The letters just roll off the tongue now. We aim to prevent the transmission of HIV from Mother to child in pregnancy, labour and delivery and breastfeeding. In the West this is done under the close guidance of highly specialized physicians, monitoring closely lab values and providing highly specialized services. In the rest of the world it actually becomes a fairly simple and yet effective program run by locally trained midwives and nurses so that women living in the far corners of the earth can know that there is something being done to stop the transmission of HIV to their babe.
What that means in Goronyo is that when a woman comes to the health clinic for her first prenatal check up, along with checking her for the standard pregnancy blood work, we offer her an HIV test. If this comes back positive, Anna our counselor will bring her into a private room and begin to explain what the implications are.
I am sure, the world over, women’s reactions are unique to them but share similar themes: what does this mean, what will my partner say, should I even tell my partner, what does this do to my baby, am I going to die?
Already in my short time here I’ve been witness to a variety of situations, none of which prove simple, all of which raise so many issues.
One woman was barely allowed the time enough to receive the result…her husband pressuring her to leave the clinic as he had thought she had spent enough time there and he had other things he had to do. Even with counseling she was unable to come to terms with the diagnosis and fled the clinic.
Another woman had accepted Anna’s offer to accompany her back home to her village to offer support to her as she told her husband. Anna relayed the story back to me. She told her husband and he responded “umhmm”. Anna clarified, “she’s telling you she has HIV”. “and so?” he responded. He then disclosed that he himself is positive and has been receiving care in the neighboring city. He had basically just been waiting for either her to become positive or deliver and then move the family to the city.
What a crazy twist of feelings we all had about this. On one hand, how evil you think of the man who is just waiting for his wife to be infected with a preventable illness, but on the flip side, we now know she will have access to care for herself, and assume her husband will support her in coming to the clinic for their child. The complexities of these issues are only the beginning.