Looking towards the future

Found the blog meant for Tuesday:

I am writing this blog at a much earlier hour because we had to leave the clinic at 12:00 today because Shola, our local coordinator, was worried about our safety during the strike. Apparently because the unions and the government have not come to an agreement yet, the strike is in full force and many of the striking workers target hospitals and clinics. They do so because they know the nurses and doctors are still going to work and getting paid while the strikers are not getting paid and fighting for a salary increase that the doctors and nurses will benefit from. While this is justified, it is definitely beginning to have an impact on our program. We hope that tomorrow we will be able to go to clinic. Even though we only got in about 4 hours today at least we got to go.



Today I shadowed a doctor and his staff who are a part of a research study (I do not have all of the details with me because I stopped by my house before coming here and left my notebook there) that began in January 2007 and is being conducted at 5 sites around South Africa to study HIV positive pregnant women during their pregnancy and during the first 18 months of life of their children.



In order to qualify, the women must have a CD4 count between 200-500 (below 200 is a diagnosis of AIDS). Then a random sample of these women are given ARV treatment between 32-36 weeks. They are then followed throughout the life of their children. A key part of the study is focused on whether or not the women feed their children by breast milk or formula. While the US recommends exclusively formula to babies with HIV positive mothers, WHO (World Health Organization) recommends exclusive breastfeeding during the first six months. They do so because if mothers do not have the ability to give sanitized formula (AKA do not have a stove or running water) it is better for them to give the babies breast milk because they are more likely to die from an infection from unsanitary water. The women are paid to participate in the study, however the doctor overseeing the study at the clinic said that of course ethically the baby and the woman's health are put first. It will take 4-5 years for the study to be completed and will involve a sample group of 1500 women. The results of this study will most likely rewrite the current WHO protocols according to the doctor I worked with.



Before meeting the doctor I had a chance to sit down with his nurses who wanted to know all about our health care system. They thought that the US had universal health care, I told them we didn't but once I got into the particulars of our system they felt like we were still ahead of them in terms of the health care we provide in America. For instance I asked them if they saw a lot of HPV or cervical cancer and they laughed. They said of course they saw a lot of it: The South African public health care system does not mandate pap smears until age 30 and then only every 10 years after that (unless of course a woman under 30 comes to a clinic with symptoms requiring a pap smear). When I told them the ages we typically start doing pap smears and how often they are required and how many women avoid getting their pap smears they couldn't believe it. We have so much to be thankful for.

Speaking of being thankful, our family (myself included) absolutely loved Regina's dinner. The girls were all gathered in the kitchen with us asking us what we cook and how we cook it. I told them about burritos--they had never heard of a tortilla so I said I would make Quesadillas.

Until tomorrow, sending my love to all.