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Jaribu – uone (Try and you’ll know) Swahili proverb. I’ve been in Kenya three weeks now and it’s strange how the time feels both short and long. My Swahili feels like I am still on day one, my knowledge of HIV management just beginning, and the friendships I’ve formed seem like we’ve known each other for months already. From the start of my rotation, the clinic staff enveloped me into their vibrant community and the patients spoke honestly to me about not just their diagnosis, but about their lives and experiences. Each day has brought new knowledge; how to treat the complications of HIV, the challenges of the health system and the individual struggles patients go through to maintain their health.
The Coptic Hope Center provides a full spectrum of services to HIV patients including counseling, antiretroviral medications, social work services, nutrition advice, and the prevention of mother to child transmission. I’ve had the amazing opportunity to rotate through the various departments and see how each of the different services compliments the other. A patient will receive a new HIV diagnosis as they sit with counseling ready to discuss their emotional needs and helping them to understand what the diagnosis means. They will then see a nurse and doctor to screen for opportunistic infections and be started on antiretroviral treatment that takes into account their other health issues. They’ll meet with social work to discuss how they can overcome financial challenges and, finally, they may meet with Family Planning to discuss what birth control options make sense for them at this time.
I sat with counseling today and struggled to hold my tears as a woman received a new diagnosis of HIV with her brother at her side offering support. She had had a preliminary positive test result last week, prompted by some mild lymphadenopathy, fatigue, and a sore throat. As we showed her the blood test that confirmed, yes, she was in fact HIV positive, she broke into tears. “I had hoped the first one was a mistake. I had hoped so much.” She and her husband had been married for years and had two children together. She was angry and shocked, but most of all, she wanted to know if she would live long enough to take care of her kids. We assured her that with adherence and proper health maintenance, she absolutely would. We sat in silence for a lot of the visit. And it seemed to be exactly what she needed.
I had little idea of what to expect when I stepped off the plane three weeks ago to a country, even a continent, I had never been before. While I have lived overseas on my own, the challenge of being surrounded by a language completely foreign to me, and stepping into a clinic where I had little expertise was daunting. Each day I walk into the clinic, my white coat folded neatly inside my backpack next to my lunch, and find bravery thinking of how strong, honest, and trusting the patients are that I meet here. They have often traveled for miles to Nairobi to give care- making my own dusty walk to the clinic seem very, very short.