Africa Vision 19

Africa Vision 19

Bebedja, December 10, 2007

One week in Bebedja

Time flies when it is quiet. What a great week it has been. Getting to know more about the province of Longone Oriental, the people that live there and the hospital in Bebedja. Tonight I left the hospital terrain to go for a fruit shake. A lovely papaya, banana and guava shake. It was so good I took two huge jugs. Dromir and I paddled at bicycle speed through the back lanes of Bebedja on his motorbike as the manholes here as big as men. Road construction and it may take some months more.

Bebedja lies on the main highway (big word for a two-lane dusty road) and it is from there that some of it specific problems come. All over town are little bars and restaurants. Truckers and travelers from all over the country on the way to the south east of northwest drop by. For as little as 2 beers or a meal or two to six dollars girls sell their services for the night. It is not surprising that Bebedja has such a high number of HIV positive people living in town. Some estimate may be up to 20% amongst the group of young adults.

A second boon with some major ramifications is the oil that has been found nearby. Men come from all over the country to work in the region and when while their wives are still in the cities they come from in Bebedja or Doba they find solace in mistresses or girlfriends for the night. Fights and traffic accidents at night are also common as is alcohol intoxication. There are campaigns ongoing to prevent the further spread of HIV. But it is clearly an uphill battle. In that context the work I saw in the HIV clinic was very positive.

I sat in part of the morning for the consultation of those patients included in the program of antiretroviral drugs. It was impressive to see how serious most of the patients are with their life long medication and how much they adhere to the monthly drug controls. For a check up of their CD4 (an indicator of cells in the blood showing how successful the drugs are in suppressing the virus) they need to go to Mondou a costly day trip up and down. Mexican sisters (2 nurses and a doctor run this program) and they work in a building next to the hospital two days a week.

Even with the best of care and treatment opportunistic infections are still frequent. Tuberculosis, fungal infections and malaria are common. The treatment of these infections is not always straight forward as there is interaction between the antiretroviral drugs and the other drugs.

Several of the patients are admitted to the hospital. One of them is pregnant and has been coughing for 3 weeks. None of the antibacterial drugs have helped until now and the suspicion is that she has tuberculosis. In an ideal world this lady would have a caesarean section, would not breastfeed but feed by bottle, and after delivery the newborn would receive antiretroviral drugs for a week. Our surgeon however has left for the capital two weeks ago and it is unlikely that she has enough money to afford powder milk.

Bottom line remains that several hundred patients are receiving affordable life saving drugs in a setting where basic drugs or vaccinations are often missing. All in all this is a major feat.

See you soon,

Ashis