I set out for LUTH by 5.30 am on Monday the 20th of May. I was not a little apprehensive at the number of people I would meet there, the time I would waste, the routine I would have to go through and the way the healthcare attendants would treat me/us. To help alleviate at least some of my suffering I packed a big bag which had books and writing material to help pass the time, and act as some form of escapism.
As I mentioned in earlier posts the HIV treatment centre got burnt about a year ago. I was therefore expecting to experience some difficulty locating the new place as LUTH is very big; but I was wrong. The new location was quite easy to find, and as I discovered later, very close to the previous one. As a matter of fact they converted the former conference room into the clinic/consulting room, offices and treatment rooms. Then they had patients sit out under sheds made of corrugated roofing sheets and wooden planks. The ground was a mud floor.
I was a bit surprised to find, upon my arrival, that there were not too many people lined up waiting. If there were too many they would have been about 20. I went in to give my card to the attendant so they could search for my file, expecting to answer several questions related to where I had been for 3 years and so on. Naturally, in their way of behaving he asked where have you been? I was not prepared to be questioned by attendants so I said ‘it’s a long story’. He demanded, ‘what is a long story, have you been outside the country or what’? Of course I had made up my mind not to be harrassed by these guys so I repeated ‘it’s a long story’ with a straight face. He dropped it.
We had to wait quite a while before the process commenced, but I noticed the atmosphere had changed. It seemed people had begun to come to terms with this illness and were quite relaxed in the hospital. Though I pretended not to be listening I got caught up in the conversation the guys sitting in the row ahead of me were having. One of them worked in a bank and he was praising the new initiative where people would be given drugs in 3 month installments, which meant he would not have to always seek permission to leave the office for his appointments. The others concurred, then one said he didnt care if he had to take permission, he just wanted to get well. The third said, it was easy to get well, just taking drugs, eating right, living right, and they are fine. It wasn’t an intense conversation, just a casual one, they could have been speaking about the weather. I also noticed though, that the centre was full of low-income earners. Just going by their dress, their conversations and their mien, I could tell that the teachers, hairdressers, petty traders, housewives, secretaries were the ones attended to here. Where were the bosses, the senior management execs, the school proprietors?
Among the people waiting was a catholic reverend sister in her habit and veil. A young looking lady who could not be more than 25 years old she looked particularly uncomfortable to be there, almost ashamed, like she wished she was invisible. Once in a while I would see her glance around to be sure noone was looking at her, or at least be sure she wasn’t too conspicuous. I wondered how she contracted the virus.
After we checked our weight and blood pressure in turn, it was time to see the doctor. I must commend the doctors at the centre, they have great bedside manners and the one that attended to me was quite friendly and cool. He wondered why I was away but there was no high-handedness, he had a regular chat with me and even explained what I didn’t understand. I asked him about the low-income versus high income earners coming for treatment; he speculated that the high-income earners were friends with the senior doctors and they had the opportunity to be treated privately and differently from the regular patients. I was then sent to counselling and to have my blood drawn to check for CD4 count and viral load.
It is amazing how good things come out of bad; because the centre got burnt the staff learnt how to do things faster, albeit less politely, and because things were more efficient it meant those people profiting off making the process faster for those who did not want to stay long, were left in the cold. So what did they do, they approached people personally. Imagine my surprise when I stood up from my consultation to find the attendant who kept asking where I had been telling me to follow him to the ‘bleeding room’ as the lab where blood is drawn is called. I went with him and along the way he told me I should make sure I see him when I was done. Drawing blood was a smooth, efficient, painless process that took all of 2 minutes. Apparently, someone somewhere is thinking of how to make things less difficult for human beings. The counselling section was very full and I had to wait for a little while. I was a bit surprised at how full it was since it was meant to be a 0ne-on-one session. However, with the unsolicited help of that ubiquitous attendant I got in just after one group left.
The counselor was speaking to an elderly lady. I could tell from the lady’s responses that she was uneducated and this was her first-time there. She didn’t seem to grasp the significance of the illness she had acquired or the breadth of the treatment required. The counsellor was trying to explain to her that her CD4 count had gone below the ‘healthy’ threshold of 350, it now read 311 so she would be required to take drugs. She wanted her to explain in her own words why she will need drugs but the woman did not seem to be able to grasp the numerical difference between 350 and 311. The counsellor seemed exasperated, not to mention irritable; I wondered why she did not just use currency to describe the quantity! This woman was obviously a trader. Finally the nickel dropped and she explained using naira and the lady finally got it and left to receive her medication. Then it was my turn, and she was going to attend to me until someone else came in. It was a heartbreaking sight.
A slim, tall man aged anywhere between 30 and 4o years opened the door of the counselling room and with his hands on her shoulders, steered a girl into a seat adjacent to me, with an air which said ‘ I am with her but I don’t have the illness/ this is your life’. She was very young and you could tell even though she had her hair shorn that she was very pretty. The look on her face and the air around her was disbelief. The counsellor told me to take a seat aside while she spoke to her. Truth be told, I strained to hear their very hushed conversation, not out of nosyness but out of pity. She said she was 15, the counsellor asked her if she had heard of HIV, I did not hear her answer but her reaction made the counsellor say, but that’s why you are here. The expression on her face almost moved me to tears. I was too happy to leave when the counsellor pleaded that I give them a moment. Outside I wondered about the psychological options for a little girl diagnosed with HIV, wondered if she would be ostracised. Wondered about the man who brought her in and if he was responsible for the transmission, if he had been sleeping with her because I have seen such crazy things happen.
A few minutes later it was my turn to go back in and the counsellor just asked me some questions to ensure I would stick to my treatment and consultation routine, and sent me off. I was then free to go. But not before the attendant hurried after me and handed me his phone number telling me to text my card number and my name the evening before my next appointment. Afterwards he asked me when I wanted the test results to be ready, I said as soon as possible, he said ‘then you know what that means, since this is Nigeria’ so I asked him if it wasn’t meant to be ready before my next appointment. He agreed that it was, so I said I would wait for it. He then told me giving money to people was like giving alms, it wasn’t because I necessarily needed anything from them. (Eyes rolling). Anyway, suffice it to say I parted with 1500 naira that day. My next appointment was a week away.