As a new hospice physician in the Washington D.C. area, I’ve begun having more exposure to patients with endstage AIDS. The other night I attended a lecture that made my mouth drop. The topic was HIV and the impact it had on citizens of D.C. The lecturing began with a sobering statistic: Five percent of adults (that’s 1 in 20 adults) in D.C. have HIV and 1 in 50 have AIDS. This is more than double the national average.
Why is the prevalence so high? The answer is complicated, but poverty plays a major role. I’m learning US Congress makes many of DC’s decisions since the city does not belong to a state. Thus the school system is in shambles, the social programs are under-funded and under-prioritized, and sexual education and the prevention of HIV is victim to political wrangling.
The good news is that HIV is no longer a quick death sentence. Because of extremely sophisticated research HIV is a chronic disease – one can live a much longer life with fewer complications. The bad news is that treatment and education for HIV patients has to be just as sophisticated (treatments are expensive and require strict adherence to the therapy) and DC does not have the resources to make this happen. Washington, DC’s bureaucratic health system makes it hard for people to access the needed medications and patients don’t have the social support in place to help them take their daily pills.
I couldn’t help but see the parallel with the HIV epidemic in Africa. I spent a month working in a hospital in Lilongwe, Malawi. In this hospital it was assumed that 75-80% of the patients were infected with HIV. The disease has devastated a generation and left the life expectancy at 49-51. I once again ask why? The level of poverty, lack of education and political wrangling has allowed this disease to continue to spread and countless to succumb to its ravages.
So how do we approach a problem like HIV? It’s important to mobilize communities to expand education and organize resources so people can gain easier access to treatment. This is where Outreach International’s approach can be so effective. By helping local communities address these issues, people are empowered to take preventive measures and to support those that are already infected.
-Jeff Manuel
Jeff Manuel, our guest blogger, is a Family Practice Physician who is currently in a fellowship for Hospice and Palliative Care.
Comments