She walked into my clinic room carrying her 3-year-old sister on
her hip. The 3-year-old was tired and on the verge of tears. They
sat down at the chair next to my desk, and the caregiver tried to
comfort the 3-year-old even as she pulled out the bottles of HIV
medicine for me to check. Her face calm and composed, she had the
usual multitasking ease of someone well-accustomed to looking after
a small child.
But this caregiver is only 10 years-old. A child herself.
The pair of them had walked for over an hour to get to their
monthly visit at the HIV clinic. The 10-year-old had to carry the
3-year-old almost half of the way.
And, yet, this is only a small taste of the burden this
10-year-old carries. Since her mother died six months ago, she has
been the "head" of their little household. Caring for her little
sister. Trying to find food for both of them. Maintaining their
tiny home in a shack that once served as someone's cooking space.
And, amazingly, giving her younger sister medicines and taking her
own medicines twice a day, every day.
Her eyes are old.
They have an elderly, bed-ridden grandmother who is technically
their guardian, but the 10-year-old reports only seeing her two or
three times since her mother died.
"Food is a problem," she says. "It is a struggle." There are
some kind neighbors who, while they say they already have more
children than they can afford, are often willing to share a meal
with the two orphaned girls. Those neighbors have probably stood
between life and death for these girls.
I go next door to consult with the clinical officer about what
we could possibly arrange for these two girls, and the clinical
officer tells me that she saw a 7-year-old who came in by herself
earlier. Another child living with only a very sick and old
grandparent. Another child forced into great responsibility so
Frankly, do not have much to offer these children. Our social
support services have been cut dramatically with the
current round of USAID/PEPFAR funding, and we no longer have a
social worker or Orphans and Vulnerable Children services offered
at this clinic. There is no one for me to send to the house to
follow-up on them or to try to manage their cases.
Of course, what they need most are parents. I can't provide
I try to piece together some follow up through my study
personnel and connections in Eldoret (which is a 3-hour drive
away.) I give them some shillings and the protein bar I had carried
along for my lunch substitute. I feel like I am sending them out
Just before they are leaving, as I try to muster up my usual
talk about hope and the future and staying healthy by taking
medicines, the 10-year-old stops my heart.
"We will carry on," she says. Carry on, small warrior.