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
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
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
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.