Jess in Zim

The mango season is over here in Gweru, but everything else, for me, is just beginning.  The slow learning of language and landscape that makes me feel like an infant again.  Adjusting to a climate that finds me shivering in the early hours and then hurrying towards the shade at noon.  Recognising faces, remembering names and then, finally, coming to know the characters of my new friends and colleagues.  Adapting to my new home- lizards on the patio, geckos in the kitchen and frogs in the shower.

Over the past few weeks I have visited district hospitals, rural clinics and town offices.  I’ve had meetings with doctors, nurses, community workers and head men in aging provincial offices and under trees.  Slowly, slowly, from the blur of arriving, my work here is coming into focus.

At the end of March, I spent my first full day as supervisor at Lower Gweru clinic.  Early in the morning, we took the road from Gweru through the countryside, past the dam.  On our arrival, patients were already gathered under the thatched shade- almost two hundred of them.  Most arrive on foot, others on donkey carts.  Sicker patients often arrive in wheelbarrows.  I was greeted by the news that two of our four nurses were off sick.  We grit our teeth, juggle our small remaining team and get to work.

I find myself assisting a student in the bleeding room.  I can’t see the end of the queue, but we put our heads down and, after a long morning, eventually the last patient is bled.  The many samples are taken to be processed at the MSF-run laboratory at Gweru Provincial Hospital, and we move on to perform the daily rapid HIV tests.

A small group of patients, who have spent the morning receiving pre-test counseling, are waiting.  I look them in the eye, smile.  Check their names, give them mine.  We draw their blood with a needle and syringe.  As we’re doing this, I reflect on the fact that, statistically speaking, two of these six tests will be positive.  I don’t know which ones yet- maybe the seven year old boy who, bravely, didn’t flinch at the needle.  Or the twenty-two year old young man with the shy smile.  Or the shawled grandmother, who looked pleased when I tried an Ndebele greeting.

I’m not used to this.  At home, I am distanced from the laboratory by long corridors, swinging doors and white coats.  Results are returned without judgment, as sterile figures on a computer screen.  Here, as I watch the blood and buffer solution chase up the test strips to their inevitable and intractable conclusions, I’m sobered by the immediacy of it all.  If I look up from the desk, out of the window I can see the quiet huddle of patients on a bench in the shade, waiting to see if their life is about to change.

Statistically speaking, two of these tests will be positive.  But I want them all to be negative.  I don’t want anyone to contract this corrosive little virus, which starts by eroding trust and intimacy and works right down through flesh and bone.  I want them all to be negative.

But they’re not.  We don’t beat the statistics.  Two of our six patients will receive a positive result in a few minutes.  I distract myself with documentation.  I try to comfort myself with the fact that these two patients, like the other four thousand treated at our clinic, will at least receive excellent care and access to the essential, life-saving drugs too many of their fellow Africans are denied.

The clinic

Tags: hiv, rural clinics, statistics

This entry was posted on Thursday, May 13th, 2010 at 5:13 am and is filed under HIV/AIDS, Nurse, Zimbabwe. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.