Monday, October 25, 2010

October- November 2006

 Yesterday Fezile, Buyile, and I set off to visit Spelele.  We left at 830 and, after a lot of waiting, and a long bus ride (on that dry, dusty, dirt road) we get to the stop at 11ish.  As we were preparing to walk the long distance down to Spelele’s house, we were stopped by a man who identified himself as the gogo’s brother.  He said that Spelele was not there, that she had been taken to the hospital in Mbabane.  What we gleaned from what he was saying was that they were intending to amputate the arm above the burned off hand.  We waited another hour for the bus to return to bring us back, resolved to go to Mbabane in the morning to see Spelele, certain that she was frightened and lonely.  We were met this morning at the bus station in Mbabane by Brendan, a former PCV who is now helping to run the Young Heroes program for NERCHA, the governing body for HIV outreach here.  Brendan is as close to a perfect young man as you could get- handsome, self-contained, intelligent, sincere- you kinda want to pinch him to see if he is real.  He is so much so that you wonder, if you are cynical, if there isn't some deeper pathology ready to erupt.  He was so welcomed by and integrated into his Swazi community that he was chosen by them to represent them at the annual Reed Dance, the most important ceremony in the country, just a couple months after he arrived in country last year.

Anyway, Brendan went with us and we found Spelele on the children’s ward.  She hadn’t had surgery yet and we learned from her aunt (the gogo wasn’t there) that they weren’t amputating.  Instead, they are going to try to remove the significant scar tissue that is preventing her from extending her elbows.  We also learned that the doctors think that beneath the scar tissue covering the stub of her missing hand, they can detect finger movement.  It seems they think at least some of the fingers may be buried beneath the mound of scar and that they can sense movement.  Swazi hospitals are not equipped to deal with that type of surgery but they may be able to refer her to someone in South Africa who can help.  The auntie tells me there is simply no way the family can afford that.  I tell her all she needs to do is find out the details and get Spelele there, and I believe the rest can be taken care of.  How exciting and how timely.  If this had come a month later, I’d be gone and her hope with me.  If there’s anything we can do to make this happen, then it will happen.  We saw Spelele smile and heard her talk for the first time. Some days are altogether good to be here.

Running with the girls 10/6/06
I went out for a run tonight.  Two of the younger girls from the orphanage went with me, Fikile and Kayelihle,as did Dumsile, a tall, thin, athletic, and studious high schooler.  It has been a while since I ran with the girls.  I have been gone more than here in recent months and, when I do run, it is usually very early.  All my life I have wanted to be a morning runner.  I admired, tremendously, those who could jump out of bed, irrespective of weather, and take to the road or the gym.  I would drive by them on my way to the lab in Petaluma, seeing them through the glass front of the building on the treadmills and cardio equip, knowing more were upstairs in the weight room.  And I admired them, their sincerity.  I have run for many years now and, finally, I can run in the morning.  It started when Sindi and Maseko, two very overweight women at the bomake market, wanted to start exercising.  They asked me if I would walk with them, but the only time they could get away was half past five in the morning.  The rest of the day they are at the canteen at the bus rank, cooking or hoping to cook for whomever could pay a few bucks for a meal.  So half past five it was.  And after we did one lap, of about 2.5 miles, I would continue to run another couple laps.  They have since lost interest, the cold of winter giving them an excuse to rest again.  Me, however, when I am not away from the orphanage for one reason or another, well, I prefer the morning run.  My body still does not eagerly await the sun.  I am older and stiffer and the morning is a sharp reminder that at least my most agile days are behind me.  And I love the evening run as the sun is setting, especially with the girls at the orphanage, when I have had the whole day to warm up.  But now I prefer a day that starts with my hair flying and a cool wind in my face. 
Today, however, I am with the girls, the two small ones barely 10 years each.  They are running barefoot and in tattered skirts, skipping over sharp stones and gravel that would stop me flat.  Fikile flaps her arms like a bird as we fly down the dirt path toward the main road.  She is a stocky little thing, all muscle and grit.  Her freeness fills me.  There are problems at the orphanage where I have been places, problems for sure.  The place is poorly managed and the facility is horribly run down.  But the housemother here, who takes care of these 27 children, is a good woman.  The girls are so much better off than other children on homesteads in the community.  Here, the girls are not beaten, abused, or molested like so many young girls on homesteads.  They are outspoken and have a strong sense of self and of their immediate community.  They do everything for themselves, collecting and cutting firewood, growing vegetables, grinding corn all day long, cooking, etc.  And, because there are so many and the work is divided, there is much time for playing and singing, both of which happen spontaneously and randomly.  They are noisy.  God they are noisy.  I used to think I would never get used to the noise.  Now I notice it more by its absence- when they are at church or at bed time.  For an hour or two, the peace is sublime and I just sit, immersed in stillness.  After too long, I become edgy, I miss the way they fill the air with song and laughter.  And noise. 
 I have meant to write about the girls and I cannot bring myself to do so.  It is too close, too personal.  Each of them is unique and each deserves a book, not a line or two on a web journal.  Every time I think of leaving them, which is imminent, a tremendous sadness falls over me.  When I moved here, it was made clear that the orphanage was not my job.  My job was to do HIV outreach and education in the community.  The orphanage was my homestead, where I lived and, hopefully, became a role model or mentor for the girls.  So, I made sure it was not my job.  Consequently, it has become my family.

The children’s ward 10/12/06
I have been in Mbabane for a few days for “close of service” medical examinations.  While in town, I was able to stop in the children’s ward and see Spelele.  She has been there for over a week and they only took her to surgery today because there were not enough medicines and surgical supplies to do more than the absolutely essential surgeries.  I arrived while she was in surgery and did not see her; however I was able to visit with the other mothers and children for a little bit.  I brought a fuzzy teddy bear to a little girl I met there the other day who is dying of cancer.  They showed me her belly- an inverted U of gleaming staples stretching from one side to the other- and told me the doctors opened her up and found cancer everywhere.  All they could do was close her back up again.  The little girl is beautiful and she is loved and she is dying.  Her mother does not seem to understand that the child is dying and I was not going to take that away from her.  She will be sad soon enough. 
I also gave the kids a coloring book and crayons to play with and some candy. 
As much as I do not want to be the "umlungu", the white person, in the role of benevolent benefactor, it takes so little to make a difference in their day.  A day at the hospital, with nothing to do, nothing to watch, no books, no toys, a day here stretches.  And these children are here for a long time.  I looked over the child with spinal cord injury I met the other day.  His mother speaks perfect English and has her infant child with her as well.  She helps me to communicate with the other mothers.  She and her other child both sleep on the floor near the injured child.  He is about 9 and was hit by a vehicle.  Except for his eyes, immense against his tiny face, he is immobile.  He probably weighs as much as his much younger sibling.  It will not be long for this one either.  
I sit and chat for a while.  An attendant comes in who knows me from Hlaitkhulu and he sits with us as well.  We talk about HIV and I encourage all the women and their children to check their status.  The attendant tells me that when culture was strong and girls remained virgins, HIV was not an issue.  It is the girls fault.  Of course I respond, I can’t not now.  I go on a bit about the men who have children with several girls and women, leaving at the first sight of pregnancy and taking no responsibility.  I don’t know of any young women with children (and I know many) where the father of the child is present. I then lapse into my diatribe about how there is nothing for girls and women here other than what men allow them, and to be with a man is often just a means to get by.  The man looks down, he doesn’t disagree, and the women are surprised and more than a bit pleased, to hear someone speaking for them.  It’s true, it’s not always that way, and the girls are responsible for their own behavior, but it’s mostly that way.  I check the little girl with cancer on my way out.  She lies on a small metal cot, staring silently and clutching the fuzzy bear.  It may provide some small comfort in these next few days, weeks at most.

