Snapshots

I mentioned in a previous post that things have seemed very busy in the clinic lately. There are lots of stories of people I’d like to tell in detail but I keep putting them off and realize now I’m never going to be able to get to them with the justice they deserve. So here are some quick synopses of some of the patient care we’ve been involved in lately.

Zanthemba has AIDS and tuberculosis. I took this picture in March, shortly before I left for Djibouti and Ethiopia, when he had just started TB treatment. I wasn’t sure he’d be alive when I returned. But he was and he still is. I recently sent him up to begin preparation for anti-retrovirals. Given how many difficulties I’ve had with the ARV prep process in the past, it was remarkable how easy it was this time. I chalk that up to my increased expertise, relationships with the right nurses, and the fact that Zanethemba knows me and trusts me and does whatever I tell him to.

Lindiswa just gave birth to her second child. She’s 17. This is notable for a few reasons. Both children are by the same father and they have been traditionally married. I’m not sure how I feel about that but there it is. She stood out from the crowd of other young pregnant women because she was transparently honest and open about how difficult it is to be pregnant and she was absolutely hilarious about it.

Ntombizine is about my age and just gave birth to this baby. She came into the clinic kind of nonchalantly one morning and tried to tell me something. I was having trouble understanding so I asked Dorothy what was going on. “She just had her baby,” Dorothy told me. Oh. The baby had been born a few hours before in her shack and now Ntombizine wanted a ride to the government clinic to formally register the birth. I was happy to oblige, though I must confess that being around newborns always makes me nervous. They seem so fragile. Ntombizine also has AIDS but - through a process that was much more complicated and involved than it should have been - got nevarapine almost at the last possible minute to prevent transmission of HIV during birth. Then the nurses at the clinic told her not to breast feed, which infuriates me, but that’s a story for another time.

Jackson is very sick. In fact, I haven’t seen him in a few weeks and I wonder if he is still alive. He used to be a pretty energetic and kind of funny older man but his condition has deteriorated so rapidly and I was shocked when he came in looking like this. It’s kind of unclear just what is wrong with him. I think it has something to do with excessive alcohol intake and a swollen abdomen but there are some eye problems and possibly TB at work as well.

Nomantombi used to be an energetic and kind of confrontational young woman. I respected her energy, even if I didn’t always appreciate being on the receiving end of it. She’s HIV positive but was seemingly asymptomatic for all the time I knew her. But rapidly in the last few months she has markedly deteriorated and now labours just to make it to the clinic. I have been giving her lots of rides to appointments so she can ultimately get on ARVs but it has been a frustrating process that is taking too long to bear fruit.

Her medical records make fascinating - and tragic - reading. She’s 21 now and the records start when she was 8, documenting when she first starting taking family planning (age 12), when she had her first baby (age 14), when she tested positive for HIV (age 15), how she was brought in after a bout of glue-sniffing, all the times she had been assaulted, and much else. Perhaps if - when - she gets ARVs, it will mark a new start to what has been a difficult and obstacle-ridden life.

To close on an upbeat note - and not one primarily medical-related - here’s a picture of Ziyanda holding her first quarter report card. You might remember Ziyanda and all the obstacles she has endured in her education from an earlier post. She did remarkably well in the first quarter, including an 80-percent in English. I can’t communicate how astounding that is, when you consider what I’ve already written about what “doing well” means around here. (She also got a 13-percent in science. “Bad teacher,” she told me.) When she showed me the report card she also wanted to talk about going to college and has already begun doing the research into scholarships and application deadlines. I wish I was going to be around to help her see that process through.

(On another education note, Mbuyiselo, the young man who also has a complicated history that I once wrote about, has apparently been kicked out of school. I just found this out and haven’t been able to track him down yet. If it’s true, given all the work I put into getting him into school, I’m going to want to punch that guy in the teeth when I find him.)

And these are only the people I have pictures of. Numerous other cases like these walk through the doors every day.