Series: Technology, Morality, Power, AIDS Part IV of VI: A Tough Conversation

This is a conversation I’ve had too many times—in prisons, where at least I could offer medications, in Haiti where nothing was available,and numerous times over the last decade in African villages—during the time span from 'no access to medications' to 'greatly improved availability.'

I think I’ve cried every time I’ve had to tell a patient this harsh news.  God just made me that way.  I cry easy.  I guess (and hope) patients take it at face value—it’s just compassion.  I feel their pain—some of it anyway.  It is a big deal, so it’s not like crying is inappropriate exactly.  It’s just that I’m pretty sure that most
doctors don’t cry so much.

Antiretroviral medications (for the HIV virus) have exploded on the scene in the last decade.  In remote Kenya in 2006 we had to go to great lengths to get them.  By 2007 it was easier—we unloaded a box of them from the plane once a month.  But even in 2007, the clinic was paying for them out of their own budget.  Generous missionaries were paying for the pediatric patients.  I won’t forget those two little girls.  They brought my Joi three giant white land-snail shells from the forest—nearly as big as baseballs.  We keep them on a shelf in our home. They remind me to pray for those two little girls—and wonder if they are still alive.

By now, even in remote Tanzania, I know that I could have HIV drugs in my hands within two hours if I needed to. But I’m a mzungu (white person) with money, knowledge, and access to a car.  Our little clinic here still doesn’t have them.  We are waiting for the government to make good on their promise to provide antiretrovirals (ARVs). The clinic here just can’t afford them.  There is a government clinic eight kilometers away that sometimes has them.  For now, we send patients there—or into the city.  Even so, I’m amazed that they are available at all. Africa is changing rapidly.