Life expectancy 10/14/
Swaziland has recently achieved a new distinction- the lowest life expectancy in the world, now 32.62 years of age.

Free my soul 10/29/06

I was on the bus, headed to town to check email this morning.  The bus was crowded, having come in from Manzini, and I ended up having to stand near the rear of the bus.  Oddly enough, Dobie Gray’s “Drift Away” came on the bus radio, for some reason tucked inbetween horrible music that passes itself off as gospel here.  I start singing along, quietly, and noticed someone singing at a bare whisper with me.  A man in a seat near the window, holding his young daughter on his lap, joins me a verse into the song:
 “Beginning to think that I'm wastin' time
I don't understand the things I do
The world outside looks so unkind
I'm countin' on you to carry me through
Oh, give me the beat, boys, and free my soul
I wanna get lost in your rock and roll and drift away
Oh, give me the beat, boys, and free my soul
I wanna get lost in your rock and roll and drift away”

And the man’s eyes are closed and there’s a half smile on his face…

“And when my mind is free
You know a melody can move me
And when I'm feelin' blue
The guitar's comin' through to soothe me
Thanks for the joy that you've given me
I want you to know I believe in your song
Rhythm and rhyme and harmony
You help me along makin' me strong
Oh, give me the beat, boys, and free my soul
I wanna get lost in your rock and roll and drift away
Oh, give me the beat, boys, and free my soul
I wanna get lost in your rock and roll and drift away”

We get to the end of the song and we know we shared a moment out of place, out of time, across cultures.  I guess we're all looking for a little release sometimes.

And so it ends 11/7/06

It was excruciating leaving the girls.  Words don’t do it justice.  I have just finished my exit interview with the PC Country Director and have officially closed my Peace Corps service.  We had a party at the orphanage Sunday afternoon attended by all the girls, Manthoba and Tigi, the neighbors’ children, and Simphiwe’s 2 little ones.  We had chicken, rice, cake, cookies made by the girls and I saturday, etc. The girls made little movies on my digital camera and we all had a great time.  Then I fell apart.  It was too much.
The following morning the girls all came to my little rondeval to say goodbye before they left for school.  I did not want them all there when the PC came to collect me, I could not have borne the looks on their faces and to see them all standing there as I drove off, so I made arrangements to be picked up while they were in school.  I hugged each and kept a smile on my face so they could remember me as happy to be with them.  The pretense was exhausting and by the time the drive came, I had nothing left.  I wanted to enjoy my last drive from Hlatikhulu to Mbabane, through those beautiful green hills and overlooking South African mountains in the distance, but my mind kept shutting down and I have little recollection of the journey.
More to come…

Reflection 11/14/06
It’s been a week now since I’ve left Swaziland, and I have had some time to myself to reflect.  Quite honestly, I am still not sure if anything really means anything, if anything really is important.  I left my home and my relatively comfortable career two years ago to find Joel.  No, of course I know.  Joel is dead.  I get that.  But I came to Africa, planting myself in the middle of a raging AIDS pandemic, to try to understand that simple yet incredibly complex fact.  And after so many deaths and so much sickness these past two years, I am still no closer to the answer.  In 4 days, Joel will have been dead 3 years.  In 4 days, thousands more will die on the African continent because they had the poor taste to have been born into lives of poverty and suffering that don’t remain in anyone’s consciousness longer than Madonna’s next act (although the hell with the critics who would rather see a child deserted and raised in an orphanage, somehow equating that with a rich cultural heritage- the hell with you all. What are YOU doing?). 
I learned a lot more than I wanted to about the absence of ethic and moral will.  HIV has become a big business in Africa, supporting tens of thousands of organizations and salaries that serve no purpose beyond their own financial survival.  Millions of dollars have been spent supporting the hotel and restaurant business in the name of AIDS, as workshop after workshop is held to “discuss issues and strategies” over buffet lunches (as scores of overweight women attending the workshops are stuffing their purses with food while thousands in the rural areas can’t take their antiretrovirals for lack of a decent meal).  And as a young boy is dumped at my local hospital to die of AIDS-related opportunistic diseases, the headlines of the national paper read, “Swazis must beat their children.”
So, what have I learned?  I saw young 23 and 24 year olds leave their safe homes and families in places like Iowa and Minnesota to live in the middle of Africa, in the middle of nowhere, in the middle of an AIDS pandemic, in the middle of hell.  I listened to them as they told stories of the children on their homesteads who were so sick that the only way they found comfort was to be carried on the backs of these young, idealistic volunteers when the child’s own family members had no time or interest or perhaps just not enough energy left to hold children at all.  I saw these young volunteers from America bring 7 year old girls to the clinic for treatment of HIV and sexually transmitted diseases as a result of rape by grandfathers, fathers, and uncles.  And I listened to the confusion and despair as they saw the rapists, abusers, tyrants excused by the family, victims robbed not only of legal recourse but of any recourse at all.  I saw these volunteers fight with nurses and doctors for the lives of young children that no one wanted to test or treat for HIV and that no one wanted to care for anymore.  I saw volunteers cry with despair after learning of the sexual relationships between adult teachers they called friends and the very young girls attending the volunteers’ anti-HIV and health clubs.  I saw the final volunteer who had yet to be touched by this disease here fight for his young sisi’s life at the hospital, trying to work things out with the doctor while still keeping from the family the fact that she was HIV positive.  And I remember his sms, shortly after midnight a week later, telling me he was “at her funeral now”.  No one was left untouched, no innocence was spared.
And beyond the HIV issue, I saw young children whipped with a cane as they each got off the bus, their only crime being that the bus was late, and I clearly recognized the delight in the eyes of the “discipliner” (who refers to his beating stick as his “motivator.”)  I saw incompetence and greed rewarded as organizations continued to flourish in the absence of accountability and at the expense of orphans and vulnerable children.  I saw patients die in hospital for want of routine care, as IV fluids run dry days earlier and medicines are out of stock in the pharmacy.  I saw children abandoned by their mothers.  Many children.  Abandoned by their mothers, their fathers unknown faces at the other end of abandoned seed. And in the face of all this horridness, I saw young Peace Corps volunteers do battle the best they could, some in a very quiet way, others more outspoken or with more sophistication, living on homesteads without even clean water, or any water at all, while their Australian, Swedish, and Canadian counterparts lived in relative comfort in the major cities as they partnered with the NGOs who continue to get fat.
I saw lives saved, literally one by one, by young people who believed they could make a difference.  And they did make a difference even though many more lives were lost along the way.  They made a difference to people who were dying, when no one else either cared or noticed. The US may have made many mistakes in its foreign polity, but this is not one of them. I learned how important it is to be “seen” at the end of your life, however short or long it is, how important it is that someone knows you lived and breathed and shared the air with the rest of us.  The lives that Peace Corps volunteers couldn’t save they at least acknowledged. 
I’m still no closer to finding Joel, no closer to understanding any of this.  So my journey continues.  It doesn’t matter much what contribution I make or don’t make, not to me anyway.  I just move on, do what comes next.

