May 22, 2007

Children’s day. Today the hallway is full of mothers and infants. My overwhelming thought as I manoeuvre my way to the exam room after praise and worship is that this is unmanageable. This is just not possible. This cannot be done. There is no way that 4 prescribers can see this many critically ill children in one day, in a small third world clinic with no access to modern medical technology. I just cannot be done………and yet, it is done:

Matebello- age 3

She has been on ARV’s for six months. She is growing, talking, developing and complaining. Like any other three year old, why should she be happy about waiting half the day in a crowded hallway and than letting a red-haired, white-faced stranger examiner her. There was no way I was going to get my hands on her. I took her very vehement, loud and defiant rejection of me as a sign of good health and left well enough alone. ARV’s have allowed her to be ‘normal’.

Pule Mothea- age 10

Here with his grandmother. His father is absent, his mother is dead. He has an older sister who is also cared for by this grandmother. She is well. He has been on ARV’s for 2 years and has the most brilliant smile. He is the size of a six year old. No child with ARV’s has a fighting chance for an normal growth pattern. They are all painfully small. As he was leaving, Chris taught him to “give me ten” and Pule was thrilled.

Sebabatso- age 6

Diagnosed in April of 07. Her weight is only 14.2 kg. She is beautiful. Her father is absent, her mother is at work and is also HIV positive. She is here with her older sister who, up until this moment, was unaware that Sebabatso was HIV positive. She is aware now. This little one is quite sick with a CD4 of only 11%. She will need ARV’s urgently.

Kamoho Mosipele- age 2

He is here with his grandmother who looks tired, old and overwhelmed. Kamoho’s mother died in January, he is an only child. He weighs only 9.8 kg. He has endstage HIV and TB. He is so lethargic that he is barely able to cling to his grandmother. I asked if she would put him down so that I could assess his development. He took two steps that seemed to drain him of all energy before he grasped for his grandmothers skirt. A child robbed of all vitality, all energy, so close to death is not a sight anyone should ever have to see. This should not be.

Near the end of the day, I was walking into Pharmacy and standing against the wall, was Pule. He has been here all day. As I walked by, he beamed his lovely smile at me and put out both his palms. “I’ll give you ten, my little friend.”