Tuesday January 13th

Today I had many misadventures getting my internet hardware. Kiran, the IT guy, is super unreliable. He said he’d be back in an hour (3 hours later I called) and then another hour. And then ten minutes (an hour after that), 10 minutes more. But I got it. I finally got it. My little TATA cellular modem. And it will be activated by Thursday at 4’oclock. And then I will have my own internet! Yessss!

We have a patient right now who is pulling at my heart. She is an HIV/TB widow, age 30, and she is really sick. Her CD4 is 30 this week, and she seems to be struggling more each day. The state of HIV in Andrah is really terrible. The major mode of transmission is hetero-sexual, through commercial sex workers. I’m hearing the same story over and over again. Man goes to prostitute, and contracts HIV (according to 2007 data, one in five men over the age of 18 in A.P. has been with a commercial sex worker at least once in the last 12 months). This man then brings HIV home and his wife contracts it (monogamous married women make up over 30% of HIV cases in Andrah) . Unaware of the virus, the wife may become pregnant, and without seeking treatment can give birth an HIV positive child (6% of A.P. HIV cases are children). The husband dies, leaving an HIV positive widow who must now bear the social stigma (when your husband dies of AIDS, everyone around you knows/assumes you have it too). She is oftentimes shunned from her family, work and community, and must find a way to feed her children. And sometimes these women turn to prostitution.

Is your heart broken yet? Because mine is feeling the strain.

So the patient that I have been seeing is facing this right now. She has no job, she has been abandoned by her family and is really struggling financially. She is very beautiful, and has a wise, proud face that has been ravaged with struggle. The really hard part is that she has three children, and the youngest one (age 6) is staying with her at our ward. He is just the cutest thing, and I am very worried about him. Rubina is our HIV counselor (and has been a very good friend to me). She educations patients about their conditions, helps them find jobs and is currently looking for some kind of program for this woman’s youngest child, or at the very least to find a job for the oldest child (age 11) who can to support the younger siblings. If this woman dies on us, the boy has to go somewhere, and we don’t have a “where” yet. The woman’s three children have not been tested for HIV, she won’t allow it. She is holding onto the hope that after she dies, someone in her family will take in the children. If it is confirmed that the children are HIV positive, it is even more unlikely that anyone will. Not only is the social strain a huge burden, but so is the medical condition.

So this little boy has become my buddy. I brought him a ring pop today that was red. Red is his favorite color. I am worried about him spending so much time in the ward alone, while his mother is sleeping, I think he’s starting to realize what is going on. During my lunch we go outside and play hopscotch, and today we flew a yellow kite. I told Rubina that if his mother dies, and we don’t have somewhere for him to go, I want him to stay with me in Guest House 1 until we do. (Which I’m sure would not go over too well with Mrs. Rao and Dr. Hrishikesh.) Rubina said she’ll keep on it.

Rubina and I have little talks about this stuff. Apparently sex education in public schools is a hot political issue. Currently, there is no formal education system in place for students in India relating to STI’s, HIV/AIDS or sex until the graduate level (M.A. equivalent). Sex, and diseases that are related to sex, are a cultural taboo. According to what I’ve been reading, in the last five years its gotten much better, and people are starting to be more aware. However, we still have patient after patient claim they got HIV from drinking bad water, or eating food prepared by an “unclean” person. I know lots of people in India are working very hard to combat AIDS, but this ignorance makes me crazy. Millions of people are dying in this country of an uncurable, but preventable disease, however, we can’t talk about it at school because it threatens the culture? I think AIDS is already threatening the culture.

So at dinner tonight the little boy and I took a survey of everyone’s favorite colors. His, as I mentioned, is red. His mother’s favorite color is maroon. Mary’s is orange. Marta’s is pink. Uncle’s is white. The older patient who wears a big dot chose purple. Larshmi’s is blue. Shobba likes pink. Marheswarie couldn’t decide between light green and yellow.

After dinner the girls busted out the henna cone and had at my left palm. Everyone took a finger. Shobba wrote my name in Telegu on my middle finger, Larshmi drew flowers on my palm. Maheswari is a henna-star and drew some beautiful designs up my ring and pinky finger. The little group of Indian women that I hang out with are so funny. They gossip and nurture and take care of me just like my friends back home (well, maybe not just like back home, but it sure is great to have friends). My henna art is all part of development into a fashionable Indian woman. Next lesson: the sari. In the meantime, henna smells like cinnamon dissolved in vinegar.

Tomorrow is Pongal, so I don’t have to work. Pongal is the Telegu celebration of New year. I don’t know much about it, except to wish people “happy Pongal” and that there will be a lot of kites. Which should be cool.



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