Lusaka, Zambia - Summer 2005, Journal 2
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A gravely ill boy with a mountain of medications and an insurmountable language barrier is enough to keep me awake for three days. Sadly, it was us or the Kamwala compounds. On Friday night, he ate little food and wanted nothing more than to sleep. I was certain of his irritation as I showered him (probably his first time in months) and changed him into clean clothes which we had borrowed from a neighbor. He slept little that night, and thus, neither did I. On Saturday, we borrowed another neighbor's guest house and watched videos such as Shrek and Care Bears, as they were the only animated videos available and he seemed to like them. Somewhere near the end of the second movie, I realized that he had already drifted off to sleep and that Jackie and I were the only ones truly concerned whether "Dark Heart" was going to help the Care Bears save the life of the head camp girl. The reality of this situation was apparent at dinner that evening when Tim explained what to do if Josh died during the night…a situation we nearly faced around 4 in the morning. On Sunday, after some brief work at the Kassisi orphanage, we decided to alter his medications in hopes of treating the unknown disease that was quickly killing him. Sunday night was a four hour escapade of trying to help Josh take nearly 40 different pills and spoonfuls of medicine, which he saw no reason to take. After all, they certainly hadn't helped him up until now. This was not an easy task with a child who has been trained for years to see through the guise of tricks such as "yummy yummy yogurt" and "why don't we all drink some mysteriously colored juice?" After several hours of gagging and vomiting, I slowly came to realize how a neighbor or distant relative, living in a fatalist African society governed by hunter/gatherer survival reasoning may find little reason for such efforts…especially while caring for 11 other children. We finally decided to recruit a local woman, the pastor's wife, to speak with Josh and encourage him in a manner that only a mother can do. Our ploy eventually worked and Josh was able to rest for a few hours.
I was terrified to find that I had actually fallen asleep for an hour, and upon awakening, couldn't hear the familiar cough and wheeze of the boy lying next to me. Much to our surprise, Josh was sleeping quite comfortably and his fever had abated. We woke him around 1 am to give him his last dose of meds, which he easily accepted. For the first time in many days, he voluntarily ate breakfast and looked quite well. Unfortunately, the high dose steroids were most likely the cause of his miraculous recovery, but were certainly no cure. Hopefully this will buy time for the other meds to work.
In the 13 years of his life, I wondered if anyone else had ever cried for Josh.
As we were apprehensive about keeping Josh with us for more days, and offering some sort of hollow attachment, we knew we had to find him other accommodations for the night. After all, his medicine was helping and he was no longer in the grave state he was on Friday. After much discussion, we decided that the children's ward of the hospice would be better for him than elsewhere…at least for the night.
In time, I do wonder what I will think of our time with Josh. Will he look back and see us as well-intentioned caregivers, or pill-pushing tormentors who abandoned him as so many others have. I have no doubt our care allowed him to survive a challenging few days, but to what end? Even if he does survive, will he be strong enough to break stones in the rock fields? In a city where selling nicer plastic bags to people leaving grocery stores is a legitimate job and where the street kids live in sewers underneath Cairo Road, even the healthy are condemned.
Joseph Simonetti, Med 2 (Class of 2008)
Joshua Yambazi, age 13, succumbed to AIDS on September 4, 2005. He weighed 33 pounds.