“Care and Nutrition for People’s Living With
HIV/AIDS (PLWHAs)”
A lecture, delivered by Dr. (Mrs.) Bernadetta Korubo at a workshop at
Alueken Town Hall, Ogale Village Community in the Eleme Local
Government Area of Rivers State, Nigeria.
Tuesday, January 17th and Wednesday, 18th, 2006.
The workshop was organized by The HIV/AIDS Project of the Centre
for Environment, Human Rights and Development (CEHRD) with
support from the National Action Committee on AIDS (NACA), Abuja,
Nigeria/World Bank, USA.
© Copyright 2006 by Dr. (Mrs.) Bernadetta Korubo and CEHRD. All rights reserved, in
accordance with the World Trade Organization (WTO) Agreement on Trade-Related Aspects of
Intellectual Property Rights (TRIPs). Readers may make verbatim references and/or copies of
the information here within for non-commercial purposes, provided that this copyright notice
appears in all such copies and references.
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PREAMBLE:
People living with HIV/AIDS hereafter refereed to as (PLWHA) can be cared for
at home and when the need arises at a Health centre, care given at home is
called HOME CARE.
HOME CARE
This could be in the form of home visit or live-in care. The person who gives the
care is called a care provider.
(1) Family member
(2) A friend
(3) A support group member
(4) Health worker
(5) A volunteer
The care provider will need “A KIT” (Container)
Containing:(1) SOAP
(2) GLUCOSE
(3) GLOVES OR PLASTIC BAGS
(4) SOME PLASTERS OR BANDAGE
(5) TORCH LIGHT
(6) A PLASTIC SHEET
(7) SOME SIMPLE MEDICATIONS like pain killers and anti-diarrhea. (flagyl;
septrin. etc) and vitamins (Vit. B-CO, Vit-C)
(8) GV PAINT
(9) RAIN BOOT, UMBRELLA
THE ROLE OF THE CARE PROVIDER
The care provider will:(1) Bath the sick
(2) Wash and iron their cloths
(3) Give emotional care
(4) Give physical care and spiritual care
(5) Keep the PLWHA Company
The care provider must have empathy for the patient, he/she must love, be
patient and tolerant, and must not use harsh or degrading words on the patient.
He/she must be very encouraging and reassuring, even at the point of death.
Caring for PLWHA is a TEAM WORK A and calls for concert effort. The people
providing care must be vast in knowledge of HIV/AIDS and they must work in
agreement.
THE HOME CARE SHOULD BE:(1) Informative (telling PLWHA who you are, why he/she needs you)
(2) Educative (educate PLWHA on the latest discoveries on HIV/AIDS)
(3) Counseling (Help PLWHA to make an informed decision)
(4) Nursing care (Bath them etc)
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(5)
(6)
(7)
Help with house hold jobs (cleaning, washing, cooking)
Spiritual (Feed PLWHA with THE WORD OF GOD)
And include Referral when necessary
BASIC FACTS TO BEAR IN MIND
HIV/AIDS has no cure. The infection weakens the body so much so that body
can not fight the virus or get it out. When HIV enters a person’s body, there
may be no sign; the person may not feel that anything is wrong with him/her.
The person may be going to farm, or to fish, even go to school, and he may be
not have any strange feeling, however the virus will be multiplying (Increasing
in Number) inside his body. Then with time the person’s condition starts getting
worse as the virus is increasing inside the person’s body, and the person is not
taking any drug. Eventually the entire system of the person breaks down
completely.
The person is aid to have Full Blown AIDS.
When a person’s condition deteriorates to full BLOWN AIDS, such a person
develops different sickness at the same time. He does not present with any
specific symptom like in Malaria, rather, there are so many symptoms:
(1) Fever that comes and goes
(2) Cough
(3) Rashes on the body
(4) Frequent stools (Diarrhoea)
(5) Headache
(6) Cough
(7) Sore in the mouth
(8) Vomiting
In providing care for PLWHA, the care provider needs to observe precautions so
that he himself does not get infected. These precautionary measures are the
same all over the world and are called universal precautions.
