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.

braceletofhope.ca

The Fatherless:
Will the world allow for more children to be orphaned by AIDS?

"If I have denied the desires of the poor or let the eyes of the widow grow weary, if I have kept my bread to myself, if I have raised my hand against the fatherless knowing that I had the power to help, then let my arm fall from the shoulder, let it be broken off at the joint." Job 31: 16-19

Sounds pretty extreme. A man named Job wrote this.  He was man of very high moral and ethical standards.   It's kind of and eye for and eye, tooth for a tooth comment, fairly typical of his time.   He was under great duress and suffering.  He wondered why God had allowed the horrific losses in his life to occur  given that he was such a righteous and just man.  It's a long story but suffice it to say, Job understood how important justice for the oppressed was, especially justice for widows and orphans.  He had lived a life that focused great efforts towards upholding that justice.

Justice:  I like that word.  It was never a part of my vocabulary until I witnessed the devastating effects of injustice.  Justice is the conformity to moral rightness in action and attitude.  It is the upholding of what is just and fair.  In the gap between justice and injustice falls the poorest in the world;  those that do without the basic necessities of life in a world where the most affluent generation in history lives, breathes, consumes and plays.  En mass, that generation, of which I am a member, has kept it's bread to itself.  It has denied the desperate needs of more than 2 billion impoverished people who live on less than $2 a day.  It has developed  the power to help but uses that power to help itself, not those in greatest need.

In the summer of 2006, I held the hand of an 8 year old while he suffocated to death from the combined effects of HIV and Tuberculosis.  His name was Lefa.  He died because of where he was born.  He died because of a complicated and messy century-long history of colonialism, slavery and oppression that left his country too resource poor to provide him with a public health system that could have prevented the spread of the disease and a health care system that could have treated him before his disease reached it's end stage.  He died because of the greed, apathy and neglect of people of power, wealth and influence; people who saw fit to raise their hands against the fatherless.  Their are now 18 million who are fatherless in sub Saharan Africa.  Eighteen million AIDS orphans and many of them will die just like Lefa did.

I don't know, but the way I see it, incapacitating the wealthy, corrupt and oppressing powers that reek havoc in our world by disabling them at their shoulder joints doesn't sound like an unreasonable consequence.  Kind of grisly but it would do the trick.

Amputating the limbs of unjust people is obviously not the answer.

Day 1 in Lesotho:  The 'ordinary' people on the Bracelet of Hope Team

 In Sesotho, Karabow means, "the answer".  I believe there is an answer and that answer  is you and me.  We have the power as ordinary citizens to correct injustice.  Good and ordinary people who, as individuals have very little power but collectively can do the impossible.  And that is just what we are doing.  I watched Lefa and many other children in Lesotho die.  Now, I have the privilege to watch as many other children thrive.

It is good and right and just.

Makhauta

Karabelo and Hlompho

My Good Samaritans

Rob Butler, Jim Wadleigh, Ann Wadleigh, Tracey McGrath, Ed Gal, Noma Vales

This morning a team of amazing people left for Lesotho.  They are Dr. Rob Butler, Jim Wadleigh, Anne Wadleigh, Tracey McGrath, Ed Gal, and Noma Vales.  Philip Maher took this shot at Pearson International.  They are just about to fly out of JFK in New York.  It will take them 16 hours to arrive in Johannesburg, South Africa and from there they will drive into Lesotho.  Rob, Jim and Noma will lead a group of 30 business people in Lesotho providing business education and encouraging the development of skills in growing small businesses.  Ann is a social worker.  She will spend her time focusing on the foster homes and the AIDS orphans that Bracelet of Hope supports.  Tracey has loaded six suitcases full of clothing, toys, school supplies and toiletries for the kids.  She has the task of interfacing with all of our partners in Lesotho who will counsel and support Bracelet of Hope as we move forward with the development of an AIDS treatment facility in the country.  Ed is our media expert.  He will be capturing images and videos that we will be using to create our new website and to launch our massive crowdfunding campaign.  Phil will use his talents as a photographer.  He will bring home thousands of images of the beautiful Basotho people and the beautiful country they live in.

