Arjun in Kakamega

RECAP OF THE DAY:  Woke up really early, had to rush off to work to make the training session at 8:00 am, got there, no one was there yet, I was really upset, then everyone randomly showed up at 8:15 am, we started, everyone came to the training, it was really good, I felt a little sick after so I went home, rested until after lunch, Peter and company came to visit to make sure I was okay (aaaw), we talked about my projects, went back to work, started typing up description of the training, worked on patient waiting time survey, the data collection is finished, now all we have to do is analyze everything and write the report, I posted a memo to the hospital about the waiting time survey, people seemed really interested in it, had an interesting discussion with Charles Aluvisia about the Comprehensive Care Clinic, came home, started working, going to sleep early because of training tomorrow morning, going to Kisumu tomorrow to get some equipment, hopefully the grant results and online fundraising starts soon, sleep.

REFLECTION

I’m glad to report that the emergency responsiveness training is off to a good start.  People seem interested, especially the non-medical staff, so it’s looking good.

I had an interesting discussion with Charles Aluvisia today, a man I have come to respect greatly at the hospital.  He’s an elderly guy who works as a volunteer in the Comprehensive Care Clinic.  He is HIV-positive and has dedicated himself to counseling other people living with the disease, connecting people with the disease to form support groups, and ensuring that people with the disease adhere to their ARV treatment.

To overcome the cultural stigma associated with HIV is one thing, but to then dedicate one’s life to supporting others with the disease – all for no pay – is something else altogether.  Charles and other volunteers at the CCC are the most spirited group at the hospital.  In fact, during the patient waiting time survey, the CCC turned out flawless timecards and had almost 90% of their patients return them.  Compare this to the 70% of patients who returned cards from the outpatient ward and the fact that half the cards we got were not filled out correctly.  The only difference, really, is the mindset and the work ethic of the people involved.  Charles is always excited to be at the hospital and is putting in a ton of effort into co-training with me.

Seeing someone I respect then talk to me about the discrimination he faces on a daily basis even within the hospital makes me really upset.  He and the other volunteer counselors that work in the CCC are not allowed in the hospital kitchen; they related to me a story about how they were yelled at for getting a cup of tea from the hospital canteen, and they showed me a posted sign that prohibits CCC volunteers and patients from entering the kitchen.  If this kind of ignorant discrimination can persist in a hospital, where people are fully aware of how HIV is transmitted, can you imagine what kind of treatment these people receive in the community?

I wanted to do something for Charles and his team of volunteers.  My desire is to get them on the hospital payroll, something they deserve, especially since they serve more patients than most of the rest of the hospital staff on a daily basis and have positively affected more lives.  What did they say when I asked them what they would like?  A motorbike.  Why?  So they can travel to remote areas where HIV-affected individuals live to counsel them, make sure they adhere to the ARV treatment, and deliver medication.

We’ll ignore for the time being that these people – who probably need money the most of anyone I’ve met so far, given that they earn literally no money – asked not for money but instead for a tool to expand the scope of their public service.  We’ll focus instead on the specific thing that they asked for:  a motorbike.

As it turns out, there is a shiny new motorbike locked away in the hospital garage that has been there since I arrived at Iguhu and has not moved in the three weeks I have been here.  Apparently, the Ministry of Health Services gave four of these things to the hospital a while back to use during public health trips.  One of them is in use, and given that the hospital owns two large vehicles which are more often used for public health trips, this particular motorbike is never used.

I tell this to Charles, who knows about the motorbike.  The thing is that the motorbike was given to the hospital for use by “the hospital staff.”  When “they” got the motorbike, Charles tells me, the use of the motorbike by the CCC was out of the question, because he is not considered one of “them.”

I am outraged at this on many levels.  Charles and his team of volunteers are single-handedly attacking a continental epidemic on no pay.  They see dozens of patients a day, host counseling sessions, distribute ARV treatments, test CD4 counts, keep diligent records, connect patients with others, and more.  It is outrageous to me that they are not considered hospital staff.  I can identify ten individuals who work at Iguhu who do less work than anyone in the CCC but are paid.  So it is ridiculous that CCC volunteers have to donate their time in the first place, but it is even more preposterous that they are denied the tools they need to serve the community better.  It’s as if the hospital doesn’t even appreciate the time and effort that they put in.  Let me tell you something – these people are pillars of public health in the community, absolute pillars.  And at Iguhu, they are taken for granted and abused for no reason.

I get along with the Iguhu staff pretty well.  I like everyone, and everyone is okay with me.  There are a lot of things that I disagree with about the hospital, but I hold my tongue, keep my head down, and do what I can.  But this is the battle I have chosen!  I’ve decided to organize all of their data, analyze it, and demonstrate empirically how valuable the CCC volunteers are.  I’m then going to present it to hospital administration and as many members of the Ministry of Health Services that I can.  I’m also going to MAKE SURE that the volunteers are allowed to use the random motorbike that the hospital has.  This cannot stand.

Even if you look at it from a “sustainable development” point of view, this is terrible.  We’ve talked a lot about avoiding aid and moving toward development.  Iguhu is relying on aid – donated, free time – to handle the AIDS epidemic that continues to rage across the country.  That’s not sustainable.  It’s time that everyone in the hospital affirms their dedication to fight the epidemic, not just those who have already been affected.

In other news, the border that I helped build in front of the hospital has begun getting painted.  It looks good!  Check out the pictures below.

Green and white border

...and more

...and more. Feel free to tell me how great this looks.