THE UNIVERSAL PRECAUTIONS
(1)
(2)
Wash hands with soap and water before and after care
Try not to touch blood or other body fluid. If you must, then put on
gloves or plastic bags
(3) Do away with used needles, razors, soiled bandages and plasters (Burn
or bury them).
(4) Cover all wounds with water proof plaster
(5) Do not share toothbrushes, razor or sharp objects
(6) Clean up blood or other fluid spills with bleach solution (Jik in water)
In the care of PLWHA the provider will have to treat the common complains and
give basic nursing care.
TREATMENT OF COMMON COMPLAINTS AND BASIC NURSING CARE
HEADACHE
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(1)
(2)
(3)
(4)
FEVER
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Soak cloth in cold water and put it on the forehead for 5 – 10 minutes
REST (PLWHA should be encouraged to rest)
Take pain killers e.g. P/mol 2tab 3 times a day until headache stops.
Go to the hospital if the headache does not go away.
Soak cloth in cold water and wipe the skin
Allow the body to cool
You could fan the body
Open doors and windows for free air flow
When the body feels hot take cold drink
Pain killer: 2 tabs 3 times a day for 3 days
Send PLWHA to the health centre if the fever persists.
SKIN RASHES
(1) Keep the finger nails cut so that PLWA do not scratch the skin with the
nail just scrub skin with your hand.
(2) Give cold bath or let him/her sit under a fan
(3) If the skin is dry do not use soap, use Vaseline, glycerine or calamine
lotion on the skin
(4) Wash and iron all clothes and bed sheets
(5) Bath PLWHA at least 3 -4 times a day.
SORES IN THE MOUTH
(1) Wash with warm water mixed with salt three time (3) a day
(2) PLWHA should not eat sweet things or pepper (pepper will hurt those
sore in the mouth, sugar is a good medium for bacteria to grow)
(3) Put GV (Gentian Violet) on the sore.
FREQUENT STOOLING (DIARRHEA)
(1) PLWHA should continue to eat the food he/she normally eats
(2) PLWHA should not eat food like oranges and green vegetables (These
will worsen the diarrhea)
(3) PLWHA should take plenty SSS (Salt Sugar Solution) made up of 10
levels teaspoons of sugar and one level salt mixed in clean water, the
quantity of 1 beer bottle or 2 mineral bottles.
(4) Give Flagyl-2 tabs 3 times a day for 7 days
(5) Give septrin-2 tabs 2 times a day for 7 days
(6) Send to health center if he/she does not feel better
COUGHING AND DIFFICULTY IN BREATHING
(1) Open window and doors for fresh air to enter
(2) Avoid too many people in the room
(3) Help PLWHA sit upright and use a pillow for support
(4) Fan to increase air intake
(5) Send to health center if symptoms continue
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VOMITING
(1) PLWHA should take plenty of water, juice or salt-sugar solution
(2) Stop taking solid food
(3) If vomit lasts longer than 1 day, send to a health centre
OPEN WOUNDS
(1) Wash wound with soap and clean water
(2) Dry and put GV into the wound
(3) Cover the wound with a bandage
(4) Cut finger nails short so that he/she does not scratch the wound, that
would make it worse.
LOSE OF APPETITE
(1) PLWHA should eat what he/she likes most
(2) Eat small meals, many times in the day
(3) Eat a balance diet (Diet should contain Carbohydrate, Protein and Fat)
BLISTER ON THE SKIN
(1) Do not brake the Blister
(2) PLWHA should wear clothes that do not rub on the wound
(3) Keep the wound dry
(4) Send to hospital if pain continues
RED SORE
(1) This is prevented by making sure there are bed sheets on the bed, and
change them when it is soiled.
