An Ordinary Day

My main responsibility here in the Grand Anse is to make sure that three hospitals in the region are testing children for HIV when they are four weeks old, and again when they stop breastfeeding. Any child who tests positive and is under the age of two years can automatically receive free antiretroviral treatment – as long as they have someone who can be trusted to bring them for monthly appointments and give them their medication regularly. Irregular use of ARV treatment would be dangerous for the child’s health as well as a waste of funds.

In the case of one orphan, the person responsible for his treatment is me. It surprised me that we were going so far to make sure each child gets treated. But Samuel lives with a charitable mission, and the hospital did not think the nuns would be able to bring him regularly. So Friday, I went to take Samuel to the pediatrician.

Samuel goes to the public hospital in Jeremie, a place where “it doesn’t seem possible anyone could get better there.” Rickety, rusting beds are jammed together in the pediatric ward, files are kept in gigantic paper registries, confidentiality is questionable. Folding chairs are spray painted on the back “PEPFAR” – gifts from the U.S. government.

Despite the fact that the physical appearance of the hospital is depressing, I really enjoy being there. Many of the staff are sharp, competent, and warm, which is a miracle. In particular, the health agents (you can identify them because they wear kelly green pants or skirts), are very cheerful when I arrive and shout hello to me across the waiting room. The social worker is particularly insightful, and he is very invested in the well being of the patients. And the pediatricians.

The pediatricians fascinate me: two very pretty, very professional young women. In this drab setting they seem glamorous. One of them entered the room with a red flower neatly arranged in her hair. The new pediatrician was wearing a low cut red floral dress with a black ruffled shirt unbuttoned over it. They speak to me in French and to their patients in Creole. (Except once when Dr. Saint Fleur said softly, in English: “Michelle. You are very quiet!”)

Like everywhere in the world, people wait patiently for the doctors to appear. There are just fewer of them here. They sweep in, do their job, and exit.

“Bonjour Michelle.” Dr. Narcisse Nadege greets me. “Is his infection any better?” Samuel has a bad ear infection, and she uses cotton to swab goo out of his ear with a worried expression. In the middle of Samuel’s appointment, her mobile phone rings. She speaks in fast Creole. “Did you put him on oxygen?” she asks. When she hangs up, she pauses. “Michelle, excuse me. I will be back in ten minutes.”

I bounce Samuel on my knee but he always keeps the same serious expression on his face, as if he knows what’s going on.

Ten minutes later, Dr. Nadege returns. “Is everything ok?” I ask. She shakes her head.

The child had died. “It’s sad.” she says to me.

I watch her calmly continue her work. I realize that there is nothing unusual about this day for her. I can’t imagine what it’s like to be her.