The man that I spoke about in a previous post, with the hypoxic respiratory failure and presumed Pneumocystis pneumonia, died over the weekend. While it is not surprising, since he was not receiving the treatment that he needed for the majority of his hospital stay, it is quite disheartening. I will never forget his face, or how hard he was working to breath. He was begging us for medicine - something, anything that would help him to breathe - and all that we could do was write suggestions for his primary team to follow. Clearly that was not enough.

Me da pena.

In addition to that man, two more HIV positive patients died over the weekend. Granted, many of the HIV patients in the hospital are new HIV diagnoses, and are presenting with fulminant AIDS and two or more opportunistic infections, putting them at much higher risk of a poor outcome. But I just can’t get this sick feeling out of my stomach that something more should have been done. The patients could have been given the correct medications, started the medications sooner, or gone to the ICU. But not here. Not in the poorest hospital in the poorest country in Central America. There is not enough money to pay for the needs of HIV patients, so we are told.

So here I am, the gringa from San Antonio who came to participate in the service of healthcare to patients with HIV in Guatemala, and I now find myself sad and quite frustrated. This is not a small problem, it is a big one. Systemic change is needed. HIV patients should be cared for by doctors that stay up to date on the newest changes in HIV therapy, not by generalists without the slightest interest in immunocompromised patients. HIV patients should have just as much right to an ICU bed as I do.