VCT (as easy as 1-2-3?)

11/11/05

We went to take Monica to VCT. She suspected herself because her husband had symptoms of an AIDS related death, and her co wives are HIV positive. She wanted to get tested for a while but hasn't had the money for transport to Migori. So we brought her. The process was painfully slow. There were rumors of highway patrols, so matatu crews were all skittish. We had to wait 20 minutes at Kanga Center before one with three seats on it showed up. And when it finally did, it turned out to only go as far as Awendo, about half way, before they decided they couldn't go on because they had expired road licenses. There were a lot of people, maybe 50, waiting for a ride in our direction. Whenever a bus would pull up there would be a mob scene, people yelling and pushing and pulling each other, trying to clamor inside with their bags. People even started climbing in the back of one bus, over the last row of seats, getting stuck on each other… A sedan type taxi pulled up and somehow we all got in (along with four others) The driver jumped out and then returned with three bottles of water, which turned out to be for the three police at the road stop a few kilometers up the road.

We finally got to Migori and walked and walked to the St. Josephs Mission Hospital. We were there almost four hours. And the place wasn't busy at all, they just weren't efficient. But they were kind and gentle and apparently much faster (I shudder to think) than the district hospital. While we were waiting and waiting and waiting I got escorted to the Administrator's office to ask if I could film Monica's VCT. The administrator, an older, heavy, ridiculously fearful and stubborn man, said no filming was aloud at the hospital. I asked why, he said to protect the patient's rights. I clarified that I only wanted to film one patient, our client, our friend, who had agreed. He still refused, and again I asked why. He said that he was afraid of me misrepresenting the hospital. I told him that I was under the impression that it was the best facility in the district, and wanted to represent it as such. He said No. I asked Why. He said he was afraid I would use the video for dishonest purposes. He wouldn't make eye contact with me. Finally I had to just ask him if he didn't mind looking at me when he was speaking to me. I explained exactly what the project was intended to do, exactly why it was important to film the VCT process, exactly how I intended to represent the hospital, and finally I explained the possible benefits for his hospital that could result. Now his ears perked up. This fucking guy. He was totally a businessman that just happened to fall into hospital administration. Now he started blabbering about needing new Land Rovers for fieldwork and buying new motorcycles and bicycles and needing a machine to do CD4 counts. Now he wanted to give an interview. I still couldn't film in the hospital, against policy, but he would give an interview and talk about the hospital's activities. I was over it, I was just planning on leaving and filming what I could discreetly on the ELPH, but I decided to interview the guy just because it felt like a victory to take the DVX out at all. But when it came down to it, he pretty much just used the opportunity to 'appeal' for a CD4 machine (ostensibly because he had to send clients to the district hospital when all that money could be staying right there in StJMH.) When I was saying ericomano and leaving, he told me that (I shit you not) the next time he sees me, I better be bringing a CD4 count machine (85,000USD.) What an ass.

Next we talked to the nun who runs the VCT clinic. I was trying to get advice from her on the best places to get HBC supplies and posters and literature for the CHEC. This lady actually discredited the idea of what we are doing, saying, 'everyone knows what they need to about HIV. (What?! Is she out of her fucking mind?!) Robert and I looked at each other, jaw dropped. I picked up the ball first, and asked if during counseling her clients ever had questions that maybe revealed misconceptions. She said Yes. I explained that that was why we felt that the CHEC was important, of value to a rural community. She explained that she couldn't give us any of her posters. I explained that I was asking where she got them, so we could go to the same source. She said that we should maybe try the National something something, we could get the phone number, um, she didn't know where, maybe the Administrator has it, or maybe we could come back another time and she could find it…

After two lifetimes of this crap (4+ hours!) Monica finally got her results (she is antibody positive.) We walked over to the district hospital to get her CD4 count measured. We stopped at the chest clinic, Robert wanted to visit a doctor somebody who hails from Kitere, but he was out at lunch. But as he was talking to the nurse, a soldier walked up with three prisoners handcuffed together, wearing threadbare and ragged white and blue striped uniforms, all looked my age, one even younger, and I think that his terrible cough was the reason they were there. The soldier had no gun but a perfectly pressed uniform, and he looked to be about the same age as all of us.

