Gratitude #1: Stories for World AIDS Day

As we lead up to World AIDS Day on December 1, I always like to share the stories of our patients in Kenya. For the 32 million people living with HIV right now today and for those of us working to fight back this virus, every day is World AIDS Day. It is my privilege to be immersed in these stories of AIDS.

During this week where we practice gratitude and celebrate thankfulness, I am going to remember some stories of thankfulness. Stories of thankfulness as we prepare to commemorate the upcoming World AIDS Day, stories of thankfulness even in the face of this terrible epidemic.

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Marian sits quietly in the chair in our clinic room, her arms wrapped around her sleeping one-year-old daughter. One-year-old Ellen breathes heavily, but only with the deep in-and-out of sleep. Her lungs sound clear and healthy when I listen with my stethoscope.

Six months ago, baby Ellen had a pneumonia that landed her in the hospital. She struggled to breathe, and the infection in her lungs almost ended her short life. Under my stethoscope, her breathing was coarse and crackly, her lungs filled with fluid and infection.

Marian had given birth to Ellen at home, and she had never been to a hospital before in her life. But worry over her coughing, gasping baby pushed Marian to bring her to the hospital facility where she thought her sick baby could get the treatment she needed. Bringing Ellen to the hospital saved the baby's life; she needed medicines that could only be given there. And it turned out she needed the hospital for other reasons as well.

While Ellen was in the hospital, the doctors tested her for HIV.Positive.When a baby tests positive for the HIV virus, it almost always means that the baby's mother is infected too.

On that day six months ago, Marian held her sick baby in her arms as she sat in a single bed on the hospital wards and she heard that both she and baby Ellen were HIV positive. Marian carried in her blood the virus that would end both of their lives. At least, that's what she thought.

"I thought that HIV means death," Marian said. "I knew we both would die."

Thankfully, Marian was wrong. Her efforts to get Ellen to the hospital meant that the baby could have the antibiotics and oxygen she needed to treat her pneumonia. And although many HIV-infected babies do die when they are not tested and when they do not get treatment, we knew now that Ellen needed this treatment. We could offer baby Ellen treatment - and Marian too. Mother and her baby were quickly enrolled in one of our AMPATH clinics, and both were started on medicines to treat their HIV.

Ellen recovered well from her pneumonia. She has been growing quickly and the medicines have helped her to progress through all of the baby milestones we would hope for - sitting, crawling, standing, starting to walk. No more rashes, no more pneumonias, no more skinny and not-growing baby.

"Look at her," says Marian proudly. "You would never know."

Marian is feeling better too. Her childbirth had left her with anemia, and she had lost far too much weight. With the medicines, she says her strength and weight have returned.

"I am thankful," Marian says. "I am thankful we have known the sickness is there and come to treatment. Otherwise, we would have been lost."

I am thankful too.

This is a devastating story, but this is also a story of thankfulness.

Marian was thankful that the virus in her blood and in her daughter's was discovered. Thankful that she could be linked into HIV care. Thankful that they could be started on the medicines that transform HIV from something that means certain death into an illness with which one can still live. Thankful that she can hold in her arms a healthy, growing, sleeping baby.

Come and be thankful with us. We are celebrating the first ever #worldAIDSdayINDY on December 1 at The Libertine in Indianapolis. It's going to be a fun mix of fashion and philanthropy, with the launch of The Pocket Square Project and all proceeds to benefit services for our HIV-infected kids in Kenya. We would love to have you there!

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Posted at 05:16

Let Your Heart Break

I have been excessively swamped in Doctor V Land by transitions big and small. In the midst of much that seems overwhelming, I know more than ever that I need compassion to walk through each day with hope for the adventure that is tomorrow. And I know in a new way how each person I encounter needs that compassion too.

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I came across these words from Melinda Gates about how to show compassion, and I loved them. I share my stories from around the world, and I know that I am doing exactly what I am meant to be doing in the midst of this unjust, difficult world. And I struggle with how to introduce others to what it means to have compassion and hope and purpose when you confront poverty and pain beyond comprehension. Here's one powerful suggestion:

The world is full of what seem like intractable problems. Often we let that paralyze us. Instead, let it spur you to action. There are some people in the world that we can't help, but there are so many more that we can. So when you see a mother and children suffering in another part of the world, don't look away. Look right at them. Let them break your heart, then let your empathy and your talents help you make a difference in the lives of others. Whether you volunteer every week or just a few times a year, your time and unique skills are invaluable. - Melinda Gates

Don't look away. Let your heart break.

