You do not die from HIV/AIDS

Scratching head?  Now that I got your attention, HIV/AIDS does wreck chaos to your immunity system, but you do not die from it, but die from secondary and ordinary viruses such as TB, pneumonia, etc., that happily and easily enter your body and overwhelm you when your immunity security guards are destroyed by HIV/AIDS.

Since this week we are having an HIV/AIDS workshops, so you may find me talking about HIV/AIDS  more than once already.  But I thought this topic is very important and I want to share those things I learned, and maybe you, my dear readers, would benefit with the knowledge.  Maybe if I wrote this using my own layman words would make this more useful and easier.

HIV - Human Immunodeficiency Virus
AIDS - Acquired Immunodeficiency Syndrome

If you look at the words in the acronym above, and think about it.  HIV is a virus that destroys your human's natural immunity war machine. HIV is a smart virus that goes after your valuable T4 cells that your body produces to fight against foreigners that enter your body all the time.  The HIV attacks these good T4 cells by entering them, changing its internal DNA, and produces yet more HIV virus that leaves the damaged T4 searching for other good T4s in your blood stream.

AIDS is a syndrome that your body will display as the result.

Acute or initial infection (first 2-8 weeks after infected with HIV):
Your T4 cells rush to fight the HIV virus.  Your T4 cells lose the fight. But during this period, your body have not yet build up enough antibiotics to show up on HIV test, so you may be negative, but yet you are actually positive.  Usually you may have mild flu-like symptoms for 1-4 weeks (like sore throat, headache, fever, skin rash).  HIV reproduces rapidly and spreads to your other organs. Your flu-like symptoms would go away.  The irony is that you may turn out negative in an HIV test, you are the MOST infectious (10 times more infectious).

Sero-conversion (6-12 weeks after infection):
Finally HIV test will turn out positive.  Your immune response is still active and trying to get rid of HIV but failing miserably.

Asymptomatic HIV stage - Dormant/Latent Period (6-11 years or more):
During the dormant stage, there are no symptoms of HIV, but HIV continues to replicate rapidly throughout your body and its organs.  You are still infectious and can spread HIV to others through contact with body fluids even though you are less infectious than during the initial infection.

Symptomatic HIV stage (when started, lasts for months or years):
Your T4 counts finally start to drop significantly.  You have very little good T4 cells left in your immune system to fight ordinary viruses that enter your body at all times.  Although you should start as soon as you are tested negative for HIV, it is important now to practice healthy, self-care and nutrition and exercise to go along with your remaining T4 cells to help your body immune system, whatever is left, to fight common viruses (flu, TB, colds, etc.).  You should also try to avoid anyone else with contagious diseases.

AIDS! Advanced HIV Secondary Diseases:
Once your T4 counts have dropped to below 200/microlitre of blood, you just have too little or no T4 cells left in your immunity system to fight against anything.  Your body is no longer able to replace T4 cells anymore.  You start to catch simple viruses and get really sick from them.  Most prevailing (yet easily treatable for healthy humans) viruses that kill HIV positive you would be tuberculosis, pneumonia, bowel infection, meningitis, and cancers like non-Hodgkin's lymphoma etc.  Depending on how well you eat and self-care, you may get sick but beat them, but you will start to have body weight loss and wasting.

Death
Death occurs as your immune system quits and the viruses (not HIV) overtakes you.

So in conclusion, you do not die from HIV/AIDS.  You get infected with HIV, and with your body having such low immunity in later stages of AIDS, and simple and treatable viruses such as TB not HIV/AIDS are actually what would have killed you.  

Two myths I just learned, but there are going to be many more:  (1) you cannot get HIV by mosquitoes.  They draw your blood (when its HIV positive), the virus dies in the mosquito, and furthermore, mosquitoes does not INJECT other person's blood into another, but just its salvia. (2) HIV positive mothers CAN give birth to HIV negative babies, and there are ways to breast feed without transmitting the HIV virus (I will learn more about that later).

The old myth have always been around -- you cannot get HIV by hugging, sitting on the same toilet seat, and so forth.  Transmission occurs only when there are blood and bodily fluids contact between the HIV positive person to another through needles, sex, etc.

The red ribbon is a symbol for solidarity with HIV-positive people and those living with AIDS.

HIV/AIDS Clinic

Yesterday, we started our HIV/AIDS training.  There are still a lot of stuff I need to learn so I can start using the right vocabulary or be able to explain better, but I wanted to post these pictures that I took while we visited an HIV/AIDS Clinic in a hospital across the street from our training center at the Tea Tot Hotel.

A lot of hospital care in Kenya is free or cost little.  However, there is always this problem where people live far, not afford to travel to a hospital, or have to work on whatever they do to feed their families that many either come initially then stopped coming or not come at all.

The hospital from outside seemed like a modern facility with several stories tall and several buildings, but when we came in, they all still look "Kenyan style" with dirt roads, concrete floors, and old falling apart stuff.

Waiting Room (outside with roof)

KSL Terp Monica explaining stuff in their records room -- lot of manual work with no computers.  Files of those that are deceased or defaulted (stopped coming in for treatment) are moved to the other room behind the windowed wall.

Seems that they focus on checking for and treating those HIV/AIDS that may or already got TB.  It seems that because the HIV/AIDS have much lower immunity, so they get TB easily and often. The Chest Clinic focuses on TB with exams and xrays.

Click on picture to enlarge to see better.  See that all counseling and services are free.

HIV/AIDS Pharmacy.  They screen patients to determine if they are reliable with their visits and medication, they would supply medication for 30 or 60 days between refills.  If they find some patients not reliable, they require them to  refill every 2 weeks. They cannot afford seeing scarce medication go to waste.