The CD4 count machine was in another building, at the end of the compound, which was built by a German NGO focused on PMTCT. The CD4 count is supposed to cost 800/=, a sign on the wall said so, but somehow Robert got it for 500/=, and the lab tech agreed to let me film. So that was good. There was no one in line so we were helped right away. This brought the total for Monica's VCT to 740/=, over ten dollars, way out of her price range. I'm not sure she ever would've gone if we hadn't taken her. While we were waiting for her CD4 results, a mzungu walked up, a German girl named Inga, she is doing her six-month work-study Africa residency in Migori. We hit it off and she offered to take me on a tour of the hospital, but it was raining, so instead she showed me around the building we were in, and then we found a corner and sat down and swapped stories. I explained the CHEC project after a while and she was very impressed by what we are trying to do and even what we have accomplished already, and she offered to help us get the HBC supplies and literature for the Center. The difference between the helpfulness of this girl compared to the staff at the StJMH, was astonishing.

Anyway, it was 4pm, the rain was slowing, and Monica had received the results of her CD4 count (324, she cant start ART yet), so I took Inga's number and set off with my gang. Robert wanted to go visit whoever is taking care of his sister's house in her absence (she's still at hospital in Eldoret), and Monica and I wanted to get back to Kanga, so we split up. Matatus were still scarce, the one we managed to get onto was crammed. We drove to Awendo. When we got there, I saw the roadside was packed, hundreds of people waiting for matatus. When we pulled up people were already trying to clamor in to our bus before we had even come to a stop. I was thankful that I didn't have to deal with the mess. But then, someone was talking to the tout, and suddenly the bus was turning around, and the tout was telling us he wasn't going any farther, and we were fighting to get our change back, and the next thing I knew, I was standing on the side of the road with 200 plus Africans, holding my DVX bag, in a light drizzle, the sun setting behind the grey rain clouds. The matatu drove away, leaving us for the vultures, throwing us to the hungry dogs. The air was tense at the Awendo bus stage. There wasn't any sort of line or order, and it looked as if some people had been standing there waiting for a bus for hours. There was a resigned sort of anger in their eyes. But many were not resigned, just angry, ready to do what it took to get a ride. I was neither resigned nor angry, I was slightly amused at the prospect of another adventure, though I didn't want the adventure to last long, because I could see the rain was going to come down hard and the sun was going to set, and I surely didn't want to be stuck in Awendo after dark, in the rain, with my DVX, and no infrastructure (like a phone or hotel or even restaurant) in eye sight. When a matatu would pull up, a dozen people would start running along side of it, demanding to be the one let on if someone was getting off. Usually there were only one or two seats available, if any. I stood and watched the scene for a minute. Normally I would have had few problems getting on a bus in this situation, but here I had my camera and DVX to get home safe. But by a stroke of luck, a bus pulled up right in front of me and the tout said there were three seats. There was already a dozen people trying to push past me from behind, and I could have easily got on, but I wanted to get Monica on first. One guy was being especially aggressive, trying to push past me, and he actually managed to wriggle by, he was just to my right, so reached around and grabbed him by the right shoulder and yanked him down. He whirled around to yell at whoever had grabbed him, but fortunately fell for the trick and whirled around the wrong way, where he was faced with a bunch of little ladies. I used the time to slide back in front of him and block the way. I couldn't seem to get Monica on board so finally I just jumped into the last seat, and then just as the tout said no one else could get on, I gave the seat to her. But I hung out by the door of the van as the tout was dealing with some business, and just before they took off he let me cram in too.

It turns out that Othies was at Awendo at the same time, we just missed each other in the crowd. He told me that he was stuck there until 9:30pm, and finally he had to pay 70/= to take a Nairobi bound big bus home. He said that the driver had asked for 100/=, but 70/= was all he had. (The fare for Awendo to Kanga is 30/=.)

I don't know what to say about today.

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