Yesterday I attended a lecture and discussion with Andrew Lansley, the Secretary of state for health, in the houses of parliament. I was invited quite last minute to go by my friend whose father is a member of the Conservative muslim forum, who were running it. I am neither a conservative nor muslim but the event was non selective so I still went.
Obviously as it was organised by a political organisation there was a lot of political behaviour involved in the whole thing which would be unnacceptable in any other social situation, commenting on Andrew Lansley's love of pies and a lot of juvenile eye rolling. The main event was to be a talk by Andrew Lansley on the state of the NHS and the reforms, followed by a question and answer session, but in the words of the man himself, 'he would give a response but it may not be an answer'
he reforms have been met with a striking amount of criticism, but rightly pointed out, it has bubbled down a bit recently. He first started up with the need for the reforms, to improve the care further and to save money to combat the mammoth debts. The
Of course as he was figurehead for the reforms, he undoubtably gave a rather biased view. It is easy to become very believing of the majority viewpoint in such an enclosed area with no means of research and proof so we should always examine credibility and reliability to ensure we get the whole picture.
After there were some interesting questions asked, including one about what we we should expect in the profession of healthcare in the future. According to Mr. Lansley, being a doctor offers a lot of opportunity for career development, the highest salary in Europe for a medic and a great degree of security, I'm sold!
He was also asked about what they were doing to reduce waste of funds, in particular relating to IT, Mr Lansley said that the government reviewed the contracts they had with IT companies and cut the ones which weren't delivering, good for the NHS and their funds, but bad for the company who just lost a major portion of their income and would have to reduce staffing, it will never be a win-win situation. The IT solutions would then be changed up for more personalised services with lots of choice rather than a one size fits all model.
He was asked how the government is using their own social marketing strategies to combat powerful advertising of unhealthy products and he said that they were aiming for a more empowering outlook on the adverts rather than a nagging response and were already running many successful campaigns including the Change 4 life and new invisible smoke ones. The more information is made accessible, the better informed the general public will be.
Thursday, 14 June 2012
Tuesday, 12 June 2012
Legionnaire's outbreak
I am currently following the legionnaire's outbreak on the news. On Saturday there were 36 confirmed cases of legionnaire's disease, all living or working in the west of Edinburgh. There are 15 people in intensive care due to the disease and 1 person, Robert Air, has died due to it. It was predicted that the levels of the illness would peak this weekend as the possible causes of the outbreak are being shut down, investigated and treated. The last outbreak of a large number similar to this was from a cooling tower, which is capable of distributing the virus over a long distance via water droplets which are inhaled. Although they are investigating the source of the outbreak, it is possible that the source may never be identified, as past experiences have shown. This would be very undesirable as it would not aid to the further prevention of similar outbreaks.
Legionella bacteria grow well in warm temperatures, 35 to 46 degrees, but presence of this should only be seen as a problem if there are notably high levels of the bacteria. In addition many people may inhale the bacteria and show little to no symptoms.What makes some people more susceptible to the illness? Well, obviously those who are immunocompromised are more likely to suffer from symptoms, as are those who smoke or have lung illnesses. Most sufferers are middle aged or older. Aside from major outbreaks, it can be difficult to diagnose this disease due to the rarity and wideness of the symptoms, approximately 90% of cases go undiagnosed!
So how are the authorities dealing with this outbreak? Firstly they are treating the patients with antibiotics including erythromycin and clarithromycin. The patients are sustained with fluids to avoid dehydration and an oxygen supply. To prevent further spread, the treatment of possible sources, 3 buildings with cooling towers in the area begins as soon as possible, before confirmation of the presence occurs. Treatment involves using chemicals to kill the bacteria, although all buildings should follow the guidelines to prevent the spread and growth of bacteria, by keeping the water below 20 degrees and by keeping free of impurities and preventing stagnation. This includes households although large factories carry a higher risk. Water samples will be taken from these suspected sources and swabs taken from the cultures will be grown on a variety of agars over a long period of time in the preferred growth conditions in incubation.
