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Source: info.med.yale.edu, Author: Leonard
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s 2005-2006 marks the inaugural collaboration with the site, Dr. Leo Calo was the first Yale resident in the Yale/Johnson and
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Notes From Abroad
Yale/Johnson and Johnson International Health March 2006, Vol. 1, No. 12
Tugela Ferry, South Africa: Treating HIV and TB in Rural Settings
By Leonard Calo, M.D. Internal Medicine Department Yale School of Medicine
As 2005-2006 marks the inaugural
collaboration with the site, Dr. Leo Calo was the first Yale resident in the Yale/Johnson and Johnson Program to complete an IHE at the Church of Scotland Hospital in Tugela Ferry, South Africa. He worked there for six weeks, between January 6 and February 17, 2006.
women have children with them, and many have colorful bandanas wrapped tightly around their heads, which signal that they are married. Most of the patients are thin, with wasted temples and extremities whose underlying bony structure is readily visible. Today is Monday, a day for blood draws to check CD4 counts and viral loads. Newly diagnosed patients will have their first education session about HIV, the opportunistic infections, the importance of disclosure to partners, the adherence required for treatment to be successful, the medication regimens and their side effects. Some returning patients have been on treatment for months or years and are just here to pick up their medications, a month’s worth of triple therapy doses prepackaged into small zip-lock bags and stapled to each day on a monthly calendar. Most patients are taking one of two regimens the South African government is funding through its rollout of anti-retrovirals (ARVs) for all HIV-infected individuals (efavirenz-3TCstavudine or nevirapine-3TC-stavudine). The clinic is now treating 700 such patients, adding 100 new ones with each month that passes. An additional 100 patients are receiving a once daily ARV regimen (efavirenz-3TC-videx) started in the setting of TB co-infection, as part of research collaboration with Yale investigating the feasibility of extending the directly observed therapy (DOT) model used globally to treat TB, to HIV in HIV/TB coinfected patients. Contrary to arguments in the recent past that treating HIV in rural, third
Dr. Calo with a family receiving home-based care. The mother of the eight children is infected with HIV and TB.
It is early morning. The torrential downpour that materialized yesterday and carried several children away with the river has given way to the summer heat, and the mud has turned to dry earth and dust once more. A crowd is growing outside, composed mostly of patients who have walked long distances to be seen, some referred from the inpatient wards for HIV testing. They fill the space in front of the mobile home that serves as our clinic and line up alongside the female TB wards, where some shade from a blue plastic canopy may be had. Some of the
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