Update on Yashwini

Yashwini was admitted to the hospital about a week ago, as her feet were completely swollen and she couldn't eat. The doctors said that her lack of activity led to edema. She normally isn't the best eater, and has been tired lately---a side effect of her ART. After staying in the hospital for about two days, she insisted on going to her house for a day, then, she promised, she'd come back to Karunya Mane. We encouraged her instead to come directly to KM, but she was quite adamant about going home, as supposedly her blind mother was visiting.

We took her to her village but there was no mother, an apparent misunderstanding or miscommunication. She insisted then on staying home until Sunday, three days away, after which time she would return to KM. She lives with her sister and next to her brother and his family, but nobody is willing to take care of her, insisting that we take her with us. But it's hard to take someone when they're not willing to go. Her daughter went with her husband to Bangalore, for how long nobody knows. As Yashwini can barely walk, someone has to be near her at all times.

We returned on Sunday, at which point she cried and insisted on staying home for two weeks, until the 22nd of this month. There wasn't much we could do, even though, again, her family insisted we take her. We reminded her to continue to take her ART (which she is doing) and to eat healthy and practice good hygiene.

Often, the poor are difficult to help when they are sick, not only because they often don't take their medicine properly. The family is often unwilling to help, the patient lives in squalid conditions yet insists on staying there, and he or she may not have the knowledge or capacity to understand how bad his her her health condition really is.

Two more women on antiretrovirals

This month, two more of our women began taking antiretrovirals (ART) as treatment for HIV. One woman, Yashwini (named changed to protect her identity) had her CD4 test done at the government clinic in late March, and the results showed a 303 count. After she had gotten sick, she was referred to the private HIV clinic in the area that had the facilities to admit her and care for her as an inpatient. While there, the doctors suspected that her CD4 count of 303 was incorrect and ordered another test. That test came back at 44 (people with healthy immune systems register CD4 counts between 1000 and 1500), dramatically different from the first test and a bit upsetting.

The doctor recommended that she start on ART, but since Yashwini had been discharged, we could not find her very easily---the street women sometimes wander around the city, or go back to their village for a couple of days.

In mid-May, Yashwini finally reappeared and was quite ill, with a fever and severe dehydration and fatigue. We admitted her to the HIV clinic, where they treated her, and she finally started on ART.

Our second woman recently found out that she is positive, but the government clinic did not do a CD4 count that day and told her to return in two weeks. As she was moving into Karunya Mane, we took her to the private HIV clinic for a checkup and requested a CD4 test, as she seemed quite weak and frail, weighing at most 25 kg (55 pounds). Her test results showed a CD4 count of 26, and she immediately started on ART.

The ART has some side effects, such as dizziness, nausea, and fatigue. Encouraging the women to continue taking their medicine even while experiencing these side effects is very important, as once the drugs "kick in" (after about a month), we have seen tremendous improvement in their health status, which is then their encouragement to take good care of themselves and to properly take their medicine.