The Black Lion Hospital has a large outpatient HIV/AIDS Clinic that I wanted to visit. They have 7,000 patients registered in their computer and estimate that they follow approx. 4,000 regularly. “Lost” patients are a major problem, and those numbers may be rather optimistic. In Kenya, AMPATH (Academic Model Providing Access to Healthcare; funded and managed by the University of Indiana) has successfully mobilized a very ambitious outreach program that sends vans to the countryside seeking out new patients, as well as those who are non-compliant. No such program exists here, and only patients who present themselves are seen.
Today after the AIDS doctor saw 15 patients (“chronic-follow up”) and there were no more in the waiting room, he went home. It was 11AM. His nurse, an older man who had worked at the hospital for 32 years stayed on till noon to counsel the 8 patients who had come in for HIV testing. The nurse said the stigma is quite great, so very few will get tested in their own area and instead come to Addis.
This clinic receives all its drugs free of charge from Johns Hopkins and Tulane University, and frequently American doctors and researchers come to the clinic to assess the information gathered and use it for their research. Certainly, this to be a very symbiotic relationship. Only one drug is available, Lopinavir (Kaletra) and it is taken twice daily. Patients from all countries are seen for free, many come from Djibouti, Sudan, Eritrea and Somalia and will receive as much medicine as needed until they are able to return to Addis, often enough for a year or two. The nurse said the most prevalent mode of transmission is unprotected sex and he counsels about this and readily distributes free condoms. He said homosexuality and prostitution are not a problem in Ethiopia, though that must be his own opinion; research does not bear out him out.
