Tuesday, February 7, 2012

Two Little Pink Lines

What we were up to this week:

This past week Sam and I (Fallon) have stayed behind at the Mukambi Safari Lodge, to work with the villages nearby. We have had so much fun, and have some incredibly far-fetched tales to share and laugh about when we get home (getting our jeep stuck in the jungle mud while being surrounded by a pride of lions, getting attacked by baboons, finding a wild hippo in our lodge and being trapped behind the bar while we watched it eat furniture, learning how to drive standard on a safari jeep, getting smacked in the face by a bird while driving 100km/hr in the jungle–just to name a few).
After submerging ourselves in the community and assessing their needs and resources, we decided that HIV/AIDS was a major rising concern within these villages. Our week mostly consisted of community teaching on common problems here like Malaria, diarrhea, malnutrition, proper sanitation, dental hygiene and sexual health. We spent one of our days here working at the remote clinic of Chunga, which proved to be a very eye-opening and frustrating experience for the both of us. We were alone in the clinic with a Nurse-Aid, and our two patients of the day were a woman in a complicated labor and a woman having a heart attack. This clinic, about 2 hours away from a hospital, was lacking SO many things that care was not even possible for these women. This left us feeling very discouraged, helpless and frustrated. There was no blood pressure cuff, oxygen, none of the medications we needed, nothing to set up an IV, and no radio or form of communication with anyone who could help; There we were, in the heart of the jungle, alone, running a clinic with no help and among people who do not speak English! This was one of the many “This is Africa” moments we have experienced since being here.  In hindsight, we were very proud of ourselves for how we handled both situations, and we impressed ourselves with just how much we DO know. By joining heads and piecing together the knowledge we have learned over the past 4 years, we were able to keep the woman with the heart attack alive long enough to send her to a hospital two hours away-where supplies were hopefully more plentiful.  
Our big project of the week was to organize a community information session on HIV and to do family testing. After a long 12 hour day of testing, our report concluded that roughly 25% of the village is living with HIV. That means that for every four test results we gave today, we had to tell someone that they were HIV positive.  Stuffed in a hot room with the stale air weighing heavy on our chest, we were the bearers of the news that these people’s lives would be forever changed. After testing positive with one test, we performed a confirmation test, which takes one drop of blood and a few drops of a chemical solution. After waiting for about 3 minutes, pink lines appear. One pink line means the test was a false positive, and two pink lines means that it was indeed a true positive.
After calling the first positive result back into the room (by their number), our hearts sink. We recognize the person as a friend. Sam and I look at each other from across the room with panic in our faces. What words do we chose? How do we say it? Do we make eye contact or look at the floor when we tell them? What tone of voice do we use? Do we reach for their hand? Suddenly our 4 years of education felt like it hadn’t prepared us for this moment. We will be graduated, competent, registered nurses in a few months, how do we not have the right words? Nurses always seem to know what to say.  After taking a deep breath, Sam hesitates and says: “So, this result shows two lines which means that you are potentially positive for HIV…so now we have to do another test to confirm”.  Our friend covers their face with their hat. We are lost for words. How do you console someone whose life has just completely turned upside down? You can’t tell them that “everything is going to be okay” when it won’t. They can’t speak at this point either. Silence. All of our eyes are blurry, focusing on some non-occupied space on the floor.  This is it; this is their life now; no turning back or doing things differently. No second chances. Our friend will forever be a different person when they walk out of this room, and we were the ones to tell them.
I take their blood for the second test, and we wait. Three long minutes of waiting, and staring at the test, and at each other. I feel my heartbeat in my ears, and everything else falls silent. I look at Sam for strength and see her go white, fighting back tears.  Our friend leans back on the chair, blankly staring at the roof, feet tapping.  I focus on the test, and will the second pink line to not show up. Please, please, please. After what feels like an eternity, it happens: two little pink lines.  I sit there longer, pretending the results hadn’t come up yet. Choking on my own words, I say “it is positive”. I feel angry at myself, and frustrated that I have no words to say. Our friend is sitting in a dark place, confused, hurt and uncertain of their future, and all I can do is look at the floor. Say something, say something!
