People are started on the medicine when they have HIV and their CD4 count is less than 350. This is because they are now at risk for many other infections that are life threatening with AIDS (TB, pneumonia, Karposi Sarcoma, etc). The government in Zimbabwe provides the medication (they actually get the medicine from the Global AIDS Fund). Only hospitals can start people on the medication however clinics can then give people their medicine. People must always go to the same place to get their meds (here they get them for 2 months at a time).
Sister McCarty starts people on the medications here. I have sat in with her on her counseling sessions that she does when starting people and it is very interesting. Kathy will not start people unless they bring their spouse or a responsible adult that they live with. This is to ensure that someone will help make sure the person takes all of their pills. She also insists that their spouse and all of their children are tested before starting them. It is a huge committment for these people to start the meds because it is for the rest of their life (which can now be many many years because of the medicine).
I went on the ART Outreach with 3 other nurses and a nurse's aid (Mooty, Benny, Juliette, and Mother). The clinic at Kapfunde is by the high school and the primary school their but they actually have their own building for the clinic. When we arrived a crowd of men, women and children were waiting out front for us. We unloaded all of the medicine (two large chests of it). Mother said good morning to everyone and they started dancing and singing. Then Mother made sure that everyone knew all of the nurses. They want to make sure to make a connection with the people at these clinics so that they keep coming. Of course they had never seen me before so she introduced me to all of them. She told them that I was from America and that I would tell people at home about the clinic and what we do here. They believe here that if you trip over a rock it means someone is talking about you. So she told them if that happens it means I am talking about them.
After the singing and introductions we had to pass out all of the charts for people (there were about 300 people there). There were so many people that we divided up the charts and had to call out all of their names. People were laughing when I tried to pronounce their names and I kept having to ask Juliette.
Once the people had gotten their cards, they got in line to be weighed by Mother. Then they came into the room where we were to get their pill bottles. Benny and Mooty filled out all of their medical cards and then Juliette and I handed them their pills depending on what regimen they were on. It took almost 4 hours to pass out all of the medicine (over 1,000 pill bottles). When one woman was leaving, she turned to me and in English said, "Thank you for giving us a second chance at life." I was a little embarrassed because I felt like I had nothing to do with it really, I was at the very end of the line distributing it (and it had been going on without me). But I wish that I could be making an impact like that and it reminded me why I love doing this.
We packed up to leave. Juliette asked me if I had ever used a Blair toilet. I said I hadn't yet. Luckily at the hospital and the guest house we have real toilets- but everywhere else around here they only have Blair toilets. These "toilets" are really just holes in the ground. I went in and looked and decided to hold it until we got back to the hospital.
On our way out the Sub Chief said hello to us, he was an old man with clouded blue eyes (made it almost look blind but he wasn't). All around here are tribal lands so there are chiefs.
Passing out medicine at the ART Outreach in Kapfunde
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