curbside conversations

My job description often has an interesting effect in Kenya. When Kenyans ask me what I do and why I spend half of the year in their country, I tell them that I am a pediatrician who specializes in providing care for children with HIV. This opens up some interesting conversations.

On many occasions, this leads to discussions of just how prevalent HIV is in their country (7% of the total population) and how many children have HIV (at least 150,000 in Kenya).  We talk about drugs for HIV, how they work, and how they can allow a person with HIV to live a healthy, productive life for a long time. We talk about why there is so much HIV in sub-Saharan Africa. People have a lot of questions, and I'm happy to seize the educational opportunity.

Sometimes, after I have shared what I do and we have talked about various issues related to HIV, I start to get the disclosures. I can often tell when it's coming…a hesitation, a glance, and then a quiet admission. "My brother went for a test and it was positive." "My sister died and they said it was HIV." This is not something that you talk about widely here. In most cases, you would not want it to be public knowledge that someone you love died from HIV or is living with the virus. People fear stigma and discrimination.

I had one of these disclosures in the taxi tonight. "My brother, he is in the hospital. He has TB and he is not coming up."  And then a little while later…. "Actually, they are saying they did a test and that he has HIV."

I might be the first person outside of the family who has been told these secrets, and  I am so honored to receive this information. I know the weight of the secret. And I know that the weight can sometimes be made lighter when we can talk openly about the diagnosis and treatment, when silent and much-worried-about questions can be answered. These discussions have led to some other special opportunities for me - the chance to talk in churches about caring for people with HIV, educational sessions in schools and orphanages, leading discussions with an entire family. I figure that, if we are going to make any progress with this virus, we need to combat the stigma surrounding it, and that is going to take a lot of talking and a lot of love.

Posted at 14:08

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