Tuesday, 21 October 2014

Beautiful Makhauta

Makhauta:  October 21, 2014, Lesotho, Africa

This past weekend, one of my long surviving patients past away.  I loved him.   I found out about his passing this morning as I was starting a very busy office.  I sat at my desk, staring out the window, a mountain of work ahead of me, wondering how I would be able to tend to the needs of my patients today.  How would I pick myself up and push on with this aching heart?  I wish I could tell you his story, tell you the reasons why we loved him so much.  I wish I could tell you how he made us laugh and what nickname I used for him.  I wish I could tell you about the burdens he carried.  I wish I could help you understand how the world had broken him over and over again and how he just kept coming back, standing up straight in the face of it all.  I wish, in a strange way, you could understand how he made me feel each time I met with him.  He loved me too.  I remember the twinkle in his eye and the mischievous way he would tease me about being straight and how he would take advantage if he had been straight too.  Healing in the doctor patient relationship happens best when it is rooted in respect and love.

I can't remember how many years I took care of him or how many illnesses we conquered together.  He lived much longer than he should have.  I like to think that it was, in part, because of the amazing team of people who watched over  him all these years.  We stood with him on the front lines of the war against HIV.   We fought together.  

By mid-afternoon, heavy fatigue settled in.  It would have been much healthier if I had headed home to grieve, at least for a day.  I was reminded by one of my medical partners this morning that we are trained to keep moving, healthy or not, there is no room to grieve.  Then, this email arrived with this beautiful picture of Makhauta, taken in Lesotho earlier in the day by Philip Maher.  Can you pause for a moment and study her stunning face and incredible smile?  When I look into her eyes I see life.  I see joy and a comfortable confidence.  

Makhauta is only 13.  She lives on a mountain in Lesotho, in a foster home with her biological brothers and three other foster children.  Her grandmother takes care of them all and Bracelet of Hope supports the entire foster home.   Makhauta was born with HIV; it is a disease that does not discriminate, whether you are an aging gay man or an adolescent, young woman.  Luckily, the medications now available to treat HIV do not discriminate either.  They work just as effectively for my patients here as they do for those infected everywhere in the world.

New research shows  that with the powerful medications now available to treat HIV, a person who begins treatment in their twenties can live a normal life expectancy as long as they continue these medications for life and as long as they have regular medical follow up.  Research also shows that while on effective treatment, it is almost impossible for an HIV infected person to transmit the virus.  Pregnant woman on these medications will not transmit the virus to their newborn babies.  

And all it takes for most newly infected people, is one pill, once a day.

Makhauta's mother did not have access to these medications.  Both of Makhauta's parents died before she was five.  Last year Makhauta was dying too.  Although she was on treatment that was once effective, she developed resistance to one of the key medications needed to keep the virus in check.  There were no other options left for her in her country.  I am not going to tell you how she received the medication that is now allowing her to live and thrive.  Suffice it to say, that each time Bracelet of Hope sends another team of people to Lesotho, Makhauta gets what she needs.  

Can you pause for another moment and look at her beautiful eyes?  She exudes joy and life and freedom.  She makes her world a much better place.  She  makes it possible  for me to keep standing on the front line of that battle against HIV, even though, today, there is one less soldier in our ranks.  

A new clinic in Lesotho will treat 10,000 people, many of them children like Makhauta. I will grieve tonight but tomorrow I will be grateful.  Grateful  for the long life  my patient lived and grateful for the thousands of people who will receive that same opportunity because of the work we do.....it is a vision well worth fighting for.

Farewell my friend.  It was a pleasure knowing you.


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