I aim to follow the outbreak over time and hope that this raises awareness for the good practice to prevent the spread and increase the efficiency of diagnosis. I hope that the predictions of the numbers decreasing are realised because this disease has a very high mortality rate, of 5% and otherwise, the symptoms are, like most diseases, unpleasant. The outbreak of the disease must be terrifying for those in the area, not knowing if they, or their relatives, will fall ill. It is not the most friendly of diseases.
Sunday, 10 June 2012
Day 3 in the labs- Ward rounds and all the rest
Apologies about the lateness, This is about Friday. Okay so the title is a bit misleading as I spent the majority of the day outside of the lab. At the start of the day I was met by the quality manager who talked to me about his job, it is all about ensuring that all of the data produced from the labs is high quality and that the labs run following strict procedures which includes health and safety. The man regularly carries out audits to ensure reliability and that the correct records are taken, so that, in the event of legal action taken, proof of correct procedure can be shown. This is obviously a very important job as it not only ensures high quality data, but assures patients and doctors of this fact. This is in addition to the external tests carried out and the even more internal controls carried out regularly, it is evident that checks are a very important feature in the pathology labs. When they didn't use to be, mistakes went unnoticed and it was difficult to make improvements as they weren't sure where anything went wrong.
After this I went to the ward rounds with Dr. Riley. I had assumed that this meant seeing to all of the patients but I was informed this term means different things from hospital to hospital and that in this hospital it meant attending a meeting with all of the consultants about patients on that particular ward. They discussed current treatment, results from the pathology departments and possible courses of action. For example they used their different expertise to decide whether a patient is ready to be discharged, or if they should go onto the medical trial (something which proved very popular in the meeting I was in). An interesting issue raised was a man who was a Jehovah's witness and who therefore could not accept blood transfusions that he needs but could accept blood produced from stem cells from his brother. It doesn't seem to make much sense to me but it is a good way to overcome this issue. Even if it is somewhat more time-consuming and expensive, it is worth it as the care of the patient should always be put first in healthcare, no matter what they believe. Religion can often be used as social support in illness so should not be discouraged if possible.
After the ward round, The doctor and I went to his office and returned calls which he had accumulated during the duration of the meeting. He is a consultant microbiologist so doctors from all over the hospital contact him for advice and guidance on interpreting microbiology results and courses of action to take. As I have no formal training in microbiology, most of the discussion was alien to me, however I did recognise information from my stint in microbiology and the doctor did his best to explain as much as he could to me. This was interesting because it was the first time which I saw the data from pathology applied to the patients and healthcare itself. The doctor expressed his concerns at the lack of microbiological training of the new junior doctors, so I will take the advice to return to pathology work experience during my medical course to gain an extra dimension so I can be one less burden to the consultants and work more independently. However, just because the current junior doctors are not completely understanding of microbiology, it doesn't mean my generation will too, healthcare and healthcare education is developing all of the time. The doctor may just have very biased views as he is the person who receives all of the doubts.
After lunch I was scheduled to be doing practical work in microbiology, when I told the doctor this he laughed and said that they would be using me for slave labour. Ready for this, I returned after lunch but, to my disappointment there was nothing for me to do, the workload varies greatly which can be very difficult to deal with. I got shown the multiple tests done on spinal fluid of patients, checking for cell counts included. During this I saw a red blood cell under the microscope, which did not live up to its name of being red, may I say! Again, several tests were used for the same purpose to ensure reliability.
I was then sent to the receptionists to help them. We went to pick up the mail and collect paper. Although these tasks may seem simple and meaningless, these are necessary for the running of the department, and without the clerical staff to organise it all, the department would fail to function. A woman I know who is a nurse believes that clerical staff are greatly undervalued and underpaid and fears that this may result in resentment and unpopularity of the job. We also did some shredding, the infamous work experience task, which is used to ensure confidentiality of the patients and avoids leakage of private and possibly sensitive information, which is entrusted to the department by the patient and doctor.
