Manoj and his friend Sunil (names changed) strolled into the link-ART office today and quietly sat down, neither of their feet touching the ground as their skinny legs and knobby knees dangled over the chairs. At 7 years old Manoj is one of our youngest HIV+ patients, but also one of the most responsible. Manoj and Sunil walked 15 km to get to our office today so that Sunil could pick up his ART medication from us for the month. In his high little voice he told me how important it is to take his ART medication every day and says he follows all of our instructions strictly.
Manoj was extremely sick when he was brought to Jeevan Jyoti Hospital over a year and a half ago. Malnourished with a vicious fungal infection across his face, he was never able to attend school because he was always out sick. Both of Manoj’s parents died when he was young so his older sister has been raising him. She couldn’t afford to care for him anymore and had no idea what to do.
We put Manoj right on ART and now a year and a half later he’s a healthy, little boy with bright eyes and a mischievous grin. Manoj (and our counselor who visits him regularly) says that his sister takes very good care of him and monitors his medication and nutrition daily. With RMF and Jeevan Jyoti’s help she’s set up a small convenience shop near their home where she makes enough money to take care of their modest household expenses.
Back in April I blogged about an HIV+ pregnant woman who came to talk about terminating a pregnancy. She had already lost 4 children, still births, before she was diagnosed HIV+, and then saw no hope in this 5th pregnancy. When she came in however, she was already past 3 months pregnant, too late for an abortion. We counseled the family that its possible for an HIV+ mother to have an HIV- child, 99% positive actually, if the family follows the proper Prevention of Mother to Child Transmission protocol (PMTCT). I’ve never seen someone more relieved and hopeful in my life than this woman that day (here’s a link to my original blog: http://www.realmedicineblog.com/2010/04/12/the-most-beautiful-smile ).
Over the past 6 months our patient and her husband have been extremely diligent about following all of the doctor’s orders and our counseling advice. The expecting mother was religious about taking her ART medication and made sure she ate for two. When the time of her due date came near, the family went to Indore, the nearest ART center for delivery.
On September 9th, our two HIV+ patients welcomed a beautiful, healthy, 2.6 kg, little boy. Before even calling his family to tell them the happy news, the father called Devika, our HIV counselor who had been with the family every step of the pregnancy, to tell her the news.
This is a post for my mother. Everyone who hears that Real Medicine Foundation is working in Pakistan wonders about the security. All we hear about Pakistan in the media is about the violence and War on Terror. I have to admit, despite being a seasoned traveler, as a blonde American I was a little worried about my trip to Pakistan to visit RMF’s clinic in Balakot, KPK (formerly NWFP), especially when blast went off at a famous Sufi shrine in Lahore a day before my arrival. After two weeks in Pakistan however, I have to say that I’ve been completely safe and have enjoyed a warm reception everywhere I’ve gone.
In Balakot, I was greeted with nothing but hospitality and gratitude. While the kids stared and giggled, the mothers eagerly spoke to me about their problems and thanked me for RMF’s help. No one asked about my nationality or politics – they only cared that I was there to help. Dr. Martina Fuchs also had a similar experience visiting the Balakot clinic last year. On her visit the local leaders organized an unprecedented community meeting, bringing together a variety of stakeholders (who often can’t be in the same room together) from the community to talk about the health care needs of Balakot and the roll of our clinic. A few of the patients I met on my visit to Balakot remembered Martina and enthusiastically asked about her, her family, and sent their best wishes.
This kind of hospitality is not unique. The people of Mansehra and Pakistan as a whole are known for their warmth and care for visitors. It’s only in the past few years, with the encroachment of the Taliban into KPK that this area has gotten a dangerous reputation.
Today I had the privilege of visiting RMF’s Clinic in Talhatta, Balakot, KPK (formerly NWFP). I have to admit I didn’t quite believe the RMF team when they said that we’re the only health care provider in Balakot, the valley worst hit by the 2005 earthquake and with a population of over 120,000 people. While I had no doubt that RMF must be doing amazing work in Balakot, I assumed there had to be other NGOs providing health care. Hadn’t the whole world run up to the mountains of NWFP after the earthquake? Doesn’t USAID give billions to Pakistan? I was incredulous.
Today I got the chance to not only see for myself the amazing work we’re doing, but also see for myself that we are the only ones providing health care. Driving through the valley, the roadside is littered with placards announcing the donation of every NGO and government under the sun but five years later everyone has pulled out. There is one small government hospital, a beautiful brand new facility which is tragically underutilized: the x-ray room and laboratory remained locked, the doctors too busy in their private practices, and OPD hours shortened.