Under one roof

When children reach the age of 24 months, they no longer qualify to receive free antiretroviral treatment. The reason for this is that they are less at risk of dying in the short-term. Very young infants are quite likely to die of HIV before they are diagnosed.

This is the entire idea behind our program, which seeks to identify children as quickly as possible after they are born so that they can have a chance to survive.

But for children who don’t get tested until HIV until they are older, they need to have a frequent CD4 count. The CD4 count is a measurement of your blood cells. With HIV, your CD4 count descends over time. The CD4 count determines whether you can receive medicine. A CD4 less than 350 makes someone eligible to begin treatment.

I had written a big note on my calendar for today. Kids should have their CD4 count checked every six months. One of my girls, Achelove, had not had her CD4 taken in nearly a year. I wanted to be there personally to be certain her blood was drawn for the test, so this didn't get delayed another month.

Of course I wrote that note before the electricity crashed.

Today I walked into the external clinic looking for Achelove, three years old. As I walked quickly through the room, a tiny hand wrapped around my pinky finger. A little girl with her hair groomed into a poof at the top of her head and in a dirty white party dress looked up at me with wide, hopeful eyes. I smiled at her and kept moving.

A health agent passed me. “Possible, is Achelove here?”

Possible pointed back at the girl in the party dress. Achelove had remembered me.

But when I found Dr. Narcisse, we hit a wall. There was no electricy (for nearly a week now) so they couldn’t perform a CD4 test. Achelove and her mom had to come back.

“Dr. Narcisse, when do you think the power will be back? When should she come back?” We stared at each other, uncertain. Achelove kept tugging on my hand. I turned to her mom.

“Do you have a phone?” She shook her head, no.

I turned to Dr. Narcisse. “I will give her a phone, and we can call her when there is electricity.”

“You are going to buy her a phone?” Dr. Narcisse laughed at me.

“No, we have phones we give to moms for when we need to contact them. For the program.”

“But Michelle, aren't you going to the HIV support group now?”

I looked at the mom, then at Dr. Narcisse. Taking care of Achelove was important. “I’ll go get the phone first.” I turned to the mother – “Wait for me. I’m going to get you a phone. I’ll be back in 30 minutes.”

I raced out the door, across the hospital, to my car. Wilfrid and I drove back up the broken road to my hotel, where I dashed out, grabbed the neon green Motorola phone and charger, and jumped back in the car. This is when I realized the phone wasn’t charged.

That’s ok, I can charge it at the hospital. Except no. No power. I grab Wilfrid’s car charger and plug the phone into the car. This is ridiculous.

So many of the families in town don’t have electricity, so they charge their phones at the hospital in the waiting room. What are they doing now that the generator is dead? I wonder.

When I get to the hospital, I can’t turn the phone on. “Charge it at the Red Cross” suggests Wilfrid. I doubt they have power, but I try. Asier is there, and I see computers plugged into the wall. “You have power?” I ask hopefully.

“We had power for 10 minutes. From a solar panel. But now that’s dead too.”
I go back to Wilfrid, ask him to charge the phone in the car, and go inside the external clinic to stall for time.

I have to ask Achelove’s mother to sign a contract – written in Kreol – asking her to keep the phone charged (ha) so I can reach her and to tell me if she loses it. I don’t like to give women money or phones in public. I decide to commandeer an office. Since there is no power, a lot of the hospital is abandoned. I wave for her to follow me and find an office with a window since the interior offices are nearly pitch black without light. I read part of the contract to her, since she is unable to read. I point to a line and ask her to make a little cross in place of her signature.

Achelove’s mom has been quiet this whole time. As we start to exit the office, she starts to speak: her mother and father had just died of cholera. I pause, horrified. I don’t know what to say to her.

know there are families here in Haiti that are not touched by cholera, or HIV. But I feel like the problems, the pregnant fifteen year olds, the young women getting HIV, the families hit by cholera – this problems are not arriving separately, at different doorsteps. They are all under the same roof.

Unfortunately, the only small thing I can do is to get this one little girl back to the hospital. Her mom is very quiet on the drive home, for good reason.