I am so glad I have had the opportunity to carry out my work experience here and will remember and apply all of the lessons learnt. It can be difficult to think of finite lessons learnt during work experience, however it often becomes obvious of continuing trends throughout the period, in this experience there was themes of reliability and quality more than anything else, because when you ask for a test to be carried out on a patient's health, one should not have to allow for error.
After this I went to the ward rounds with Dr. Riley. I had assumed that this meant seeing to all of the patients but I was informed this term means different things from hospital to hospital and that in this hospital it meant attending a meeting with all of the consultants about patients on that particular ward. They discussed current treatment, results from the pathology departments and possible courses of action. For example they used their different expertise to decide whether a patient is ready to be discharged, or if they should go onto the medical trial (something which proved very popular in the meeting I was in). An interesting issue raised was a man who was a Jehovah's witness and who therefore could not accept blood transfusions that he needs but could accept blood produced from stem cells from his brother. It doesn't seem to make much sense to me but it is a good way to overcome this issue. Even if it is somewhat more time-consuming and expensive, it is worth it as the care of the patient should always be put first in healthcare, no matter what they believe. Religion can often be used as social support in illness so should not be discouraged if possible.
After the ward round, The doctor and I went to his office and returned calls which he had accumulated during the duration of the meeting. He is a consultant microbiologist so doctors from all over the hospital contact him for advice and guidance on interpreting microbiology results and courses of action to take. As I have no formal training in microbiology, most of the discussion was alien to me, however I did recognise information from my stint in microbiology and the doctor did his best to explain as much as he could to me. This was interesting because it was the first time which I saw the data from pathology applied to the patients and healthcare itself. The doctor expressed his concerns at the lack of microbiological training of the new junior doctors, so I will take the advice to return to pathology work experience during my medical course to gain an extra dimension so I can be one less burden to the consultants and work more independently. However, just because the current junior doctors are not completely understanding of microbiology, it doesn't mean my generation will too, healthcare and healthcare education is developing all of the time. The doctor may just have very biased views as he is the person who receives all of the doubts.
After lunch I was scheduled to be doing practical work in microbiology, when I told the doctor this he laughed and said that they would be using me for slave labour. Ready for this, I returned after lunch but, to my disappointment there was nothing for me to do, the workload varies greatly which can be very difficult to deal with. I got shown the multiple tests done on spinal fluid of patients, checking for cell counts included. During this I saw a red blood cell under the microscope, which did not live up to its name of being red, may I say! Again, several tests were used for the same purpose to ensure reliability.
I was then sent to the receptionists to help them. We went to pick up the mail and collect paper. Although these tasks may seem simple and meaningless, these are necessary for the running of the department, and without the clerical staff to organise it all, the department would fail to function. A woman I know who is a nurse believes that clerical staff are greatly undervalued and underpaid and fears that this may result in resentment and unpopularity of the job. We also did some shredding, the infamous work experience task, which is used to ensure confidentiality of the patients and avoids leakage of private and possibly sensitive information, which is entrusted to the department by the patient and doctor.
I am so glad I have had the opportunity to carry out my work experience here and will remember and apply all of the lessons learnt. It can be difficult to think of finite lessons learnt during work experience, however it often becomes obvious of continuing trends throughout the period, in this experience there was themes of reliability and quality more than anything else, because when you ask for a test to be carried out on a patient's health, one should not have to allow for error.
Thursday, 7 June 2012
Day 2 in the labs- Microbiology and Haemotology
Today was very different from yesterday, obviously due to me being in different departments and also because of different people. The people who you shadow and who explain things to you really affect your overall experience. Although the majority of people are very kind and understanding of my low level knowledge, a few seemed very frustrated and annoyed at having to spend the time explaining things to me. I am very greatful for those who are sympathetic because I understand that in many working environments like these where there are important deadlines, it really puts people out to explain every minute detail. This taught me about how precious their time is to get the job done properly.
