sofie’s stories can sometimes be unreliable… not because she likes to lie, but because she herself doesn’t understand. (well, the last time she had some brain infections, she said she “sakit otak”)

The nurse wasn’t busy when I got in, so I sat down and had a chat with her.

Sofie actually came for her appointment at the ID clinic yesterday. She was so weak, her eldest son, this year sitting for his SPM, had to miss school to accompany her to the hospital. Imagine having to go up and down the bus when she could hardly walk.

Sofie was warded due to allergies to the new ARV medications given to her. She didn’t seem to adjust to the first regime of ARV given to her, so the doctor started her on a different regime. Apparently this time the side effects were even worse. She was so weak she could hardly walk. The nurse got a shock when she saw Sofie on a wheelchair during her appointment yesterday morning. She didn’t expect to see Sofie’s condition that bad. She had lost a lot of weight too (and she never had much weight to start with!). After she started taking the new regime of ARV medication, she couldn’t even eat. Every time she ate something, she’d vomit. Thus the loss of weight. Although the doctor told her to call the ID clinic if she had any problems, Sofie just decided to continue with the ARV and wait until her appointment day.

The doctor decided to get her warded so she could be put on drips and so she can regain her energy. She’ll be off ARV for 2 weeks before the doctor decides to put her on another regime of ARV. Hopefully her body will be able to take the next regime of ARV.

It was almost 11.45 am by time I went up to the ward to visit Sofie. I knew which ward she was in but I didn’t know her bed number. The board outside the ward didn’t have the names of patients at each bed. I thought I would have to go bed by bed to find her but apparently that wasn’t necessary. She was on the first bed. Sleeping on the chair by the bedside was small-sized Saiful, who spent the night there accompanying his mother. Saiful told me he had problems coming back up to the ward after he went down to get some food from the canteen. The guards didn’t believe he was 13 and so they didn’t let him in. Saiful had left his IC in the ward so he couldn’t prove his age to them. However he appealed, saying that he was accompanying his mother in the ward, one of the guards whispered to him, teaching him to use the back way. That was how he managed to get back in.

Sofie looked a bit better today, but she may need to spend at least one or two more days at the hospital for observation.

Anyway, while I was with the nurse at the ID clinic earlier, the nurse told me about a new case. A 24 year old pregnant lady, got married in Thailand to a guy whom her parents dislike. Until now the parents are neither aware of her marriage nor her pregnancy. The last time she went to visit them was during the last Raya, so I guess her pregnancy was not obvious. Her marriage has yet to be registered in Malaysia. She knew of her pregnancy for quite some time already, but only went for proper check-up last week. Her husband brought her to a private clinic, but when blood tests indicated she was HIV+, the private clinic immediately referred her case to Ipoh GH. The doctor at the ID clinic immediately started her on ARV, while the O&G had fixed her operation (to deliver the baby) for early next week.

The husband didn’t come along with his wife during last week’s appointment. Neither had he come for his own blood to be tested. According to the nurse, the lady gave all sorts of excuses why the husband couldn’t come. The nurse ended up babbling to her, to the extent that even the doctor told the lady, “You tengok! Sekarang you punya makcik (pointing to the nurse) pun sudah marah sama you!”

Hmmm… something smells rather fishy. I have a feeling there may be some other facts she may be hiding… like why her parents dislike the guy… why her husband didn’t come along to the hospital… why they didn’t bother to register the marriage…

I have taken down her details from the nurse just now, but I think I will wait until next week when she gets warded at the maternity ward, and this time I probably should visit during visiting hours… with the hope of meeting the husband as well. If the husband doesn’t turn up at the hospital to visit his wife after the delivery, then there definitely is one big stinking fish!

My first clinic duty for the year

Previously, we had volunteers on duty at the ID clinic on the 1st and 3rd Wednesdays of each month. However, since I went back to doing freelance work in July 2010, having more free time to do voluntary work, I decided to take up the 2nd and 4th Wednesdays so we could cover more cases. Otherwise, when there are new cases on the 2nd and 4th Wednesdays, none of the volunteers would be there for the ID clinic to refer them to.

So yep, beginning this year, the duty roster has 2 teams covering the 1st and 3rd Wednesdays, while the 2nd and 4th Wednesdays will be covered by myself and any of the trainees. I’ve already told the trainees I’d be there every 2nd and 4th Wednesdays, so if they want to join, they can join me on those days. However, so far, none of them has taken up the offer. Ah well, if they are not taking up the opportunity to learn (you can learn a lot from the clinic sessions, really), then it’s their loss, not mine.

Yesterday being the 2nd Wednesday, off I went to the Ipoh GH, alone, for my clinic duty. Before that, I went over to the State Welfare Department first. You see, on my way back from the assessment visits on Tuesday, I received a call from a JKM officer, asking me to come over to their office to get our cheque. The grant for my NGO had been approved and the cheque was ready for collection. Alhamdulillah, a good start for the year. We got RM5K.

I wasn’t really in a hurry to go the hospital… usually cases, if any, would be referred quite late. This time, however, the moment I got to the ID clinic, headed over to the doctor’s room to see the nurse, I was told there were several new cases and one was already there. Ah, I didn’t have to wait long. So I went over immediately to the counselling room.

The first case referred was a young chap in his mid-20’s. Unlike many cases where they found out about their HIV when they get warded for any other illnesses, this guy found out after donating blood. He went to donate blood at the shopping complex during a campaign, and a few weeks after, he received a call from the blood center telling him about his HIV infection, and that they’d be sending him a letter soon. He waited, but no letter came. So he went for blood tests at a private clinic and the results came out the same… reactive. Still unable to accept the fact, he went to the blood bank personally and got the same results. Then only was his case referred to the ID clinic.

When I spoke to this guy, he admitted it was still quite difficult for him to accept the fact. However, he was rather calm. He stays with his parents and they don’t know of this latest development. If he shows an upset face, they will somehow sense that there was something wrong. I told him it would be good to talk it out to someone and he agreed to be assigned a buddy so that he can talk to someone outside his family/friends circle.

In most of our cases, the clients would usually feel more comfortable talking in their mother tongue. However, for this guy, an Indian, he specified if possible he didn’t want an Indian buddy in case that person turned out to be his relative. So I assigned him one of my male Malay volunteers.

Immediately after handing back this guy’s file to the nurse, I was given another case. This time a Malay guy, ex-IVDU. He claimed he had stopped taking drugs since 2004 when he came out of the Pusat Serenti, but somehow he still looked like he was still taking the stuff. Even the nurse commented that his guy looked rather “blur”. This guy found out about his HIV when he was warded for TB late last year.

The next case referred to us was an educated-looking Chinese guy in his 40’s. Divorced, no children. He was divorced since 2004, and when asked if there was a possibility that his ex-wife may have been infected, he was very confident she was not. He looked like he knew what he was talking about, so I guess he knew pretty well how he got infected – and that must have happened after his divorce.

One more case was referred to me after that. Another Chinese guy, tested HIV positive when he was warded for TB. He seemed rather confused, and in the process managed to confuse me as well… :) Apparently one of our volunteers had already spoken to him by phone before, when he was just “suspected” of having HIV. Now that he is confirmed HIV+, I decided to assign the same volunteer to follow up on the case.

Those were the 4 cases referred yesterday. All males. All single. 2 were assigned buddies, 2 were not. But I definitely didn’t assign myself to any of the cases, as they were more suitable for the guys.

Next clinic duty will be in 2 weeks time…