They are my Good Samaritans along with so many others who have travelled to Lesotho, supported us financially, given their gifts and talents to our efforts and prayed for One Country AIDS free.  They are helping us as we shoulder the burdens of the people we love in Lesotho.

I wish them safety and success.

Anne-Marie

This is my Religion

I had the privilege of touring a beautiful art gallery in Europe a few weeks ago.  I am not big into galleries or museums, or so I thought.  I could never reconcile my love for history with my avoidance of museums.  This gallery was different.  Brightly lit from windows on all walls with skylights perched in arched, high ceilings;  this building was magnificent.  The art was displayed in full view with patrons lingering an unobstructed, arms length away.  I was moved by so many pieces but I stood transfixed in front of this one. 

This is Aime Morot's rendering of the Le Bon Samaritain.   The Good Samaritan;  a timeless, biblical story that we all know.  A man was walking down the road from Jerusalem to Jericho.  It's a dangerous road.  He is mugged by robbers, stripped naked and left for dead in a ditch.  First a religious leader and then a man from a 'priestly' family saw the man but intentionally past on the other side.  Then a man from the country of Samaria walked by.  What he did was no small feat.  First he tended to his wounds putting oil on the places where he was hurt and then he heaved him up onto his donkey and walked him to an inn.   The injured man was fully grown.  He would have been dead weight.  I would imagine that the Samaritan would have used all of his strength to load him on his donkey.  It would have taken a tremendous heave and once he was up there, the commitment made, the Samaritan would have had to keep him up there, hoisting the body over his shoulder, perching it over the donkey.  

This doesn't look easy to me.  This was in the middle east.  It was hot, most likely mid-day, the sun beating down.  The Samaritan didn't call 911 and wait for the ambulance to arrive.  He made a conscious decision to sacrifice his time, his strength, his money and his comfort to tend to a perfect stranger, a stranger who was considered an enemy.  

Look at this image.  It is amazing.  The Samaritan had no idea who this man was.  No one would have faulted him for choosing the apathetic option of his predecessors. 

 "It's hot, I am sweaty.  I have my own business to tend to.  There is not enough time.  I am not strong enough or capable enough to do anything anyway.  He is beyond help.  Someone more qualified should do this.  I am inexperienced.  It is not safe.  I can't afford the distraction."

 It is infinitely more comfortable and much easier to do nothing.  But the Samaritan sacrifices all of it:  his wellbeing, his comfort, his time, his energy and then his money.  He not only saved the man's life but he made sure  the man was safe and then he guarded over him.  The whole night.  A deposit at the inn would have been quite enough but do you see what the Samaritan did?  He took full responsibility.  Before he left, he made sure that this vulnerable stranger would be well cared for.  He left his guarantee for complete coverage of all future costs incurred during his recovery.  He took full responsibility.

I love the determination on his face.  It's as if he was totally meant to do this, like he's done it before and given the chance he'd do it again without a second thought.  It's as if he was made for this, designed for this, purposed for this.

Here's the catch:  we are all designed for this.

We are hard wired for good, compassion and courage.  We are fully equipped to do what needs to be done for the good of our neighbours and our fellow man.   We were never created to be so self absorbed, so distracted by the unimportant, so focused on our own comfort and well being.   

Here's the truth:  the suffering in this world is monumental and unimaginable but not insurmountable, never insurmountable.

Can you imagine what our world would be like if we all lived up to this same standard?  What if each one of us used our shoulders to carry the victims and the vulnerable of the world?  Those who are suffering under the weight of grief and loss.  What if we used our collective strength to lift our fellow man out of the ditch and onto the road to recovery and health?

  

Entrances and Exits:

Reasons to work towards a country free of AIDS

  I just finished an evening run.    I am very good at keeping my inner anguish at bay for weeks at a time, but tonight, I let it flow.  Life does not get easier.   I often forget the source of my suffering and then I find myself shocked by the sadness and grief that flows when my soul is given the space to grieve.    I allow myself to catalogue my losses.  Not often, but just at times like these when the grief seems otherwise unjustified.    The last year has been ripe with losses, too many to process in the short period of time in which they inundated my life.   I spend my days witnessing the suffering of others.  It is a gift to be that witness.  I understand that suffering is universal and at times, relentless.  

