This will be my last post from Addis, but I do plan on posting more pictures and some stories when I get home, where the internet is something I can lovingly take for granted. We have spent two weeks doing some amazing things, and so much of it would not have been possible, or at the very least would have been so much more difficult, without the generosity of all of you—but also of Bekah and Jonathan Dhillon, who are living and working here with their two young children for a year. Keep them in your prayers as they round out their year here in Addis.
Yesterday was spent with the HIV and TB project where Bekah and Jonathan work. I had an amazing day talking about HIV care here in Ethiopia and HIV care in the US. It was great to be able to share research results with them on some of the projects I jave worked on for the last 10 years through IMPAACT and PHACS. I was able to talk about our HOPE program, and they talked about the issue of women continuing to have babies after diagnosis. The thought initially was to counsel them to have no more children—kind of like what we were doing not that many years ago in the US. They found that no matter what type of counseling they gave them they still kept having kids. So we talked about the HOPE program and how a counseling program for healthy pregnancies is something that they could possibly entertain. It’s hard when many time the pregnancies might not be planned by the women and may be a product of "coercion". So, again empowering women with as much information as possible may be a better way to move forward, and they were discussing just that.
In the afternoon I was able to see several of their HIV + children. This was so interesting and so much fun for me. I loved seeing kids with HIV and talking about their health histories and their medications and providing some education to the health care providers, as well as to the families when I could. I also really was able to learn so much about how the care of kids with HIV in the community differs from the care provided in an orphanage setting, and also about their similarities. Again, the same old problems with adherence are universal when the kids hit adolescence. One thing that’s clear is that some of the kids who were not yet on HIV medications probably should be, and we would likely see some great growth and better overall health if they were. This project was willing to fund more viral loads for the kids, and we talked about when a viral load might help. I shared some case studies of the many kids who come home from Ethiopia with that dreaded K103 mutation-making, non-nucleoside analogue—a poor choice in the long run. They all agreed it was due to the Nevirapine used in PMTCT (Prevention of Mother To Child Transmission). It was one of my favorite days in Ethiopia, just being with Beakh doing the home visits and seeing patients in the afternoon and just getting to talk about HIV care and ways to improve it.
Today I visited an another orphanage, Kidane Mehret, and that was an awesome experience which I will share with you all when I get home. All the orphanages (care centers) I visited were so different—they all had similar challenges—but the overall feel and they way they handled things were unique.. Thanks again to all of you for following me and supporting me. More pictures and stories to follow.
Love,
Emily
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