anniversary 11/18/06
It seems I’ve always appreciated the inevitability of death.  Joel’s death made me acutely aware of its randomness though.  So, when I walk down the street, I am keenly cognizant that something could come falling out of the sky from nowhere to land squarely on my head, or that some poor sucker driving down the road toward me could suffer an unexpected stroke causing his car to jump the curb and smash directly into me.  Life is that capricious, death that unexpected.  And I think when one really understands that, everything changes.  Everything either loses its meaning or its substance- not in an awful, heavy, “godicantgoonbecausenothingmeansanythinganymore” kind of way but in a way that keeps you separate from the world while still being in it, still being a part of it. The everyday world takes on a kind of transparency and the telos, the endpoint as it were, is to pull back the thin veil and get a peek at what lies behind it.  After Joel died, for many days, I floated in an ocean of my own breathing , each breath an audible wave breaking across my mind.  All I really remember, until the moment I took Matt’s arm to walk into the Phoenix, into the memorial service his strong, amazing friends had prepared for him (and thus for me), was the roaring of my own breath in my ears and a state of paradoxical grace the belied the awful event that precipitated it.  And wherever it was that I went during those days, I came back different, something at the core of me changed forever.

Moving on 11/28/06
If you get this image,stay with me.
As I start on my new journey, I am leaving this site which highlights my volunteer experience with HIV outreach work in Africa.  I will travel on through west Africa, Egypt, and India and will find a new blog site to describe my journey. I wanted to leave this as is.  I will be posting my new home when I find it.  These journal entries will be included in a book currently being edited by a couple RPCVs and will include the experiences of a number of PCVs in Swaziland.  I will post more about that as time goes by. 

June - September 2006

For those of you interested in reading the Argus Courier article about my work here, the link is:
We just finished our Close of Service Conference where we discussed the logistics of ending our 2 year committment in Swaziland.  As it stands, I will be leaving the country in early to mid November.  I will be traveling through West Africa for a month on the way to India, where I expect to study yoga for a few months before resuming my work on humanitarian efforts.  I will continue to post during my travels and in India.
I will also be documenting my last 2 months with the girls at the orphanage and with the people in my community.  It will be difficult to leave and I expect some of the entries will be quite sad.  Please bear with me.

On Friday I spent the day with Julie, my closest PCV friend here, as her community celebrated the opening of an NCP (neighborhood care point for the care and feeding of orphans and vulnerable children) the building of which was, in no small part, due to Julie’s hard efforts.  The day was also an opportunity for the community to bid farewell to Julie, as she is leaving a little earlier than the rest of us because her grandfather, who has loved her and written her faithfully, every week of the 2 years, has fallen quite ill recently.  Julie has been the quintessential PCV, investing herself fully in the PC experience.  She lives in a very isolated area, one and one half hours by old and unreliable transport and by dirt and rock road, to the nearest town, thankfully mine.  She planted herself firmly in the community and learned to speak siSwati fluently.  In so doing, she has certainly touched lives more profoundly than many of the rest of us have done.
 I couldn’t begin to count the numbers of people, including more than a few children, that Julie has brought to the hospital in Hlatikhulu (my town is her nearest clinic) for HIV testing and treatment, as well as for a myriad of other problems.  And her efforts have had far reaching effects: One of the first women Julie successfully got on ARVs, and then saw through a horrendous allergic reaction to the drugs which causes the skin around the mouth and eyes to blister disfiguringly, has since become uncharacteristically open about her status and has encouraged many others to test and seek treatment.  And after months of seeking help for a small boy, barely 7, who was orphaned, HIV+, neglected, and sick, the boy is now doing well and will be situated at one of the few wonderful community based orphanages in a rural area, where he will get the attention he so needs.  That he has been schooling this past year is solely due to Julie’s contributions.  To see them together brings me near to tears.  And there are so many more stories and occasions where Julie has put her community and her neighbors before her own needs, sometime to the point of near self neglect. 
So, it was due and fitting that she be honored on one of her last few days at site.  Important dignitaries were there from the community, including the chief, and a film crew from Swazi TV.  Julie delivered a moving speech in siSwati, swallowing back the tears at points, and I noticed that more than a few people in the audience were wiping their eyes as well, including men for whom showing emotion is unheard of here.  The most poignant moment came when Julie acknowledged her “counterpart” and dear friend, Mpumi.  Mpumi was assigned as Julie’s “swazi counterpart” in her community.  The PC asks the community to identify someone who will work with the PCV in the community to act as a bridge for the volunteer and to help with the mitigation of the HIV crisis.  Julie and Mpumi have worked closely together for two years and have become like sisters.  Mpumi is now employed as a community HIV outreach worker by World Vision, a position she would not hold were it not for her work with Julie.  As Julie acknowledged her Swazi sister, Mpumi sat a couple rows back, head bowed, tears streaming.  Mpumi’s been crying for weeks.  This is a very difficult parting.
The older women in the community did a wonderful song and dance for Julie after which they gifted her and dressed her with traditional wear. 
We all ate; a cow had been sacrificed- again, a great honor.  I stayed the night with Julie and was glad to be with her on such an important day.  I was struck by how genuine and deep her experience had been, how she exemplifies what we all should strive to be. 
And, as is unfortunately the case, Swaziland allows for no happy endings… On Sunday, one of Julie’s friends from the community, who had been sick and in the hospital the past couple weeks, passed away.  She had been on ARVs for some time, had been doing well, and recently contracted cryptococcal meningitis.  She leaves behind 5 small children, now orphans.


