Sunday, August 22, 2010

Buckling Down

Now that I’ve gotten settled into a (temporary) living situation, there are fewer random life-associated things to report. Early this week I had another meeting with Prof. Mayanja, Aggrey, and Ekwaro, and we decided to move forward with exploring possible work to be done on the topic of HIV in older adults (>50). 

Much has been written about how the HIV/AIDS epidemic affects older adults in Africa, mostly discussing how they have to take care of adult children and orphans, and the impact of providing that care on their own health. However, there’s only been one publication (that I have found) about older adults with HIV/AIDS in Africa. There have been a couple dozen publications from Western Europe and the US about virologic/immunologic/clinical outcomes in older adults with HIV, comorbidities, different antiretroviral treatment regimens, etc., and I spent most of the rest of the week reading those. I still have maybe 20-25 articles left to read, but it’s a cool feeling to know that at the end of that I will have read most of what has been written about this topic.

I’m excited about exploring this area. I’ve started jotting down notes about information we might be able to generate here that would 1) improve the care of older Ugandan adults with HIV (and perhaps older Ugandan adults in general), 2) inform fellow health workers in order to improve the care of older African adults with HIV, and 3) inform the international community about the unique situation that older adults with HIV face in this setting (due to different risk behaviors, social/economic/cultural factors, medications available, comorbidities, and so on), compared to patients in the West.

Of course, the actual work is going to be designing and implementing a study that will allow us to generate this information, but my plan is to dive into the literature, try to get a nuanced understanding of what is known, how it was discovered, and what needs to be done, and then to start to think through a protocol. I’m going to have to rely on Aggrey and Ekwaro (and many other people here) to help me discern what is relevant and feasible.

I also got in touch with colleagues at the Action Group for Health Human Rights and AIDS (thanks Sarah!), which is a sister organization of Physicians for Human Rights. I’m hoping to visit them in the next two weeks, and will write more about the organization for the PHR Student Blog after that. I’ll probably also write about Peter Mugyenyi’s book “Genocide by Denial: How Profiteering from HIV/AIDS Killed Millions”. Mugyenyi is the official Ugandan mentor for my Fogarty program, so it was fascinating to learn about his work at JCRC over the past 20 years, as well as his perspectives on access to essential medicines, TRIPS, patient care, etc.

Random Notes:
- Scoured Nakumatt (one of the 3 main supermarkets) for a Pinot Noir, without luck. Found lots of Pinotage, which Wikipedia informs me is South Africa’s signature wine and is related to Pinot Noir. Sipping on it now (out of a tea cup) and it tastes great!
- Submitted 3 abstracts to the annual Makerere College of Health Sciences Scientific Symposium, two of which were with friends at Uganda Village Project and one about work with PHR's Student Program. Fingers crossed!
 - I want to start taking language classes soon. Luganda costs $105 and Kiswahili is $150 for 30 hours of tutoring. Not bad at all. I think I’m going to start with Luganda since I know a bit, and then branch out to Kiswahili later.
- There was hail during a rainstorm here today. The “nuts of the water of heaven” as Achebe calls it his classic, ‘Things Fall Apart’. Reminded me of Spring in Texas.

Temporary housing at Golf Course Apartments. Not too shabby...
View of the golf course, out of our (temporary) living room window. $100/person/18 holes.

1 comment:

  1. Sujal - I love the updates. I also love the "diving into the literature" (i.e. working on a project in a country where it takes weeks to months to get something going, so the best thing to do currently is to read and read and read to get better informed until there is some actual movement on work). I hope all is well.