Patient Counseling and Examination room.  The bed behind Monica is a Gyn bed with leg stirrups.  I am not used to seeing such private space be so public -- windows are open and people can look in from outside.

Nutritionist.

Doctor Office in a tent outside.

Click on picture to enlarge.  You can see a "menu" of services with their prices.  Also see the "wait times".  I was told this is full of crock.  Oh well.

My First Final Exams!

No the exams are not for me.  I developed two Term III final exams for Form I (Freshmen) and Form II (Sophomore) Chemistry.  My Deaf Ed coordinator in our Pre-Service Training (PST) informed Davin and me that we would develop final exams, give them out, and grade them. Davin and I are the only ones in our group that teaches in the secondary education while the rest of my group teach Primary education.

So, last Thursday I was given Form I and II Chemistry text books (very thin and they contain the curriculum for the whole year), a note from a teacher indicating what page to start from, and what page to end to, sample exam used previously, and two student exercise books (which are pretty much about to crumble).

So my journey toward the examination are eye-opening but yet not that surprising.  Its more of "seeing it for myself" than "believing what others say" kind of enlightenment.

There were only like 15 to 20 pages in both Form I and II that they are to be tested -- the material that were supposed to be covered for the entire Term III (two months or so).  So, thinking, with such a little amount of material to study, the questions and their answers should be simple and straightforward.  

So I developed questions that are straight from the text books, and some questions are simple.  I did realize its hard to test if I was not the one who taught the context.  

My Form I and II Chemistry exams.  Both are two pages (front/back), Form I had 10 questions while Form II had 12 questions.  Some questions have maybe 1 to 3 parts (like A, B, and C).

I was also told to come to Machakos Secondary School for the Deaf at 10am yesterday (Saturday).  I was a little perplexed that the class have to meet on a Saturday and do my exam.  But later I learned that  there are other teachers who made them take their exams yesterday as well so that the teachers can do other plans on Monday.  Furthermore I learned that my exam was "practice exam" and that the scores do not count.  So I am double-perplexed for them to make the students take two exams, especially when mine was on a Saturday when they could be playing football (soccer) and volleyball.  Oh well.

Anyway, I came to the school at 9:45am promptly and chatted with the students for a while.  But by 10am all students went to their classrooms to wait for their teachers politely.  I went to the teachers' staff room and waited there until 10:45am.  I have heard often that teachers are not prompt and are often late,  but not "late according to our standards" but "late according to Kenya's standards".  So I experienced it first hand.

Finally she came, and simply allowed me to enter the classroom and start doing my thing.  Its quite an experience to see how classroom culture here is different than what you see in America.  All students are very respectful.  They were very serious and focused on their exam.

Form I (Freshmen) taking my Chemistry Term III Final Exam

They look focused and serious about the exam eh?

Later on, in a different classroom, I gave out Form II exams to these students.

Form II (Sophmore) taking my Chemistry exam as well.  

After they were done, I chatted with them some more, and I learned some things that made me feel bad about the exams I developed.  First, they do not even have the textbooks.  They said for Chemistry, they have only one or two, and sometimes they are shared by the class, or not.  So, some questions I used for the exam was from the textbook, so there are several questions where they simply haven't clue how to answer because they never saw them.  Secondly, in their exercise books, they pretty much copied the text from the textbook that their teacher wrote on the blackboard.  Of course the teacher would not write the whole textbook, so they missed out so much knowledge and examples that exist in a textbook.  So, had I known that, I would have tested them using their student exercise books so I know exactly what they were taught, but then, how would I know they understood them when they were simply copying text into their books.

Second eye-opener -- as you see in the picture below, Kenya has a different grade scale.  If you get only 75% correct, you receive an A.  In America, you have to have something like 90% to get the same grade letter.  Furthermore, if you only get the entire exam half right (50%), you earn a C while in America, you simply would have failed.

So, comparing grades between American and Kenyan children is like comparing Apples and Oranges.  Also if a student actually aced an exam with something like 90%, the kid would not be noticed as s/he would be grouped with others that earned A by getting their exams at least 75% correct.

Kenyan's Grade Scale -- notice that earning at least 75% gets you the best letter grade A while earning only half correct (50%) gets you a C.  This is not just for the deaf schools, but all schools in Kenya.  So, we cannot compare grade scores with American kids, since they have to earn at least 90% not 75% to get an A.

So, for Form I class, only one kid got 81% while everyone else fell below 75%.  One interesting observation I had for Form I was that the girls in the class performed better.  Five girls were in the top six.  I was under the impression that girls in Kenya tend to perform poorly when compared to boys due to their culture and responsibilities (with their families, not at school which tend to treat both sexes equally).  But then, this is only one exam with one class and of course cannot be generalized across other classes and across schools in Kenya.

Form I Exam results. Column from left to right: Number students, earned marks out of max marks, percent, letter grade, number of girls in that group, at bottom on left shows class average, and bottom on right shows average for girls, and average for boys.

I believe if I had an opportunity to do an experiment -- where I would do the SAME exam on SAME class, but I sign the questions (not give answers of course) in KSL, they would have scored better.  I also am confident that if I (not being egomaniac here, but any fluent KSL teacher with positive attitude) taught the class myself on this same context, I think I can bet my Harley that they would have scored much better.  

More on this stuff later when I am situated in my own school site for the next two years.  I look forward to start teaching.  I will be moving into my new (old) home on or around December 15th, but the first school term of 2013 starts sometime in January 2013. 

Hakuna Matata!