HIV in the Past

Care and Support for people living with HIV have been going well. I conducted a brief review of this service this month when I returned to Pokhara. Several years ago, in conjunction with a local fellowship, we began Care and Support service for HIV affected people living in the fellowship area. At that time some were in end-stage disease, most were not aware of and not taking antiretroviral medication. The majority were frequently ill, requiring hospital stays and not able to keep down employment due to weakness and frequent illness. Nutrition was poor. Half of the client’s children were not attending school.

HIV Now

Now all the people who had the end-stage disease have passed away. Some clients have been reconciled with their families and left Pokhara to go and stay with their own family. The remaining clients are all now taking ART medication for their HIV. Their health has markedly improved. The men are all in paid employment. We are working with several of the women on various income generation possibilities. All children are now attending school. Nutrition has generally improved, except in one family where the father is alcoholic which is causing several problems for the family.

We are very pleased with the changes that have occurred over the last several years for these clients and their families. Some care and support are still required, with counselling, advocacy, income generation and health input. But given the level of improvement, the level of our involvement does not need to be as high as before.

Chronic Disease

At the same time, chronic diseases have increased markedly in Pokhara. Healthcare has improved. People are living longer. With increased lifespan, lifestyle and dietary changes chronic diseases such as diabetes, blood pressure, heart disease, lung disease are becoming more common.

Most Nepali’s are not used to dealing with chronic disease or caring for family members with a chronic disease. Having to manage diseases by taking long-term medications or long-term lifestyle changes is not well understood by many. They are used to acute infectious diseases where a short course of medicine cures the problem – or by sacrificing chickens or goats to a witch doctor to fix something. Many people are struggling with how to deal with their chronic condition or how to care for a family member who has cancer or chronic disease. There is a big need for better awareness, understanding and management of chronic conditions, and support for people who are caring for chronically ill or frail elderly family members.

Last week I encouraged our staff and the local fellowship we partner with in providing HIV Care and Support to prayerfully consider the possibility of expanding the current HIV care support service to include people with other chronic diseases.

Handwashing

Handwashing stations in schools have been a big success. Followup has shown they are being used well and appropriately by students and teachers. Several other schools in our working areas around Pokhara and south Nepal are now requesting assistance to construct these and have instruction on hygiene and handwashing.

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