Home visits

This morning we went to AHC early to meet with the director of Home Care so that we could go on a home visit, an hour’s drive out of the city in a very rural area. It is so rural that instead of an address, the family must draw a map to the home when they are set up for home care. The house was on stilts as they all are, so that when the rains come, you have some hope of staying dry. This first house was home to a 3 y/o and her mother, both HIV positive and on therapy. The child had been hospitalized for 6 months when first diagnosed and was quite ill as you can tell from her tracheostomy scar. She is small for her age with thin hair, but she hugs her teddy bear and rocks it- a sure sign that she is loved and cuddled. The nurse is the sweetest man. He takes time to play with the child before he examines her, and he is gentle, professional and very kind. I was close to tears when he opened a new package of pajamas and with great tenderness, dressed the little girl. The child has been home for 6 months with monthly home care visits and during this time she has not required hospitalization despite less than desirable blood work. Before we left, he gave the family a bag of food, standard care for home visits. The food included fresh fruit, vegetables, dried fish (a staple), eggs and rice. A different group delivers large bags of rice to each of these families monthly and the hospital provides seeds so that the families can grow some fresh greens.
Our second stop was closer to Siem Reap The little girl came out to meet the nurse and was clearly happy to see him. This child has been on treatment for two years and is a nice size with shining hair and a great smile (except for the cavities). She appears much healthier than the first child and is very pretty. She also got new pajamas but was clearly waiting for the food bag. When it was opened, she grabbed the bag of fruit, and then took the sausage bag as well. I do not know the name of this fruit but it is reportedly quite sweet and she seemed very excited about it.
The homes are on platforms and consist of one room. The floors are slats with gaps so dirt and trash fall through. Chickens abound and walk into the houses (think bird flu) and there are wells. Trust me when I tell you the water does not smell nice. They lay mats on the floor to sit and sleep and the kitchen, well – it is one of the pictures since I can’t describe it. On hot days they sleep in hammocks under the house and there are hammocks upstairs as well.
This organization does very good work. The standard of care in the hospital is high and the quality of care is good. This home care program is working and I was delighted to learn that the medications for the HIV patients come from USAID. One funny note- at lunch one day we were accosted as usual by children trying to sell us stuff which we declined to buy. In an effort to change our minds the young girl started to recite facts about the US- the capital, the population, the upcoming president’s name and the current president’s name. The other, younger girl pipes up- “and nobody likes George Bush”. She must have been about 9 years old- we cracked up.