rushing again

I will write a quick explanation. Yesterday’s blog entries were probably a little cryptic. By the time they finally fixed the internet my host family was waiting for me in the car. So I just pasted in what I had written the last few days and left. I had so many nice letters in my mailbox and I didn’t have time to answer any of them, but I will try to send you all individual letters as time permits. The internet guy is not here this morning and so I am again writing a message on one computer while waiting to be able to use the other computer.I should add something about the 15 hour train ride that happened between the Moscow entry and the one after it. We were in a 4 person sleeper car. It was just Tracey, a Russian guy and me. The guy turned out to be very friendly and we chatted until about 10 pm while Tracey was sleeping off the Vodka party she and some others in our group had had the night before. I slept pretty well in my sleeping bag liner.The train was only scheduled to stop for 2 minutes in Chapaevsk—that gives you some indication of the size of the town J We made sure that we were ready to jump out before it stopped.Yesterday we went around to all of the different clinics along this street which, kak raz, is called medical street. We went to the AIDS testing center and to the laboratory where they do the first blood analysis. If they test positive, then they have to give more blood and to send it to Samara for a confirmatory diagnosis. They also test for hep A&B and other STDs there in the lab. They are building a nice new looking children’s hospital across the street, but in the mean time they are really “roughing” it, even by Russian standards, as far as their amenities go.A few really impressive things came up about their system here in Chapaevsk. One is that they are able to keep people’s HIV status confidential. They do not have a separate clinic for the HIV positive people to receive medical treatment and HIV positive people are apparently not experience the same medical discrimination as those I read about in St. Petersburg. I think that this has everything to do with the dynamic group of doctors with whom I am working. Also, I think that the size of the town allows them to move programs into action pretty quickly. The second thing, which is actually almost too surprising to be true is that so far all of the pregnant mothers with HIV/AIDS have received ARVs and since their program started no babies have been born with HIV. They still have don’t have the technology available to confirm that babies are not HIV positive until they are 18 months old. I need to go around to tour some more clinics again today. Next week we will start working in/with each of the clinics on a more individual basis.Just a little more about the rest of today. We went to the drug rehabilitation clinic today and talked with some drug addicts who are receiving treatment. It was really interesting to hear them talk about methadone... They know that it exists and they were asking us why the doctors there don't give it to them. Tough situation. The Russian government doesn't allow methodone treatment at all. They seemed pretty satisfied with the treatment that they were getting in other ways... The doctors do give them some other drug substitutes to ease the transition, but nothing even close to as strong as methodone. But they receive free treatment unless they want to remain anonymous... Yes there is a special room cordonned off for the people in rehab who want their efforts to remain "anonymous" and are willing to pay for it. Anonymous AIDS tests are also more expensive than the ones where you give your name etc. I think that the fees are just to discourage them from anonimity. It's not as though their files were any less confidential... It's pretty sad. They are basicly just there taking a break from drugs for as long as they can manage, they all said that they were sure that they would start using again soon after they got out of rehab.Then we went to a technical school to talk about AIDS with a class of future auto mechanics. (a high risk group). Their understanding and reactions were pretty similar to what you would see in the US. The major difference is the focus on Narcotics (IV drug use) as the main risk factor... Whereas in the US it's more focused around sex.