Public Health by day Discotech by night
Hanuman
Hindu Temple to Shiv
June 6, 2007
Today was our third day at Sahara Michael’s Care Home and we started the morning by doing ward rotations with Dr. Gupta. After lunch Dr. Gupta continued his lecture regarding HIV, the World Health Organization’s (WHO) Clinical Stages of HIV/AIDS: Stage 1. Window Period –the virus has entered the body and the body is making antibodies but not enough to show up on a test, this period is usually 3 months. Stage 2 is when CD4 (white cells) count is 500 and the patient is asymptomatic (normal person’s CD4 count in between 1000-1500); Stage 3 involves CD4 count of 300; and Stage 4 the CD4 count is less than 200, this is when opportunistic infections (OI) attack the body and this stage is defined as AIDS. In the US Antiretroviral (ART) medication is usually started at CD4 levels of 400, however in developing countries like India they start it at 200, mostly due to cost and the toxicity of the medication. Most of the patients that present at the clinics have CD4 counts of less than 50, usually around 10, as they often wait to be tested for various reasons, including socio-economic and socio-cultural stigma.
Tuberculosis is almost synonymous with HIV here from what we’ve seen and what we’ve been told by the doctors that work with HIV patients, as it is a highly opportunistic infection and in such cases, the OI must be treated first before the patient is put on ART.
The WHO criteria for suspecting HIV include 1. Clinical, 2. Weight loss, 3. CD4 count; 4. Performance scale-if the patient is bedridden for 50% of the month, which usually occurs in stage 4 aka AIDS.
Farah and Paul are pre-med and have a scientific background, Sej is a nurse, but this is all new to me, well with my BA in History and while I don’t understand most of the uber biological stuff, I am able to comprehend and appreciate most of the clinical stuff. And while I’ve read and learned about HIV in fragments, this lecture gave me a more rounded view of the virus.
After our rotations we went sightseeing and saw some beautiful temples devoted to Shiva and took some wonderful pictures. We decided to go to an upscale Indian restaurant called Indian Colours and Spices however it was not yet open so we ended up at an another upscale restaurant right next to it called Tonic. Tonic was more like a ultra-lounge/restaurant in the Euro-American style and while we were finishing up dinner a dj set up and started playing techno music for the beautiful Indian people. We had a great time laughing about our public health clothing in such an upscale establishment, but a three-course meal including ice cream cost us $15 each, so we’ll file this one under indulgence.
Tomorrow again is Sahara Michael’s Home, Friday we’re going to Sahara’s Women and Children Center, whose director is a strong advocator of women’s rights, so I’m looking forward to that. Saturday is supposed to be Jaipur and we have our fingers and toes crossed that it will happen because we want to ride elephants. Yes me on an elephant. Farah wants to ride a camel, but those things are temperamental and I would rather stay away from them than be spat at by a camel.
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