TASO Summary

I came to TASO to learn about HIV and it socio-economic impact on developing 3rd world countries. I really wasn’t sure what I’d be exposed to or how involved I would be in treating HIV patients. My college funds internships like this one with the expectation that students tackle a major global or social justice issue. HIV prevalence and a lack of volunteers are two major global issues deemed important by the World Health Organization so TASO seemed like a good place to work and to increase my understanding as to why HIV is so prevalent in East Africa. I imagined that I was going to physically assess patients and interact with them to learn about their lifestyles and ways they could live healthier lives. At the end of my internship, I can say I accomplished most of what I set out to do, but have learned much more about the factors promoting HIV prevalence than I anticipated I would.

Upon my arrival, I was placed initially in the medical lab to assist with collection and analysis of blood samples. I was annoyed that I was placed in the lab, because I could have easily found a lab to work at in the US. Having traveled all this way to Uganda, I wanted to be able to interact with patients. Thankfully, a brief meeting with the medical coordinator resulted in designing a schedule, in which I would move around to different departments each day, and interact with and assist a counselor. As a result, I was able to gain a better understanding of various activities at TASO.

I typically worked in the clinic Mondays and Fridays, where I would collect blood samples from patients for CD4 counts and test for other communicable diseases (e.g. malaria, tuberculosis, syphilis). The activities on Tuesdays and Thursdays varied greatly; I spent some days in the adolescent clinic, where kids and young teenagers were rounded up and asked about any difficulties in adhering to their medicine(s), how school was going, how to eat healthier, and how to live in sanitary conditions. While these lectures were given to a general audience, adolescents then met with counselors one on one to discuss any private issues. Another clinic that was held on Tuesdays was the Prevention of Mother to Child Transmission. This clinic was specifically for mothers, and like the adolescent clinic, consisted of a group lecture followed by individual meetings. HIV positive mothers were given the necessary instructions to keep their babies HIV negative (taking anti-retroviral medicines while breastfeeding, visiting TASO to test their babies for HIV, etc) before meeting individually with counselors.

On Tuesdays and Thursdays, I participated in Community Drug Distribution Point trips, called CDDPs. TASO has set up meeting places in surrounding villages where they visit every six months to re-bleed patients for CD4 samples and to administer medications. People in a village travel to a central point and within a few hours, everyone can be treated. On these trips, I was responsible for managing clients’ files and assisting with blood drawings. We would sometimes visit multiple points, with each site containing 10-50 clients, so those days were always exhausting. Wednesdays were by far the quietest day of the week. TASO tries not to schedule appointments on Wednesdays, so there aren’t too many patients to attend to. The day is usually spent analyzing samples from the clinic or CDDPs, and recording hard and soft copies of patient results. It is imperative to run samples and record quickly because samples will just backup if they are not analyzed. TASO has a few other programs that offer mentoring sessions to other health clinics. In short, I primarily assisted physicians in clinics and helped counselors in counseling sessions.

Despite being exposed to the various departments, there were some difficulties I personally experienced that I wish I had more support for. When I first began working in the clinic, I was thrown into pricking and drawing blood from patients without any real training. Maybe people assumed since I was white and from the US that I had already learned basic medical techniques. I really struggled with the first few patients I had; it wasn’t until I had to desperately ask for help that someone corrected my technique. It would have been more helpful to me (and less painful to the patients) if someone had sat me down, and taught me the proper technique for bleeding. Lesson learned – speak up when I don’t know something! Another problem I had was the language barrier. Few clients knew English, but Luganda and Lusoga were the most common local languages used at TASO. I usually was paired with a counselor who was bilingual, but we moved at a rapid pace as there were a fair number of clients who needed to be counseled. I understand I could have spoken up about having someone translate a conversation for me, but I still didn’t appreciate the promise from the medical coordinator that never materialized. If there is one regret about my experience, it is not being able to talk in greater detail with the clients. The stories I heard from the English speaking clients were very thought provoking, and I could only imagine what other stories I may have missed.

For these negative experiences with TASO, there were many positives that served as a counterbalance. My time at TASO has shown and taught me a lot about HIV prevalence and healthcare outside of the US. I learned patient communication skills and lab techniques that I will likely encounter or use in a medical setting. I learned how to maintain composure if a patient proved to be difficult or uncooperative. I learned how counseling programs and trips to the field demonstrate both encouragement and support to patients who are doing their best to break free from the grasp of poverty. I learned that HIV prevalence isn’t really a medical issue at all; there are so many political, economical, and social factors that President Museveni and his party can tackle which would result in empowered, educated people. I would not have learned any of these things if I was working by myself. There was never a day that I worked alone. Whether I was in the lab, or in the field, I always had a supervisor with me. The staff at TASO helped me refine techniques when dealing with patients, but also shared their insights regarding the larger problems Ugandans faced. Being able to talk with sensible, educated workers really helped broaden my understanding of a country that most Americans know nothing about. My interactions with the staff have definitely been the highlight of the trip, and I’m very grateful that they were willing to have such delicate conversations with me. TASO does great work. As long as it has dedicated staff, TASO will continue to make its vision of an HIV-free Uganda more of a reality.