This is the story of Amina (name changed for this purpose)
It is Thursday morning and as usual I get up at 5.30am. I quickly start to go through my routine morning duties ensuring breakfast for the kids is ready, assisting them in taking their baths, helping with feeding, dressing and finally putting them into the VAN for school. After that, I continue with the few more things I have to complete before heading off to the clinic. I sweep the entire house and do the dishes then have my bath, grab a cup of tea and off I go.
Immediately I open the gate to the clinic, I am greeted by Amina, who has been fortunate this morning to get some waakye (rice and beans) for breakfast. She warmly greets me with a sad face that she tries to put a smile on and asks me to join her for breakfast. I thank her and tell her to eat all the food.
She is my first client of the day. Amina is someone I have known for months when she was referred to us for management of her HIV status. She is in her 40’s, is a widow and has 2 sons. Her eldest son is married and lives with his wife and child in a far away poor village in Mali (where Amina’s parents originated). Her second son, who is in his early 20’s was never able to complete school as there was no financial support and so who has since his teenage years been fending for himself. He is now a mate on our local trotros (kind of a bus conductor) but makes so little money in this field that it is not possible for him to be visiting his mom that often as he lives in Kumasi and she is in Accra. Every so often he will call to ask of her health but that is about it. Amina therefore is mostly on her own.
Amina was diagnosed with HIV a little less than a year ago and was referred to us. She never has money for the services provided her and she is very grateful that despite this, WAAF and IHCC take care of her. She is a client who spends the longest time at our clinic, not because we take long in seeing to her but because after she is done, she will just hung around. She prefers to spend her time in the waiting room where she meets other people, sometimes gets people to give her some change and has at least people to talk to. She will do this until we are almost about to close and then she will leave.
This morning as I have her In the consulting room, I see that despite all the anti retroviral medications we are giving to her, despite the supplements and the good care, she is not gaining weight and still looks a bit malnourished. Of course, when I start to ask how things are she begins to weep and tells me the same story I hear every time she is around. There is no food. She tells me that sometimes she has only fifty pesewas on her and then she will ask me: ‘ and with that what can one buy in Accra” – she is absolutely right as this is not enough for a meal anymore. Then she continues: it is only God! God is helping me stay alive. Of course I ask more and then she tells me, sometimes a good Samaritan will pass by and see her and then give her 1 cedi. Sometimes the lady who sells “pure water” and who knows how I am struggling will offer me a few sachets. That is how I manage.
Amina says that when she was not sick and had the strength, she used to collect empty water bottles which she would in turn sell to market women who used these bottles to sell their produce. Now she says, I have not the strength to go round looking for the bottles. I also never went to school so there is not much that I can do than be a trader. If I want to start something now, I do not have the money to do so. I would like to sell biscuits to the school children but I will need money to get the biscuits first before I could do that. if I can only make enough a day to feed me and then save some to enable me get my medicines, I will be fine. She weeps as she says this.
She continues to tell me that she lives in a compound house with people who are distant relatives. When I ask why they do not help her, she says they want nothing to do with her. She suspects they know about her status. She says, even the small girl who normally sweeps the compound will intentionally leave my area when sweeping. If they cook, they will not offer me anything and most of the time, they do not cook anyway. They all buy food outside as they can afford to do that. Sometimes, I sleep without eating.
Of course, the little I can do, is to keep encouraging her and so I engage her into a conversation where I tell her never to give up. We never know why ones situation is the way it is but we should always try to fight our problems and not to have self pity. She listens eagerly to all that I say and then finally just says to me, even If I could have more people like you giving me such hope, I would feel so much happy. Thank you very much doctor and may God bless you, she kept saying to me.
At the end, Amina, again was able to get all her medicines from us, she stayed around, came a couple of times to show me the few 1 cedis she had received from about 3 or 4 other clients of the clinic , for which she was very grateful. Although not a sustainable way to help Amina, for now we have been able to sort her out for a meal or 2. We will continue to look for possibilities to help her (in a more sustainable manner). We have referred her to a support group, where I think she will be able to at least get some support in terms of sharing her experience. I am just happy that I was able to put a smile on her face for a while.
These are common stories we hear at the clinic and WAAF continues to find ways to support as many as we can.
Whenever you feel sad and bad, always think that there is definitely someone out there who is feeling more sad than you, whose situation is worse than yours, so step up, take control over the situation and move forward with a positive mind. Thanks and greetings from Dr. Naa