That aside, I learnt and experienced a great deal today, similarly to yesterday, a lot of great machines have recently taken over many of the jobs which previously had to be done manually, saving time and improving detail. However, controls and tests need to be done both internally and externally; quality assurance schemes send specimens to check that the results in all of the labs around the country are consistent and accurate. These are very important as inaccuracy could mean, in the case of blood transfusion, sudden death for the patient. In science, new developments constantly change the working environment, allowing more precision and ease, this makes it an exciting field to work in. Medicine especially, because there is a great demand for new knowledge so there is a vast amount of research carried out in all fields.
Today I also got the opportunity to look at some bacteria under a microscope, and even with a stain it was very difficult to recognise, also photos of different white blood cells and different bacteria on agar are extremely difficult to differentiate, perhaps I was being very naive thinking that cells would just simply be obvious, there is challenge in the diagnosis, despite all of the handy tests and detail. As one of the ladies I met today said 'bacteria don't read textbooks!'
Whilst in the blood transfusion section the message that blood, platelet and organ donors are still greatly needed despite the recent campaigns raising awareness. When I told the man about the assembly that I plan to give to my year about donating these, he was pleased- especially due to the fact that my school has a high ethnic minority proportion and the demand for donations from these ethnicities are significantly higher than for white British donations. He advised me simply to tell them the facts, to simply educate and not preach in a judgmental fashion. This is probably the best persuasion method, especially in an area like this which some people may be sensitive about.
Similarly to yesterday, whenever the patient record appeared anywhere, I couldn't help but think about the situation of the individual, wanting to know their story and whether they recovered well or not. This leads me more strongly to believe I would like to be a general practitioner, working with the same people over a prolonged period of time and be able to offer continuing support.
That aside, I learnt and experienced a great deal today, similarly to yesterday, a lot of great machines have recently taken over many of the jobs which previously had to be done manually, saving time and improving detail. However, controls and tests need to be done both internally and externally; quality assurance schemes send specimens to check that the results in all of the labs around the country are consistent and accurate. These are very important as inaccuracy could mean, in the case of blood transfusion, sudden death for the patient. In science, new developments constantly change the working environment, allowing more precision and ease, this makes it an exciting field to work in. Medicine especially, because there is a great demand for new knowledge so there is a vast amount of research carried out in all fields.
Today I also got the opportunity to look at some bacteria under a microscope, and even with a stain it was very difficult to recognise, also photos of different white blood cells and different bacteria on agar are extremely difficult to differentiate, perhaps I was being very naive thinking that cells would just simply be obvious, there is challenge in the diagnosis, despite all of the handy tests and detail. As one of the ladies I met today said 'bacteria don't read textbooks!'
Whilst in the blood transfusion section the message that blood, platelet and organ donors are still greatly needed despite the recent campaigns raising awareness. When I told the man about the assembly that I plan to give to my year about donating these, he was pleased- especially due to the fact that my school has a high ethnic minority proportion and the demand for donations from these ethnicities are significantly higher than for white British donations. He advised me simply to tell them the facts, to simply educate and not preach in a judgmental fashion. This is probably the best persuasion method, especially in an area like this which some people may be sensitive about.
Similarly to yesterday, whenever the patient record appeared anywhere, I couldn't help but think about the situation of the individual, wanting to know their story and whether they recovered well or not. This leads me more strongly to believe I would like to be a general practitioner, working with the same people over a prolonged period of time and be able to offer continuing support.
Wednesday, 6 June 2012
Day 1 in the labs- Biochemistry and Histology
I am doing work experience this week in The Royal Marsden's pathology department. This is where a lot of diagnostic work relating to cancers is carried out. Today I was in Biochemistry in the Sutton site and Histology in the Fulham road site.