The African nurse we are working with finally talks. “It’s okay my child, accept it, accept it! Do not be sad. Take these results and live with them! Accept them and you will be free to live!” I feel torn by my own emotions right now. I feel so relieved that someone else said something and I no longer have to, but I feel angry at her words. My anger turns to her now, and I want to yell at her. No! Let them cry! This is NOT 0kay, they will not be okay! You cannot “just accept” that you are sick, and that you will die at a young age when you have HIV here. You cannot “just accept” that your spouse has cheated on you and given you HIV, and your young children might be sick too; They might be left with no parents. You cannot “just accept” that you might be fired from your job now, because you have HIV. When the nearest doctor and pharmacy is at least 3 hours away and you have no vehicle, how do you get your life saving medications consistently? It is NOT okay!
Luckily this longest ten minutes of our lives passes when our friend leaves to go get fresh air.  I could use some myself…the stagnant heat trapped in this room is unforgiving. We move on to give more results now, 52 more. Again, fourteen more times today, we crush people’s world and tell them they have HIV. Pregnant women, new parents, young couples, grandparents; this disease seems to leave no one behind. Some cry, others just stare at the floor. Some couples get their results together, finding out together that they no longer hold a negative status. Some husbands and wives come alone and find out they are infected. I can see that they are struggling with how to tell their spouse that they have been unfaithful, and to come get tested as well.  At least for these people, I can take personal comfort in placing some blame onto them. It makes it easier. “Well she shouldn’t have been sleeping around.” “Serves him right for cheating on his wife”.  I get angry at myself for having these thoughts, judgements. I make myself go back to thinking of these people as people and not their possible actions. It makes it harder to break someone`s world when there is no anger held towards them, or no blame to place, but I struggle to do it anyway.
 We get through the day, and go back to the comfort of our lodge. The workers who we had just tested are there, serving us again. Bringing us drinks, serving our dinner, making our beds and un-tucking our mosquito nets, walking us back to our chalet in the dark to make sure we are safe. They look at us in the same way, as if nothing happened and as if we weren’t the ones who bared them bad news just a few hours ago. I feel guilty, because I cannot look at them in the same way. I can’t help but feel like I need to be nicer to them…have an even friendlier tone than before; in an effort to compensate for the news we left them with earlier. I try not to show pity, but it’s there.
Before leaving Mukambi this morning, we hugged the workers goodbye. They all had a sincere “thank you” for us, including our friend and others who we tested positive for HIV yesterday. That’s when I realized that sometimes there are no words-even for nurses. In some situations there are no “right things to say”, or no “right way of saying them”.  It’s okay to just be with a person during a tough time, and to just embrace the silence between you. A loving and genuine heart and sincere intentions can be felt from another in times just like this…especially when language is a barrier and words are empty.
We have learned a lot from this week long adventure, about ourselves, capabilities, strengths, weaknesses and about the world around us. We experienced moments of extreme happiness, and moments together of sheer panic and sadness. We hovered between feelings of wanting to leave and go home, and moments where we never wanted to leave. There were moments where we came close to peeing our pants of laughter, nights where we shared the same bed because we were scared (yes, two grown women sharing a twin bed and hiding under the covers-despite the African heat), and moments where we came close to both breaking down out of raw frustration. While sitting on the bumpy bus ride back to Mongu, there is not a single experience we shared this past week that I would take back or live differently. We appreciate every high, low, and “This is Africa” moment we’ve shared this week, and look forward to what Mongu has in store for us these next couple of weeks…After being attacked by wild baboons, running a clinic alone with no supplies or contact with the outside world, and surviving too-close-animal encounters that Steve Irwin would have been proud of: bring it on Mongu, these two blonde Makuahs are ready for any adventure you throw at us.

Sam and Fallon
(Mobita and Nowa-our honorary Zambian Names given to us!)

 Hippo in our lodge, casually eating our furniture, no big deal!
Our home for the past week-check out their website for more pics!

1 comment:

  1. What an interesting blog post! Between all of you, you could write a novel.

    And suddenly you have personal relationships with the locals, and at once are the bearers of bad news to them. I can't imagine what it would have been like to be in that position.

    ...and! That hippo eating your furniture? Maybe now I HAVE heard it all...

    Best wishes for this week!

    Dan Eddy