Through the Pharmacy Window

by Margarite Nathe, IntraHealth International

"When I was in grade 8, I was into two things: fashion and medicine,” says Elina Nantinda, a 25-year-old pharmacy assistant in rural Namibia. “So I decided to study hard. I thought, ‘It would be so nice to work with medicine and to know more about yourself and how medicine works in your body.’”

Today she runs the pharmacy at Omuthiya District Hospital’s HIV clinic in northern Namibia, dispensing antiretroviral medicines to a hundred clients per day, on average. People come from miles around—most on foot—for HIV services at Omuthiya. And most come to see Elina at some point.

When she started this job at Omuthiya last year, Elina spent two days working with a senior pharmacist. But then that person was moved to the main clinic, and she’s been on her own ever since.

“Being alone, you learn more and faster,” Elina says. “But we need another person in our pharmacy, so that when one is dispensing the medications, the other is entering data into the computer.”

Like all the other health workers at Omuthiya, Elina is constantly busy. Yet she’s always on the watch for clients who look lost or in need of help, and her watchfulness helps the whole clinic run more smoothly.

“I watch their facial expressions,” Elina says, particularly those of clients who come to pick up their medications—and especially when they don’t ask questions. “If they look confused or uncertain, I know I have to find a way for them to understand. I know any error on their part is going to be my fault. And sometimes patients don’t want to hear instructions about their medications because they think they’ve been taking them so long, they already know everything.”

In fact, HIV has become a way of life for many in Namibia. Today, according to the Ministry of Health and Social Services, overall HIV prevalence in the country is 17.2%, and slightly higher in Omuthiya.

So Elina asks them, quietly and kindly, to describe to her how they take their meds. This is how she sometimes finds out a client may be taking too many pills at once.

“This is really bad,” she says. “They have heart pains and they don’t sleep, so they usually come back to us within days.”

Or she sometimes finds that clients are taking the pills at the wrong time.

“Today a patient came from Onyaanya,” Elina says, which is 39 kilometers away from Omuthiya. “I could see the patient didn’t look normal. I asked, ‘How do you feel?’ The patient told me, ‘Sometimes after I take my medication, I feel like I’m drunk after two hours, and I want to sleep. I just feel like I’m not normal. It’s not me.’ So I asked, ‘How are you taking this medication?’ I found the patient was taking a tablet in the morning”—which is contrary to current guidance.

So Elina explained that the client should start taking the medication at night before going to bed. 

I ask Elina why she chose medicine over fashion.

“I’ve always been a hard-working lady,” she tells me. “I used to visit the orphans in Windhoek, and I wanted to help them. I worried that God would feel bad about me if I’m not doing something to help.”

She hopes to become a full-fledged pharmacist someday, but will have to raise money for school.

Then I ask Elina if there are any other health workers in her family. She tells me no, she is the only one. So when any of her relatives is feeling bad, they always come to her.

“I feel so proud about that,” she says.

Elina Nantinda is employed through IntraHealth International’s USAID HIV Clinical Services Technical Assistance Project in Namibia, which is funded by the US Agency for International Development through the President’s Emergency Plan for AIDS Relief (PEPFAR). IntraHealth is working with the government of Namibia to increase the number of health workers providing HIV services and provide the support and training they need to reach the country’s goal of an AIDS-free generation. Read more about IntraHealth’s work in Namibia. Valery Mwashekele and Cherizaan Willemse contributed reporting to this story.