I received this from Lu yesterday and thought it was very sweet. It requires no further explanation on my part:
I had to retire Joel's shoes today. I wore them as long as I could, and
I'm not throwing them away, but they had a huge hole in the sole and if
I stepped in anything even remotely wet, water would soak in. I tried
fixing it with duct tape, and all manner of things, but to no avail. I
believe the story of those shoes goes something like this:
-our friend Leo got them for free at his work somewhere, wore them for
about a year
-gave shoes to Joel, he wore them for about a year
-shoes went with him to the army
-shoes came back with his personal effects
-I wore them from that day until this afternoon
it was important for me to wear them, but I feel that I have made my
peace with them. I'll keep them around, and maybe even slip them on
from
time to time, but I think it's time to let go. I might enlist the art
kids to make an art project out of them, that would be great!
~Lu
The folks down the road 3/6/05
Yesterday Simphiwe and I went to visit people from the neighboring community and to take some food to those in desperate need. If there is a hero to this Swaziland story, it is in someone like Simphiwe. He is a 29 year old Swazi male whose gentleness, equanimity, and grace under pressure leaves me in a constant state of awe. He is a volunteer with a local NGO overseeing HIV efforts in this area. For four years, for less than USD 20/month, he gets up each day and goes out to make the world a better place. But his is a story for another day.
Our first stop was to see Mazaza. When we first saw Mazaza, mid-January, he was sitting on the ground outside his round stone, stick, and mud hut. He had been in an accident some time ago and his body was badly burned and broken. Most of the fingers had been burned from his left hand and one side of his body is covered in scar tissue. His right leg is broken about 5 inches above the knee and when he lifts his thigh up from the ground with his hands, the knee and lower leg simply fall away from the leg, attached only by skin and ligaments. The leg had never been repaired. When I sat down on the ground next to him, quiet tears ran down his cheeks. He was hungry and he seemed broken in other ways that are less tangible.
Since that first visit we have been back several times- to bring food or simply to see him and let him know he is on our minds. When we saw him today, he looked good- a broad smile stretched across his face, his cheeks full and hinting of health. He was actually sitting up off the ground a little, on a plastic jug or box turned on its side. I wondered if he missed Mandla.
When we first came, Mandla lived in a tiny mud, stick, ad stone hut perhaps 15’ from Mazaza’s rondeval. Unlike some of the swazi mud huts that are tightly constructed, this was a makeshift shelter that provided scant protection from the elements. We learned that someone had set fire to his previous home. Mandla was emaciated and desperate looking, and his tears were less subtle. He had been treated for TB for quite some time and was not improving. My feeling was that he was not being treated for the underlying cause and I suggested he come into town for HIV testing. We saw that he was sleeping on the ground, on damp dirty blankets, which would serve to exacerbate his illness. On our next visit, Simphiwe and I went back to town and Simphiwe managed to talk the owner of the local lumber yard out of some old discarded planks so Mandla could be elevated a few inches from the wet ground. The owner gave us the old planks for free but charged us to take them out there. There is so little for free here. A week later Mandla was dead. Simphiwe was disheartened. I told him that, for the last week of Mandla’s life, he didn’t have to sleep on the cold wet ground and that he should take heart that he had provided some small comfort to someone at the end of their days. Sometime that has to be enough, especially here. We left Mazaza in good spirits and thanked the gogo who cares for him. Perhaps she is his mother, I am not sure, but she is “sangoma”, a traditional healer, and she talks to her ancestors. I wonder what she says to them in these dark times.
We walk on down the dirt road to find the gogo with the 2 tiny children whose faces haunt me at night. Ah, this is a sad story. This is an old woman whose leg has been broken for more than a year. I gather she had some treatment at one time, but it was ineffective. When we first encountered her, she was lying on a small bed in a dank, smoke-filled hut, her broken leg swollen and fluid filled. Two tiny children were with her in the hut, one about 3’ tall with huge liquid eyes standing naked in a small bucket of dirty water, trying to give himself a bath. His smaller brother hunched in the corner. They looked feral. The gogo explained that her daughter, the mother of these small ones dropped them off in July and took off to find something better for herself on the outskirts of Manzini, in an area known for its sex trade activity. The gogo is incapable of leaving her bed and cooks for the tiny ones in a pot by the side of the bed, hence the smoke filled room. She explains that she stopped eating some time ago because she is unable to extricate herself from the bed to go outside and relieve herself. She lifts her shirt to expose folds of flesh that indicate she was heavy at one time. She says she asks God to take her every day and is considering taking her own life. If this woman dies, no one would know for days, or maybe weeks, and these tiny children, whose faces disrupt my sleep, would be climbing over her dead body trying to wake her, helpless about what to do next. There is a small maize field outside the hut and we learn that the gogo dragged herself on her elbows to plant the corn some months ago, during a time she was feeling better. It is unlikely the corn will ever be harvested, unless it is done so by thieves.
