In the northern part of Ghana, HIV/AIDS is not as widespread as in other parts of Africa (http://www.avert.org/subaadults.htm).
BMC does not have a program to supply the medicines for HIV which are called HAART (Highly Active Anti-Retroviral Therapy). Once a patient is diagnosed, we give treatment for the immediate complaints, then refer him/her to one of several hospitals in Ghana that can provide the medicines for the treatment of HIV/AIDS.
As the disease progresses, HIV patients have a certain appearance of having a chronic illness, much like end stage cancer patients. They become very thin. The temples next to the eyes sink in causing “bi-temporal wasting.” Whenever I see this physical sign, I begin to look for clues of HIV or another chronic illness. As HIV starts attacking the immune system, the body loses its ability to fight off common illnesses.
When testing a patient for HIV at BMC, a form must be filled out. On the form is a list of the presenting symptoms/signs which prompted the test. Some of these included:
- chronic weight loss
- chronic fever
- chronic diarrhea
- candidiasis (yeast infection – thrush) of the mouth and esophagus
- presence of other sexually transmitted diseases
I made the diagnosis in several patients. The patients often have vague complaints or symptoms. In 2 or 3 patients, the tip-off was oral thrush – white “sores” or patches on the tongue, palate (roof of the mouth), or in the esophagus.
The saddest case was a woman who presented with several months of diarrhea. She was incredibly thin and weak. Her eyes were sunken in with a distant stare. She could hardly sit up in the wheelchair. At first her family told me that she had been sick only 2 weeks. After a few more questions, they revealed that it had been several months. As I sent her over to the chaplains to be tested, the family asked if there was anything I could do for the patient’s baby. A family member unwrapped a small bundle she was carrying in her arms. She moved the cloth to reveal a tiny 4-month-old child – skin and bones – who appeared not yet ready to leave the womb. Both the mother and the child tested positive.
Whenever a doctor at BMC suspects HIV, he must fill out the form and send the patient to the chaplaincy office. The chaplains perform the test, relay the results of the test to the patient, and discuss the patient’s options for treatment if positive. Most importantly, they offer the patient encouragement through the love that Jesus offers, prayer and support.