Monday, November 10, 2008

Fearing the Unknown

When we first arrived in Kaabong back in June, some village elders found out that I was a nurse and people started showing up at our compound all hours of the day. After several crazy months of seeing sick people whenever they chose to show up, I’ve gotten the community into a schedule that works better for me and keeps me sane. First I had to seek permission from the Medical Supervisor at the hospital to be treating people for minor health problems. It’s really just a lot of first-aid that I do on a day-to-day basis. I now see people on M/W/F and some Saturdays from 9am-1pm (African time…so I’m usually late).

Last Wednesday, the first two patients I saw were men who both had scabies. Basically, scabies are mites that get underneath the skin and make people itch. When someone comes to me with this problem, I make them bathe first before applying Malathion cream to the affected area. I gave a bucket of warm water and a bar of soap to the first man who complained of this problem. He was a thin but well-dressed man. While he was bathing, the other man came and presented with the same problem. I told him to go around back and bathe with the first man. Men here all bathe together and don’t mind nudity as much. The second man went around the shed but came back quickly and said he wanted another bucket, different water, and new soap. I was perplexed. I asked what his problem was but he wouldn’t say. He got a new bucket and headed down to our borehole (well) to bathe there. While he was gone, the first man presented himself before me clean and ready for the lotion. I held the bottle and poured lotion into his hand so that he wouldn’t contaminate the bottle by putting his fingers in the medicine. He smeared himself up and walked away happy. The second man returned from bathing five minutes later and I asked if he was ready to put the lotion on. He asked me if the first man had already used lotion from my bottle. I told him ‘yes’. He then politely refused the lotion and said he’d be on his way. Again I asked him what was wrong and this time he said that he didn’t want to use the same lotion that the other man used. I informed him that I had poured the lotion directly from the bottle into the man’s hand and that the man had not handled the bottle. Still, the man refused and left. Later our day guard explained everything. The first man who had come for scabies treatment was HIV positive and the other man had known this. He was scared to touch anything that the first man had touched, even refusing medicine from the same bottle.

As I talked with our day guard about the need for HIV education in the area, he agreed that most Karimojong people have misconceptions about HIV. School children are taught about HIV but many, many people don’t go to school and don’t receive this training. As a result, those with HIV carry a stigma. It’s really a sad situation that people don’t understand the disease and treat others badly as a result. I tried to think about how we treat HIV positive people in the U.S. and I’ve realized that it’s not much different than the Karimojong treat their people. Deep down, many Americans still hold fears when around HIV positive people and even an ‘advanced’ society discriminates against their own.

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