On this day the gogo is feeling better and is actually sitting up on the bed. This is the first time I have seen her sit but my slight relief is dampened by the coughs and labored breathing of the little ones, who have recently contracted the flu. Someone is being sent to find the mother so the gogo can go in the hospital for a couple weeks to have her leg treated. We tell the gogo that, if the mother cannot be located, we will try to find someone who can care for the tiny ones while she is hospitalized. I also ask Simphiwe to have her get someone to contact us if the children become sicker. Given the situation with the mother, it is reasonable to be concerned that one or both children might be HIV+. Before leaving I kneel down and put my hand on each child’s chest, feeling their little hearts beating and wishing that some of my own health could somehow be transmitted through my skin and their threadbare shirts.
We walk on further down the road, hoping to find Babe M’s place. We ask some small children we meet along the way and are told it is “la pha”, over there. They follow us at a distance, giggling and shouting encouragement. On my first trip to this neighborhood I did not meet Babe M. He was out working his fields. But I did see his children. His wife died a couple years back, bleeding to death from complications of childbirth. He cares for the four children on his own and cultivates several fields to provide for them. The youngest child, 2 years old, was being carried on the back of his older but small sibling. The infant was covered in scales and oozing sores such that his eyes could not open, barely recognizable as human. It pained us all to see this child and I told the woman with me to have Babe M bring the child in to the VCT for HIV testing. The next Monday I approached the VCT and saw him sitting there holding this little one close to him on his lap. Actually, they were holding each other. The doctor I had met previously in the ARV clinic passed by and came over to greet me. He took one look at the infant and said the baby needed to be hospitalized. I told him, unfortunately, that the mother is dead, there are no other relatives, and consequently, there is no one to stay at the hospital with the child (required in the face of a severe nursing shortage). He told us to take the baby to the lab for HIV testing but that is was his professional opinion the child was suffering for congenital syphilis. He told us to come by the office at 11, bypassing hours of waiting at the clinic. It turned out the baby was negative for HIV and had been receiving treatment for 2 years for external symptoms- the sores and upper respiratory sequelae- nearly at the expense of his life. I saw Babe M with the baby 3 days later as he was registering one of his other children at the primary school. The change in the infant after just a short course of antibiotics was striking. Today, about 4 weeks later, almost all the sores are gone from his face and the eyes are open. The child is cooing, animated. There is a big open sore on his neck and Babe M is afraid he might relapse. We have agreed to meet at the clinic again and see the doctor together. Babe M and baby M still cling to each other as if sharing a pact of grief at the loss of the mother. But today a renewed spirit and vigor is also shared between them. Babe M is grateful to us and sends us off with a bag of peanuts and a smile.
Simphiwe and I walk the several miles back into town and I am happy to be in his company. I delight in his company. We part ways in town and I head back to the orphanage. The girls are busy playing, so I head out for a long run. Upon return, I am greeted by the housemother who has just returned from Manzini. I can see by her face that something is not right. She tells me her son, in his twenties and living in the city, died yesterday. I wrap her in my arms, knowing that for this there is no comfort.
Yesterday began with a rattle at the gate. In Swaziland, it is common practice to stand down at the end of the entryway to the homestead, which can be quite a distance from the actual house, and either rattle the gate or cry out “ekhaya” until you have caught someone’s attention. This morning my attention was caught by Babe (pronounced ba-bay, meaning father or older male) M standing outside the gate with the baby on his shoulders. I have seen them thus so often that it sometimes seems they are one. Even when cultivating his fields, there perches the small child on his back.
