Not an ‘Easy Fix’-by Brenda Jansen

(story began in November, 2009...read last paragraph for today's update)

Daily life is a laborious, painful grind for many Malawians. Meeting the basic needs for themselves and their families consumes the hours of each day. Poverty, disease and hunger constantly threaten their lives, wearing them down, eventually snuffing out hope. The size and scope of the problems in this society overwhelm those who could offer help. In our nine years in Malawi, we’ve learned that by helping the individuals or families who ‘cross our paths’, those we become aware of, we can make a difference.

I recently became involved in a crisis in the life of a Malawian friend of ours, "James". He has been an AIDS patient at the Partners in Hope Medical Center (PIH) for a few years. James and his first wife, both HIV-infected, were divorced several years ago, leaving their three young children in her care. It was later discovered that their oldest daughter, "Naomi", was HIV positive as well. Adding to the already sad situation, Naomi’s mother died not long afterward.

James married a second wife, each of them being aware that the other was HIV positive. He had hoped that she would care for his children as her own, but he realized that this was not in her heart to do. So, James took his children to his elderly mother who lived in a village more than an hour away, committing to provide money for their needs, as he had a steady job as a night guard in the city.

This week James learned that Naomi was admitted to the district hospital nearest his mother’s home, and was critically ill. The family did not have resources for a healthy diet, and Naomi had not been getting regular care for her HIV. Starting and stopping ARVs (AIDS medications), her grandmother apparently was not supporting her treatment. James was caught in a complicated family dynamic, between a wife who refused to help and a mother who apparently wasn’t capable.

When my doctor husband, Perry, learned that Naomi was diagnosed with pneumonia, but also had had fluid extracted from around her lungs, he suspected that she had tuberculosis (Tb). In talking with the doctors at the hospital, he learned that they were delaying Tb treatment, wanting to wait another week to see if she would respond to antibiotics. Meanwhile, she was still having a fever and getting sicker by the day. That’s when Perry suggested that I drive down and pick her up, bringing her to PIH for the urgent care she needed. I brought another Malawian friend along to translate for us.

When we arrived at the hospital, James led us to the children’s ward. It was a sad sight … limp bodies of children and babies lying on beds, many crying. Fearful and hopeless eyes of parents and grandparents met mine as I looked around the room. One sweet picture remains in my mind, that of a baby bravely getting an injection while he pressed his cheek against his mother’s bare breast, the comfort he needed at that moment. I wondered how many of those little ones had been infected with HIV, how many didn’t have two living parents, how many wouldn’t make it past preschool age.

James led us into the room where we met Naomi. By her small stature, I would have guessed her age to be about six, but she was actually ten. Her face was puffy and her body was thin and weak. Her arms, legs and scalp where covered with sores. She looked very sad and scared. I wondered what her father felt when he looked at her, if he struggled with guilt for bringing HIV into her young life. It wasn't my place to ask, and the answer was irrelevant at that point. Those in Naomi’s life would need to do all they could to nurse her back to health, and now that included us.

We drove James, Naomi and her grandmother to her home, to pick up some clothes before heading back to Partners in Hope. Their house was about five kilometers of dirt road from the main highway. I was glad to reach it when we did, because the road was getting too narrow to continue. I was the last one to enter their mud brick house. Inside the darkened living room was a very sick lady lying on the floor. Motionless, her eyes were wide open, looking as though she might die any moment. I was told that she is James’ sister. Oh my, another family member causing great heartache for his mother! Just the sight of her grabbed my heart. I went outside and talked with my friend about ways that we might possibly help, just as one of the other ladies in the house walked out the front door carrying the sick woman on her back. A couple men in a small, beat-up truck came to rush her to the hospital. I was relieved of having to sort out a plan, but I didn’t have much hope that her outcome would be a good one. This family was being hit hard, not unlike thousands of other families in this land so deeply wounded by the AIDS pandemic.

Today, Naomi is getting the Tb treatment that she needs. Measurement of her CD4 count (blood test) showed that her immune system was nearly gone. After a couple weeks, if she lives that long, she will begin taking ARVs again. If she does regain her health, who will have both the means and the love she will need to grow and thrive? How will she learn that she is valuable? Who will make sure she gets an education? These are not easy questions, and there is no ‘easy fix’. Perhaps it was God’s plan that Perry and I would get involved. Maybe there is much more to His plan, and He will use us and others to change the course of this young girl's life. With willing hearts, we seek His direction.


Update September, 2012

I am happy to report that James' second wife eventually grew to love Naomi, caring for her as one of her own children.  She is now doing very well physically, and attends school along with other kids her age.  Life is still difficult for this family, but they are facing it together.