(2) Keep changing the sick persons position every 4 hours
(3) Rub powder on the areas that touch the bed (Back of head, shoulder
blades buttocks and heels)
(4) If bedsore comes treat like open wound
LOCAL REMEDIES
PAWPAW: Wash, dry and store the seeds PLWHA Swallow 4 seeds at once on
1st day. 1 or 2 seeds 3 times from the 2nd day and continue till diarrhea stops.
GUAVA AND MANGO LEAVES
Wash and boil leaves cool it and give to PLWHA to drink 2 cups a day until
Diarrhea stops.
BASIL (SCENT) LEAF:
Pick 15 large leaves. Wash and drain them, wash hands well and rub the leaves.
Squeeze the juice out. drink all at once give PLWHA 3 times a day until Diarrhea
stops.
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RICE WATER
Pour water into a rice boil; drain off water into a cup, add little sugar PLWHA
take as often as he/she can.
COUGH AND SORE THROAT
HONEY AND LEMON SYRUP
(1)
(2)
Squeeze Lemon mix the juice with little honey and water give 1
teaspoon every 2-3hours
Galic: Peal and chew or grind to drink in a little water.
ITCHING BODY RASHES AND BOILS
(1) Aloe Vera: Wash leaves, pound, bring out juice and rub juice on the
rashes
(2) Aloe Vera and Black Soap: Slide open Aloe Vera leaves and scrape out
the gel, mix with black soap to make it smooth paste, put on the skin
after bathing do not wash off.
(3) Palm kernel nut oil: force out oil from kernel by heating the black seed
and rub it on after bathing.
Back of Cashew Tree: Remove back, wash, and soak in clean water for 6hrs.
Gargle with the water 2 -3 times a day. Do not swallow. Use sticks from the
cashew tree to clean from the cashew tree to clean your mouth at night to
prevent sores.
SUPPORT
The word support means amongst other things to sustain a person in mind,
spirit and body. It is to hold up and add strength to. Indeed people living with
HIV/AIDS need support, they need to be sustained; held up and be given
strength. They need the following forms of supports.
(1) PHYSICAL
PLWHA may be so sick that he/she is unable to stand up, or sit down. He/she
should be lovingly helped to stand up or sit down. On no account must he be
reminded of what brought him to this present condition. The provider should
keep encouraging and reassuring him/her.
(2)
MATERIAL
PLWHA will not be able to do farm work or go fishing for their upkeep. They
should be given food stuffs, clothing and money. Thank God for the African
Culture of Communal and extended family living. Friends, members of the family
should all provide victuals (food or clothing) for PLWHA.
(3)
EMOTIONAL
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PLWHA are usually depressed, anxious and fearful. They wallow in regrets and
self pity. Some even contemplate suicide. The care provider must keep
encouraging and reassuring them. His/her mind should be taken off his
condition. Introduce indoor games like Ludo, Cards, Scramble “snake and
ladder” e.t.c. the care provider should keep the PLWHA company crack jokes,
try to keep them happy.
(4) SOCIAL
The provider should keep PLWHA informed about happenings around him/her in
the political, religious and secular circles. The provider can organize small simple
party for the PLWHA, all the keep him abreast of the time and thereby heal
him/her of depression.
(5)
COUNSELING
PLWHA need and deserve a listening ear. Encourage them to open up and listen
attentively. Help them make informed decision about their life and solve their
problems.
(6)
SUPPORT GROUPS
This is made up of;
1.
Volunteers
2.
Philanthropists
3.
Religious Enthusiast
4.
Charity Workers
5.
PLWHA
They pull their resources together to render help in kind or cash to PLWHA.
They also give them moral & emotional buffer, giving them shoulder to cry on.
They make themselves available and accessible to PLWHA. The care provider
should locate a nearby support group and register the PLWHA under his/her
care.
PREPARING FOR DEATH
No matter how a patient is cared for there comes a time when death knocks.