Posted at 16:40

Bright and Shining

Here is a thing of beauty:

Ethan is 18, and he has been living with HIV since he was born. For the first years of his life, he was sickly and small. Every day, in the silence of her heart, his mother wept for him. She was sure that her son would not live.

She wanted the world for him. Silently, she begged God to save him, to spare him, to let him grow up and know love and happiness and find his way. After years of watching her son get sick over and over again, there came a day when she was given a new test result. The doctors had tested Ethan for HIV and they found that he was positive. This meant that Ethan's mother was positive too. She carried in her blood this virus that threatened to kill them both.

This was the worst day -- and the best day. Because finally getting that diagnosis meant that the doctors knew what to do for Ethan at last. He was started on the HIV medicines that could restore his body's protective immune cells and prevent him from getting sick again and again. Ethan began to grow. He became his mother's strong and laughing boy. Slowly, she began to have hope again.

Ethan has done extremely well on his HIV medicines. He graduated from high school this year, and he was the star of his school's soccer team. He loves soccer, but even more, he loves the youth of his community. His passion is to help other kids who are growing up with HIV to know that HIV is only part of the story of who they are -- that they can still growth and thrive and dream.

"I will always do all I can to support those in need of care and support," he says.

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Ethan has organized a youth soccer tournament for kids ages 10-14 who are also growing up with HIV. He has 10 teams organized for the tournament, and the big competition is planned for December 1 -- World AIDS Day.  On this World AIDS Day, these children will be laughing and shouting and playing their absolute best on the soccer field. These children will be a bright and shining example of what it can look like to live with HIV when you have access to the medicines you need. They are the lucky ones; 2/3 of the world's HIV-infected children do NOT have access to HIV medicines. Most of those children will not be playing soccer. They will be too busy dying.

Today, these kids here in Kenya became lucky ones in another way too. Thanks to a gift from Adidas organized by our partners at The Pocket Square Project, we were given a bunch of wonderful soccer balls. Every single team will have a BRAND NEW soccer ball to play with. I cannot tell you how excited they will be -- and how delighted Ethan was at the prospect of having this kind of support for his tournament. Remember, my kids play soccer barefoot in the dirt. They make balls out of plastic bags knotted together. A real ball -- let alone a beautiful new Adidas ball -- is a marvel they will cherish.

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Their doctor was really excited too. It is a joy to see my remarkable youth leaders supported and encouraged in this kind of tangible way. HIV medicines give these children life and hope, but this kind of gift brings them the encouragement that friends around the world are cheering for them too. Thank you.

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Posted at 07:17

When you are nine...

She brought her baby sister to the clinic all by herself.

When you are nine, you shouldn't have to take care of yourself, let alone your baby sister. But when your mother has died and your father is sick and living somewhere else, you have to grow up far too fast. You are the one who makes sure that you both have food. You are the one responsible.

Caroline knew that her mother brought the baby to the AMPATH clinic. She did not know that her mother had HIV and that she was taking medicines to try to prevent this virus from infecting her baby. She did not know that the baby needed to be tested for HIV or when the baby was supposed to come see the doctor. But she knew that they should come.

Caroline's mother spared her baby from HIV. By taking the medicines to prevent the virus from passing to her baby during pregnancy or during breast-feeding, she kept the baby free of infection. Caroline is not infected either.

Even though the medicines spared her baby, Caroline's mother did not manage to spare herself. From what Caroline describes, she was very thin, coughing too much, and one day, a few weeks ago, she did not wake up. (The doctor's guess would be that she had TB.) The day that she did not wake up will shape every day of life for her two girls.

We have a program for Orphans and Vulnerable Children that can help orphans like Caroline and her sister, and I was grateful to be able to refer them for assistance and follow-up. I was grateful to enlist help. I was grateful for a social worker to try to figure out if there was an adult who cared about them who could lift some of the responsibility from the shoulders of this nine-year-old.

I was grateful, but I keep thinking about them. A nine-year-old and her baby sister and the mother we could not keep alive.

Posted at 08:09

Wordless Wednesday

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Posted at 08:06

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