My mum and I were perplexed as to what the difference between haemotology and biochemistry was but I was told almost immediately that whilst haemotology was the study of the cells in the blood, biochemistry was focused on the blood plasma itself. I was shown around the biochemistry lab and spent a period of time with each member of the team, each relying on one another to keep the system working effectively and on eachother's knowledge to carry out the task efficiently and to constantly improve. One major lesson I learnt was the importance of considering the sample and the results as individual, even with the data being numerical and seemingly objective, for example, if a patient normally had a marker count of 2 which increases to 4, and another patient with a marker count change from 200 to 1000, it may not necessarily make the second person have worse cancer- one always needs to refer to the patient's history before drawing conclusions. At the end of the morning the consultant talked me through the reasons for why they carried out all of the tests, ranging from kidney function via calcium levels to specific enzymes relating to specific cells (if treatment is successful and the cells are broken down the enzymes will be releases). This linked everything together nicely.
In the afternoon I caught the trust bus to the Fulham road site and managed to make my way to Histology without much trouble. I was shown around by a lovely lady who talked me through the process which a sample goes through whilst in the department. It is a very laborious process involving soaking in fixing agent for several hours and changing between water soluble and fat soluble several times. As the image of the sample varies so greatly from which angle it is viewed from, it is of high importance to follow protocol and place the sample in the wax flat down. Although in every medical environment hygiene is exceptionally important in the histology department it was important not only to protect the reliability of the sample but to protect oneself from the dangerous chemicals used, a constant downdraft was employed to prevent inhalation of the fixing agents. Probably the highlight of the day was being able to see a complete female reproductive system removed, it was different from imagined, much more sturdy and I've always envisioned it as a series of negative spaces rather than the organ it is.
During both the morning and the afternoon validation was continually highlighted as a major issue, incorrect readings or values can result in misdiagnoses and potentially fatal consequences. When dealing with tissue samples and tubes of blood it is easy to forget why the tests are being carried out in the first place, and that they belong to a person and their life may depend on the result. Personally, my eyes kept being drawn towards the names and the dates of births of the people to which the samples belong, remembering the importance of the results.
Despite the obvious mammoth importance of the accuracy and speed of the diagnostic work from the lab aiding treating the patient, Today has made me more sure of my desire to work as a clinician rather than in a laboratory, I'd prefer to access the patient and be able to support and care for them through the illness (when a jaw bone was brought out of the box to be cut up to be made into slides, the only thing in my mind was concern for the poor individual now without a jaw bone!)
I very much look forward to tomorrow and if today is anything to go by, I expect to learn a lot. An early night for me then!
Saturday, 2 June 2012
The Wellcome collection
As mentioned yesterday I went to the Wellcome collection on Thursday, it was primarily to see the temporary exhibit about the brain- 'mind as matter' which I had read about in a magazine. The Wellcome collection is 'a free visitor destination for the incurably curious' I liked that phrase so much I renamed my blog after it!
This exhibition was fascinating and covered a lot of topic from the old fascination with measuring intellect in brain size to modern day brain surgery. There were many different displays which I loved but I had 2 favourites. There was this amazing video of bloodflow to different regions of an individuals brain, by brain scan whilst he was listening to some music, you could listen to the music and it really does demonstrate how music can affect brain functioning, with there being sudden bursts of red (signifying high levels of blood flow) as the music climaxes. There was also photos and testimonies of several different people who planned to donate their brains to medical science and research, it was weirdly peaceful to hear their motives to donate and it did make me stop for a minute and think about the end of life, to me it seems daunting and distant but to read such objective accounts makes me think that it is not so terrifying and that good (furthering of knowledge of brains) can come out of the worst events.
Upstairs there were two more exhibitions, Medicine man and Medicine now. Medicine man is a selection of artefacts collected by Sir Henry Wellcome and contains all manner of items, some unusual, such as napoleon's toothbrush or a mourning hair brooch, but all really interesting. There was an audio tour and after trying to use it and discarding it as useless, i tried again and heard a very easy to follow commentary on certain objects.
