Monday, May 10, 2010

More Assessments and a Visit to a Clinic

My trip today with Ribbon of Hope Self Help Group took us to Lomolo, about 40 minutes cycle from Mogotio and the main road. The conditions were not too bad, despite heavy rains recently. We visited three families, one of which has two orphans. As with the other villages, everyone seemed equally deserving and, no doubt, there are many other deserving families and orphans in all the places we visited.

There was a woman with twelve of her own children (two of whom are grown up) to take care of, yet she is also taking care of a teenage orphan who is doing very well at school. I really don't know how she makes her meagre income go so far! There was also a woman with no children of her own who is taking care of two orphans (who are not siblings). One of them is HIV positive, the other may be, but has not been tested. And there is a young mother who is so sick herself that she is finding it difficult to look after her one daughter.

Once we have done the assessments we can get a better idea of how we can help, especially in ways that will support the whole family. We need to find income generation activities that will give the family extra money and some of that money needs to be forthcoming very soon. Everyone we have spoken to has arrears of some kind, along with bills that soon have to be paid. People do a combination of borrowing and begging sometimes, but most very poor people don't have easy access to microfinance.

On the way to the village, we passed a man who had to make the difficult and expensive trip to Mogotio to see the area chief. Apparently, the microcredit organisation he went to insisted on him getting a letter from the chief. In addition to the time and money (including lost earnings), the chief will require some money, too. Asking someone in a position of authority just to do their job doesn't come cheap.

After the assessments, we went to see a client who is in a local clinic. He's very sick, either not responding to his antiretroviral (ARV) drugs or just not taking them. Neighbours say he was drinking a lot, which often results in people not adhering well to their drug regime, for whatever reason. The drugs are hard to hold down when you don't have enough food but also, probably, when you have a hangover.

Anyhow, we didn't get to the bottom of it because he had such a bad bout of meningitis that he looks like he is recovering from a stroke. He is finding it hard to talk and is difficult to understand. My colleague says he probably has other impairments in addition to his speech. He is emaciated and weak, which is not surprising. We can only hope that his current condition improves and he gets back to his ARV regime. But it's not a foregone conclusion.

On the subject of medical facilities, there was an article in the paper recently about an assistant health minister who visited a hospital in Bungoma, unannounced. I don't see the point in letting a hospital know you are coming as many things can be done to make conditions look better than they are. Anyhow, the man got many shocks. He saw how long people had to wait, some even dying as they waited, the arrogance with which people are treated, the conditions in the hospital and the tendency of people working there to try to cover up things. There were even the bodies of some children that had been left on a bed and he was told they were sleeping.

The man must have a fair idea of what things are like in public hospitals. If he doesn't, he should look for another job. Hospitals are underfunded, understaffed and cannot deal with the number of patients they get. The staff are often not very well trained, they don't get paid too well and they are underequipped. Drugs and other things are in scarce supply and buildings are old and crumbling. These are the conditions in which, UNAIDS claims, only 0.6% of HIV transmission comes from unsafe medical practices. Just how much evidence do they need that this claim should be reconsidered?


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