Rainbows

10.11.2017

While counseling a new CBS reactive client, these came out. 

It’s a sign, a promise. 

I have a feeling you’re going to be fine.

He said, “I will be. I have to be. I need to be.
#fortilocandia

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Turn Time Back

10.10.2017

Ever thought of turning back time?

Maybe lingered in that one long unending moment of pain?

Or lived in the past where things were a lot better?

Instead of making the most of the time you have.

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An overnight at Gigantes

07.09.2017

We got to the first island (Balagon Island) at around 1130am yesterday. Boom! A girl friend got stung by a big jelly fish. We were frightened that we had to bring her over to the nearest island where an e.r. is set up, we didn’t had to. She didn’t waste a tear and manned up. She was involuntarily trembling but yeah, she was fine after a few hours.

Lunch was served at MJ’S in the Island of Gigantes where we were checked in. We were served grilled scallops and pork with monggo beans. 

It was a pleasant lunch although the flies around us were bothersome. We ate at a cottage outside the resort. 

Around 2, we went on to 4 other islands.  Tanque island where a seawater lagoon was located in the middle of the island. Unfortunately, the water (tide) was not high enough to reach the lagoon. We went on to Cabugao island where we went up around a 30ft high hand-made stairs by the side of a mountain—to take pictures. After Cabugao, Bantigui sand bar but the tides covered the sand bar. We proceded to antonia beach but there wasnt much to do there, we transferred to Puting baybay (white shores) but the boat stayed around 20-30 meters away from the shore, the group just jumped into the water and tried to enjoy, of course everyone was paranoid about a possible jelly fish invasion.

(Top pic taken at the tanke saltwater lagoon. Bottom pic from Bantigui)

Last island was Puting baybay Where as always, I was able to get a good shot of the sunset. 

We got back to MJ’s before 6. Dinner was served.  Crabs were fresh and meaty. The stir fried squid was a tad overcooked but well seasoned.

We got up around 6am for breakfast. Hotdogs, Scallops adobo and Rice.  Nothing fancy but good enough to start a day off. We headed back out to Tanque island and the lagoon was nice, t’was a bit high tide and the place was filled with water. We also went back to the sand bar where the sand lined the sea, as if a 4-6feet wide (100-200 meters long) sand was floating in the middle of the sea.

Back at MJ’s at 1130sh for lunch. We were served Chicken Binakol and Breaded scallops (unfortunately the locals didn’t had tartar sauce dips).  It would have been a nice lunch had it not for the flies. 

We left around 130 for a 40min boat ride back to the port.  Before we left, I approached the TG supervisor and gave my card, told her if she has time, come over to ilo-ilo for HIV testing. She was interested and I felt guilty because I opted not to offer HIV screening the night before–knowing I had a few kits with me (and the ghost of laziness took over me)

MJ’s offered unlimited soda and coffee, staff were nice and cute kids helped serve food and clear table.  We paid 1,699php (around 34dollars) per head for the entire island hop package, boat rides, accommodation and food. Not bad. 

The islands were nothing special. The water was better, clearer at Bohol.  Food was good, but better in places like Cebu and Boracay.  People were definitely friendly. Boatmen were funny. 

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A Hell of a Day

09.07.2017

Septembet 6. 10am. Went to Antipolo to see a client, diagnosed 2015 but he never sought treatment.  We talked, talked, had lunch, and talked some more.

4pm. Went back to Quezon City,  further north of the city, to see a client diagnosed 4-5months ago and has been symptomatic for the past two months. We talked, talked, talked, had dinner, and then talked some more.

Between  10am and 7, I had to make several stops to respond to emails, take and make calls, and reply to text messages.

Got home around 830pm,  and someone wanted to get tested. I wanted to reschedule but he’s very anxious so I said yes. He said we can meet around midnight. I told myself, “rest, baby!”

11pm, I got an endorsement for another client for screening, drove out to his place 10 minutes away.  And then off to my midnight schedule who arrived late 130am.  

215am. I was on the way home and a call came in. “DON’T ANSWER THE EFFING PHONE!” I told myself, but after three missed calls, I parked and called back. Another lost to follow up from last 2016, wanting to seek treatment.

