This morning I was seeing Xolani. He's 7. Has HIV. Has been on ARV/HAART for 2 years. When I called his name, he jumped up, and grabbed his grandma's arm. He's a smiling, happy 7 year old boy. Wearing a smart button down blue shirt with a white long sleeve shirt underneath. The look I try and pull off when I want to look like I am still in my 20s. His granny is likewise delightful, greeting me with a generous smile and a firm handshake.
We enter the room. Before calling them, I had grabbed the chart and read through the note that the counselor had written.
"Xolani knows why he takes his medicines. He is doing good taking them [sic]. He feels good. His granny knows the names of his medicines, and how to give them. Granny is the only provider. Parents are dead..."
I talk to Xolani and granny, examine him, he's doing great on his meds, virus is suppressed, his immune system is strong. He's happy, talkative. Singing a song which I don't recognize, mainly because it is in Zulu. He's a well adjusted boy, especially given his life circumstances, thus far.
Granny: His mom died on Saturday.
Mental Halt. Saturday. As in 2 days ago. So I enquire a bit, she was living in a nearby house. I had assumed that she had died long ago, there is no sign of grief in this child. There is a cultural element in play here as well. My friend S (of S&S) has been explaining his relationship to his mom, and how culturally it is the norm/expectation of children to be raised by the grandparents, even before AIDS created an orphan culture. When parents had to go off and work in the city, grandmothers were the providers, and essentially had a mother role as well. But still.... Saturday?
And so this shock, and somewhat discomfort lead me to question some thoughts. And I decide to take a formal poll today of what parents are alive.
XN: both dead
KM: both dead
SM: both dead
AM: mom dead
ZM: mom dead
SM: both dead (not a duplicate)
PM: both alive.
Either ZM or AM's mom died 2 weeks ago.
We saw about a 120 kids today in clinic. All united by HIV/AIDS. During the busiest portion of the day, I looked around in the waiting room, and for once, the extreme of ages really hit me. Young kids, there with grandparents. Maybe I've been in a bit of denial about how absolutely destructive this fucking virus is. Today I forced myself to really look, and tabulate the consequence.
Me: Grandma, is he doing ok?
Granny: Oh Doctor, he's very healthy.
I know he is healthy, I know his CD4 and his viral load, and I've looked in his mouth, felt his lymph nodes, his spleen tip, and his liver. I know his body is healthy.
Me: (beating around the bush) If you think he needs to see the counselor with his mom passing, let me know
Granny: He's a strong boy, he'll be ok.
And I hope, optimistically, that he will be ok. I hope that granny lives another 15, 20, 30 years, as she is his only family.
