Who can use this handbook?

The handbook is designed to be used by health care workers.

In this handbook, the term health care workers includes staff in clinics or hospitals, and village or community health workers who are in direct contact with people with AIDS and their families. The handbook can also be used by social workers and those involved in HIV/AIDS counselling.

As a health care worker in any of these categories you can use this handbook when providing home care yourself or when teaching others to give such care.

What is home care?

In this handbook, home care means any form of care given to sick people in their own homes. It can mean the things people might do to take care of themselves or the care given to them by the family or health care worker. Care includes physical, psychosocial and spiritual activities.

The term family is used to refer to the person (or people) with the main responsibility for caring for a person with AIDS in the home. In fact, the person providing such care may be a blood relative, a relative by marriage (a spouse for example), a friend, a neighbour or some other person.

How can you use this handbook?

This handbook is divided into two parts:

Part I

Part I of this handbook is a teaching guide which is intended to help you to provide important information about HIV and AIDS to the community, to the sick person and their family, or to anyone who is being trained to become a community health worker or a volunteer. Some sections in Part I may also be helpful as part of an in-service training programme. Much of the information in Part I is presented in the form of a story which uses words and pictures to describe how HIV and AIDS affected the lives of a woman called Yulia and the people around her. You should use this story to teach people about HIV and AIDS and you should show the pictures as you go along. To help you to do this all the pictures used in Part I have been printed in a larger size and are provided at the back of the handbook in the section entitled Pictures for Teaching. Part I can be divided as follows:

· Chapter One explains the importance of teaching and illustrates some of the common difficulties which may be encountered by health care workers by using fictional examples.

· Chapters Two and Three provide important information about HIV and AIDS through a story about people who may be familiar to you.

· Chapter Four describes how to care for someone who is dying, again using the story.

Part II

Part II of this handbook is a reference guide to help you, as a health care worker, to provide care for people with AIDS and their families. This part of the handbook will also help you to show people how to manage at home. Part II is composed of the following:

· Chapter Five describes the common symptoms and problems of AIDS - for each symptom, the following information is given:

- Problems and possible causes
- What to do at home
- When sick people and their families must seek help.

This information will help guide sick people into the health care system. However, health care workers will need to decide when and where to refer for additional care, depending on their training and the system in which they work. In addition, space is provided for you to make your own notes on each of the major symptoms and problems, as well as on resources for additional care and support.

· Chapter Six explains what you should know and do about two special conditions: tuberculosis and pregnancy.

· Chapter Seven provides basic information to help you instruct people on how to take common medicines in the right way and how to deal with the problems that might occur when taking them. However, it does not tell you how to decide which is the right medicine to prescribe. Such information, for health care workers prescribing medicines, can be found in the World Health Organization's Guidelines for the Clinical Management of HIV Infection in Adults and Guidelines for the Clinical Management of HIV Infection in Children (see Resource List).

Use Part II of the handbook with the standard treatment guidelines of your country.

Every health care worker who is providing medical treatment to a person with AIDS should have a copy of the national standard treatment guidelines which give the correct medicines and dosages for all diseases common in your country. If your country does not have general guidelines the government probably provides specific guidelines for certain diseases, such as tuberculosis, and diarrhoeal diseases.

The laws, regulations and practices that determine who can prescribe certain medicines and in what circumstances are different in each country. In some places almost any medicine can be bought from a store by anyone, while in others only doctors are allowed to prescribe certain medicines. Some medicines sold in pharmacies or village stores can be very useful. Others are of no value. Also, people sometimes use the best medicines in the wrong way, so that they do more harm than good. To be helpful, medicines must be used correctly.

Additional useful sections

· The Resource List gives details of publications or documents, concerned with HIV and AIDS, that might be helpful.

· The Pictures for Teaching used in the story in Part I should be used when teaching others about HIV and AIDS. Some of these pictures have therefore been printed in a larger size, and are provided at the back of the handbook.

Remember, you can use the handbook:

· to answer your own questions

· to answer the questions of people with AIDS, their families and communities

· to remind yourself of important points and procedures

· as a teaching aid to remind yourself of helpful and important teaching points or to show information to the people you are teaching. And remember to:

- show pictures from the handbook while you are teaching; this can make the lesson clearer and more interesting

- help the people you are teaching, if they can read and write, to copy out the instructions they need so they will remember what you have taught them to do

· as a place to write down additional information, ideas, solutions, or special notes, in the space provided.

Keep learning!