Medicine now fast forwarded everything into the present, the clue was in the name. This contained many pieces of artwork centric on medicine and the human body. There was a terrifying piece which mechanically opened and shut an eye at long intervals, just when you were not expecting it! I'm embarrassed to admit I did scream... At the end there was a large wall full of visitors artwork on particular topics, I chose sleep, I thought this was nice as it allowed everyone to leave their marks (until they get replaced by the next people, that is).
I highly recommend visiting this collection as it would be interesting for all ages and as a plus, It's completely free! We spent a long time in the Wellcome collection, more than we had anticipated, probably due to me getting encapsulated in every artefact and struggling to more on quickly. We had to rush our dinner, not desirable... ;)
This exhibition was fascinating and covered a lot of topic from the old fascination with measuring intellect in brain size to modern day brain surgery. There were many different displays which I loved but I had 2 favourites. There was this amazing video of bloodflow to different regions of an individuals brain, by brain scan whilst he was listening to some music, you could listen to the music and it really does demonstrate how music can affect brain functioning, with there being sudden bursts of red (signifying high levels of blood flow) as the music climaxes. There was also photos and testimonies of several different people who planned to donate their brains to medical science and research, it was weirdly peaceful to hear their motives to donate and it did make me stop for a minute and think about the end of life, to me it seems daunting and distant but to read such objective accounts makes me think that it is not so terrifying and that good (furthering of knowledge of brains) can come out of the worst events.
Upstairs there were two more exhibitions, Medicine man and Medicine now. Medicine man is a selection of artefacts collected by Sir Henry Wellcome and contains all manner of items, some unusual, such as napoleon's toothbrush or a mourning hair brooch, but all really interesting. There was an audio tour and after trying to use it and discarding it as useless, i tried again and heard a very easy to follow commentary on certain objects.
Medicine now fast forwarded everything into the present, the clue was in the name. This contained many pieces of artwork centric on medicine and the human body. There was a terrifying piece which mechanically opened and shut an eye at long intervals, just when you were not expecting it! I'm embarrassed to admit I did scream... At the end there was a large wall full of visitors artwork on particular topics, I chose sleep, I thought this was nice as it allowed everyone to leave their marks (until they get replaced by the next people, that is).
I highly recommend visiting this collection as it would be interesting for all ages and as a plus, It's completely free! We spent a long time in the Wellcome collection, more than we had anticipated, probably due to me getting encapsulated in every artefact and struggling to more on quickly. We had to rush our dinner, not desirable... ;)
Friday, 1 June 2012
HIV and Immigration
Yesterday I had very a busy day; I went to the Wellcome collection's exhibition and to the Royal Society of Medicine's lecture about HIV and immigration. I'll post about the Exhibition tomorrow but for now I'll tell you about the lecture.
At first I was very apprehensive about attending the lecture as, despite being told otherwise by my well seasoned friends, I was expecting it all the be a bit over our heads- degree level information. It was in the very impressive Royal Society of Medicine in London and although it was a public event, there didn't seem to be anyone below medical student level, except us.
Expectations aside, I really, really enjoyed the lecture. We all understood it all,apart from a pesky 'CD4 count' (which I promptly looked up- a marker on the outside of many immune cells apparently), and the speakers were all very engaging. The lecture was mostly centred on the troubles with preventing HIV vertical transmission in the UK and how we could apply effective methods from Africa to the UK.
Obviously I cannot recall word for word the lecture but I'll try to give the 'highlights' and basic gist of it all. Firstly, There are several issues involved with diagnosing those of African origin with HIV, either because people don't think they need it because they are not one of 'those' people or because it is simply not offered- many doctors believe that they are not well trained enough to carry out the councelling if a positive result did occur. There is a high percentage of late diagnoses in African individuals in comparison to other ethnic groups, which is bad because the earlier treatment begins, the higher success of avoidance of vertical transmission. In addition, if a positive result is shown, due to the shame and stigma surrounding HIV (HIV is positively correlated with domestic abuse in Africa) , many individuals, women especially, do not tell anyone about it, and therefore lack the social support so badly needed, perhaps resulting in depression. Although offering social support, their religious faith may negatively affect their health, encouraging them to rely on prayer and God rather that the Antiretrovirals they have been prescribed.
