Bobby Farris - CMC Missioner
As Director of Healthcare Outreach, my week began as usual:
Monday—5:00 am: shower, breakfast, review the day’s schedule and set off to the homesteads for CD4 blood draws (monitoring blood test for HIV positive patients) by 7:00 am. Thandiwe, a Swazi nurse, and I succeeded in finding everyone home that morning. However, one patient, Tobhathana, a 26-year-old woman with AIDS, needed to be transported to Good Shepherd Hospital, approximately 70 kilometers from the mission. We had planned to go there that afternoon to deliver the blood we had drawn, so we arranged to take her with us. When we arrived at the hospital, we learned it was a holiday. This meant they would not accept any of the blood we had drawn, and the cost for Tobhathana to be seen and admitted was doubled. So much for things ever being routine. Upon returning to the mission, we learned the pump that brings water from the river to our homes was broken.
Tuesday—Up by 3:30 am to leave by 5:00 am to gather 14 patients for transport to the hospital for their monthly supply of AIDS anti-retro-viral medication. Unfortunately, the dirt roads, with their many hazards both seen and unseen, had left one of our tires flat. Needless to say, we had a late start. Outside Siteki, where the hospital is, we were met with another frequent obstacle - vehicle inspections conducted by the local police to generate revenue. They were gentle with us as we had a car full of patients, and only gave us a warning to have our signal light glass replaced.
At the hospital, one of our patients realized he had forgotten his paperwork regarding his tuberculosis treatment. Patients here must carry all their medical records with them, because no patient medical charts are retained by hospitals, doctors or clinics. On our return trip to the mission to get his records, we were not as fortunate with the police inspection. We were charged 20 rands (about $3.50) and told we could not return without having the signal light repaired. We phoned ahead to the mission to procure another vehicle as well as the medical records. With those in hand, we once again made the hour-long trip to the hospital.
I proceeded to the ward where Tobhatana had been admitted the day before and was informed she had passed away during the night. I was also told that Vuyisile, a 17-year-old woman with HIV and TB whom we had admitted to the hospital the week before, had died over the weekend. To have known these two young women and watch them succumb to this ravaging disease was devastating to me. Upon returning to the mission, we went to Tobhatana’s homestead to tell her family of her death.
Wednesday--On the road by 5:00 am again to transport patients to the hospital for tuberculosis treatment. Along the way, we encountered several of Tobhatana’s family members. They were seeking help from us as they had no money to return her body to the hospital nor purchase a coffin. I assured them we would help and they gave me a piece of twine for the dimensions of the coffin.
Thursday--Usually a planning day for me to work out the next week’s schedule of visits and hospital trips. We were still without water, so I was glad to work alone most of the day. I visited the woodworking shop on the mission to procure a coffin. Mr. Dube was most gracious in making a coffin to be ready by Friday afternoon. His fee was reasonable by American standards--550 rands ($100.00) for immediate service. Most Swazis in the lowveld don’t make that much money in a month.
Friday--In the Healthcare Outreach office seeing patients and being available for the RHM’s (Rural Health Motivators) who assist us with patient care out in the bush. The coffin was ready by 5:00 pm, so we loaded it into the back of the truck as we would be leaving at 6:30 am Saturday morning.
Saturday--Thandiwe and I arrived at Tobhatana’s homestead by 7:00 am. Five of her aunts and an uncle traveled with us to the hospital. They carried a reed stick and a sheet from her bed with them. Thandiwe explained that they use the stick to talk to Tobhatana and tell here everything that is happening as she travels back to her homestead and her funeral service is held. We paid the necessary fees for her body and drove to the hospital morgue for her corpse.
The family members were given latex gloves and shown into the morgue. Her body was lying next to another inside the cubicle. The family removed her body and personal belongings, placed her in the coffin and we began our return to the bush. Her family sang and talked to Tobhatana the whole way home. Her homestead had been draped with a canopy and protective fencing for the ceremony.. As several men carried the coffin to the door of her hut, the women all began to wail and grieve. As the coffin was placed outside the door everyone knelt and prayed. We followed the procession into the hut, knelt on grass mats and continued to sing and pray as those outside continued wailing. After a respectful pause, Thandiwe and I expressed our sympathy to the family and excused ourselves from the hut.
Sunday--Mass is celebrated bilingually, in Siswati and English, by Fr. Peter in our parish church. It is a beautiful domed sanctuary with amazing acoustics. The music is a capella and quite uplifting, something I definitely needed after this most challenging week. I was extra thankful today as the pump was repaired and we again had running water.
We hear repeatedly the HIV/AIDS statistics - 42.2% of the adult population in Swaziland is infected with HIV/AIDS, 78 people die each day in a nation with a population of less than 1 million. Life expectancy here in Swaziland is now 30 years and there are more than 70,000 orphaned children. It is daunting to experience these statistics first hand -- watching whole generations decimated by this disease. Unfortunately, modern medicine and AIDS education compete with poverty, rural isolation, traditional healers, cultural mores, and a society which until very recently would not, nor legally could, acknowledge that HIV/AIDS even existed. A ray of hope I’ve seen since my arrival in February is a greater awareness and acceptance of the reality of this pandemic as more and more people here in the lowveld agree to testing and treatment.