We are off to the clinic, held in a ramshackle building adjacent to the hospital. Unlike the latter, the clinic has some semblance of order although it is no less dingy and suffers no less disrepair. We walk into the room to scores of people seated on old church pews spaced about 8” apart. In the corner, partially curtained by an old stained sheet, sits the intake nurse. Perhaps 15 people tightly pack each bench, with about 10 benches to the room. Overflow snakes out the door. Smaller benches by the “nurses station” contain people waiting to have their blood pressure taken. We are too late for the hymn, which starts the morning intake, and take our places on one of the last benches available. After each person hands over their records, mangled pieces of paper they carry with them documenting previous visits, they are sent to another area to see the consulting nurse. We inch along the benches and arrive at the intake nurse about 2 hours later. People here are very sick and at the rate at which one makes one’s way to intake, it is possible to get a good long look at misery. Sometimes it vomits at your feet. Baby M does not need his blood pressure taken, shaving an hour off our wait, and we move to a long bench to repeat the snake crawl. Fortunately it is a nurse I have met, a young man from Zimbabwe, who directs us to a long, dark hallway where we are to wait for the doctor. We are number 18, black, not to be confused with blue or red, signifying other consult rooms. I leave to go a few blocks to get bananas and bread for father and son. When I get back I see that the lines have not moved. We have been here for 3 hours already. We are finally seen about 1:00, four hours from our arrival. Based on prior experiences, it seems we have made good time.
The doctor is a woman, rare here, from the Congo. She takes the baby’s history, prescribes the medication, and we are off. The pharmacy, we learn, is closed until 2. At this point I take my leave of the two, my main purpose served. After collecting his meds, Babe M will walk the several miles home with his son clinging to his back.
Today the rattling at the gate is a sadder story. Lindie is 8 months pregnant with 4 children. The oldest, Linda, is a boy from a previous marriage and his father is now dead. Linda lives with his gogo because the new husband did not want to support him- a common phenomenon here. Linda is 12 years old and HIV+. Sores began to appear on his legs when he was 6 and were followed by a bad bout with TB a year later. He has gotten progressively worse, sores like tiny angry volcanoes erupting on his lower extremities. He has upper respiratory distress consistent with his infection. Vacant look notwithstanding, he is a lovely and quiet child. He was not tested for HIV until last month despite years of symptomatic illnesses, and we are taking him in today to have his blood drawn for a CD4 count.
About 40% of the adult population in Swaziland is estimated to be HIV+. Most young women between the ages of 18 and 25 are either pregnant or nursing a small child. The majority of them have not been tested. While most of the attention is being placed on the adult population, many of whom will surely die, very little voice is given to the staggering number of HIV babies currently being born who will begin to get sick. A recent study showed that, while about 30% of HIV babies will not survive their first year, roughly 40% will survive past their 5th birthday. We will start to see these children in the primary schools in great numbers within a few years. We are already starting to see them now. And the schools are not prepared to either identify or support these kids. If you estimate that > 30-50% of babies born to HIV mothers contract HIV, and that approximately half of all women pregnant are HIV+, you can figure that about 15-20% of all babies being born today will be HIV positive. The implications are staggering.
I took the mother and child down to the Town Board to talk to Simphiwe because I want them to fully understand, in their own tongue, what is happening to them. I have called Simphiwe earlier in the morning and, as usual, he accommodates me. He explains to the mother that HIV can take 6 – 10 years to develop to AIDS and that it is very likely that her son contracted the virus during childbirth. We explain that her unborn child is at risk and that if she is tested and is positive, she can be treated with meds that will reduce the chance of mother to child transmission. We also explain that once Linda is placed on ARV therapy, she must make sure he takes the medication regularly or he will get worse quickly. She voices fears that the meds may make him sicker. We agree that the ARVs may make him sick, but they will save his life. In Swaziland that is sometimes the choice, either live sick or die. We leave Simphiwe to make our way back to town and Lindie asks me to take her to the VCT- she wants to be tested.