3am. I craved for some burger machine only to stand in queue for 15minutes, and I decided to drive thru Jollibee.  I asked the cashier if the burger I wanted was available, she said yes.  After taking my cash, she went like, “Sir, 5 minutes, ok lang?”. I took a deep breath and said, “Yes.” with a smile (YES!!!!! WITH A SMILE). I went on to the next window and the next girl handed me my soda,  fries and then, “Sir, 10minutes….”  

I was like, the girl said 5minutes.

She said, “ay, OK, 5minutes”

And from behind, the guy shouted, “Out!” 

And the girl told me, “ok na, sir”

340am. I had my Amazing Aloha- a quarter pounder with bacon and pineapple. 

Yes…saved. The long day was was all worth it. 

Now, who will debrief me?

Thanks to Grey’s Anatomy and The Catch,  and my Amazing Aloha Burger, I’m okay. And as Dr. Derek Shepherd said…

It’s a beautiful day to save lives.

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Latest Health Dep’t Order Moves Us Forward

09.22.2017

We have for so long been waiting for this to come out.  Finally, a week ago, the Department of Health signed an administrative order (2017-009) with the subject:

Policies and Guidelines  in the Conduct of HIV Testing Services in Health Facilities

Click here for the file:2017 DOH_AO_2017-0019

Some highlights of particular interest to the community are:

  • Community-based HIV screening is defined as “Non-laboratory  rapid HIV screening procedure done outside a health facility by a trained member of community-based organizations or groups”
  • ALL pregnant women and confirmed TB Patients will be routinely offered HIV testing
  • Community-based HIV screening…”shall be offered to key populations. Trained and supervised lay providers can independently conduct safe and effective HIV screening using rapid diagnostic kits.”
  • Health care workers (doctors, nurses, medical technologists, midwives) are allowed to perform the procedure (in reference to HIV screening, section VI.B)
  • rHIVda or Rapid HIV diagnostic algorithm is in the same document.  This essentially addresses the 3 weeks (or more) of waiting time for patients who got tested reactive awaiting treatment.   Of course,  clients may be link to care without the confirmatory in  accordance to  Section VI.F (Connection to care) with reference to the Department Circular  2016-0171.

So what does this mean?

It doesn’t mean shit if our social hygiene and health offices won’t respect the order from the Secretary.   It means the world for the hard-to-reach community finally with options to access screening at the comfort of their own home, or car, or shop, or wherever.

It means more and more people can access HIV screening, especially those who don’t want to go to clinics.

It means more and more organizations get to engage in the program. It also means more capacity building is needed.

It means someone has to mapped municipalities and cities without HIV testing services since ALL TB patients and pregnant women will have to be suggested to undergo HIV screening.

It means midwives, especially the private ones,  will and can have the ability to do screening to reach more women.

It means the community will have to partner with their local units.

It means the local government will have to partner with the community counterparts for community based screening to happen, and to be successful.

It means more investments around training and quality assurance.

It means a lot, lot more beyond this page.

Above all, it means saving more lives.

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When Pozzies Gather

 

09.13.2017

A few nights ago, we had the pleasure of meeting a few members of the positive community in Cebu.  It was a  fun night. We were laughing and @cebur14m was particularly funny.  Stories were shared.  Laughter filled the hallway where we were seated.

cebupz

me, standing at the back (sorry for the icons). Others in the pic: 

 

 

Serious moments were inevitable.   Issues were shared. The lack, or absence, of CD4 for some time now, and viral load.  The death of a someone at the shelter. The condition at the shelter.  Sharing about Philhealth came up. Information about baseline labs were asked.

Then the goddess of fun cast a spell yet again. Jokes flew across the room, er, the table.  It was a fun night.

It was a good support group. A real support talk. With peers. By peers. No resource speaker. No trainer. No hidden agenda.  A talk over coffee not driven by any funding agency. No minutes of the meeting. No documentation.

T’was a nice evening.

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Wil’s Road That Kept Winding

09.13.2017

road

CD4 = 5

You first came to me asking for help, you skipped treatment and wanted to come back for your ARVs.  I referred you to Ed. It took sometime before you eventually did.

