Thursday, February 28, 2008

Cry baby

Anyone who knows me very well knows that I cry very easily. I cry when I get nervous. I cry when I see a Hallmark commercial on TV. I cry at "Extreme Home Makeover." I cry.

So, today I wanted to cry all afternoon. I spent the afternoon at a pediatric HIV clinic in the public pediatric hospital and all I wanted to do was cry (don't worry, I didn't). The physician saw about a patient every 10 minutes and each one was the most adorable little child ever. If anyone has any doubts as to how important it is to prevent maternal to child transmission of HIV/AIDS, you need only to meet one of these children and just imagine the life they will lead - full of countless pills, unmentionable stigma and discrimination, and health consequences that medicine has yet to fully understand surrounding the long-term effects of HIV infection.

The patient encounter goes as follows. The doctor sits at the desk, calls out the name of the next child to be seen. The child and his/her caregiver comes in and sits in the two chairs next to the physician. The physician records his observations and findings while asking the caregiver (who is sometimes the child) whether they take their medicines accordingly, whether they have any side effects, whether the child is eating, and if there is any change in health. The doctor then writes up a prescription for the meds and the child and caregiver leave. And the cycle repeats itself.

The drugs are given to the children free of charge, courtesy of PEPFAR (quite possibly, the best thing President Bush has ever done during his time in office). However, what cannot be remedied with money is the stigma that these children and face.

The most heartwrenching patient I saw was a boy, around 11 years of age. His mother and father died of AIDS when he was less than 2 years old and he is being raised by his grandmother and great grandmother. Both of them hold onto old beliefs and misconceptions about HIV. They don't allow him to go to school or the nearby orphanage because they're afraid that he'll infect the other children. He is in charge of his medicines and responsible for knowing how and when to take them. He's 11, but looks around 7 and was obviously depressed and withdrawn. I can only imagine his day-to-day, where he receives little to no stimulation, no education, and no play time. To top it all off, his strain of HIV was resistant to first and second line treatments and the only thing available to him was a salvage treatment - which was being put at risk because he wasn't taking his medications as directed. I'm tearing up, just thinking of him.

Really, in a world (and country - Vietnam has a new upper class whose income and spending rival even the wealthiest Americans) where there is such wealth, this should not be happening. We should be able to protect the weakest members of our society and provide them with basic human necessities, including love.

I have to mention that I was the only cry baby around today. None of the patients, ranging from 3 months to 13 years old, cried. Not a single whimper, peep, or scowl.

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