Mt. Meru, a government hospital, in Arusha:
Lasting Impressions
• Drips of blood along the footpath.
• Agonizing screams throughout the vicinity brought on by the death of sons, daughters, husbands, wives, mothers, fathers…. HIV/AIDS rate in Arushan teenagers and young adults is estimated at 19-25%.
• Women treated as second class citizens. For example, female patient is diagnosed with ‘depression’ and is being held in the psychiatric ward. Her husband has a mistress in town; patient cannot accept this. At times she is despondent and at other times she becomes completely enraged. I was asked to intervene. The reason for the patient’s behavior was clear for me, a woman who has been raised as a first class citizen in Ireland and the U.S. Wouldn’t any of us react in that manner upon hearing this news?
• Sex: Weapon of Mass Destruction. Sorry, but that is how I felt after meeting yet another family, each member dying from AIDS. The eldest son is pictured below.
St. Elizabeth Hospital in Arusha:
• Dead bodies wrapped in cloth, lying on the bed of a truck, waiting to be taken away from the hospital.
• A lot of fungal infections, in places I would never have imagined.
• Patient dying after hours and hours of struggling to keep her alive, too much blood lost, blood, urine, sweat everwhere; handing over many ampoules containing Ketamine and Phenobarbital.
• Foot powered breathing machines used during operations.
• Hard working doctors.
• Discouraged and heartbroken doctors.
Second newsletter
It was around 3pm in Arusha, East Africa and the converted shipping container I was working in was starting to bake Dr. PalaPala and I alive – Tanzanian and Irish stew, anyone? Once again my colleague was cracking jokes about his red-faced albino friend to each patient that came in. “Oh well” I thought to myself, “at least it makes them laugh.”
Then Esther walked in, a girl who is one of the people from Africa with whom I have shared a moment of life. This moment has impacted me and will always stay with me. I am sure that she has long forgotten me and I cannot say I blame her. Esther is 19 years old and she had discovered her HIV+ status five days earlier. We took her medical chart and the questions started: are you still in school? Do you live with your Mom and Dad? Nope. Father lives in the very rural part of Tanzania, so Esther’s been living with her aunt. Her mother died of malaria years ago.
Silence. Esther is so quiet when Dr. P is asking her questions. You can hear the banana tree leaves rustling outside ever so slightly. All present are extremely down-hearted about the news, which is odd, as we see this every day, twenty times over, and sometimes are even capable of smiling. When Esther does actually respond to Dr. P, she sounds like she is five years old. Her voice is a whisper, her hands are trembling and her eyes are full to the brim with tears. There is talk about her test results being given to her aunt and how now her aunt wants nothing to do with her anymore. The dam breaks and tears run down her beautiful brown skin. Esther seems lost in her memories as Dr. P persistently asks her who her “friend” is but she won’t answer. He tries again: “Where does he stay? Where did he stay?” Dr. P gives up and calls Helen into the “office”. Helen is the HIV/AIDS counselor at the hospital; she had been strangely quiet that day when Esther first got the news. Since Helen is addicted to making fun of everyone – especially “Mzungus” with shaved heads, I figured that it must have been Helen who counseled Esther.
Helen clues us in. With no one to support Esther and no formal education beyond primary school, Esther had been even more vulnerable than many of the other uneducated young female teens to falling for the “love-trick”. The man who played the love-trick on Esther was in his late thirties, “I will marry you, take care of you. I love you, do you love me? You do? Well, show me” had been the words he used. But, as it turns out, he already had two wives. Esther slept with this man and that is how she ended up contracting the virus.1
Esther went to get tested after she heard the rumors circulating through her village that the man was married and that one of his wives had recently died from AIDS. Can you imagine the courage it must have taken to get tested that day? Most choose the safety of self-delusion and that is one of the problems with the spread of the virus.
Esther is raw right now; five days – the rest of her life. The words are already out in her community; she’s stigmatized. This is evident by the woman who came with her: Mary, an HIV+ neighbor. Here in Tanzania, the infected stand together, they take care of their own. It is as if Esther is part of a new club and now initiation begins with her prescription for Full Blood Picture, CD4 counts and expired multi vitamins from India. 2
Esther starts sobbing. I get up to hold her hand. I should be used to this by now, but I cannot let her go. Only 19 years old, it could have easily been me. Dr. P and I exchange that look and we know what we have got to do. He knows his duty and his heart and I know mine. Esther needs psychological support, she needs a network and I think “OK, I’ll talk to Mama Asha of Chawakua (the only non-corrupted HIV/AIDS NGO in Arusha). I’ll convince Peter of ‘Tupo’ to let Esther join his HIV club and we will think about vocational training or finding fees for her to attend a accelerated secondary school program. Esther needs to get a skill so she can take care of herself. There has got to be something for her, there is and together we will find it.”
If there is one thing that I have learned here so far, it is that life is not about giving up on ourselves or people around us. I believe it is about having the courage to openly care for those in need. I know that it is risky as love can cause pain. However, it has been my experience that when I permit myself to love, I feel intensely alive in a way like never been before.
Keep well, my friends!
STM
1 A woman asking her partner, especially if the partner is her husband or an older man to please use a condom usually results in an outlash of accusations or physical abuse.
2 Even though the HIV prevalence rate here in South Africa is 17-25%, much higher than the 8% in Tanzania (18-22% in Arusha), I have noticed much more stigma here and less banding together of HIV infected people. Since working at Baragwonath Hospital and Sowetto Hospice, I have interacted with many people whose statuses are kept secret. I should have more information about this and the other aspects of HIV/AIDS in South Africa next month.
