Monday, 26 November 2012

A long walk

In the run up to World AIDS Day 2012, the UNAIDS has put out a global report on the HIV epidemic.  Called 'Results', the report is upbeat as it tells of massive reductions in new HIV infections over the last decade (700,000 less in 2011 than in 2001), huge increases in the numbers of people taking ART (8 million world wide now - over half of those eligible to take it) and big reductions in the death rates (500,000 fewer people died of HIV in 2011 than in 2006).

We celebrate this and are thrilled to see some big-picture changes!  We have seen some of these shifts first-hand in our own work.

When we started out in 2002, Jeevan Sahara Kendra was basically caring for the dying, Today our team provides a continuum of care which starts with encouraging people for testing, talking through what the results mean, helping those with HIV assess the progress of the disease, working out a treatment plan and starting on the appropriate ways of treating including in-patient admission if needed... all the way to end of life care when we see the meds just not kicking in any more and what the person and their family primarily needs is comfort care.   All along we are committed to whole-person care through listening, caring, praying, helping care-givers and linking up with people from local churches.

At the level of our friends who are living with HIV, things are still very far from being rosy.  We do see people living so much longer - but the challenges remain.  Daily.

Last Friday we reviewed the weeks work at JSK  - and these are notes about four of the priority patients that one of our home-based care team has.

a.  Mrs. Tamarian (all names changed of course) continues to suffer from long-term bleeding.  The govt. hospital has refused a hysterectomy a number of times.  Her son needs to have his viral load done, but Mrs. Tamarian is avoiding the team.  She is depressed and wants financial help, but does not take positive steps to meet regularly with the people from the local church.  Our team is frustrated by the passivity in Mrs. Tamarian - esp. with the various options that she has.

b. Mrs. Langru is living in an abusive relationship.  The man she has her child with has left his wife and is living with her, but is beating her regularly.  The team is at wits end about how to help Mrs. Langru and her small infant child.  Mrs. Langru's behaviour in the past has been erratic.  Her current choices continue this path.

c. Mrs. Nandu and her two daughters are just not taking their ART well.  Each week at least one of them will forget to take their doses.  The team has made charts, followed up repeatedly, talked and prayed with this young widow and her adolescent daughters, but real change just does not seem to take place.

d. Mrs. Bani has been taking her TB medicines from a private doctor.  She is irregular on them and needs to be shifted to free meds from the government.  The team is also trying to get her into the free treatment stream for her ART meds as she is spending a lot at this time.  Mrs. Bani seems disinterested in her treatment at present.

Four lives. Each very complicated.  Each enmeshed in various levels of relationships (or lack of relationships) with their extended family and people around them.  Our team tries to visit them regularly - to meet and understand - to encourage and to pray - to help make positive steps forward.

Its a long walk

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