 Simphiwe was in town for a few days for school break and we agreed to meet in town this morning to walk out to Mbotjeni and visit Manthoba, Tigi, and gogo.  It has been so very long since simphiwe and I set out on any given day to make the world a better place and I was pleased, as always, to be in his company.  We met at the store so we could pick up some cornmeal and beans to take to gogo and simphiwe tucked the goods in my pack and put it on his back and we set out.  The walk to Mbotjeni is beautiful.  The way is all down hill from town and you can look out over the expanse of green rolling hills, trees and forests, and Swazi homesteads.  I never tire of it even though the area is very reminiscent of Northern California (or, in some places, even the high desert in southeastern Arizona).  Swaziland is beautiful and it is difficult, sometimes, to grasp the sickness and suffering that is occurring just inside this homestead here, and that one over there, and on the homestead further up the road.  Like a beautiful woman whose cancer overtakes her just underneath her tender skin.  We arrive at Mbotjeni and Tigi sees us before we see him, running to greet us and take us to the homestead.  He grabs Simphiwe’s hand, happy to see him even though it has been some time.  Gogo is where I often see her when the days are nice, lying on a mat outside.  I am relieved I don’t have to see her dragging her cumbersome body across the ground by her elbows to be able to enjoy the sunshine.  Unfortunately, Manthoba is off fetching water for the homestead.  He is likely carrying a jug as large as he is, unless he has managed to scavenge a wheelbarrow somewhere. The river is a ways from the homestead and he is unlikely to be back before we leave.  I ask gogo how Manthoba did in school this year and she chuckles like a pleased little girl, “kahle kakhulu”, really great.  She is worried that there will be no one to help Tigi get into school once I leave.  He is due to start in January.  I assure her that Red Cross is coming to see her soon (they have been coming for a year now) and, if they don’t come, I will make sure schooling for Manthoba and Tigi for next year is taken care of before I go.  I don’t tell her that I, too, am worried what will happen to the three of them when I am no longer able to check on them.  I would like to think their neighbors will help, but it isn’t necessarily so.  And because the boys are just abandoned (to a gogo who can’t even walk) by both parents ( althought I think the father died this year- the mother is still unaccounted for), they don’t qualify for programs like Young Heroes that only cater to double orphans.  Even if they did qualify, gogo couldn’t get to the post office to pick up the money.  Sigh.  I remember the first time Simphiwe and I came here- gogo hadn’t left her bed for months, hadn’t eaten, and was significantly depressed, begging God to take her.  Today she is looking pretty good- the simple little stone and mud hut is the same, her burden no lighter, but she is in good spirits.  And Tigi looks good and well cared for.  Simphiwe and gogo chat in SiSwati for a bit and I am able to pick out more and more of what they are saying, still far short of where I should be.  We take our leave and make the walk back into town.  I am not sure what we talked about or if we talked at all.  It was simply good enough just to be with him again.  We parted in town and he said he would try to get up to see the girls this afternoon.  He is attending a funeral in the morning and heads back to South Africa directly after that.  He says there are too many funerals now, it makes him sad to come home.  He doesn’t even ask after people anymore for fear he will learn they are gone.
Simphiwe was good to his word and showed up at the orphanage in mid-afternoon. The girls adore simphiwe but are always shy to see him or be around him.  He sits in my rondeval for a while, just talking, and then we go outside so he can greet the housemother.  He chats a bit with her and then it is time to go.  He comes back to the rondeval to retrieve a couple books I am sending with him (Hesse’s Sidhartha for one) and I catch him on the step and wrap my arms around him to tell him he is one of my favorite people on the planet.  He gives me that smile that is so uniquely his and is grateful (although it is still awkward for him to be hugged).  The girls gather outside to say farewell and I walk him down the road, long past the point where it would be polite to let him travel on by himself.  At some point I let him go, otherwise I might just go with him back to South Africa.  With Julie gone, and Simphiwe leaving again, I am feeling very alone.  Not friendless but without friends near enough.

May 2006

The girls are on break from school so 10 of them and I set off to the neighboring community to see Manthoba, Tigi, and their gogo (the one with the broken leg).  Manthoba has just started 1st grade this year and the girls had not seen him the week before the break, so we were a little worried about him.  It was past time to take them some cornmeal and beans anyway, so off we went.
Manthoba was away fetching whatever water his tiny 7 year old arms could carry when we arrived but Tigi was sitting outside with gogo, who crawls on her forearms to get out of the bed and sit in the sun. 
An older, thin, weathered man was there with a young boy.  I hadn’t seen them before.  He was helping repair some leaks and the broken window of the stone and mud hut where gogo and the two boys live. We have had some awful storms this year and th floor of their single room has been flooded several times.
I asked the man about the boy.  It was his son.  He has one more at home.  I asked about their mother.  Ah, she has been gone several years, no one knows where. I ask if he is working.  He looks at the ground and says no but he is trying- he is looking.  I ask gogo if she is paying him, a silly question because I know she has no money.  So I ask him why he is helping her then. “Because she needs help” he replies.  I am taken by surprise.  If it is not for pay, or not for immediate family (and even then rare) help is not willingly given (although rare exceptions exist).
Manthoba shows up and we ask why he has not been in school  He says he was coughing but is fine now, so he will be back on Tuesday when the break is over.  He and the girls go off to collect firewood for gogo.

I sit and chat with gogo for a while, nodding as she chastises me for not having stopped by sooner.  The days just get away from me but I promise t return sooner with anew wash bucket to replace her cracked and broken one.
I take my leave to go see Babe (bahbay) M, who lives about a mile away and who I hear is home these days.  I want to be sure he and the family are faring all right after the death of his infant son.  I get to the homestead gate and call out, “ekhaya.  Ekhaya M.”  There is no immediate response but his dogs have never been particularly mean so I enter and start to walk down the path to the small dwellings.  I walk past the few finished layers of the new house he is building, single handed, brick by brick.  I notice a recently dug square pit, obviously intended for a latrine, and for some odd reason am struck by the squareness of the pit. On of his remaining sons, this one about 4, comes out on the path to greet me.  I ask him if babe is home.  “Ukhona”.  He’s here.  I approach the small grouping of 3 huts and see a figure lying outside on a at.  Oh, god, it can’t be.  The only was this could be babe M, lying down on a mat in the middle of the day, would be if he is very sick.  I have never seen this man sit, except at the hospital early on as he held his young sick child on his lap.  Otherwise he is always working, building, planting, weeding, cultivating, or coming to and from church with the children. 
I sit down next to him and it is only then that he is aware of anyone’s presence.  His eyes flicker open, the whites yellow tinged- almost brown, and he recognizes me.  Always the immediate smile that makes me feel the sun rises and sets where I stand.  He rolls over on his side to shake my hand and greet me, still capable of the social generosity.  
His belly is so distended I wonder that it doesn’t burst.  I look at his lower legs and ankles- grossly swollen.  I am reminded of my friend Michael the last time I saw him, so ravaged by the cancer that his vital organs had begun to shut down, his swollen belly and lower extremities belying his thinness.  He died within a week.
I ask babe why he is not at the hospital.  There is no one to stay there with hi (for those who don’t remember, the hospital is so poorly staffed that admissions usually require that a patient be accompanied b someone who sleeps under or next to the cot, on the floor and attends to their needs).  The oldest of the 3 remaining children, a 12 year old girl, is too young.  I look at this man, his hand in mine, and know he will die without medical care.  He may even die with.  I tell him I will try to find someone who can stay with him and that he must be in the hospital. 
When I get back t town I head for the canteen where the bomakes cook for whatever customers they can get.  There is a make cooking here who lives near babe .  I find her and tell her I will even pay if she can find a make willing to stay at the hospital with babe M. She agrees to ask around.  It’s the best I can do.
I go home and cry.

