While serving in the Peace Corps, I worked on completing my Master’s in Public Health with the University of South Florida through the Master’s International Program. I chose to forgo the typical thesis to have an adventure and do a real-life project instead!
I volunteered in the HIV Treatment center at the Hospital in Buea, Capital of the Southwest region in Cameroon. The hospital and my position with Peace Corps was partly funded by PEPFAR (President’s Emergency Plan for AIDS Relief).
Left: Location of Buea, captial of the Southwest region.
Middle: Me with the hospital administrator.
Right: The hospital tucked in the foothills of Mount Cameroon - a beautiful view to see every day walking into work!
The center is called UPEC (a French word that, for the life of me I can’t remember!) We serve over 3,000 clients a year giving them life-saving medicine and support. The clients (sometimes up to 150+ a day) would start arriving at 6am and wait to be seen to get their pills for the next 3 – 6 months. In true African time, we would arrive at the hospital in the morning usually around 10am and grab their workbooks that had been placed on the stool outside the door (making sure to keep them in order!). We don’t have an appointment system for them to sign-in, so their book is the placeholder for their turn. The clients are responsible for their own medical book with the date of their next visit, their updated numbers and pill regimen; while we hold a file with their medical information. Some clients are healthy, others are not doing well. There is a Doctor on staff who diagnoses and prescribes medication. However, the clients can’t always afford the money to get a prescription if the medicine is even available that day. We call them one by one to take their blood pressure, temperature, weight and update their lab numbers. It is difficult for the clients some days when the machine that gives their updated numbers is broken (which is often), they make the best of the situation.
Left: The client files. We sort their books and find their file to update all their paperwork by hand.
Middle: A coffin from the morgue on top of a van for transport to the burial site.
Right: The only Hemodialysis center around for miles.
The barriers to care in Cameroon are tough for the people to overcome. Transportation is a big problem, especially if they are coming from a small village where it can take an entire day to make it into Buea where the regional hospital is located. Most of the villages are accessible only by motorbikes and the older men and women cannot physically handle the voyage.
Another barrier that exists everywhere in the world is stigma. People are afraid of what they do not know. And most of the time, myths about HIV keep people from understanding the virus. Many people believe you can get HIV through methods such as sharing a cup, towel, etc.
The barriers create what we call a “loss to follow-up” which means the person has missed their appointments for months. We search for the person in order to get them back on medication, or in the case they had passed away to update their file and offer condolences.
Left: My co-workers “Auntie Cathy” on the left and my Counterpart/Supervisor “Aunty Cathy”. We refer to each other as “Auntie” or “Uncle”
Right: Me and Auntie Sally
Here are a few HIV facts:
· Transferred through blood, used needles, semen and vaginal fluid.
· There are many strains of the virus and a person can be re-infected with a different strain.
· Cameroon has the most variety of HIV strains.
· The cycle exists through adolescent girls and older men. The men infect the young girls who then infect their counterparts. The adolescent girls get money, security, comfort, food, etc. from the older men and in turn get infected with HIV. (This has been proved through various studies and trends in data). This process is known throughout all the world as means of survival for women (and some young men).
· An HIV positive woman can give birth to a HIV negative child.
· A discordant couple (one HIV+, one HIV-) can have a baby without the other partner or baby becoming infected.
· 1 in 5 people (20%) don’t know they are infected.
· HIV is the virus and if left untreated, it turns to AIDS.
HIV is so common in Cameroon many believe it’s only a matter of time before they are infected, so protection isn’t necessary.
HIV/AIDS does not discriminate.
Apart from doing initial intake, I worked in the counseling room where community members would come to get tested. I gave them pre-test counseling about HIV transmission; most of them had no formal knowledge of the virus. I also did post-test counseling where I gave the person their result. This was the hardest part of the job and I did not take it lightly. It is interesting to witness people accept a positive result. This is because they see it as inevitable which is not true, it is preventable by 96% when those who are positive take medication.
My favorite part was working with the children at our clinic. We had a special Saturday each month dedicated to teaching children who are HIV positive about their lifestyle and diagnosis. We help the caretakers (many children are orphans from HIV/AIDS) take care of the child and offer support to explain that they are HIV positive. It was a humbling experience to witness these children living a strong and healthy life. All the children at our clinic were born HIV positive through birth which is preventable through planning and medication.
Transmission of HIV to a child through delivery or breastmilk can be prevented. The women must be on her medication which makes the virus weak and will not be able to get passed along. Unfortunately, not every woman has access to good healthcare; therefore, many children are exposed and become positive through delivery or breastmilk.
I worked alongside amazing women and men who are loving, caring and supportive. They welcomed me with open arms and made me feel at home the first day I showed up to work. I wasn’t sure what I would be doing, but they really helped me learn the process and even let me practice my Pidgin! They never made me feel insecure or out of place. I felt loved and accepted, the most I’ve ever felt in my life.
A party to celebrate becoming an association at the hospital isn’t complete without matching outfits!
The project I completed for my master’s degree included teaching Malaria prevention to people with HIV because they are more susceptible to disease and sickness. I designed a poster to teach the clients how to protect themselves from Malaria.
I did various HIV education and testing events with the help of the hospital staff. I also taught at small groups around the city and gave talks on HIV education and transmission, menstrual health, and healthy relationships.
Left: Testing in the filed with my co-workers.
Right: The tent to draw them in and help decrease the stigma by making testing more available.
A unique experience to put together a testing event in the community! In the states, I wouldn’t have been able to do this since I am not qualified.
There is so much information and I could go on and on about my experience of people living with HIV and the clinical process, but I will end here. If you have any questions or want to learn more about the barriers to care you can email me at the address below.
Knowledge is power!
This is especially true when learning about other cultures and a virus so massive with a broad history and a mystery to most of the world.
The experience of serving with the Peace Corps was the most life-enhancing adventure for me. I miss Cameroon and my people every day. Not a day goes by that I don’t think back on my work and what I learned from the people that surrounded me. Writing this blog has been good for my heart, it has called me to remember the simple life and how much value it holds. Richard, my husband and I plan to return to Cameroon one day, Lord knows when, but it can’t be soon enough!