T-minus <10 days.

December 5^th, 2007

 

I woke up this morning to a strange sight. I was back in my bed in Nairobi, in my nyumbani salama with my homestay family. Blinking the sleep and sunlight out of my eyes, I looked at my room and was greeted by an unfamiliar sight: my bags, haphazardly packed with khangas hanging out the side, Nakumatt bags peeking out of corners, and my life for these past three months or so being slowly rounded up and prepared to be brought home. I only have two more days left in Nairobi before we head to Mombasa again to do our ISP preparations for about four or five days, then back to Nairobi for our last couple in Africa, and then onto a plane headed back to Dubai. Unbelievable. 10 days till the end of my semester abroad. This has easily been the fastest semester of my life.

 

Karissa and I left Kisumu on Sunday, thankfully getting out of town before Raila came in for a rally – Raila = the opposition for the presidency, and he’s a Luo, and Kisumu is Luoland central. There weren’t any riots, but the town must’ve been absolutely crazy that afternoon, so I’m glad we took the early bus.

Saturday was World AIDS Day, as it is every December 1^st. I spent the day volunteering with Tuungane, as they helped out with the official celebrations, which were held slightly out of town in a big field of a high school. Let me put it this way: the event was very, very African. Heh. I got to Tuungane at 7:30, per Topistar’s request, and didn’t move until 9:45. Events were slated to start at 10, and they started at 12:30. I pretty much sat around and didn’t do anything until around 2, when I helped Topistar and a handful of other Tuungane volunteers hand out soda and bread to the mass populous attending the events. People were perplexed by a mzungu offering them a soda and serving it to them at first, but they gladly accepted it. The proceedings for the day were being done in Swahili and Luo, so the day was pretty ineffective to me, but it was nice to be able to help out. And I got a sweet tshirt with the national AIDS campaign logo on it: “Pamoja Tuangemize Ukimwi” – “Together, we can end AIDS.” I got a hat, too! But it was so damn hot outside. When I got back to the hostel, I was heat-exhausted and sore from hauling soda. But we got delicious Indian food for dinner, so that was swell. Indian food in Kenya is so. freakin’. good.

 

Sunday and Monday were spent in transit and writing my ISP, respectively. As of right now, I am just beginning to start my discussion and analysis of my field work, which should be the bulk of the paper, and I’m on page 39. hahaha. I start off my paper with two quotes that I have unashamedly ganked from my hero, Paul Farmer:

 

“Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.” – Dr. Martin Luther King Jr.

 

“The microbe is nothing; the terrain, everything.” – Louis Pasteur

 

I’d also like to throw in another one of my favorites, but it’s more development than health, per se: “Rats and roaches live by competition under the laws of supply and demand; it is the privilege of human beings to live under the laws of justice and mercy.” – Wendell Berry

 

The three weeks I spent in Kisumu were amazing. Even in that short time, I saw things that were inspiring and devastating. I saw dozens of HIV+ mothers who had been given a lifetime of new hope when they were told that, yes, their child is HIV-. And I saw women’s whose lives came crashing down around them in a single sentence as the PMTCT nurse and I told them that their rapid HIV test had come back positive – “Una virusi kwa ukimwi,” “You have the virus that causes AIDS.” Some of them bent their heads and said they had known, that they had gotten a test a few months ago but hadn’t wanted to believe the results. Some started to cry in dismay, stating that they had only been married a few years and had been faithful to their husbands the entire time. One girl I saw rejected the results and left, saying that the test was lying and couldn’t be true. Almost all of them, though, almost all of them, asked if the baby in their womb would be OK. My week that I worked in PTMCT at the Provincial Hospital was heartbreaking and harrowing, and I didn’t even understand half of the language being used. But there are some things you don’t need language for; there are some things that are written across our faces as plain as day, and you need no translation to understand the overwhelming grief in their eyes.

 

When you put a face to HIV, when you see someone’s life change in the instant that they are told they are positive, it changes you. I wanted so very much to give them hope, to tell them that they can have negative children and live a full, exceedingly normal life. But I lack the language, I lack the training, I lack the wisdom. But I wonder how much of that is wishful thinking on my part. Of how much use are all the miraculous medical interventions we now can do when a woman is going to be thrown out of her house and stigmatized by her entire community, being blamed for her sickness that is rarely her fault? What use is neviraprine and AZT when a mother will be forced to breastfeed her child past 6 months (with skyrocketing chances of transmission) because there is no food for the child? Where is the telos of medicine? What are our ends?

 

It’s like something one of the jaded peace corps volunteers said to me about Africa: first it breaks your heart, then it breaks your soul.

 

But not yet as for me. Yes, even that one measly week I worked in the hospital was gutting and exasperating, and I have no idea how the PMTCT counselors do it day in and day out. But these are miracles: it is nothing short of a miracle that a man who was once doomed to a death bed in a few short years can live healthily to see his grandchildren. It is nothing short of a miracle that a HIV+ woman can give birth to a HIV- child. They are miracles, they are feats of the human mind and spirit and they are incredible. Medicine can be so much more than sustaining a chronic cancer patient past the points of logic and hope, it can be so much more than prozacking our nation into dumb complacency. Medicine can bring health, health is the first part of life, and life is a miracle.

 

Of science and the human heart there is no limit.

God, how I pray that is true.

 

Back to work, my friends. These thoughts that I’ve been thinking over the past three years or so are finding their way into paragraphs and sneaking their way into footnotes, and I think at the end of day I’m going to have a pretty baller ISP. Miss y’all like mad, and I’ll truly be home before you know it.

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