Babe M has been in the hospital for a couple days now.  There is a teenage boy staying there with him.  I am uncertain of the relationship.  It is a son but it must either be a son of a previous marriage who doesn’t live at home, or it is the son of a brother.  A brother’s children are also called “sons” and “daughters”.  He looks horrible and isn’t eating.  His fever seems to come and go.  A doctor crisis exists at the hospital.  3 Cuban doctors recently brought in to help left the country after the woman doctor and her friend were assaulted in their home in the middle of the day in a robbery and failed rape attempt.  The home is just down the road from the orphanage where I live.  The one doctor on duty for all the wards has taken the weekend off.  But babe is still better off here, on a cot on a ward where the potential for help exists, rather than laying on a mat on the ground at home with only small children to attend to his needs. This afternoon babe whispered that he would like some cheese and I will bring him some in the morning. I took that as a good sign.
Earlier in the day, we visited Spelele, the little girl who was badly burned, to see if the arm had been amputated and, in general, how she and gogo are doing.  Traveling to Spelele’s home is no small feat, taking over half the day to get there and back, but I still feel badly that I am not able to get there more often.  Her home is quite some distance from my community.  Gogo says the arm may not need amputating above where the hand burned off.  The medicine seems to be taking care of the infection.  The money from the Young Heroes sponsorship (see is helping keep Spelele in better health.  She handles herself pretty well with one hand gone and only partial use of the other.  I watched her as she held a lemon against her chest with the wrist of the “good” hand, bending her fingers at an angle I would think not possible to peel the fruit.  She goes with gogo everywhere as there is no one else to stay with her, and there is no time or inclination to pamper her, so she is learning to adapt.

Me & Spelele. we are both ok.

When I left Babe M at the hospital last night, he was in a great deal of pain.  He died before morning.  Cancer.  He was preceded in death by his wife 2 years ago and his 2 year old son only weeks ago.  He was in his late 30s and leaves behind 3 children.  He was a good and kind man and the world was a better place while he was in it.

Felicity and I spent the weekend together at Vic Falls, Zambia.  It was a much needed break and wonderful beyond telling to see Fizzy.  We laughed and cried (well, I cried) and I achieved a much needed balance.  Saying goodbye was sad.
For my friends and colleagues at the Buck Institute, I am touched and grateful for the kind words and thoughts you sent me through Felicity.  The money you sent for my birthday will go toward a couple good causes.  Tomorrow we are taking a tiny girl and a 7 year old boy from my community to the eye clinic in Manzini.  Your gift will go a long way to restore and improve sight for both of these children. Thank you.  My needs (aside from jaunting around Africa to hook up with good friends) are pretty simple and even a small amount of money can achieve great things here.  I am careful how I use and do that but I will make sure to post and let you know what my birthday present ended up being.  The best gift was to know that I am missed and that you are keeping up with the stories here.  So many people live and die here after a life of often great suffering.  It is important to me that someone over there knows that Babe M, his baby, Lungile, Nokuthula, and many others lived and maybe loved and laughed and that they died horrible senseless deaths.  I think we can do something here.  I think we can save lives.  Keep us in your thoughts.  Best, Alyson

For joel 5/31/06

For Joel on what would have been his 21st birthday and for mothers everywhere:

Lord Protect My Child

Bob Dylan

For his age, he’s wise
He’s got his mother’s eyes
There’s gladness in his heart
He’s young and he’s wild
My only prayer is, if I can’t be there,
Lord, protect my child
As his youth now unfolds
He is centuries old
Just to see him at play makes me smile
No matter what happens to me
No matter what my destiny
Lord, protect my child
While the world is asleep
You can look at it and weep
Few things you find are worthwhile
And though I don’t ask for much
No material things to touch
Lord, protect my child
He’s young and on fire
Full of hope and desire
In a world that’s been raped, raped and defiled
If I fall along the way
And can’t see another day
Lord, protect my child
There’ll be a time I hear tell
When all will be well
When God and man will be reconciled
But until men lose their chains
And righteousness reigns
Lord, protect my child

“As each minute ticks by, another African child dies from AIDS.” From Global Aids Alliance

April 2006

Live to fight again 4/5/06
By some great cosmic kindness, both T and her brother B are still alive and on ARVs now.  They will live to fight or die again another day.  I believe we have maybe reached a turning point in this battle.  I went in with T to see the ARV doctor and was amazed that he recommended that her boyfriend, if she has one (which she does not currently) and her 5 year old son come in for testing.  A year ago, even 6 months ago, that kind of recommendation, in a hospital where doctors do not even talk to patients directly, was unheard of.  The boy is relatively well, but has been coughing lately.  It will be important to know so that we can take extra care to keep him healthy as long as possible before starting treatment if he is HIV+.  Because ARVs are not going to be available for all who will need them, and because compliance is difficult when people are too sick or live to far to come in or when the clinic runs out of one of the tablets, it is better to keep from having to start ARV therapy until it is absolutely necessary.  The thinking in the "Western World" now is that the sooner one starts, the healthier they remain.  That thinking is a luxury here and, unless we want to support the emergence of a myriad of drug-resistent strains, it is best to try to keep someone healthy as long as possible.  With poor diets, dirty river water for drinking and bathing, and generally unhealthy living conditions, that will not be too long anyway.

Get involved 4/7/06

I urge all of you to organize an AIDS candlelight memorial in your community.  This is a wonderful opportunity to educate people about the millions of lives that are being lost to this disease, especially on the African continent where we don't seem to be making enough headway.  As you stand, with candles lit, you will be standing with those of us here and around the world who are actively fighting the battle.  You can also use the event as a potential fundraiser, especially those of you on college campuses or in large institutions, but please make sure that whatever funds you raise are accounted for and go directly toward HIV relief.  The website,, has a lot of information about how to organize such an event.  You can make it big, or you can keep it simple, but stand with us on the 21st of May to remember those who have died, those who live with HIV, and those who still have a choice.  If you are able to organize the event, please send me a picture of the event and I will share it on my blog as well as with those who stood in Hlatikhulu and elsewhere in Swaziland.