On our way back to the hospital, we are stopped by a lovely and very pregnant woman who is in apparent distress. Lindie, who speaks some English, explains to me that this woman is in to get the CD4 results, and hopefully some medicine, for her husband who is too sick and weak to stand, much less to come in himself. She is hoping I might help somehow but I am unclear what she wants me to do. I drop Lindie off at the VCT and go with this woman to the ARV clinic, which seems less overcrowded than usual. I soon find out why- the results of last week’s tests did not come this morning and, consequently, will not be available for another week. When your CD4 count is <200, and you are symptomatic, a week can kill you here. I take the woman to a nurse to try to gauge her situation better. She lives several miles from town and is hoping I will come see her husband. She wipes an eye, tantamount to sobbing in a country that shows little grief, having had to bear so much of it. I walk her home. It is a long journey through town out to the neighboring community. We turn and head downhill on a narrow, rocky dirt road wide enough for one car. We hike on and on and I wonder at the thought that she makes this trip so often at the end of her pregnancy. We walk down an overgrown footpath and arrive at the homestead, 3 small mud and stone huts and a mangy dog with an angry red eye. We pass through the doorway to where her husband, Sikhumbuso, is lying strangely twisted on the bed. Of course he can’t walk- there is not a bit of muscle mass left on his body. He will die. She says he stopped talking 2 days ago. Oddly, he has a piece of cooked potato pressed against his mouth. Apparently he is able to eat a little, but the diarrhea, “umsheko”, keeps him from deriving any nutrients. After 5 months in Swaziland, I am still amazed at how little it takes to sustain life. That this man breathes at all is an enigma to me. If he has any awareness of our presence, he gives no sign. I suspect his mind is somewhere preparing for its final journey.
There are no neighbors with cars to take him to the hospital. Christ, there are no neighbors with electricity, phones, or running water. There are no neighbors with much of anything, not even hope these days. I trudge back into town to hire someone to pick him up and take him to the hospital. I find a young, plump Swazi man in a battered old Toyota pickup who will collect Sikhumbuso and take him to the hospital for E20. Expensive, but there are no other solutions- it is too far to carry him. We get back to the homestead and the man’s brothers, one barely out of high school, carry him to the truck. It would take only one, what with the slightness of him, but he is long and cumbersome. His pregnant wife has dressed to accompany him. At 8 months pregnant, she will be the one to sleep under his bed on a sponge pad during his stay. I watch them drive away knowing in my heart it is too late but also knowing the gesture would not be forgotten by the family.
I was late getting home to begin my community rounds. We are going door-to-door taking a census of who lives at the home, who is orphaned, who is sick, etc. After what transpired earlier in the day, the grinding poverty that greets me at each homestead seems somewhat less brutal. It is relative and here you can always find someone who is worse off.
I headed into town with the intent of checking on the sick man at the hospital. I am sitting in a small “canteen” where the women cook and serve customers at old picnic tables covered with torn pieces of old plastic tablecloths. I look up to see S’s wife standing at the edge of the table looking down on me. What I am able to gather, with the help of a make who speaks some English, is that they denied him admission. She does not know why. She says she will try to bring him to the ARV clinic next Wednesday if she can get transport. I do not tell her that he will not live that long.
Went to visit Bheki today. Bheki is the brother of the first young woman I took to the VCT, who subsequently died leaving 2 small orphans. Early 20s, young, beautiful, now dead. In a country where a week can mean life or death, she fell between the cracks. Her life was a casualty of mistakes and bad timing. I met Bheki a week after I took his sister to the VCT. He was 29, tall, skeletal, and extremely ill. He came because his sister paved the way. I remember the day- it was a Wednesday and, because it was a Wednesday, he was able to go right to the ARV clinic to have his blood drawn. Sometimes it is good that the clinic is crowded shoulder to shoulder, because I am not sure he could have stood that long on his own that day without being pressed on all sides by other people. I had things to take care of and I remember going back to check on him several times, taking him some food at around 4, 8 hours after his arrival, because I feared he would not last the day. He persisted. He returned the following week for his results and easily qualified for ARVs. Bheki has a 7 year old daughter, whom he loves, and a young sweet wife, and he was resolute. Over the past few weeks I have seen him steadily improve. And when he sees me, his face lights up. He thinks I am sent from heaven and, for a few minutes, he makes me think so too. Then I remember that all I really did was show up and it was enough. So I was dismayed, recently, to hear that Bheki had been in the hospital for a couple days. I couldn’t swallow for the fear that he might not be complying with his treatment and we might have to bury him as well. I felt an urgency to go see him, to beg him to comply, to help him any way I could. This one I will not lose.
