Wednesday, 22 June 2011

HIGH RISK

I’m confused but I’m not afraid, I’m strong but I need to feel comforted and supported.
It was one of those usual busy days on labour ward at Bwaila. Most of my time is now spent teaching students of all categories sharing my skills and knowledge so that others may learn. Clinical/ bedside teaching is what I love, what I do best. My role is well accepted and well established now and I am sought out by the students to supervise their work.
So it was that two weeks ago whilst supervising one of our students I received a needle stick injury. Having administered the injection of Oxytocin for the removal of the placenta I had carelessly left the uncovered syringe and needle on the bed. Later whilst wrapping up the cloths on which she had birthed the needle entered deeply onto my left hand. I removed my gloves (we wear two pairs for extra protection) and went to the sink to wash. The best thing in these situations is to squeeze the wound to make it bleed. Unfortunately as the entry had been deep there was little blood however hard I squeezed I knew this mother was HIV positive and that I should therefore seek assistance promptly. Alongside the maternity unit there is a busy and successful HIV clinic that supports our work. I hurriedly left the labour ward to visit their clinicians. I am working on the busiest labour ward in Malawi and possibly in the whole of Southern Africa, I am working at Bwaila. It is an extremely high risk situation in which we try to protect ourselves but inevitably accidents do happen. Since arriving here over 3 years ago I have been regularly tested for HIV as a matter of course. Small needle prick injuries whilst suturing have not alarmed me but this was different. After testing negative at the present time I was prescribed the usual medications to assist my body in rejecting the virus. Post Exposure Profilaxis (PEP) is a combination of Anti Retrovirals ( ARV) I will have to take these drugs for one month then be retested after three months to ensure that I havn’t been infected.
So how do I feel?
My first reaction two weeks ago was that of anger. How could I be so careless?
Every morning and evening I have to take the medication. This is the hardest for me. Consciously putting these powerful drugs into my otherwise healthy body to do all manner of harm to my cells and tissues whilst supposedly preventing transmission, which I may not even need, I find hugely distressing.
I was warned of all the possible side effects, nausea, diarrhea, weakness, tiredness etc. ‘you will feel sick for month’ I was told. I was having none of this I decided! I would be fine, I would feel fine, and life will go on as usual!
And to some extent it has. Sometimes I get a bit weepy, I am often very tired and weak but apart from the occasional wave of nausea, I am just fine.
I am not afraid; I truly do not think I will contract HIV
I won’t publish this now but wait for 3 months to share this with you all.

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