Baby m 4/11/06
Baby M died this weekend.  He had been doing so much better and apparently became sick and died very suddenly.  For a year or so now we had been treating him for an allergy to peanuts and to the local detergent (the latter is very aggressive and other young children have a reaction to it).  As soon as we took him off peanuts and got the bacterial infection on the sores taken care of, he rallied significantly.  When his father was able to get work, he left the child with his sister, some distance away, because the other children were schooling and couldn't watch him.  This man has struggled so hard to care for these 4 children since the death of his wife after childbirth.  In Swaziland it would have been so easy for him to take in another woman to take on the load.  He chose not to.  He cultivates all of the land he has available to him and is single-handedly building a better home on the property.  When he can find work, he takes it to bring in whatever cash he can to keep the children in school clothes and buy necessities.  God, he loved that baby.  Most of my visualizations of Babe M are with that small child riding on his shoulders, even when working in the field.  How thrilled and grateful he was when the child rallied.  Baby M was staying with the Aunt when he developed a bad "asthma attack" and died.  I suspect an allergic reaction and anaphylactic shock.  I have also heard that the father is now very ill, with a swollen stomach and legs. I will go to see him tomorrow.  It would be devastating to lose him as well. 
Children are left parentless and homeless daily now.  Last week, in my community alone, a gogo died, leaving 3 orphans, the children of her children, to be farmed out to whatever orphanages can take them.  The security guard at the primary school also died, his wife having preceded him by a year.  Three more orphans.  This country will regret all the money it has spent on HIV workshops and training in high end hotels, training care givers who are not giving care and peer educators who are educating no one, wasting millions on structures and projects that sit half finished and poorly managed, when the  time comes to have to house the thousands of orphans who are left stranded when the old grandmothers die.

March 2006

Still crying on Wednesdays 3/1/06
The ward doctor discharged “B” today despite that he is unable to walk, keep food down, etc.  Even though he is HIV+, they wouldn’t start treatment today. Said they couldn’t start without a CD4 count.  It’s not true.  He meets the clinical criteria of full blown AIDS.  I think they just sent him home to die.

Spelele 3/11/06
We went to see Spelele today.  We met this little clip of a girl in September while she was in the hospital being treated for severe burns to the abdomen, arms, hands, and under her jaw.  Her right hand had been completely burned off and she had lost a couple fingers and partial use of her left hand .  This diminutive child, just two, with both parents dead and only her old gogo to look after her, had fallen into the fire where gogo cooks.
We had not seen her since her discharge and 2 of the girls from the orphanage and I went to find them to advise them that Spelele had been sponsored by a family in the states through the Young Heroes program. Young Heroes was developed as a joint effort between a [then] PCV, Steve Kallaugher, and NERCHA, the governing Swazi agency overseeing all the HIV efforts in the country.  The idea is that young people (and their families through them) can offer help to a Swazi orphan. A few dollars a month brings much needed food and clothes to the children here who have lost both parents and are being cared for by a family member, usually the gogo, whose resources are already stretched beyond their ability to cope successfully.  Steve has since left the PC to work on this full time at NERCHA. The website ( was launched a few weeks ago and Steve informed me recently that a sponsor had been found for Spelele.
We had only a vague idea where Spelele and gogo lived and kept asking around.  After 2 long bus rides, one in a rickety old bus on a bumpy road that shook my teeth loose, we arrived at their community. A long rocky path downhill and past several homesteads brought us to their decaying old house.  We saw Spelele there and called out to her. She’s still a tiny thing and was a little frightened.  She bounced in place, one step forward and one step back, as if she couldn’t decide whether to run to us or run away.  She did this strange little dance for a few minutes, holding a dirty old plastic bowl.  As we approached, she hid her badly burned hand behind the bowl.  Spelele hides her burns.
We handed her a small, pink teddy bear we brought for her and she had to drop the bowl to take the bear.  Where her hand had burned to a stub, a swollen mass of infection had overtaken the stump. The scar tissue under her chin and around her jaw line is also pulling her once beautiful little face down into a perpetual frown.  It will only become worse as she continues to grow.
Gogo came outside and sat on the steps.  I had Buyile read her the notice of acceptance and the instructions for getting payment for food and clothes.  Gogo & Buyile reviewing the Young Heroes forms.

Gogo then asked if the money could be used to take Spelele to Mbabane, the capital, because she needs to have the arm amputated above the infection.  Of course. If we had just known. I sit there with this tiny girl on my lap, feeling her breathe, her little back alive against my chest. I ache to take her with me.  This life is hard enough under the best of circumstances and a girl with one hand gone, and only partial us of the other, what hope has she?  She holds fast to the little pink bear throughout our visit and I sense it has already become important.Spelele & gogo.  You can see where the stump was from the missing hand is now a mass of infection.  In her good hand she clasps the pink teddy bear.  Teddy bears are difficult to find in Swaziland.  Most children have never seen one.  Most children in rural communities do not own storebought toys.
I tell gogo to let me know as soon as they go to Mbabane and I will come see them.  Leaving this old, tired woman and this tiny damaged girl is painful. I am grateful they will get some help, sad that it will not be enough.

A day of abuse 3/17/06
We spent the day at an HIV & abuse drama competition in which students from 13 different schools in the area participated.  The skits were intense and most of them focused on the rape and sexual abuse of young girls by teachers, headmasters, fathers, relatives, etc. The skits were powerful and disturbing; sexual abuse is so unfortunately common here.  What impressed me most significantly was the change in the willingness to openly address these issues relative to a year and a half ago when we first arrived in country.  I am not sure how much has changed with actual behavior, but the issues of HIV, AIDS, sexual and physical abuse, rape, and treatment of women and children are certainly front and center.  Ironically, at an event for children highlighting these issues, I saw male teachers pushing, shoving, and occasionally hitting the children to get them to move or relocate.  It was as though the event were really for the entertainment of the adults attending and the children were a necessary inconvenience.
Later that night, around 8 p.m., I was lying in my bed reading a bit before I dozed off.  I heard a light and periodic bleating from outside.  I assumed one of the small goats from next door had gotten loose and was at our gate.  The noise, although soft, was so persistent that I couldn’t focus on my reading and decided to get up to see if the little animal was hurt.  It was dark outside and my headlamp reflected off the dense fog that had gathered on our hillside.  I couldn’t see our gate until I was almost upon it.  Ah, God, not a goat at all.  Little Ayanda from the woods.  Half dressed.  Crying quietly.  I took her to the main house and we were able to sort out the details.  Ayanda’s mother had beaten her and sent her off, in the woods, in the dark of night.  She had nowhere to go and managed to get to our place.  If I had not heard her, I imagine I would have woken up to her barely clad body curled up and shivering outside the gate.  She stayed with the girls that night.

Saturday 3/18/06
Ayanda's brother
The housemother, 2 of the girls, and I walked Ayanda home to her place in the woods.  The mother denied beating or sending her off; however I have heard from several sources that she beats the girl regularly and she certainly had not been out looking for her.  In fact she was asleep when we got there and registered no surprise at all to see us.  All of the children look bad, they are showing classic signs, again, of protein deficiency, Ayanda the oldest and the worst.  I told the mother I would buy food for the children if she comes to help the housemother at the orphanage for a couple days but I would not give her money because I knew it would be spent on booze and cigarettes.  It is a miserable life, and I guess she derives what little pleasure she can, but I can’t support that at the expense of the children.  I don’t know what the status of the shelter is now but am still absolutely convinced that a safe place to stay, a little income and job training, and regular food would make a real difference in their lives.