CD = 3

You came back and this time, your condition was worse. You were given the basic labs and was found to have CMV, your left eye was going blind.  You were thin.  Very thin.

CMV Bout

You had to process PCSO assistance to secure your CMV meds since they cost a lot, too much even for a middle class citizen.  But you were unable to sustain the efforts of going to the charity office to secure assistance, you were on and off with your valcyte.

Cebu

We eventually decided to bring you to Cebu, where gancyclovir would be more available and where you can be housed temporarily in a shelter, for free.  We raised money for your plane ticket.  It took more than a month before you had your first gancy, and then your succeeding gancy.  But shortage came, and you had to stop.  The plan with your sister was to bring you back to Manila for treatment, again.

Silence

We never heard from your sister.   Until a few days ago when we were in Cebu with a group of pozzies and they mentioned you in passing. We were surprised.  They said you were gone. They said you died.  In disbelief, Ed checked the facebook posts of your sister. And yeah, you’re gone.  You left last June. It’s been three months. You left.

Memories

As with the others, you are now just a memory. “Just”.  It’s sad,  Do people even remember you?  Like when you attended the rooftop (er, a.k.a. penthouse) gathering where I thought you were doing better. Like when you came to Quezon City to get some money for fundoscopy.  Like whenever you would come in to the clinic for your labs, or refills.  Like when you used to work before your body came down with complication.  Do people still remember you?

Questions

I was left with questions:

  • Why was it too difficult to secure PCSO assistance especially for someone with no family to help him out, and who’s physically challenged to go through the queue at 3 in the morning?
  • Was I wrong to send you to Cebu thinking you would get the much needed treatment and attention there?
  • Was I wrong to send you to Cebu having heard that the shelter was depressing and sad for people who lived there?
  • Was I wrong to assume you were doing okay?
  • Do you hate me?

Answers

  1. Your never-ending winding road ended. You’re okay now. Better than ever.
  2. I’m sorry.

 

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Region 3 (Central Luzon) Treatment Facilities – as of June 30, 2017

09.04.2017

For your reference, here are the list of the Central Luzon treatment facilities as of July 05, 2017:   ( IF you need a soft AND CLEAR copy, please email hashcommunityoperations@gmail.com  OR try this file: ART FACILITIES AND PERSONNEL DIRECTORY as of July 5, 2017)

Region 3 ART Faci1Region 3 ART Faci2

For more information you may contact this reliable coordinator from the region:

Mr. Joseph Michael D. Manlutac  / 09321968475 / chd3hivaids@gmail.com

 

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Zamboanga (HIV) Adventure

08/30/2017

August 27, 2017

We got to Zamboanga around 1 in the afternoon and we went on to our hotel.  We did an online booking and we found (the night before) Jardin de Lavina.  It wasn’t a fancy hotel but for 1500ish per room for two night (already),  it’s not bad. The room was in fact big enough for 2-3 people.

This is out first stop and we had to meet community organizations and orient them about screening at the community level.  My immediate problem was that I haven’t heard from the Save the Children coordinator who’s supposed to choreograph the entire Zamboanga trip — meetings and more meetings.   The last time  I heard from him was via email when he was asking for 4 letters so he can give out to the people we’re suppose to meet.  That was August 21st when we sent him the email.

Good thing “Jet“came into the picture (the girl I wrote about the other day)

August 28. 2017

28th was the National Heroes’ Day so we were luck to have met some community members. Again, thanks to Jet.  Also, credit goes out to our friends from Youth Alliance for Filipino Advocates’  Sam who linked us to his colleagues in Zamboanga, and  Association of Positive Nurse Leaders Advocates (AYNLA).

21268182_10212858808492634_539578724_o

The meeting was productive primarily because we had a clearer picture of how the community is in Zamboanga.    We heard about the concerns and the potentials of the city.  So yeah,  t’was a good place to start the 3-city meeting this week.

Well since the coordinator did not coordinate, and we’re leaving in a few hours and we haven’t heard a word from him, we scrambled to looking for contacts and our project manager (Ed) was able to find “Loida” of the Zamboanga City Medical Center (ZCMC) where the treatment hub was.