This morning I asked where Bheki lives. “Down there”, they tell me. Well, in Swaziland, when they say “down there”, they mean way the hell “down there”, over that hill, across that expanse of grassland, and down the side of that mountain- land that has no knowledge of tire tracks. On my way I stop at the home of Bheki’s gogo. There is a very sick man there as well, Sdumo. He is 35 and looks wretched. I recall someone stopping me at the bus rank a few days back telling me I needed to go visit “Sdumo who was sick”. He slumps in a chair on the porch with his head hanging, too sick to look up. His illness is palpable- I can almost taste it. On the porch I am surrounded by African women who are amazed to see me there. I speak with Sdumo’s cousin, in her 30s, who has a fairly good command of English. I explain that it can take 6-8 years before someone becomes sick and so it is the mistakes we make when we are young and foolish, with fire in our bellies, that kills us when we are older and married, with a couple kids and a spouse. I explain how HIV infects the “emasotja”, the immune cells, over that 6-8 year period, such that the body can no longer fight diseases. I tell her Sdumo must come Wednesday and be tested and if he is positive he can be treated and he will get better. She says he will come. She says she will come to be tested as well. Everytime someone tells me they want to be tested, a sweet little high note plays in my heart. They send me off to Bheki’s house, “down there”, with a young boy to keep me company and show me the way.
I am relieved when we finally get to a place where we can see “down there”, down the mountain where Bheki lives. There are about 6 or 7 mud huts in a line overlooking the valley. It is green and lush and the maize is growing nicely. They see us coming long before we get there and a chair has been placed outside one of the huts for me. Three adult women and many small, half-naked children, sit on mats. Bheki comes, carrying his own chair. God he looks good. By our standards he would be extremely gaunt but, relative to the emaciated collection of bones I first met, he looks good. He sits down. Again the smile- as if the sun rose and set in my presence. I get over myself quickly and ask how he is. He says he is better, that he was sick for a few days but better now and much better than he was a few weeks ago. With some trepidation I ask him if he is taking his meds. “Yes” he promises, “every day”. We sit, looking out over the maize field and talk about the statistics and that many people will die. His English is not good, but it is good enough to understand what is to come in this country. He shakes his head, “ah, people must know their status, they must treat, they must live.” He is convincing. I ask about his wife. He says he is trying to persuade her to test- he will try to bring her Wednesday when he comes in for his meds. I compliment him on the maize field and he tells me the monkeys come and steal the corn. “They take too much.” It is time for me to leave. As I climb back up the mountain, I wonder how it was possible, as sick as he was, what wellspring of effort and determination, enabled him to climb up that mountain the day he first met me at the VCT.
The new statistics are out. It seems to be true. Not only are the HIV rates not going down, they are not even stabilizing. Swaziland is now at 42.6% prevalence in the adult population (16-39). In the age group between 25 and 29 years old, the HIV infection rate is at 56%. In 8-10 years, about ½ of the current adult population will be dead, sick, or dying. And the HIV babies- no one is even talking about them.
The price of ARVs 3/14/05
The new statistics are out. It seems to be true. Not only are the HIV rates not going down, they are not even stabilizing. Swaziland is now at 42.6% prevalence in the adult population (16-39). In the age group between 25 and 29 years old, the HIV infection rate is at 56%. In 8-10 years, about ½ of the current adult population will be dead, sick, or dying. And the HIV babies- no one is even talking about them.
Wednesdays 3/16/05
I cry every Wednesday. Wednesdays are the only day of the week they can draw blood for CD4 counts because the blood must be sent all the way to Mbabane for analysis. Wednesdays are also the days when the results are brought in for the previous week’s samples. Wednesdays are the saddest day in the week. People come in from all over, many have walked miles to get here. And they do not come unless they are very sick. They crowd into the small waiting room by the scores and the line snakes out the door into the yard for some distance. Those who cannot stand lie on blankets or old jackets in the hallway or on the grass outside. These are “the tired, the poor, the huddled masses yearning to breathe free”, or just to breathe at all. The walls are splotched black with mold and paint peels away like rotting skin.
I am there with the 2 pregnant women from last week. Lindiwe has brought her son, Linda. I get his results from the nurse- a CD4 count of 118. He is well on his way to full blown AIDS but, ironically, I rejoice because now he will receive treatment. The other woman, Sikhumbuso’s wife, has managed to bring her husband- they hired transport and carried him in. He is propped up in a chair looking a bit goulish.