January - February 2006

New year 1/2/06
so, my new year's resolution will be to try to keep a better journal.  I will at least start this month and try to write 2-3 entries per week which I will enter when I am in town.  Christmas was hectic.  All of the girls were at the orphanage, plus the housemother's son and the new little boy, Zita, with whom I have bonded, so there were 30 kids and the two of us adults.  It was great having the girls home (the older ones generally have to spend the whole 6 wk break in Manzini weeding the maize fields of the old woman who owns the property where the orphanage is situated) as I didn't think gogo would let them come.  As is was, I had to pay transport for all of them, but at least they were home.  I got them all kangas (colorful african cloth worn as clothing) while I was in Tanzania with my sister and they all dressed up in their kangas and did some African dancing and singing.  I will try to post a couple pictures.
My new year's eve was quiet.  My 3 good PC friends, JZ, Mel, and Steve, were all out of the country, and Simphiwe was busy with his friends.  So I went to a nature preserve to try to re-find my spiritual center (which has been eluding me these past few weeks).  I was not successful and just pretty much lonely and exhausted from Christmas.  I did have a great dream about Joel that night- he had come back after being gone a long time and it was great to see him.  For some reason I also ate a lot of pralines & cream ice cream in the dream, scooping up extra pralines.  After Joel and I had a happy reunion, he said he was going off to see Alex for a while.  So Al, if you saw him, he came from my place.  Don't dream of him much, but the dreams are always good. 
So, more entries and more sadness.  But as important as it is to remember us here, and what is happening, it is also important to celebrate the goodness in your lives and squeeze out the best of all of it. 

Simphiwe 1/20/06

Simphiwe is leaving next week and I am struggling right now.  For those of you who don’t know or remember, Simphiwe is a 28 year old Hlatikhulu resident who has spent the last several years as a volunteer "operations and youth coordinator" for AMICAALL, a Swazi NGO dealing with HIV.  He is well trained in HIV outreach as well as youth empowerment.  He has worked, literally, 7 days a week.  If he is not engaged in AMICAALL projects, he is helping me in whatever effort or project I have underway, sometimes as simple as taking food to people in the neighboring community at 8 o'clock on a Sunday morning, but also as noteworthy as securing the location, approval, and estimates for our youth center renovation (the building of which he has overseen and which is almost ready to open to the youth of the town) or organizing an HIV educational program.  He has overseen the development of the soup kitchens in the Hlati area, has organized and overseen the AMICAALL peer educators as well as the AMICAALL-trained home based caregivers, has been responsible for the implementation of Hlati HIV surveys, the allocation of food for the needy, and the organization of HIV educational events.  I am sure there are a number of other AMICAALL duties he performs that I have not listed here. He has done this all despite a well-paid inefficient absentee local coordinator who is generally either in another town or somewhere at a conference, workshop, or meeting and who, when she is around manages to delay, obstruct, or foul up whatever is going on here. And he has done so for about E100 (<20 USD) a month (a volunteer's stipend here) for 3 years.
 Just recently AMICAALL decided to officially hire a full time assistant local coordinator for Hlatikhulu who will assume all of the functions Simphiwe has been performing.  Because Simphiwe did not meet the educational requisite, he is not degreed, he was not able to compete for the position.  Of course they are happy to keep him on in his current position; however, Simphiwe has two children who live with him and his mother, for whom he want to be able to provide full support.  He is currently training the new coordinator and will be leaving in a couple weeks to begin a course that will give him certification in architectural draughting after which he hopes to find secure employment.
 In addition to all of that, Simphiwe has been my best friend in Swaziland.  We haven’t spent a lot of physical time together here, beyond what our HIV outreach calls for.  That just isn’t done here- men don’t spend a lot of time in the company of women here.  But he has always been there on the other side of a dark Swazi night, when I need to send a message to someone to say I am hurting or lonely.  And he sends a message to me every morning greeting me and wishing me a good day.  And when I have those random thoughts I want to share with someone, it is him who I contact first.  He has been my lifeline here and he is leaving and I am struggling with it.

Too hard 1/24/06
Ah, this week is too hard. Generally I try not to make this about me, but this separation is difficult for me. damn. damn damn damn.

Tag board 1/30/06

I was disappointed to see all the supportive tags erased from the board.  I think this happens automatically because there are so many spam tags coming in and no way to control for those.  Knowing you are all reading and checking in was stunning for me, and very helpful.
As is often the case when people leave, the final week or so of parting did not go well.  It is not uncommon, when people are close and are having to say goodbye, that they create tension or arguments in order to (subconsciously ) manufacture some emotional distance that makes parting easier.  Teenagers do this when they leave home, a phenomenon called separation and individuation.  So it is with adults as well.  So it was with Simphiwe and me as well.  We did not part well.  Enough said.
I have had some success with regards to getting people interested in new CD4 technology from the states that would facilitate getting timely estimates of immune function in HIV+ people.  For those who don't recall, there is essentially one piece of equipment (a flow cytometer) in the country to process the immune cell counts, and it is located in Mbabane.  For every HIV+ patient, they must go to the nearest hospital, from miles around, to have their blood drawn on only one day, Wednesdays, following which the blood is sent to Mbabane to get the CD4 count.  The results aren't available for another week (unless the truck breaks down, or something goes wrong, which can add another week or two).  As volunteers, we have seen people die for want of a timely CD4 count.  There are technologies available in the US that would equip every clinic in Swaziland with the capability for CD4 counts at the cost of about one new flow cytometer and I have been trying to capture someone's interest in these technologies for about a year. Just recently the Ambassador's office expressed some interest and we might actually get some movement. 
I expect to be on the upswing next week.  This has been an especially difficult couple months for me on a number of fronts, not the least of which has been the end of this important relationship, and I was unprepared for the fall out.  I hope to resume the stories here that I so hope provide a small window into what is happening here.
Thank you all for your love and support.

Help for ‘in the woods’ 2/7/06
I just met with a couple from a German organization, "Hand in Hand", who are interested in an idea for a shelter for homeless women with small children.  As you remember, Simphiwe took me to visit the 2 women and 8 children who were living in the woods in an abandoned car garage. All of the chlidren were extremely ill at the time from malnourishment.  Women, when their husbands die, have no real rights to property so the husband's family can come and evict them from the homestead.  It happens all too often and these vulnerable women and children are left to squat on whatever property or abandoned structures they can find and eke out whatever meager and hopeless existence they can.  Simphiwe and I agreed that it would be good to try to interest someone in a women's shelter that could serve as a shelter for some of these women as well as a free or inexpensive preschool for people in the area who cannot afford to send their children to normal preschool. Since then, we have developed the idea a little further. In Swaziland, the government is encouraging the formation of Neighborhood Care Points, NCPs, which would provide a cooked meal for orphans, vulnerable children, and the elderly who have no means of support.  We thought the shelter could also serve as one of these NCPs for children and elderly in the Hlatikhulu area.  The women who live in the shelter could help with the preschool and with the cooking for the NCP, as well as run a laundry service to support the shelter and provide a little income (we need to get someone to donate an industrial washer and the clothes can be hung to dry).  Recently, a very active German NGO in Swaziland, Hand in Hand, has been talking with Peace Corps Volunteers about needs in their communities.  I am only one of a couple who are living in relatively urban areas. I discussed the idea with them today and they are very interested.  If we can get the town board to come up with the land and can demonstrate commitment to the idea, they will build the structure and have already drawn a rough plan of a potential shelter.  Some things they will not provide, e.g. furniture, the industrial washer, pit latrines, etc., but we can probably come up with those.  I am very hopeful and will meet with the town board at the end of next week to put together a group who can work on this.  This would be the first structure of its kind in the urban areas here and it would be a potential pilot for other such endeavors. 
On a very positive note, the primary school in the area has agreed to let Ayanda attend even though her mother cannot pay school fees.  The mother somehow managed to come up with an old hand me down uniform and, when I saw little Ayanda at the school, barefoot but happy, well, suffice to say she has school shoes and notebooks now.  She is so vulnerable out there around men who are also "squatting" and drinking and dangerous.  At least for a few hours a day I will know she is safe.  At a shelter, I would know she is safe most of the time. 

