Saving Lives One Pack at a Time

Thought I better give you a run down of what I am actually doing here, don't want it to sound like all I do is go to the beach and eat food!

I work in the pharmacy at Zithulele hospital and probably the largest amount of what the pharmacy does is dispense ARVs, the drugs which HIV+ patients take to fight the virus and allow them to continue with a healthy and happy life. HIV is rife - I'm pretty sure S.A has a 20% HIV rate as a whole, and a poor rural area like here is bound to be higher.

On Wednesdays and Thursdays, all the local HIV patients come to pick up their meds from the clinic at Zithulele. Some of the patients walk for miles and miles to pick up their meds, such is the importance of them. ARVs must be taken at very precise time intervals, with only about 15 mins leighway (is that how you spell it) between it working effectively and not working. You have to have about 95% adherence or it doesn't really work. Last week I visited all the outreach clinics in the area that the patients go to for other things apart from ARVs and it threw into perspective how far the patients have to come. It took an hour IN THE CAR to get to some of the places, and people go further than that because they live off the beaten track – it's hard to know just how long that takes on foot. It is very expensive to take a taxi so the patients have a difficult time just getting the meds, let along remembering to take them, and then living with the horrible side effects e.g. peripheral neuropathy [check out that for a fancy word].

Wilo clinic - a possible future ARV site

To help the patients out, we are running a system where we prepack meds at the hospital and send them out to the outreach clinics so the patients can pick them up at a place that is convenient for them. This is called down-referral. At the moment there are two clinics we use, Ncwanguba and Mapuzi. I am responsible for getting all the medicine out to the clinics on time and packed correctly according to the prescriptions. There are about 80 Mapuzi patients and over 250 Ncwanguba patients and the numbers grow every week so I have my work cut out! I have to keep records on a computer system called iDart, track patients files, pack individual prescriptions that contain various ARV regimens, TB medication and other chronic meds and check that all the packages get picked up at the clinic.


I've learnt so much about pharmacy work in the last three weeks, thanks in no small part to Monique the pharmacist and the other pharmacy assistants, Fesiwe, Thabo and Zandile. I am pretty sure that there is no way a 17 year old with no qualifications would be given a role like this in the UK! It's an absolute mission to coordinate everything and on top of it all, Monique left on Wednesday so we are a bit lost without her! I am learning more and more about different drugs, prescribing meds and the ins and outs of HIV which is really interesting. Plus I am carrying on the Hanson family tradition of pharmacy! Hello to Grandma, Auntie Linda and Deborah Brown (ok you aren't a Hanson and you aren't called that anymore...) if you are reading!



On Tuesday, Monique, Tom (head of health programme at Jabulani) and I went out to Mapuzi to oversee the first clinic. It was absolute chaos. We were crammed into a tiny room with one table and one chair (luckily someone found another 3 chairs) and dispensed for 3 hours solid. There were six of us working including 3 lay counsellors from Mapuzi. Patients turned up for the clinic who weren't meant to so did not have a pack, but needed to pick up ARVs because they had none left, so it was a logistical nightmare to make a plan to get everyone sorted for medication. Patient records here are generally kept in exercise books that are completely battered and soggy from the rain, so everyone ends up with a mess of different reference numbers etc etc and it's such a far cry from the UK (and you think the NHS is a mess!?). But somehow, it all worked out. Monique and I worked until 8pm that night to make packages for the people who turned up unexpectedly ready to send with a courier the next day, which I think may be the first of many long days here – I already work from 8am to around 6pm as it is!

The next couple of weeks will be a learning curve as I oversee my first packing for Ncgwanguba clinic as well as working in the Zithulele clinic, prepacking in the pharmacy and all the other odd jobs that come my way. And don't forget that I work for Jabulani too! Maybe that will come under another post...
Either way, I'm having an incredible time working here and getting to take things on that I never could do at home. It's good to have a challenge and nice to know that what I'm doing matters, as Monique says, ARVs is about saving lives one pack at a time... :D
Sigqibila!

xxx