The care provider must make sure the patient sorts his/her life with God. Make
sure he confesses all his/her sins and that he forgives every one who offended
them. Find out whether he/she left any will, if not help get a lawyer to prepare a
will. Find out how he will like to be buried, find out colour preference, help him
say his final prayer. If possible call in a priest to give him communion and say
farewell to everyone.
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REFERRAL
Referral is when a patient is sent from one place to another to get better care.
It might be from home to a health center, hospital or to a support group for
PLWHA or to church group for examples. When PLWHA becomes very sick for a
long time and especially develops:(1)
(2)
(3)
(4)
(5)
(6)
(7)
Sores (thrush) inside the throat and cannot swallow
Serious loss of water especially through diarrhea or vomiting
A high fever or one that keeps coming back
A cough that does not go away for up to one month
Frequent stooling that last for more than one week
Confusion
Serious vomiting for more than 24hrs, he should be taken to the
Hospital.
CONCLUSION
People can live 10 years after contacting HIV if he/she lives positively. “Positive
living” is what people living with HIV/AIDS can do to live longer and healthier. It
means changing the way you behave and think. It involves doing the things that
help you, avoiding the things that harm you or others. It includes the following
in:
(I)
ENVIRONMENT/HYGIENE
Keep your surrounding clean by;
(1) Cut or weeds grasses around your house and throw away all used
water to keep mosquitoes away
(2) Sweep your room and keep them clean from dust
(3) Wash bathrooms and toilets with disinfectants and cover latrine holes
(4) Keep your kitchen, cooking thing and food free from flies. Do not leave
food uncovered.
(5) Wash and dry all plates and pots after cooking.
(II)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
PERSONAL HYGIENE
Take a bath at least twice daily
Wash your cloth with soap and dry them in the sun
Brush your mouth and teeth at least once a day
Keep your hair clean by barbing or plaiting it
Cut your nails regularly
Cover your hair when cooking
Wash your hands well before and after eating, and after going to the
toilet
FOOD AND HIV
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Though food cannot cure HIV/AIDS it helps to keep the body strong to fight
illness. PLWHA need a balanced diet (i. e. eating food that contains
carbohydrate, protein and fat).
(1)
(2)
(3)
CARBOHYDRATE: Give energy and include corn, rice, yam, cassava,
potato and other sugary foods.
FAT: Gives energy, it includes oil, butter and margarine, fatty meats
and fish, coconut, palm kernel, cashew nut.
PROTEIN: Builds and repairs the body, meats, fish, eggs, milk soya
beans, nuts, groundnuts, egusi.
VITAMINS AND MINERALS
Protect the body from sickness. Vegetables: bitter leaf, Ugu, Melon, Carrot,
Cabbage, fruit like pineapple, banana, pawpaw, guava, and mango, orange.
Water helpes break down food and keep the body health. PLWHA should take at
least 4 litre (4 beer bottles) of clean water everyday.
FOOD HYGIENE
(1) Cook all foods well before eating
(2) Wash all fruits and vegetables in clean water before eating
(3) Boil water before drinking, if it is not clean
Avoid alcohol, drugs and smoking, these may cause HIV to advance more
quickly. Under the influence of alcohol people are involve in risky behaviour
like having sex without a condom.
WORK, REST AND STRESS
Staying active helps one avoid getting depressed, stressed or worried. Stress
affects the body’s ability to fight illness. Take enough rest and avoid hard labour
that tires your body.
RISKY BEHAVIOUR
Don’t be careless about sex with your partners. Practice safe sex using a
condom or abstain completely. You can be re-infected if you have sex with a
partner who is HIV positive and this increases the amount of HIV in your body
and you could get other sexually transmitted infections.
Dr. (Mrs.) Korubo is a Port Harcourt - based AIDS/HIV counselor and medical
doctor, she is one of the project consultants to CEHRD. This paper was also
delivered at Akpide Community Hall, Biseni clan in the Yenagoa Local
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Government Area of Beyelsa State, on July 22nd -23rd, 2005 at
organized by CEHRD for the rural people.
a training
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