Monday, February 18, 2013

HIV Gets Personal

Botswana is a country plagued by HIV. It is estimated that nearly a third of the country is infected, although those of us working at the village level believe this is likely a very conservative estimate. And that doesn't even begin to take into account the devastation the disease has brought on the rest of the populous, most notably the children who are often orphaned and those loved ones who are left to assume the burden. The country has set lofty goals to eradicate the disease but, unfortunately, seems to be falling short. This is why Peace Corps is here. We are here to work in the health sector - improving organization's capacity to help - and to inspire and motivate children and youth to live healthier lives. As such, we meet and befriend many people who are living with HIV.

The work I am doing in Botswana puts me in direct contact with numerous people who are HIV positive. Whether it be through assisting my NGO and the Clinic with improving home-based care services, collaborating with the Support Group on projects, or playing with children affected and infected, I have gotten to know so many individuals whose lives are forever impacted by the disease. It has opened my eyes and my heart in ways I could never have expected. 

That being said, there has always been some semblance of distance. Although they are people that I work with all the time and who I care about, I have been able to look at them as colleagues or smiling children first and let the disease take a backseat. I don't often have to see the deterioration nor experience first-hand its impact. Their HIV status is only one aspect of who these people are and, honestly, it isn't all that important. As long as they are taking care of themselves - adhering to their ARV regimen, eating nutritiously, and being supported by family/friends/caregivers/my NGO - then we can all carry on with our lives as normal. That is, until two weeks ago...

Two weeks ago a very dear friend of mine sent me a text message that said "Kamogelo, I am having a very serious problem. I am not sure when I will be coming back but I need you so I will find you when I return." I frantically tried calling her but she did not answer. I waited (im)patiently for nearly a week before I heard from her. When I did, she assured me that she was okay but that she wanted to talk in person.

With nervous hugs and hand-holding, she carefully told me that her husband of nearly twenty years, who had been very sick lately, underwent a series of tests at a nearby hospital. After ruling out prostate cancer and a slue of other things, he finally succumbed to an HIV test and learned that he is HIV+. In shock, he refused to get his CD4 count read to find out if he should start ARV treatment, despite urging by the doctor and my friend. My friend said that what happened next was an almost psychotic episode by her husband, who left the hospital before he received HIV counseling and demanded they go directly to their lands in the Kalagadi. He then refused to say anything more on the matter, would not discuss his newfound status, and began making ridiculous requests and talking gibberish. This lasted for four days. 

After returning to the village, my friend's husband holed himself away inside the house. He got even more sickly. He continued to refuse counseling or to get his CD4 count tested. My friend begged him to talk about his status with her or with a counselor from the Clinic or with a trusted friend. She hasn't been able to process her own feelings about his new status because she has been so overwhelmed with helping him grapple with it. She is constantly worried about him.

This is the first time I have witnessed this side of HIV - the emotion, the turmoil, and the tragedy before the recognition and acceptance. To listen to my friend talk about the struggles she is going through and how hard it is for her and her husband to come to terms with things has been heart-wrenching. This is someone who I deeply and profoundly love and she is going through something I cannot even fathom and I don't even have any point of reference. Everyone I know who is HIV+ have already come to terms with their illness to the point where it's practically a nonissue. And every time I ask her how she is doing and how she is coping, she (of course) brings the concern back around to her husband. It is devastating to feel so helpless. I can only imagine how they must feel.

I am humbled that she chose me to talk to and believes in our friendship enough to share this burden with her in some way. Right now, all I can offer her is hugs, which she says is enough. 

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