May 2005

5/14/05

Since I last wrote, baby M has relapsed and has been in the hospital.   When the sores rebound, they do so with a vengence.  He was discharged yesterday, after 16 days in the hospital, still not well.  For 2 years this poor child has been sick and there seems no end to his misery.  Lately he has had transient periods of health, followed by relapse. Babe M has been at work, so the little 13 year old sister has been caring for the child.   When they discharged the baby yesterday, she wrapped him in a blanket on her too small back and headed home.  I sent them off in a khumbi,, not wanting her to trudge the several miles home barefoot, carrying the child and all his belongings.  They wave goodbye from the back of the van and my heart is heavy at the sight of them.

Bheki's wife, Lungile, has also been sick all this time.  She left the hospital in Manzini where she has family.  She has been back in the hospital here for several days.  She is near death- the sores in her mouth and throat prevent her from eating and the vomiting and diarrhea are just on the sidelines in case she does.  She was finally placed on ARV therapy yesterday and I am hoping for a recovery.

Lungile 5/16/05

Lungile is dying.  The ARVs came too late.  She is not able to hold down liquids much less the  panoply of pills that might save her life.  I spent the afternoon with her and watched her progressively slip away.  The yellowish, pus filled sores that line the inside of  her mouth and throat are starting to creep out at the corners of her pretty, delicate mouth. When I first came onto the ward she was cognizant.  Unable to speak, her eyes gave some sign that she was aware of my presence.  In an act I found poignantly futile, her auntie was pouring a capful of liquid into her mouth that simply dribbled out the side of her lips and onto a dirty washrag that was placed under her chin.

I left Lungile long enough to visit Lindie, Linda’s mother, whom I heard had lost her baby in delivery.  We found Lindie on the maternity ward.  She looked at me mournfully.  “Nozipho, my baby is late.”  People never use the word death, or any variation thereof.  No one dies, they are late, they are gone.  She makes room for me beside her on the cot and we hold each other for a bit.  I have nothing for her but my tears, which I give gladly.  She says she wants the doctor to “close her”.  She does not want to be pregnant again. I kiss her all over her beautiful sad face and tell her I will be back tomorrow.  I tell her to have Linda come see me so I can be sure he is taking his meds.

By the time I get back to Lungile, she is no longer aware of my presence or her surroundings.  The woman in the cot next to her died while I was out and there is a heavy empty space where her bed used to be. Lungile’s eyes are open a fraction with only slivers of white showing.  I sit and hold her hand and think how lovely she is, even in what are probably her final hours.  I think how much she looks like her 7 year old, the baby, whom she will probably never see again.  I wonder how Bheki will manage.  Gogo, of course, will take the children, but with no job and no hope for one even in the distant future (unemployment for men Bheki's age is at 40%), how will he pay school fees, buy clothes, books, etc?  And above all, how will he bear the loss of this lovely young woman who has shared this difficult life with him?

I look at Lungile who is dying because she had sex.  Pure and simple. How can this be? Where is the fairness in this?  The distended belly, the lifeless body, yellow fluid oozing from the corners of her mouth as she lays there- this all from sex.  How can this be?  A continent dying from sex.  Something so natural, so necessary, now so deadly.

Now gone 5/17/05

Lunglie’s auntie just came by.  Lungile died at 11 last night.  We sat on my doorstep and the aunt let me hold her while she cried, rare here to openly cry, especially with a stranger.

Lungile, like Nokuthula her sister-in-law, young, beautiful, with 2 small children, now gone.  Who will tell her story?  Who will remember her?  Who will know that for a brief moment she stepped lightly on the planet?

Cd4 counts and flow cytometers 5/20/05

I have been trying to get someone at a higher level interested in getting another flow cytometer for the country so that we can get CD4 counts more often than once a week.  I wrote the Director of NERCHA, the governmental agency that oversees HIV/AIDS efforts here and he says it is out of his hands, that the Ministry of Health is just not interested in putting the money into this effort even though we could get help through organizations such as the Clinton Foundation.  Here are the subsequent email exchanges with him which just about say it all:
Dear D,  Thanks for your efforts on our behalf.As to the flow cytometer, if the Ministry could just sit with me at the ARV clinic on Wednesdays, for hours and hours as the line snakes out the door and those who are too sick to stand lie on dirty coats on the floor, if they could just sit at the bedside of someone who is dying because they fell through the cracks, because a week can mean life and death in Swaziland... I am attaching a picture of Bheki Kunene and his two children.  I sat by his lovely wife's bedside 2 days ago as she was dying, I watched her life slip away. I want people to remember them. People are dying not only because they have AIDS, but because they have AIDS in a country where the medical infrastructure is collapsing and not able to handle current patient load, much less what the patient load will be 8 years from now, when about one half of the adult population will be dead, dying, or very ill.  I see people die simply because they fell through the cracks. I have heard you speak and I know you agonize over this.  Surely there is something we can do.  alyson

Hi Alyson, you will recall my words at your graduation as PC volunteers. 'Welcome to the hell of the real world' and that 'this will be a life changing experience'. The frustrations you feel, I feel have full sympathy with. At a management level where we are trying to do what we can to assist a whole nation of sufferers it is almost unbearable to cope with the lack of sympathy and capacity and down right obstructionism we encounter. People just don't seem to care for their fellow human beings suffering and death. But as a Christian that is what motivates me. I will continue the struggle in spite of them and do what I can. Ultimately we will have the satisfaction that we succeeded in spite of them. Keep up the good work. You know you have our support. D  

Joel 5/31/05
He would have been 20 today, that big magnificent kid with the great smile.  Yesterday I went to visit Robben Island, where Nelson Mandela was kept prisoner for 18 years.  Joel had great respect with Mandela and with the struggle to end oppression.  He would have appreciated the day.  He would have agreed with me as well, I think, that there are still 2 South Africas, much like there are 2 Americas, and that equality is still far from reach.  Ah, Joel, too, is far from reach and I miss him sorely.