Solomie Deribessa, MD, MPH
After the morning report, patients’ charts had piled up on my desk and the nurse started calling one by one.
The first patient came just to refill drugs, the second one had common cold, the third had skin infections but then comes Abiti.
Abiti was my fourth patient. He was brought to the clinic by his aunt who wore prosthetic appearing shoes. I stretched my hands as I would greet all my patients but she held back.
I was caught by surprise and again stretched my hands.
She burst in to tears. I was shocked and went around the table to comfort her. Her eyes welled with tears, she wrapped her hands with neṭela (ነጠላ) which is a handmade scarf-like cloth made of cotton. I shook her wrapped hand and I tried to console her.
“You know Doctor” , she said and continued, “HIV , Leprosy and poverty are deadly combinations . Though I am walking, I feel like I am a dead person. It has been several years since I became diabled like this because of Leprosy,” she paused to wipe her tears.
“Two decades have passed since I received a hand shake from people.”
I asked her why?
“Because people think that they may get Leprosy if they touch my hands or body but the worst of all is they think I have HIV. After I lost my brother and his wife because of AIDS, I brought his two sons to live with me , both of them are HIV positive but we didn’t know until later after my husband died. When the neighbors knew that I am taking care of kids with the virus and later after my husband died of HIV, they completely shut me off; they are not even talking to me. “
Back in 2007 the stigma towards people living with HIV had been immense, that was the time that people used to expel HIV positive people renting their houses and were closing their doors for HIV positive neighbors. The stigma is still strong in Africa and many parts of the developing countries. In Western societies and among educated people in many major cities in Africa, HIV is just another chronic illness and millions are living with the virus taking their anti-viral medications.
She continued her story,
“On top of everything I became a widow; my husband died a year ago of HIV/AIDS.”
Looking at my perplexed face, she quickly followed,
“The death of my husband was my fault”.
She said her husband was bed ridden because of leprosy. They had meager resources and barely had anything in the house. They shared needles and blades to shave; didn’t have money to buy extra. They didn’t know then that the boys had HIV.
I felt terribly sorry and wanted to cry. I asked her if she has been screened for HIV and she said she had never been tested. After a brief counseling I asked her if she was willing. She agreed but also added that she is a dead woman walking.
One hour after we took the test, all of us in the clinic sighed with relief. She tested negative for HIV. We overjoyed to tell her the result and we called her to the private counseling room to announce the good news. She was somewhat relieved but she still has to take care of Abiti and his brother … and the stigma…of both HIV and leprosy… and the challenges of deep poverty.
They left the clinic reassured that I won’t abandon them like their neighbors.
(This is based on a true story, actual names are not used)
Dr Solomie Deribessa is an experienced pediatrician who is a pediatric infectious disease fellow at the Addis Ababa University in Addis Ababa, Ethiopia.