Knowing it will be some time before a doctor sees them. I go to look for Sdumo at the VCT, hoping he has come. Sadly I do not see him in the darkened room where many are herded in for counseling, but I hope maybe I am just not recognizing him. I go back to the ARV clinic and am greeted by a young man from my community who knows me. He is tall and thin, with bloodshot eyes and a brilliant smile. There is a feel of underlying sickness about him but he greets me warmly. He says he is looking for Bheki, who is in line somewhere outside waiting for his meds, but he also informs me that Sdumo was brought into the hospital yesterday and is currently in the TB ward. We head toward the ward together and I take the opportunity, while I have him alone, to ask if he has tested. No. But he wants to. He is afraid. He makes me a promise- soon- he will test soon. We find Sdumo on the “ward”, a collection of old metal cots containing men in varying stages of death, one with facial tumors larger than his nose, eating away his face. Actually, that one is in the hallway because there is not enough room in the ward. He lies there groaning.
I look at Sdumo, whose old mother sits there wiping a tear away, and I know he will not live if we do not get him tested today. If the blood is not taken today, he will wait until next week to have blood drawn and the following week before he can get treatment (if nothing goes wrong and usually something does). 2 weeks.
We rush to the VCT to see if they will test him. One of the counselors is resistant- he should have been there earlier. I explain he intended to come but was admitted the day before and is too sick to walk. Fortunately one of the counselors lives in my community and knows him. She agrees to come to the ward to collect blood for the test. We must find a wheelchair, no small feat here, and bring him back to the VCT clinic for his results. It is almost noon and, after getting his test results, we are told he must be taken to the ARV clinic to have blood drawn today to be sent out- he is too sick to wait. Although they do not tell me his HIV results, he would not be sent for a CD4 count with a negative result. I fight my way through the crowd at the ARV clinic to talk to the nurse. She refuses to take his blood- he is an inpatient and must be managed on the ward. We get back to the ward and are told the doctor has already made his rounds and they cannot take blood without his authorization. I explain that tomorrow is too late- the blood must go to Mbabane today or he will have to wait another week. I beg, I plead, I stop just short of crying, and an attractive young nurse agrees to take his blood today. I thank her profusely, tell her I owe her, and head back to the ARV clinic. It is hours later and still my two pregnant women wait with their sick charges. They call Sikhumbuso in and his wife and I pick him up and carry him in to see the doctor. I leave the room. After a brief wait the door opens. They are giving her ARVs for him and sending him home. I am stunned that they will not admit him. The doctor says he will get better once he starts taking the ARVs. They said the same thing about the young man in the wheelchair who was sent home and was dead in less than a week. I pick Sikhumbuso up and carry him into the waiting room. He is heavier than I predicted. From there, two men help me carry him to the hospital entrance, me with my arms round his upper body and him barely clinging to me, a younger man carrying his legs, and an old man holding one arm. We must be an odd sight. We deposit him at the hospital door and I walk to town with his wife to hire transport to take him home. I tell her I will come by on the weekend. I do not expect to see him alive. I have a meeting with Simphiwe and the High School anti-AIDS club, so I do not go back to the hospital. I am confident that Linda’s CD4 results will qualify him for meds today.
On my way back home, I swing back by the hospital. I learn that they did not take Sdumo’s blood after all. He will get no treatment soon. Further down the road I am greeted by Lindie, Linda’s mother. He was not given ARVs. Something about a machine being broken. It is Wednesday. I cry every Wednesday.
Julie and I are in Nhalngano to meet with Nonpilo, who will be doing a presentation with me at the end of the month to teachers at my local schools. I will do a half hour presentation on the biology of HIV- how it progresses and why people die. Nompilo will be talking about how to live well with HIV. She was diagnosed with HIV 10 years ago when she was already sick. She will tell you how difficult the diagnosis was to accept- the associated shame. Her husband also tested and was positive. She now dedicates her life to living well with HIV and helping others to do the same. She is an expert on diet and local herbs that boost the immune system. She is healthy and beautiful and has maintained such good health that she does not yet require ARV treatment. With the collapsing medical infrastructure here and the increasing HIV rate, it will be necessary for more people to be able to live well with HIV. Their medical system will not be able to sustain them. Nompoilo organizes a regional HIV support group and she is the hope of her country.