My life has been divided into two parts:  the first 50 years were soaked in privilege and blessings, an unfair amount when compared to the lives of so many others.  It was a life full of entrances.  People, relationships, experiences, more people, more relationships more experiences all entering graciously, one at a time, building on each other until joy overflowed.  It was my mistake, or perhaps my lack of wisdom, that caused me to believe that life would always be that way;  all additions and no subtractions, people entering in and sticking like a wonderful, warm and comforting glue.

This isn't to say there weren't some very traumatic early losses but nothing like the last few years when all the exits seemed to be opened and so many of the people I loved took their leave.  

I catalogue the losses but just long enough to remember the source of the pain;  an act of kindness to my soul but I make sure not to linger here.    Indulgence may cause me to be unprepared for a future time when life fills up again.

I have learned some valuable lessons in the last year.  I sat beside a woman at an event a few days ago.  She was in her 80's.   She talked openly about her losses, in particular, the loss of her husband of 52 years.  She shared her story with such laughter and joy.  She acknowledged her loneliness but in the next breath she beamed at how blessed she had been and how she found such great comfort in remembering the time in her life when the entrances out numbered the exits.

That's how I hope to be.  When so much loss happens in such a short  period of time, the risks are great.  I have seen many people just let go of joy believing that the best way to stop the exiting is to close off the entrances;  keep new experiences, new people, new love out.  Let go of hope.  Keep a running list of the losses ruminating deep within.  Let the losses smother all chance of recovery.   Close out the light, the healing and the moving forward.  Stop seeing the beauty and the blessings that are ever present despite the grief.  Let an empty shell keep breathing while true living ceases.

I think this is why I do what I do.   For some in this world the losses are so great, so devastating, that they simply can't be overcome.   If I could just work toward closing the exits for people whose lives are consistently and unjustly traumatized.  If I could just stop the pain from being overwhelming even for just a few, then I have done my job well.  

$ 2 million

I have become a crazy person, certifiably crazy.  I don't really know how I got here.  I should be waking up in the morning thinking about the day ahead, making plans for dinner, creating a grocery list in my mind, scheming to squeeze in some exercise, wondering how to top up my RRSPS.   Instead, I wake up with a heavy weight on my chest.  First thing, before my eyes open, 5 am on the dot.  I open one eye to glance at the clock hoping beyond all hope that it will proclaim a decent hour.  Something reasonable like 6 am or 6:30 am... but no.  It always says 5 am.  For the next hour and a half I struggle to fall back into the safe haven of sleep.  I fight to keep the anxious thoughts out.  I know that if I just get out of bed and walk a few steps down the hall, my daytime brain will take over with all of it's rationalizations, and I will feel a sense of calm, reassured that my problems are not insurmountable.  

Here is where crazy comes in.  I have put myself out on a long and thin limb with only a tentative grip.  My first thought is not about the plans for the day and whether or not I can get it all done.  No.   My first thought is wondering whether I can raise another $2 million.  Two million!  Who does that?  Who makes a decision to try to reach such an out of reach goal?  Why place such a monstrous thing on my shoulders?

There is a very long answer to that question.  It comes with a very long story and I think it is time to tell it.  I have tried on many occasions to start this story with no success.  Recently, I met a remarkable young woman.  She is young and beautiful, highly educated and skilled with energy and enthusiasm that should be bottled up and sold for millions.  She is teaching me all things social media.  That is her job.  Her career.  Yep.  Thirty five years ago, heck, ten years ago, there was no such thing and now smart young people are making a career out of teaching the ins and outs of information technology and creating a stellar web presence.  Charlotte's was the only popular web around when I was growing up but here we are, a new and challenging era.

And so, here's to you Martha.  You recommended I blog and then you poked me when I hadn't posted yet.  I am curling up in a cannonball, plugging my nose and jumping in.  Two million dollars for 200,000 AIDS orphans.  That's worth a blog or two