May 29, 2009

AIDS at Work

The true story in this post is three pictures, seen sequentially. You actually don’t need the text but I’ll throw it in here to give you the context.

A few months back, I wrote about Tunyeswa, a (now-)18-year-old HIV-positive mother who has just had a disastrous life. She has walked out on her daughter more than a few times. When I saw her in February, I took this picture of her with her daughter.
Then in March I saw her again and took this picture.
She had tested positive for HIV in January and we had taken blood for the all-important CD4 count that would tell us how much the virus had affected her immune system. But she never came back with the results, no matter how many times we reminded her of it.

After that picture in March, we didn’t see her again until yesterday. When she walked in, she looked like this.
I’m not sure how clearly it comes through in the picture but it is a stunning and dramatic change. I actually didn’t recognize her at first. I thought perhaps it was a slimmer sister from the same family. Since March, she’s lost more than eight kilograms.

As she still hadn’t got her CD4 results, we drew the blood again and I drove her up to the clinic where the blood gets sent to the lab. I asked, out of curiosity, if the clinic had the results from the test in January. Surprisingly, they did. It was 216. That’s dramatically low, almost eligible for anti-retrovirals. It’s especially low for someone who is only 18. Either the virus has worked remarkably quickly on her or she contracted some time ago.

After nearly two years in Itipini, I actually have more hope about combatting the HIV epidemic than I ever have before. But people like Tunyeswa make me despair. She needs so much help and so much education to understand the significance of her diagnosis and all the work - like regular CD4 counts - she has to do as a result of that diagnosis. And there’s no indication that any of our efforts in that direction have taken root. There are other people in Itipini like this, people who are just - for whatever reason - totally clueless and uninvolved in their own health. I can do what I did today and hand-hold and escort her through the health-care system but that’s not sustainable and it’s not practical for the people in similar situations.

Thinking about Tunyeswa, I found myself thinking again about the line from Desmond Tutu I’ve thought a lot about in South Africa: “For true reconciliation is a deeply personal mater. It can happen only between persons who assert their own personhood and who acknowledge and respect that of others. You don’t get reconciled to your dog, do you?” There’s no indication to me that Tunyeswa is asserting her true, full, and complete God-given personhood in any meaningful way. And I have no idea how to help her do that.