I went to Korle Bu to pay my fees for the privilege of doing clinicals and to meet with the doctors I will be working with at the Fevers Unit. I sat in on an inter-disciplinary meeting (pharmacists, doctors, nurses, counsellors) which was quite interesting. They have clinic hours Mondays, Wednesdays, and Fridays. There are 6 – 8 doctors and they see upwards of 400 patients in the clinic each day. I must have heard wrong because 400 is a lot!
Ward rounds are on Tuesdays and Thursdays. There are about 24 inpatient beds for the HIV patients. Sounds pretty small.
Apparently, since the government started to subsidize ART in 2003, HIV management has become more of an outpatient affair, similar to the situation in the US.
I was surprised to learn that when patients come for their adherence counselling visits they have to bring a family member to document adherence. This is to make sure that there has been disclosure of the diagnosis. I think that’s an excellent idea. Otherwise, you will have a patient with HIV coming in for his medications while his wife is sick and dying with AIDS at home because she doesn’t know she has HIV.
I’m really looking forward to starting my clinical rotation. Depending on how busy I get, they will let me go to the Chest Clinic to see tuberculosis patients, and “sit in” on general medicine ward rounds. Until then, I’m going to enjoy my last few days of vacation!
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