The past few days, I have administered all of the observations on every patient we visited. Compared with the first round of blood sugar and pressure tests I did, I became increasingly more accurate and comfortable with each patient. I quickly learned that often times, I need to squeeze a patient’s finger tip after I prick it (especially with elderly patients or ones with poor circulation), to make sure enough blood comes out for the blood sugar device to accurately read and that the blood pressure band will actually not work properly if I put it on upside down.
Although HIV/AIDS is the main ailment that people associate with Sub-Saharan African, there are a multitude of other chronic illnesses that burden the local people. Plett Aid’s main initiative is focused on end of life care and assisting patients to a comfortable and dignified death, so as a result I have seen many more elderly patients dealing with a multitude of ailments rather than people living with HIV. The exposure to varying illnesses and people in ranging socioeconomic situations has allowed me to postulate questions and explore the South African Health care system as a whole, rather than strictly focusing on HIV/AIDS.
Tuberculosis (TB) is a very common disease HIV positive patients develop because the immune system becomes extremely opportunistic to infections when the CD4 cell count is considerably low. Diabetes and hypertension are also very prevalent, as well as various types of cancer. Another very common issue in African townships is poor circulation, which in turn lead to ulcer sores and unfortunately a large number of amputated limbs because of lack of treatment or poor care. Families will neglect to clean the sores and they become increasingly potent. The open wounds spread bacterial infections through the body and often times cause the limbs to become septic. As the infection increases through the limbs the patients continue to refuse to go to the clinic because of reluctance or pride or even downright negligence of personal care. The older patients often believe that they are already old so one sore can’t make things worse. I am unsure of how an amputated leg is a positive alternative to going to the clinic for a small sore, but all of the people I have seen with amputated limbs do not seem too remorseful for their negligence in personal care or they are incredibly skilled at staying positive in the face of adverse situations. One man even exclaimed that he loved his “little nub” after a nurse changed his bandages.
I find it astonishing that I have seen close to 10 people with amputated limbs – close to the number of all of the HIV, TB and cancer patients I have seen combined. It is equally as astonishing that this cycle of negligence is a common occurrence. Public health care is completely free to all people living in the Plettenburg Bay area. I started to hypothesize that one explanation to why people appear to be less preventative in personal health matters is because they know treatment is free if they happen to fall ill. Of course there are other economic factors including extreme poverty and lack of health care resources that contribute to the low amount of preventative measures people take in poor townships spread through Africa. Compared to the United States where it costs a hypothetical arm and a leg to have any significant health care administered, people tend to live more cautiously and take immediate action when something is out of the ordinary in fear of a serious illness costing their life saving to treat. And then one could argue that living in the United States is less stressful than living in Sub-Saharan Africa and people have more agency to think about the future, rather than being concerned with surviving each day. It’s a difficult idea to explore. Is a free health care system working properly if it is allowing so many people to literally lose and arm and a leg or is it worth paying inordinate amounts of money sometimes to protect your health and well being for the future?
Clara explained to me that many people are just strictly not educated about medicine, more importantly, personal health care. She said Plett Aid aims to educate their patients as they administer care, but the organization cannot possibly reach everyone, and second-hand information distribution is often times not as accurate as the primary source. There is a strong push for sexual education and condom use to prevent HIV/AIDS, but I think there is a lack of personal well-being information available to the most afflicted and susceptible communities. Personal well-being classes, including nutrition, an understanding of preventive actions, and active lifestyles, could provide the citizens of African townships the insights and motivation to plan for the future and set achievable personal goals. The sight of a small sore on a toe might not strike apprehension in a person that is also unaware of his/her poor circulation, especially if the sore doesn’t cause much physical pain. This would most likely be true in the United States. I would never go to the doctor because I scraped my knee, but if I scrap my knee in a different environment, especially one that disease transmission rates are horrifically high, I would be extra cautious in cleaning the wound because I know an open sore is more susceptible to a serious infection. The issue is, that most people in the townships wouldn’t take the necessary measures to monitor and maintain the scrap because they are either unaware of the consequences or preoccupied with other seemingly more important endeavors. The lifestyle revolves around the idea that things happen when then happen. Many people’s main focus is to make it through the day. There are no preventative measures taken to maintain long-term health. Clinics are only for the sick. In a system that is already disorganized and inefficient, one can only imagine a day when healthy patients go to the clinics for regular check-up’s.
An attempt to document my journey through 5 countries, 3 global issues and billions of people