In which I attempt to be a qualified prenatal nurse, part 2.

*Out of chronological order as this post is a continuation of the story from two days before. (7/26/2012)
Spent several hours yesterday at the HIV clinic with Esther and her mother Mary. It was good to get to know them a bit better, not so good to sit on a terrible bench in the waiting area until my back ached and my butt was numb. During the waiting I learned that Esther had meningitis around 6 years old and has never been mentally well since. We talked of the father of the baby and how he has "run away" and is refusing to pay anything for impregnating Esther.  He also has abandoned two other children with his wife when he ran away. Clearly he is going to be no help whatsoever.
When we first arrived we got Esther enrolled in their HIV positive mothers program and then got her blood drawn for a CD4 count. Hours later we were finally called in to talk with the "doctor." She handed Mary the lab slip, said her count was fine and that she didn't need anything at this time, to come back in 6 months. Wait! I practically jumped out of my chair but on account of my legs being numb wasn't able. "Doesn't she need ARVs on account of the pregnancy?" "Oh, she is pregnant?" Good grief. She is due in three months and big! And we are part of the positive mothers program- that is why we are here! But I learned that as her count is still above 200 all she gets is a daily cotrimoxazole.  Her count is around 550 but a healthy persons' should be 1000 or more so I kept pushing for ARVs but she just wasn't going to get them. I asked if the "doctor" could interpret the ultrasound results for us but she just told Esther and her mother to return the the clinic on the followup date. I explained to her that I wrote that followup date and I was the one they were going to be returning to.  Finally she wrote a referal to Soroti main hospital but as that is where they had the scan done and no one did anything with their case at that time I'm not overall hopeful for their next visit. But I did  managed to arrange for them to come back to the HIV clinic for a repeat CD4 in two months so if she does drop lower we won't lose too much time getting her on ARV's. Anyway, please pray for them. Esther is in no position to care for herself, her parents are both elderly (well into their 60's which in Uganda is not common) and the father of the baby seems like a sleeze bag.