Skip to main content

Disclosure

The waiting area is full. Children are running up and down between the benches, their mothers (and some fathers) watching them as they wait to be called into a consulting room to see a nurse or counsellor. A woman stands in front of them talking loudly in Xhosa. She bangs her palm with the edge of the other hand, as if emphasising her point. She appears to be delivering a lecture. As I get closer I recognise her as the sister in charge of the HIV clinic.

I slip into one of the consulting rooms used by one of the clinic Sisters. “Molo Sister Sibisi”

“Molo Doctor. Ninjani?” She has just given a vaccination to one of the anti-retroviral patients – a flu jab. She applies a dressing, and the man thanks her and slips out.

“Sikhona,” I exhaust my meagre Xhosa. “What is Matron talking about out there Sister?”

“She is giving them a talk on disclosure.”

“Disclosure to their friends?”

“No doctor, to their children. This is parent-child clinic day so the HIV positive parent comes with their positive child and we see both at the same time. The thing is, many of these parents do not tell the child that they are positive.”

“That the parent is positive?”

“No doctor, they do not tell the child that the CHILD is positive for HIV.”

“But how?! The child is on tablets and has been coming to clinic for years.” Most of the children here will have become HIV positive as a result of infection during, or shortly after, birth. Whilst there are treatment regimes that can reduce the rate of infection in pregnancy dramatically the mother needs to know she is positive (and many do not - or do not act on the result) and drugs need to be available at the right time.

She shakes her head sorrowfully. “Yes doctor, but there is a lot of stigma still. And they tell the child that they are taking the tablets for flu. And then one day when the child is 11 or 12 they want to know why do they take the tablets when their friends do not. And then it is very bad, because when the child finds out they often get very cross, and they stop taking their tablets, and then the virus comes back and they can get very sick. So Matron is telling the parents they must tell the children they are positive.”

“But that must difficult as well. A very young child will tell their friends and then might get into problems at school.”

“Yes doctor – both ways have their problems. But we think that the truth is the better way. Nothing good can come from secrets.”

Comments

Post a Comment

Popular posts from this blog

Otherwordly isolation

I lean across the reception desk and catch the attendant’s eye. “Sawubona,” I say, dusting off my rusty Zulu. I see you. “Sawubona, ninjani?” she replies. I see you, are you well? “Ngiyapela.” I’m fine. She grins at me. “You must be a doctor.” “I am! How did you know?” “It is only the doctors around here who use Zulu. Even if it is only the greetings.” She arches an eyebrow. “I used to work here, at Hlabisa hospital up the road. I have a few other Zulu words, you know like ‘Does it hurt?’ and ‘Take a deep breath’.” She laughs. And then launches into an excellent impression of an elderly Zulu lady rattling off a series of complaints, waddling across the reception area clutching her back in mock agony. She gets it exactly right. I have come up to KwaZulu-Natal for a few days. Tonight I am staying in the Hluhluwhe-iMfolozi game park, 20 minutes or so from where I used to work. Awarded my entry ticket, I drive into the park. The sun is low in the sky, the kills bathed in amber light. I ta...
3 comments
Read more

10 years on

The door flies open. Lele peers in. "You must come out here and see. They are doing a play!" I finish up my case file annotation and come to the doorway. The waiting area is in chaos. A gang of school children are manhandling a couple of marimba's to the space in front of the consulting rooms, a team of nurses and counsellors are creating a stage area. Patients look on mutely. Some with interest, others - presumably feeling proportionately less well - without. "What is going on?" I ask. "It is 10 years since the clinic started. 10 years since MSF first started the HIV treatment programme and proved that it could be done in Africa. So the staff are celebrating. They are doing a show or something." The sister in charge of the clinic has moved to the front of the crowd of patients. She calls for silence and then gives a short introduction. Lele translates for me. "She is saying that this is a very important day. 10 years ago people were dying. And 10...
3 comments
Read more

The first rule about run club

This is what death will be like. My heart is pounding, chest constricting, I can barely lift my foot from the ground. The sweat pours from me and my head pounds. It is Thursday run club. An hour ago Ibby was rounding us all up, exhorting us to get a move on, and allocating us to vehicles so we could lurch through Freetown’s commuter traffic to Lumley Beach on the west side of town. Half way there, the traffic solid and the heat stifling we hailed a street trader and we bought packets of drinking water (improbably branded “CLIMAX”) and biscuits (incongruously labelled “made in the UK for Aldi”). A King’s Sierra Leone Partnership tradition – started by Ibby some years ago – the whole team go beach running after work every Thursday. “The route’s fine” they tell me. “Flat, and you can 5k or 7.5k”. It started well enough but it’s 28 degrees and my pale body is unprepared. The route is straightforward but weaving in and out of other runners, stray dogs, unexpected ga...
Post a Comment
Read more