rain
Yesterday, izolo, wednesday, lwesithathu, was disastrous and infuriating.
It began with jitters, maybe from eating my breakfast too fast, or from not sleeping well the night before, or from starting at 5am to be on time for the doctor appointment at 9:30, to be on time to get the patients' blood mailed out to do the CD4 count, to see if any of them qualify for ARV treatment. 200 or lower is needed: once we found out how long and convoluted the process of getting ARVs is after you qualify makes that number ridiculous: you would be long dead, and flat out broke from the transportation costs and difficulty just getting to the adherence classes, which go on for weeks, and which many patients can't get to once. So we're reassessing the budget and time frame, wondering what we could possibly accomplish with these obstacles...we must stick to the promises we have made to the patients and their families, but there will be no knowing whether the patient will be able to even get, let alone continue treatment.
Of course, we didn't know any of this when the day started out, raining, but that was ok since we were filming in a taxi to show how the difficulty of getting around is the main reason that a person cannot adhere to the medication. Tiny kids cover enormous distances alone every morning and afternoon for school. They wave and shout 'abelungu!' (white people!) When the roads are smooth, cars go fast over the hills and curves, and there is no room for pedestrians. We went to a private doctor, who kindly allowed us to film in his practice and invited us to dinner (the health department here does not allow it, after being shown in a bad light by other programs).
After the CD4 count, it was off to the hospital, 40 minutes away, where after a few hours of waiting, our 3 very sick patients were refused; we were told to bring them to another clinic, 40 minutes away, where they would be transported by ambulance to that same nospital. Senseless, but we did it, and only one was admitted into the ambulance; then we were told that if she wasn't admitted to the hospital for whatever reason, she would be dropped on the side of the road in the middle of the night in town, at least an hour from her home in the mountains. Another patient was left in the rain, and died the next day when this happened. Suddenly health care sounded much more frightening than home care.
Reasonably, we took the patients home, back to where we started 12 hours before. This morning, we took one, a mother of many worried children, to the clinic, and were told that 3 weeks of classes were necessary even to be considered for ARV treatment, which could take 5 months. I can't believe how the AIDS counselors and clinic staff can stick to this impossible protocol when they live in the same community. It has to change, or the entire culture will not survive.
The clouds lay in heavy blankets around the mountains this morning after yesterday's rains, mist in the valleys making each hilltop its own golden island in a smoky sea. We drove above and below them, swimming in invisibility, silhouettes of women and children disappearing into the thick air. I would have liked to have filmed it, but we were running late for the clinic appointment. And I'm sorry not to have pictures to post, as my digital camera finally died, after our passionate affair of the past four years. Sometimes it decides to work, but mostly flashes 'no memory stick': any sony users out there with advice? Love to you all; you shine like the stars you are from this distance
It began with jitters, maybe from eating my breakfast too fast, or from not sleeping well the night before, or from starting at 5am to be on time for the doctor appointment at 9:30, to be on time to get the patients' blood mailed out to do the CD4 count, to see if any of them qualify for ARV treatment. 200 or lower is needed: once we found out how long and convoluted the process of getting ARVs is after you qualify makes that number ridiculous: you would be long dead, and flat out broke from the transportation costs and difficulty just getting to the adherence classes, which go on for weeks, and which many patients can't get to once. So we're reassessing the budget and time frame, wondering what we could possibly accomplish with these obstacles...we must stick to the promises we have made to the patients and their families, but there will be no knowing whether the patient will be able to even get, let alone continue treatment.
Of course, we didn't know any of this when the day started out, raining, but that was ok since we were filming in a taxi to show how the difficulty of getting around is the main reason that a person cannot adhere to the medication. Tiny kids cover enormous distances alone every morning and afternoon for school. They wave and shout 'abelungu!' (white people!) When the roads are smooth, cars go fast over the hills and curves, and there is no room for pedestrians. We went to a private doctor, who kindly allowed us to film in his practice and invited us to dinner (the health department here does not allow it, after being shown in a bad light by other programs).
After the CD4 count, it was off to the hospital, 40 minutes away, where after a few hours of waiting, our 3 very sick patients were refused; we were told to bring them to another clinic, 40 minutes away, where they would be transported by ambulance to that same nospital. Senseless, but we did it, and only one was admitted into the ambulance; then we were told that if she wasn't admitted to the hospital for whatever reason, she would be dropped on the side of the road in the middle of the night in town, at least an hour from her home in the mountains. Another patient was left in the rain, and died the next day when this happened. Suddenly health care sounded much more frightening than home care.
Reasonably, we took the patients home, back to where we started 12 hours before. This morning, we took one, a mother of many worried children, to the clinic, and were told that 3 weeks of classes were necessary even to be considered for ARV treatment, which could take 5 months. I can't believe how the AIDS counselors and clinic staff can stick to this impossible protocol when they live in the same community. It has to change, or the entire culture will not survive.
The clouds lay in heavy blankets around the mountains this morning after yesterday's rains, mist in the valleys making each hilltop its own golden island in a smoky sea. We drove above and below them, swimming in invisibility, silhouettes of women and children disappearing into the thick air. I would have liked to have filmed it, but we were running late for the clinic appointment. And I'm sorry not to have pictures to post, as my digital camera finally died, after our passionate affair of the past four years. Sometimes it decides to work, but mostly flashes 'no memory stick': any sony users out there with advice? Love to you all; you shine like the stars you are from this distance
posted by esy casey at 3:42 PM
1 Comments:
Esy & Sarah,
Hope you both are well. The photos of the landscape are amazing and Esy if your camera continues to be a problem, let me know and I will send a new one down ;-). The frustration when a life is in the balance must be very hard to bear. I can't imagine. Record both the joy and heartache. For every moment of teeth grinding frustration keep believing there will be one of absolute grace. There just has to be.
Say hello to those big open skies for me and big hugs to you both.
Much love
Gwen
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