On those days that things aren’t going, and I need to kill a couple of hours and it is too hot to walk around, I will find refuge by sitting in the pharmacist’s air conditioned office, helping him pack pills.
Monday through Thursday, the pharmacist dispenses ARVs (Antiretroviral) tablets for patients with HIV.
Here is a very brief lesson on ARVs: ARVs is the general name given for the medication that suppresses HIV in a person’s system. WIth ARVs most people can live a happy, healthy life. Botswana was the first country to offer free ARV treatment for its citizens and has worked hard to make sure that there is country-wide accessibility to this treatment. But ARV adherence requires a strict regime, taking large pills twice a day on a strict time schedule. If patients default, if they skip their pills for a couple of days or continue to forget, they can become resistant to the first line of HIV drugs. The first line is the most common in Botswana, also the cheapest. There are second-line and occasionally third-line available in Botswana, but it’s risky. When a person starts to resist to medication, they become sick and the period between the resistance and the start of the second medication is risky.
So on these days, I will sit with the pharmacist, and I will help pack the pills. I sit in as he consults individuals on how to take pills and he questions about their adherence, their diet, and other things.
This isn’t necessarily capacity building. I am mindlessly counting pills and labeling bottles. But I know of no better way to get an education on the complexity and difficulty of living with HIV. Almost every patient has a story. Some always have a new barrier to taking pills on time and consistently. There are those that come in, knowing the names of their pills, taking care of their kids. And I feel such relief, knowing that, yes, this person has got it together. While there are others that come, without knowing what ARV stands for, not understanding the importance of taking their pills on time. And its worse when the kids come in with a parent/guardian or distant relative that seems to not care. I would say majority have their act together and it’s those few who don’t, that we worry about. Do they need more education? Do need they more support? Do they just need new parents? Crappy parents are in every country and in every society, but they really bug me in this particular context.
Of course, this education is very important when figuring out interventions for people living with HIV. And I hope to be able to use to what I know, to build the capacity of a potential organization or group of individuals. It is my second year, after all, and the tides are changing.