Working in a clinic, I am an instrument of providing basic and preventative health care to many people on a daily basis. One of the ways which is do that is largely through transport as I take people to the hospital on a regular basis for anything that is outside of the care we can give them. Twice now, my vehicle has become an ambulance in emergency situations. The first time we took someone to the hospital in my truck was a young man who got hit by a car just outside of Jenny’s house (where we happened to be having a birthday party in the backyard for a friend). Luckily for this man, we had a doctor, a nurse, and a herd of medical students on sight and within 20 feet of the accident. The young man had a broken arm, a head wound, and was unconscious. We stabilized him, put him into my trunk and took him to hospital. A couple days later, I found out that he survived with only said broken arm and was here at the Bedford Orthopedic Hospital where I live, getting his arm reset. It was the greatest feeling in the world to know that I had even some small piece in providing for this guy who probably would have died waiting for an ambulance (they’re not very punctual here) otherwise. I felt important and useful and I can say that, if nothing else, I helped save a man’s life this year.
Then, early last Tuesday, some men at Itipini brought a man into the clinic on a stretcher that was shaking, mumbling gibberish, and had a fever of 104.2 degrees. He is one of our (many) HIV/AIDS patients and has not been taking good care of himself. He was as thin as a rail and hadn’t been into the clinic in a couple years for check-ups. We quickly put him in my car and I took him to the clinic at the top of the hill called Ngangalizwe, which is our partner clinic. After putting him on a stretcher and getting him inside and into a room to be seen (about 30 minutes time), the nurses there said that he needed to go to Mthatha General Hospital. So it was back into the car and onto Mthatha General. When we got there, we waited in three different lines (almost an hour of time) just to get him checked in and then waited with him another half hour or so before he was finally taken back. I left him at the hospital with his father from there. A few days later, we heard word back from some of his relations that he hadn’t made it and had passed away in the hospital. I feel guilt over not being able to do more for him – maybe the way I handled the situation was a factor in his death. Who is to blame here? Is it the over-crowded, under-staffed, inefficient hospital? Is it the lack of jobs, cycle of poverty, and poor living conditions? Or is it the HIV that was left unchecked by the patient himself? It seems callous to blame someone for his own death. It would be easy to say, “He should have taken better care of himself,” but the fact is that that is often much easier said than done in the Transkei where social and economic opportunities are incredibly lacking and the stigma around people with HIV/AIDS often reduces the number of opportunities even further. Could this man have lived were the situation a different one? In the situation and the amount of pain he was in, did he want to live? No one can say.
Through all of this, I’m finding a greater interest in medicine and HIV/AIDS because I want to be able to do more and the starting point for that is knowing more. HIV/AIDS is a disease that is present and problematic throughout the world and I am ashamed that I know so little about it; that I was taught so little about it. It was easy to be detached from the issue living in a country where it is a) not as common and b) easily managed with good health-care. Here, it is impossible to ignore or brush aside.
I will leave you all with a quote by a Senegalese senator named Baba Dioum:
“In the end, we will conserve only what we love. We will love only what we understand. We will understand only what we are taught.”