2001 to 2010

As I was going to sleep last night, I reflected on the contrasts
between my experiences in South Africa in 2001 and my current
experiences in Botswana in 2010-- specifically related to HIV/ AIDS. During my
time in South Africa in 2001, I worked at an orphanage for children
who had HIV/ AIDS. The children had all presumably contracted HIV in
utero or early in infancy through mother to child transmission. None of the
children in the orphanage were expected to live past the age of 7-- at that
time, kids with HIV progressed to AIDS and died very young. The
primary 'care' we provided to the children was good hygiene, nutrition and
a lot of love (the idea being to shine as much love into their short
lives as possible). I distinctly remember getting news that a set of
twins, whose mother was HIV positive (and the babies were presumed to
be HIV positive) were scheduled to arrive at the orphanage. We
anxiously awaited their HIV test results. When we learned that they
were HIV negative, we were surprised but overjoyed and the twins ended up being
placed in alternative care-- as the orphanage was specifically for
children with HIV/ AIDS.

Fast forward to 2010

This year I am slightly more removed from the physical labor of caring
for people with HIV/ AIDS, and my work focuses on scientific research to
prevent the spread of HIV. I recently had the privilege of visiting
the Baylor Pediatric HIV/ AIDS clinic adjacent to where I work in
Gaborone. Like the children at the orphanage in South Africa, most of the patients at the clinic contracted HIV from their mothers early in life. However, the care available at the clinic offers an inspiring contrast
to the situation I was confronted with in South Africa nine years ago.
The staff at the clinic showed me a graph displaying the average age
of the patients-- which is now extending to 20 years and beyond
(presenting new challenges of transitioning patients to adult-focused
care). Where the bell curve used to be heavily skewed toward high
numbers of infants and young children, those kids are now growing older
which is really changing the make-up of the clinic's patient population.
The prevention of mother to child transmission (PMTCT) through the use of
anti-retroviral therapies has been so successful that, with
appropriate peri-natal care it can be nearly eliminated. I am
astounded by the progress that has been made in nine short years- from
providing nutrition, hygiene and love to support children through
their short lives and early deaths, to nearly eliminating mother to child transmission and having the anti-retroviral drugs available to help children, and all who are infected with HIV/ AIDS live longer, more productive lives.