Tuesday, March 06, 2012

Village of Hope 1

(See the post above for the story of my second visit to Village of Hope.)
In 2003, during our six-week stint in Philippi, South Africa, eight-year-old Thobela, an AIDS orphan and HIV+, and I became great friends. He appeared healthy; our favorite game was, when he saw me, his running full tilt toward me and at the last moment leaping into my arms (he was a suprisingly light weight!). I recall, though, my sense of forboding: there was no treatment for Thobelah. He would most likely die. I do not know when, or if, that happened, as I had no further contact with him. Still, he keeps a firm hold on my memories. Almost daily since, I have worn a red, beaded AIDS pin, handmade by a South African woman, as “prayer beads” for my little buddy, Thobelah. and millions like him.

In 2006, during a 13-week stay in Old Mutare, Zimbabwe, I walked in the funeral procession of Shingirai, also an eight-year-old boy, an orphan and HIV+. By that time, anti-retroviral (ARV) medication had become available in Zimbabwe, and he’d begun to receive an ARV regime. However, it was too late to prevent meningitis that took advantage of his severely weakened immune system and killed him.

In 2009, during a 10-day visit in Dodoma, Tanzania, I met Eliya at Iringa Road Mennonite Church (IRMC). He was, too, an AIDS orphan and HIV+, but to an untrained onlooker, he appeared completely healthy: active, bright, responsive, his sly smile captivating. For me, Eliya became a poster child for the effectiveness of ARV treatment of children with HIV and a delightful indicator of changes in AIDS treatment in Africa since my encounter with Thobeleh six years before. Hey, perhaps my prayer beads were working!

Returning to Dodoma this time, seeing Eliya was a priority. I had heard through Dan Holcomb of Lahash that he was not doing well; doctors said his heart was enlarged. Even so, I was not prepared for the change I would see when a friend brought him to me the first day Dave and I were at IRMC. Now 12 years old, it seemed he had not grown since I last saw him in 2009 and was thinner than I remembered. He had a severe rash on his arms and legs and skin eruptions on his face. The brightness I’d remembered just wasn’t there. I was dismayed. I wondered if the story of Eliya might not after all be much different from the stories of Thobeleh and Shingirai. I felt sad for Eliya, and I felt sad that the optimism I’d been feeling was seriously threatened.

Eliya (white, printed tee shirt) dancing with his choir.
My first impressions, however, altered much when a day or two later I watched Eliya practicing with a church youth choir. The contrast between that slight, little boy and the much bigger kids around him was obvious, but still, when he sang and danced—African dancing is intense and very physical—he was amazingly transformed. I was thrilled and a little puzzled by what I saw. Although sweaty, he seemed perfectly able to keep up with the dancers around him.

Even so, Eliya’s issues could not be easily dismissed. His caregivers at IRMC were obviously much concerned, which led us to Village of Hope on the outskirts of Dodoma, one of the most remarkable places I’ve visited anywhere in Africa, It’s a Roman Catholic “institution,” but a better word might be “miracle,” certainly for hundreds of people living with AIDS. Eliya, Mama Jafeti, Edwin Angote, and I traveled there by taxi and went to the outpatient clinic. I was surprised to enter a large waiting room that compared favorably with any American medical setting. We waited a few minutes, then were led into a doctor’s office. 
Edwin and Eliya in the doctor's office.



He studied Eliya’s records, saw his current weight (the same as at his last visit, despite a therapeutic diet including Plumpynut that provided 2,500 calories daily), examined his rash, and then commented about his treatment, all in Swahili with occasional attempts at English for the benefit of the Mzungu (Swahili name for a white person). The expected viral-load blood test, the primary reason for this visit, could not be given until early April. Meanwhile, his assumption was that Eliya was not in “adherence”—not taking his medications regularly. In a previous living situation, Eliya had been one of two dozen or more people in a chaotic home situation and on his own in taking his medicine. He had recently moved to a sister’s house, and his caregivers had hoped for better adherence. Eliya readily admitted he sometimes forgot to take his medicine. The final agreement of that session was that Mama Jafeti and others would attempt to find a foster care situation where his adherence would be closely monitored, then hope for his condition to improve.
Swinging on the clinic porch

(Before we left that office, the doctor urged Edwin and me to allow an HIV test. Well, why not? As he had surely done hundreds of times before, the doctor drew blood from a finger and placed a few drops on a small test strip, then a drop of reagent—and we waited. Sure enough, after five minutes or so, only one line appeared. We were both HIV free.)

Leaving the clinic, Mama Jafeti led me to another surprising room, a large, bright, immaculate laboratory. It was quiet, one technician only writing at a table, but seemed, again to an untrained eye, to be superbly equipped. The four of us then returned to the city, stopping at a pharmacy so that Mama Jafeti could fill a prescription for Eliya,  
Village of Hope laboratory


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