There are two solutions that have been put into practice to combat these issues, firstly a peer scheme, with each woman diagnosed with HIV being paired with a woman living with HIV can give her hope and support from someone who knows what she is going through and all of the questions that are running through her head. Secondly, christianaid is working with many faith leaders to try and bridge the gap between healthcare and religion, to try and ensure that the two can work together and are not mutually exclusive, both successfully promoting the other.
Although both these methods are proving to be quite successful, there is a long way to go yet. It will be an uphill battle against HIV in this country, a doctor from the audience told us about a group operating called HEALlondon, HIV denialists, who could potentially cause the deaths of many by spreading their unfounded beliefs. We should continue to review all courses of action about HIV to ensure the methods are as effective, and appropriate as possible to prevent the loss of future lives to the vicious virus.
^^^^^^^ this was what I have learnt from the lecture, I found it thoroughly interesting and look forward to finding out about more social impacts and solutions to illnesses such as this one, and has made me only more driven to gain a place at medical school, so I can spend my life learning about such issues and evaluting treatments. I have it all to come!
At first I was very apprehensive about attending the lecture as, despite being told otherwise by my well seasoned friends, I was expecting it all the be a bit over our heads- degree level information. It was in the very impressive Royal Society of Medicine in London and although it was a public event, there didn't seem to be anyone below medical student level, except us.
Expectations aside, I really, really enjoyed the lecture. We all understood it all,apart from a pesky 'CD4 count' (which I promptly looked up- a marker on the outside of many immune cells apparently), and the speakers were all very engaging. The lecture was mostly centred on the troubles with preventing HIV vertical transmission in the UK and how we could apply effective methods from Africa to the UK.
Obviously I cannot recall word for word the lecture but I'll try to give the 'highlights' and basic gist of it all. Firstly, There are several issues involved with diagnosing those of African origin with HIV, either because people don't think they need it because they are not one of 'those' people or because it is simply not offered- many doctors believe that they are not well trained enough to carry out the councelling if a positive result did occur. There is a high percentage of late diagnoses in African individuals in comparison to other ethnic groups, which is bad because the earlier treatment begins, the higher success of avoidance of vertical transmission. In addition, if a positive result is shown, due to the shame and stigma surrounding HIV (HIV is positively correlated with domestic abuse in Africa) , many individuals, women especially, do not tell anyone about it, and therefore lack the social support so badly needed, perhaps resulting in depression. Although offering social support, their religious faith may negatively affect their health, encouraging them to rely on prayer and God rather that the Antiretrovirals they have been prescribed.
There are two solutions that have been put into practice to combat these issues, firstly a peer scheme, with each woman diagnosed with HIV being paired with a woman living with HIV can give her hope and support from someone who knows what she is going through and all of the questions that are running through her head. Secondly, christianaid is working with many faith leaders to try and bridge the gap between healthcare and religion, to try and ensure that the two can work together and are not mutually exclusive, both successfully promoting the other.
Although both these methods are proving to be quite successful, there is a long way to go yet. It will be an uphill battle against HIV in this country, a doctor from the audience told us about a group operating called HEALlondon, HIV denialists, who could potentially cause the deaths of many by spreading their unfounded beliefs. We should continue to review all courses of action about HIV to ensure the methods are as effective, and appropriate as possible to prevent the loss of future lives to the vicious virus.
^^^^^^^ this was what I have learnt from the lecture, I found it thoroughly interesting and look forward to finding out about more social impacts and solutions to illnesses such as this one, and has made me only more driven to gain a place at medical school, so I can spend my life learning about such issues and evaluting treatments. I have it all to come!
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