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| Light at the end of the tunnel, TMC style :) Tripoli, Libya 2014 |
About one year ago I joined the Pediatric Infectious Diseases Department ( PIDD), it is a relatively small and new department ( only a couple of years old) taking care of children having infected with or been exposed to Human immunodeficiency virus (HIV) !
Indeed, it is very interesting field ... before working in this place, I knew that we have HIV in Libya but I was not really aware of the magnitude of the spread of the illness.
When I first started working in pediatrics in Tripoli Medical Center in the early 2000s we did not have a special place to deal with HIV kids, we didn't even have a Pediatric infectious disease department , only we had a small out patient care clinic for it .. But now we have! Thanks to those doctors who made this a reality.
When I first started working in pediatrics in Tripoli Medical Center in the early 2000s we did not have a special place to deal with HIV kids, we didn't even have a Pediatric infectious disease department , only we had a small out patient care clinic for it .. But now we have! Thanks to those doctors who made this a reality.
The main source of HIV, according to statistics we have in Tripoli is intravenous drug addictions ... But as everywhere else it's not the only source .. Sexual transmission is also a significant source in our very conservative society!!! And when I say sexual, I mean to include not only sex outside of marriage and between homo, but also between husband and wife when one of them is infected ...
In children the main source of transmission is mother to child , but we do have a few heart-aching cases, where we have only one child in the family is infected, while his/her parents and siblings are free of HIV.. Most of these single family member cases have a history of hospital admission in Tripoli in the late 1990s ( suggesting a nosocomial acquired infection, i.e, getting infection from hospital) .. Which for me put a big question mark on the integrity of the health care system at that times. Thankfully, since the opening of the pediatric infectious department no more nosocomial infections were reported in children.
Working with HIV specially in a population like ours, opens a very different window on the society. It opens a window on the most sensitive social fabric in the community. Where all the fakes disappear and the ugliness of the society shows its face with no veils. Most of the times you deal with the executioner and the victim at the same time.. Beside, you genuinely can not decide who is really the victim. Is it the patient or the surrounding environment? The same environment created by everyone in the community, including you!
The other day, I was thinking and questioning with myself, what we are really doing? I believe in the effectiveness of our work, and it is good with tawfiq from Allah, but it is not complete. Yes, we treat the infected kids and make them live almost normal life, and even more we have completely healthy babies with infected parents ( by following the program of prophylaxis for the exposed babies born to HIV positive mothers.) Yet, we send some of these kids back to the same bad environment that made their parents infected. It's needless to say that addicted parents will more likely raise addicted children, with the absence of external intervention.
Moreover, when there is a child abuse we have no authority in our country to take that child from his/her caregivers, nor we have alternative options to move the child to be in a safe place. This will almost lead sooner or later to a failure of our treatment for the infected child.
In children the main source of transmission is mother to child , but we do have a few heart-aching cases, where we have only one child in the family is infected, while his/her parents and siblings are free of HIV.. Most of these single family member cases have a history of hospital admission in Tripoli in the late 1990s ( suggesting a nosocomial acquired infection, i.e, getting infection from hospital) .. Which for me put a big question mark on the integrity of the health care system at that times. Thankfully, since the opening of the pediatric infectious department no more nosocomial infections were reported in children.
Working with HIV specially in a population like ours, opens a very different window on the society. It opens a window on the most sensitive social fabric in the community. Where all the fakes disappear and the ugliness of the society shows its face with no veils. Most of the times you deal with the executioner and the victim at the same time.. Beside, you genuinely can not decide who is really the victim. Is it the patient or the surrounding environment? The same environment created by everyone in the community, including you!
The other day, I was thinking and questioning with myself, what we are really doing? I believe in the effectiveness of our work, and it is good with tawfiq from Allah, but it is not complete. Yes, we treat the infected kids and make them live almost normal life, and even more we have completely healthy babies with infected parents ( by following the program of prophylaxis for the exposed babies born to HIV positive mothers.) Yet, we send some of these kids back to the same bad environment that made their parents infected. It's needless to say that addicted parents will more likely raise addicted children, with the absence of external intervention.
Moreover, when there is a child abuse we have no authority in our country to take that child from his/her caregivers, nor we have alternative options to move the child to be in a safe place. This will almost lead sooner or later to a failure of our treatment for the infected child.
We have many ideas in mind as a solution for this, need to be done, but because of the unstable situations we have, our progress is miniature. Nevertheless, we don't lose hope, as a team in our department, and despite the absence of social support for our patients, plus the absence of real support from charity organizations to these kind of patients, we still struggle to make our efforts stand solid to support these children as the best we can for them to face the world, healthy and strong.
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