I stop and see Simphiwe on my way home. He is organizing a youth event for Saturday, among his dozen or so other responsibilities this day. I really stop to see him simply because I need a dose of goodness before I end my day. I stop briefly to see Sdumo and take him some juice and bananas before I head home. He looks almost dead. His body is convulsing with hiccups spaced only a few seconds apart. Each hiccup elicits a cry of pain from his TB riddled lungs. As I head out I see a young man in the adjacent bed. He is young and beautiful with clear eyes that look right into me. His eyes are surrounded by thick black sores and scabs, the contrast increasing their brightness. His mouth is also ringed by sores. I head out and down the hall, feeling the two bananas in my pocket that I have kept for myself. I turn, go back, and hand the bananas to the young man. It is my way of saying, “I see you too”.
3/18/05
I ran into a couple men from my community and we went to the hospital to see Sidumo. As with every day, his mother was sitting by the side of his bed looking tragic. She is staying there with him, this heavy, beleaguered woman who is too old and unfit to be sleeping on a TB ward. Today Sdumo was able to sit up a bit, with considerable assistance. He said he was hungry and was wanting some sausage- a good sign. For days all he has been wanting has been bananas and guava juice. We went uptown to the butcher shop. In Swaziland, a butcher shop is generally associated with a grill somewhere close by where you can brai (grill) your food. So it is here. A narrow alleyway behind the shop leads to an outdoor grill, a wonderful find for me in that I frequently crave meat but am loathe to take meat back to the orphanage to cook for myself when meat at the orphanage is an unknown luxury. We brai the sausage and take it to Sdumo and his mother. They are grateful, the mother close to tears. We take our leave and I stop by Lindiwe’s room to check on her. The blisters under her eyes are all but gone, but the lips are still swollen, scabbed, and oozing. I cringe internally at her appearance. I leave her with bananas and milk but am not sure how she eats.
In the evening I had a meeting with the doctor from the ARV clinic, another Peace Corps Volunteer, and a Minister of Parliament (MP) and his wife about a clinic they want to build in the community to monitor HIV positive children. We had a large dinner at the MPs house and spent too much time talking politics and not enough time talking about the clinic. A young man who works from UNICEF was there and we had a discussion about food provisions from the WFP. A week earlier, I met with the Swaziland director of the WFP who told me there would be food available for the orphans, vulnerable children, and needy in our areas if we could get them a list of school kitchens and neighborhood care points as well as the names of the Peace Corps volunteers in those areas. Now this young man is telling me that there is not enough food available for our area, as the drought stricken areas will be taking precedence. While I understand there are regions of Swaziland with greater need, there is no region without need. I think of the frequent HIV workshops held at expensive hotels, the high-end cars used to drive employees of NGOs, inflated salaries of some HIV workers, and I wonder why there is not sufficient food to feed the hungry in my neighboring communities. I wonder why Simphiwe works 24/7, almost for free, while others are stuffing their pockets with HIV donations. I go home full but dissatisfied.
Sdumo 3/19/05I stopped by the town meeting hall where Simphiwe was showing HIV films to some of the local youth. Not a big turnout but you are hopeful, somedays, that you can touch just one life. Just one. At around 3:00 I stopped by briefly to see Sdumo. He was able to pull himself up to a seated position, an encouraging sign. Two hours later he was dead. The sadness never ends.
On the way out of town 3/20/05I am leaving town tomorrow to head to Mbabane for a Peace Corps workshop. I went to see Sikhumbuso and his pregnant wife before I left town, expecting not to see him again when I return. I get to the homestead and call out. No answer. I wonder if he has already passed away and they have taken his body somewhere. A young woman appears with a tiny baby attached to her back with a blanket. She tells me the wife is in town but that Sikhumbuso is there. He is her brother. She asks if I want to see him and I nod, yes. She calms the dog while I enter the hut. The smell of sickness and death are heavy. I sit down by the bed, not sure if he knows I am there. His breathing is shallow and quick. I touch his forehead and arm- he is burning up. There is nothing I can do now other than to hold him in my thoughts. I leave and head back to town. A few days at a workshop in Mbabane might be just what I need.
And so it goes 3/27/05Simphiwe sent me a txt message. Sikhumbuso was buried on thursday.
