A Family With a Secret

Girl With A Secret

Once upon a time, there was a girl who lived in a family with a secret. This secret felt like a heavy blanket that weighed them all down and made them move more slowly, more cautiously.

No one could know about the secret. Not the neighbors, not the people at church, not the girl's friends from school. Not her grandmother who could be stern and scolding, but had a warm laugh and always gave the girl extra sweets. Not even her dear auntie, her mama's sister, who lived next door and always got that worried look on her face when she asked the girl's mama how their family was doing. No one could know the secret.

Keeping the secret meant that the girl was not allowed to ask questions about how her father had died. He died when she was only four years old, and the girl could remember his strong arms, but not much else. Keeping the secret meant not talking about him with her mother or anyone else.  Keeping the secret also meant not talking to anyone about the medicines she had to take every day or about the visits to the doctor once a month. Keeping the secret meant going to bed with an empty stomach some evenings rather than asking the neighbors if they could share their food. Keeping the secret meant not asking her mother too many questions.

By the time she was 12, the girl thought she was very good at keeping the secret. The only problem was, she did not know exactly what the secret was. Her mother would not tell her the secret either. The girl knew it must be something terrible, and she worried about what exactly it might be. Had the girl been responsible for her father's death? Was her mother going to die too? Was there something horribly wrong with all of them that could not be spoken about? When people looked at her, could they tell that something terrible was happening? Was she about to die too?

The girl worried and worried about the secret. And, sometimes, she felt very angry that no one would tell her what it was. Some days, she really wanted to know and some days she did not ever want to know.

Living in a family with a secret is the reality for most of the 24,000 children cared for within the AMPATH program in Kenya. Whether it is their parent's HIV diagnosis or their own, no one wants to tell them about it. Even among 13- and 14-year-olds who have lived with HIV their entire lives, only 40% of them have been told that they have HIV. You can imagine their unanswered questions about why they have to take medicines every day and their fears about just what this secret is that weighs so heavily on their family.

We got some really good news this week for our families with secrets. I found out that I was awarded a new, four-year research grant that will allow us to offer new services to help families with the process of HIV disclosure to their children and to follow how learning about their HIV status impacts the children. The grant will allow us to put disclosure counselors into a number of the clinics to guide families through this process, and the grant will let us run support groups for the children once they know their status. We'll look at how learning about their HIV status affects the children's adherence to medicines and their physical, emotional, and mental health. The eight clinics where the research will take place care for over 15,000 children and so having these additional services available for all of those families will be incredibly helpful.

Hooray for the opportunity to introduce new support and counseling services for each of the girls and boys in our program in Kenya who are living under the weight of secrets they don't understand!

Posted at 14:44

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