Lately I've been up to my eyeballs in spreadsheets and budgets having extraordinary bonding times with my computer, which is safely tucked away in one of the most beautiful buildings in Ho Chi Minh City. But the numbers meant absolutely nothing to me.
It was an incredible experience this week to visit some of the sites that we (CDC/PEPFAR) supports. Dr. Son, the project officer for care and treatment, took me to 4 OPC (Outpatient clinics) where they have a variety of activities including VCT (Voluntary Counseling and Testing), OI/STD (Opportunistic Diseases/Sexually Transmitted Diseases) drug dispensing, PE (peer education), laboratory and finally ARV services (Antiretroviral-- the treatment for AIDS). One of the OPCs had 4 doctors and 4 nurses in the same small room seeing patients. Can you imagine getting your STD checked out in the same room as all of these other people or talking about your HIV status? This violates the basic principle of treatment of HIV-- confidentiality. Anyway as I've been going through the overall budget we've found quite a bit of extra money. What an incredible experience to see a need and be able to fill it will ease! I can't wait to go back in a few months and see each of rooms being used by only one doctor!
The next OPC was like a cooking oven. There was very little ventilation, which can be unnecessarily dangerous when Tuberculosis (TB) is in the picture. The OI and ARV drugs were being stored at room temperature, which makes them less effective. Anyway about the time we started talking about negative pressure ventilation and air-conditioning with the doctor and administrator the lab man came out and was practically begging for us to expand it to the lab where he said he is roasting (probably not in those words but...). Great! Let's do it... When there is a happy doctor and lab man you may find better treated patients!
At another OPC in the rural outskirts of Hi Chi Minh City we saw that the group counseling was being held on plastic stools in front of the clinic for all to see. Again no confidentiality! So they were requesting to build a group counseling room where more HIV/AIDS patients would feel comfortable. No problem!
There are a lot of challenges with PEPFAR but one thing is that it really can meet a big need! Dr. Son said that the best thing the president has done was fund PEPFAR. It has been the only sustainable program to address the HIV need in Vietnam.
It was a satisfying week. :)
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