Day Nine (July 11, 2006)

Five thousand and sixty six, ten to fifteen new HIV patients daily. The numbers are overwhelming. There were over 100 patients waiting in the hallway this morning at 8am. It takes four physicians eight solid hours to wade their way through each one and the next day, another 100 are waiting. Another patient died in the exam room today. We saw her last week. She was unable to overcome the combined effects of HIV, PCP and TB.

Today I need to pay tribute to the children and their grandmothers. On any given day, you will see these frail elderly women carrying their ill children on their backs all over Leribe and in great numbers at the clinic. These women have lost their husbands, their children and now they are caring for their HIV positive grandchildren. One grandmother today finds the whole thing overwhelming. Her 10 year old grand-daughter never left her side and was obviously ill. Eketsang has HIV, TB, and PCP. She has been prescribed a complicated regimen of TB meds and HIV meds and the grandmother is ill equipped to manage all of it alone. When she realized today that her grand-daughter was gravely ill because of missed meds, she sobbed. When Eketsang saw her grandmother cry, she burst into tears. Elisabeth leapt to her feet, she too in tears, lifted this ten year old off her feet and embraced her. They both cried. The hug lasted for the rest of the interview. Like a robot I motored forward fully conscious of this incredibly compassionate moment. It was as if Elisabeth’s love just might stop this little girl from dying, if she just held on long enough and tight enough. I love Elisabeth.

Mofabeng, age 4, with HIV and PCP- none of us could get blood from her for lab work today. Maseabata, 3 years and 6 months, end stage HIV with PCP and breathing at a rate of 48/minute. She sleeps most of the time. She is sitting on her grandmother’s lap, an orphan. She will start ARV’s this week. I think we will save this one. Letosa, 18 months also has HIV and PCP, also sitting on her grandmothers lap. We couldn’t get blood from her either. Jamie is a nurse who can usually get blood from a stone. He looked at me and said, ‘This is not a good day at Tsepong’. I realized at that moment that that this is war. We are fighting a war against HIV in this country and the main victims are women and children. The people at Tsepong show up to work each day and leap cheerfully and energetically to the front line of this war and everyday the actions they take save lives. All day long, day after day, they save lives.

I will never be the same, nor do I ever want to be.