August 29, 2017

Since Loida confirmed about the meeting around 6-7 in the morning,and we ‘re suppose to be at the airport past 1 in the afternoon,  I thought we were just gonna kill the time in the morning waiting for our departure for Davao in the afternoon. Long story short, I didn’t get the opportunity to join them in the meeting because I slept late working and I was dead asleep til 1030 in the morning.

I woke up to a message from HDES (an organization in Zamboanga) asking if we can meet that morning. Apparently they did not receive the letter we sent the week before.  Since the rest of the team was still out (to ZCMC), I had to beg off as I have yet  to pack my things.

Ed was saying that the hospital was big.  They weren’t able to meet the treatment hub physician because, well, she was out on a medical mission and they never received the letter that Junpicar (the coordinator) asked from us more than a week ago. Some important notes about the treatment hub:

  • All new patients UNDERGO Psychiatric consult; this  is interesting as mental health has never been an auto-baseline protocol in other hubs
  • All new patients have to settle baseline lab costs of around 2,000 pesos, BUT  they can refer you to medical social services (MSS)  and 2000 can go down to 1600. BUT WAIT,  they can further use the CIU (crisis intervention unit) so the patient doesn’t have to pay for anything.
  • CD4 is done onsite.
  • Viral load is sent out (offsite).

I wish I would be able to write more about ZCMC soon. It’s just sad that I wasn’t able to join them that morning.  I wish we can conduct one more meeting there and this time,  have our new found friends from Mujer LGBT coordinate the meeting.

Anyways, I had fun. Somehow.

By the way,  if you ever need Loida of the treatment hub in Zamboanga, she may be contacted through 09177718147.

So there was a point when Ed can’t help logging into his grindr account and someone messaged him about community based HIV screening.  Ending- the guy’s already been endorsed for confirmatory and treatment. Go Ed! LOLs

 

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“JET”

08.28.2017

May 08, 2017

I just got back from a near 10 hour drive from Ilocos.  I had to see you for HIV screening and admittedly, my mind was not up to it.  Exhausted, I dragged my ass and drove to your location. You were already waiting when I got there.  And inside the car, we talked about your history,  your risks, your concerns. You. Your parents both passed away  years ago and you were in Manila alone. Working in a call center in Manila for almost 10 years, you had no one but yourself.  Your aunt’s your only family, but she’s in Zamboanga, some 1300 kilometers south of the Philippines. You have two siblings, the other one you can’t find and has not been in touch for five years. Your other sibling has a kid, also with your Aunt in Zamboanga.

Screening

The time came and we finally did your HIV screening. Reactive.  You were calm.  You didn’t go all crazy on me. You didn’t cry. Your eyes however said everything.  Your sadness was evident.  We went on to Project 7 Social Hygiene where your HIV test was done along with your baseline tests. CD4 was 164.

May 27, 2017

You went back to Zamboanga City.   You messaged me saying you have moved to Zamboanga. You messaged me on Facebook, but we met on Twitter– so yeah, I was clueless who you were.

August 27, 2017

You messaged me asking if I am in town.  I wasn’t quite sure who you were but yeah, I am in town.  We chatted and it took some time before I finally remembered who you were. You transferred treatment to Zamboanga City and you have been doing very well.   Your treatment has been consistent, although you were given anti-depressants by the Psychiatrist due to occasional depressions.    You felt you were stable and that you didn’t need your psych meds anymore.  You joined a transgenders group and has been active in the community.  You disclosed to practically everyone in town and you don’t care what others think about you. Or your status.

You’re good. You’re well. You’re well on your way.

August 28, 2017

Today, you came in early for a meeting for community-based HIV screening.  You were full of life.   You told me so much stories in the little time you spent here in Zamboanga.  You also told me how much you wanted to start helping with the HIV program in the city.

You looked happy.  And I’m glad you are.  You are looking forward to a better tomorrow– good for you.

It felt like you’ve grown so much in the past few months I have not seen you.

You Owe Me

You must have told me three times since yesterday that you owe me your life. You don’t.  You gathered your own shit and faced your fears. And I, in fact, owe you.  You inspired me to keep going. At a time when I always end my days tired, you inspired me to keep moving.

Keep Going

Please. Keep going.

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