Getting it right 2/10/06
Simphiwe's study visa was delayed, so we had a chance to get it right.  We got it right.

Failed resolution 2/22/06
I have been in Pretoria for the last two weeks undergoing medical exams subsequent to our midservice physicals.  Needless to say, I am fine; however, I regret that I have not been able to keep my resolution to post more frequently.  I will return to Swaziland tomorrow and hope to pick up where I left off.  While here, I was able to visit an incredible youth group in Kliptown, a shanty town that gave birth to the movement that helped end apartheid.  SKY, Soweto Kliptown Youth Association is supported by the National Basketball Assoc (god bless america) and they are doing amazing things.  There is a co-op where the youth learn to make arts and crafts, the sale of which go to support the organization.  They also have a drama and dance troupe, comprised of local kids living in the shanty town, and we had the good fortune to watch them practice one of their performances. We were in a dark, rundown old building, lacking electricity, with a small battery powered lamp illuminating the makeshift stage.  A couple young boys were on either side of the room, drumming an exotic beat.  The girls appeared, probably 20 of them, and proceeded to dance and recite prose about Africa to the drumming.  It was spellbinding, dark and eerie, and I thought it might be a great idea to bring some of our kids out, especially the girls at the orphanage, to show them what is possible.  This effort could coincide with the opening of our new youth center and it would be great to see the kids from Hlatikhulu put together a similar project.  I will be working on this with another volunteer from Botswana, Colman, who toured Kliptown with us and who is attached to a governemental agency overseeing HIV outreach.  If anyone wants to read about SKY, just google Soweto Kliptown Youth and you will get an idea of where I'm going with this.  Hopefully we can get some of the kids out there and I can follow their experience for you.

Back from Pretoria 2/26/06
Like refuse from a side-ended waste can, old foam mats and dirty blankets bearing sick used up men spill out from the men’s TB ward onto the floor of the hallway.  The overflow is worse than usual and I wonder if this is it, if this is the beginning of the deluge that will last years.  My charge this day is to visit two children of a neighbor.  B is 29 and was admitted Saturday.  His HIV status is unknown and his mother and I are there to encourage him to be tested.  The daughter, “T”, 25, is on the women’s ward, positive for both HIV and TB, with fluid filled lungs.  She is not on antiretrovirals yet, has not had the CD4 count done, and will not begin them until her TB treatment is further underway. The ARVs can interfere with the efficacy of the TB treatment.  We see her first, her 5 year old son, wide eyed and silent, in tow.  She is thin but able to sit up. She asks me to go with her Wednesday to get her results.  I promise to come back in the morning with some juice, which is all she is able to hold down.
The son, “B”, is in bad shape, a long ebony stick figure, unable to sit unattended, weak as weak gets. It takes little convincing to get him to request testing for HIV.  He know he will die without treatment, knows he may die anyway. 
The mother and I go to the nurse’s station to ask the nurse to take him to the VCT in the morning.  She is unable.  She is the only nurse for all these men.  The mother must go to work.  It seems that I am the only one with free time to sit and wait with him at the VCT.  I agree to come at 8.

A morning with B 2/27/06
I show up at 8 and am told “B” must go to X Ray first and there is no one else to take him.  The nurse and I drape him over the old wheelchair, which is held together by pieces of rope, and I wheel him down the hallway to X-ray, where we find a line already well-formed.  It’s going to be a long morning. I park the chair in the hall across from an old woman sitting behind a wheelchair with a boy of about 16 or 17.  His head has fallen backwards and is resting on her frail chest.  His eyes flicker open periodically, only to roll back into his head and shut again.  I can’t take my eyes off of him.  He looks so vulnerable.  On few occasions his eyes meet mine with awareness and, even though I felt I should look away out of politeness, I am unable.  I wonder what will come of him.  I wonder if I should try to find him on the ward later.
When it is our turn, the X-ray doc expects that I will lift this 6’4” gangly man out of his wheelchair by myself and lay him flat out on the table.  I struggle futilely until a female technician appears from nowhere to assist.  Somehow we wrestle him onto the table, no help from the doc who stands by and watches, and I take my leave while they x-ray him. Getting him back in the chair is somewhat easier although lacking grace- sliding here, grasping there, dropping him down into the seat as carefully as I can.  By this time it is near 11 and I wheel him to the VCT.  We are back on the ward by noon, results in hand.  It is a struggle to get him back onto the cot and I am not able to be gentle.  I wince as I pull and push and tug, but there is no sign of discomfort from him.  Once he is on the bed he folds his long limbs up, so thin, a dark praying mantis on an old hospital cot, praying for life or release from it. He will have his CD4 count taken on the ward and another week will go by before the results are in. They can treat him immediately based on a positive test and clinical symptoms, but they don’t always do that.  It’s up to the mood and discretion of the doctor.  It’s curious; yesterday, looking at him, I felt somewhat unmoved by him for some reason.  This afternoon, after our day together and his quiet patient acceptance of the hours of waiting and rough handling, I found I had developed an affection for him.  Unfortunate, because he is likely to die.

Tuesday 2/28/06
I stop in to see them both.  “T” looks worse today, unable to lift herself up.  I touch her forehead, she is burning up.  I leave some juice and tell her to stay strong, that we will see the doctor at the ART clinic in the morning.
“B” is the same, barely able to even shift his position, much less sit up.  It looks as though he has not even moved since I saw him last.  He acknowledges me and seems pleased that someone has come to greet him.
There is a cockiness to young men in this country, many drinking and having unprotected sex with an air of defiant enthusiasm.  They say that they’re “just gonna die anyway”.  I wonder if “B” was like that a year or so ago.  I wonder how it feels when the bravado falls away and death is sitting on their shoulders, a reality now.  He looks only scared and sad, any arrogance of youth beaten down, trampled in the face of this awful sickness.  I don’t fault them the stupidity of youth (I still carry some of that stupidity with me even today) and would not wish this ending on them.