ART clinic

We learned about the pathophysiology and we have heard the stats. HIV numbers are staggering in Africa in comparison to home. We knew this before coming, but nothing could have quite prepared us to see it first hand.

This week we (Shelly and Michaela) were working at The Antiretroviral Therapy Clinic (ART clinic). Each day the clients gather on rows of outdoor benches first thing in the morning and place their patient card into a cardboard box that sits at the front of this courtyard, so that their files can be pulled. The files are pulled from many small filing rooms that to us look impossible, yet our Zambian colleagues seem to know them like the back of their hands. The clinic can see upwards of 500 patients in one day.

All the nurses and staff have a meeting to start their day before the patients pile in. They pray for strength and courage and remind each other to treat each and every patient that walks through the doors with dignity, compassion and respect. This part of their daily routine we found to be humbling, and we reflected on how far these reminders could go at home in our workplaces.

Day one was the pediatric day. We hit the ground running and we had to learn the paper work and routines quickly. Some patients were there for full clinical check ups while others were there to pass through adherence counselling only before picking up their medications from the pharmacy.  Some of these children were born with HIV while others contracted the disease as teens. They were missing school to come to the clinic. Due to shortages of antiretroviral medications (ARV’s), some have to come back each month to collect their medications. The process takes most of the day and includes long wait times in the heat. Despite these challenges and hardships we did not hear a single complaint. The rest of the week passed and we had the opportunity to work alongside the doctors, clinical officers, adherence counsellors and pharmacists. For us the rooms seemed small, hot and crowded; however, our Zambian colleagues championed through their day.

The staff is working hard at implementing a community adherence group (CAG) where people who live near each other, and are doing well on their medications, can send one person to collect the medications for groups of 6. They are facing some barriers related to processes and resources. 

We experienced a day with a counsellor testing people for HIV. We saw fear while they were waiting for the result, relief wash over those with a negative result and despair in the eyes of those who tested positive. The campaign in Zambia states “Know Your Status” and we can not even begin to fully understand the courage that it took to come get tested in the first place.  This week being in the Art clinic we saw that there are many positive strides being made in the fight against HIV. Our Zambian colleagues are working hard and making great progress towards the 90/90/90 goal; Where 90% of people are aware of their status, 90% of those with HIV are on treatment and 90% of those with HIV have a suppressed viral load. Overall this week we were so very struck by the resiliency of the hundreds of faces we had the pleasure of meeting.

Shelly and Michaela