are you out there, are you listening…i will write this down and then i will not be alone again…
Posted by: sural in Peru(name that song!)
Happy Thanksgiving in advance to everyone, especially my family that is celebrating my mom’s birthday (delayed) in Vegas at the moment! I’m not only attending two Thanksgiving’s this year (which, by the way, matches the sum total of Thanksgiving’s involving traditional food in the entire rest of my life), but am actually cooking dishes for both of them! While tomorrow’s cooking plans aren’t that exciting, as of Friday I will (hopefully) officially know how to bake a pie.
I’m sure the NIH is glad they provided me with funding with which to have enough time to actually learn how to bake a pie! Well, here’s a post to say that I am thankful…
_____________________________________
In all seriousness, I’ve gotten back into clinical activities this week. Most of my experiences in Peru have been of the out-patient sort, and I suppose they have allowed me to forget how awful it is to see children really suffering– well beyond the sheer agony that is an ear exam when you are 6 months old. One of the pediatric infectologists invited me to spend time with him on the HIV service at the biggest children’s hospital in Lima, which serves as a reference hospital for the rest of Peru. Many of the children are from provinces quite far from Lima, many with HIV complicated by another infection, and often with malnutrition. I can’t imagine how isolating it must be for the parents and children alike, not only in the unknown of the hospital environment, but so far from home as well, sometimes while grappling with a heavy new diagnosis. And yet, the children clearly need to be here. So few of them look their actual age, and the range of consequences of even uncomplicated HIV infection still strikes me, even though I know to expect it.
Reading the news on the UN report, these images were in my head. It’s phenomenal that the estimates have been consistently too high, that this disease is not destroying as much of the world as we had thought. Yet, the consequences of HIV when untreated, or sometimes even when treated, are truly devastating. In medical-ese, it’s cardiomyopathy, hypotonia, malnutrition, respiratory infection, developmental delay, encephalopathy, tuberculosis, contact isolation, failure to thrive. In real words, it’s a ten month old who can’t yet sit up, struggling to breathe and placed on oxygen. 33.2 million frightens me when I think in these terms. And, the reality is that in many parts of the world*, it is still a leading killer of adults and children alike.
* As a note, Peru’s HIV rate is similar to that of the U.S., and the government provides free treatment. HIV rates are still high in certain populations in Peru, mostly men who have sex with men and commercial sex workers.
Entries (RSS)
November 22nd, 2007 at 9:10 pm
I feel you, Sural, I feel you.
Sometimes the words start to blur on the page when you keep reading about this illness or disease, that malady or sickness, or the other infection or cancer. It all starts to seem distant and somehow under control. You trust that someone else ‘is on it’ and that folks are taking care of things.
And they you do some inpatient work - and the curtain comes crashing down. Behind you see a mother with a dying child, a son looking at you and asking why his dad can’t breathe, a girl who asks if the surgeon can make her hands work again. Their only sin is that they are poor, if they were like you and me, they wouldn’t have been in this position in the first place. Families are scared, alone, broke, and making ‘decisions’ about health care when really, they have no choice. They do what they can do, which is often less than nothing.
Sometimes it is really hard to stand and look suffering in the face. It is so tempting to turn and run…