Encounters with UKIMWI

To see photos of the orphans we are working with click here.

To see photos of the Kilema area where we are living click here

The female voice drifted gently at first, perhaps a prelude to the soft singing heard around the hospital as women move so gracefully about their tasks. But soon it hardened in tone and urgency, an inner cry beyond word or melody, drowning out the morning frenzy of birdsong in the bottlebrush tree. Growing further in intensity, the voice broke through the orderly recitation of medical morning report. Reporters and listeners paused, heads turns to see a woman, prostrate on the main hospital steps, clutching at the ground around her, gorgeous kanga quickly layering with red soil.

All nearby stopped to gaze, arrested in bowing postures of sympathy as the grief enveloped them, perhaps connecting to similar moments they each had experienced. It fell to the women to attend their sister, despite their own many burdens, coaxing her reluctant legs to move, wrapping her in a clean kanga, supporting her to nearby shade and whispering soothing words in Swahili or Chagga. What words might those be and how many sunny mornings like these had found need of them?

As rounds resumed the cause of the grief became clear; a sudden death of a male patient during the night, the woman’s brother, another lost to Ukimwi, Swahili for HIV/ AIDS. I had seen him on rounds two days earlier, impossibly gaunt and fighting for air, likely beyond the reach of the HIV medications he had started only a week earlier, years later than he ought to have. The ideal treatment for him would have included intensive care, theoretically available at a regional hospital in Moshi, a 45 minute drive away. But the public hospital is full to beyond bursting I am told by my medical colleagues, and he would have to pay for care at the private Christian hospital.

And so another family in rural Africa is unalterably changed: a wife now under enormous economic pressures to provide for her children. Or worse, children now fully orphaned and dependent on grandparents to provide for them, their chances of completing education and training drastically reduced. Or worse yet, young adolescents being forced to provide for younger siblings.

Ukimwi and its twin faces of desperation and inspiration stared me in the face yesterday in clinic. A ten month baby boy, Paul, weighing only 5 kilograms, visibly struggling with HIV and probable clinical AIDS, brought in by Grace, a woman living with HIV. Mother dead from AIDS six months ago, Paul was abandoned to die by an overwhelmed father, but rescued by his ancient and stooped grandmother who was determined that he should live. The grandmother had been threatened by the father who felt she should take care of the other surviving non HIV-infected children, but her love and instinct combined to drive her to wrap the babe on her back and walk many hours to a new village, where she had without question been taken in by Grace, who calmly related these events. Sitting with me, Grace herself appeared vigorous and well and her chart yields proof that her year of HIV therapy has drastically strengthened her immune system, letting her regain the 10 kilograms she had lost and work her shamba (farm), free of the fatigue and infections which had previously troubled her.

Paul will soon start his HIV therapy and as I write this I hope we are not too late and that the extraordinary love of his grandmother will win out against Ukimwi.

Paul is one of at least 700 orphans and vulnerable children in the catchment region of the Kilema District Hospital most of whom have no direct supports at present. It is to this group we will be putting much of our energy this year, together with the team assembled here by CACHA (Canada Africa Community Health Alliance). Stephanie is a key part of the team doing outreach and home assessments and we will be reviewing how best to be of support to these children and their caregivers, through linkage to community based supports and programs which provide them the knowledge and skills to move ahead with their lives.

We will be consulting with community partners here on how to best use the resources contributed by friends and colleagues to the Kilema Support Fund (an account at Scotiabank Oak Bay – call 953-8100 if you wish to contribute) and hope that future blog posts will give an update on what we have been able to do.