She pushes up the sleeve of her shirt and I take in a deep, but silent sharp breath. She shows us what looks to be a specialized cancer that HIV+ people sometimes get and my heart breaks. Her baby needs to nurse, so she rolls her sleeve down and puts the baby to her breast, where the little one feeds hungrily.  My head can’t stop the thoughts – is the baby ok?  Is mom taking her medicine to keep her viral load low, hopefully suppressing the passage of the virus to her baby?  As I try to think as positively as I can, I know I am fooling myself and that really, adherence to the medicine has been poor.  Otherwise, why is this cancer ravishing her body?  I can tell she has a fever and offer Tylenol I have in my bag, which she readily takes. I look at the nurse and she shakes her head sadly.  She later tells me, “you’ve seen the dead walking.  She won’t live long.”

But let me start at the beginning of this very long day.

Fetid slums that house thousands of people, including some of our own, are barren of grass. It hasn’t rained in a long time and though it is the rainy season, this part of the world hasn’t seen rain yet.  Crops will fail and we will rail against global warming, yet it won’t help those who most need the rain.  Sewage slowly makes its way through the alley ways, along with four of us – Cecilia (counselor) and Veronica (project director), Jacqueline (community worker), and me.

My job right now is to visit children in their houses with and to count pills.  We are welcomed to tiny homes where we are warmly welcomed by either a mom, grandfather, or an auntie and the children whom we are visiting.  These are spot checks to determine if the kids and their guardians are taking their medicine and I count pills, calculate the days since medicine was given and we can determine if they are taking the medicine correctly or not.  After a sad visit where it was obvious the child nor the guardian are taking the medicine as required, the child and mom are told to report to the clinic today to discuss a plan.  It is imperative that the mom take her medicine daily and on time, or the child won’t do so, either.

The next visits were encouraging, with the children taking medicine as prescribed.  They look healthy and know when and how to take their medicine.

A school visit just makes me smile.  Hillary (boy) is now taller than me, with a sweet smile and the whitest teeth.  He wants to become a doctor, he tells me, as we chat after taking him out of class for a few minutes.  His class has 32 students in it and the room can’t be any larger than 10 x 8.  The kids sit crammed, one against the other, with knees touching backs. They are well-behaved and listen to a strict teacher tell them about geography.  The teacher laughs easily as we joke a bit and shows care for his students. Hillary has been in our program for 10 years and I am just so proud of the young man he’s growing up to be.

The ride to the clinic is uneventful, with lots of catching up on subjects we need touch on – how to tweak the school fee program, the greenhouse project, bunnies vs. chicken project, etc. We have lots to do and dive right in when we get to the clinic. Lunch time comes and goes when I am suddenly presented with a fried fish in a bag, along with fries and a little tomato, pepper and onion salad in its own little plastic bag.  I inhale it all and keep my eyes off the fish eye that stares at me.

Then, she walks in with her baby and I see what being almost dead looks like.  Veronica and I talk and try to plan so that the baby is not affected by her mother’s AIDS.  How do we ask a mother to stop breastfeeding when we know she can’t afford goat’s milk or baby formula? How would that ever be an option, when the water is contaminated and her baby will die of diarrhea? I worry about the 2 year and 9 year olds at home. What will happen to these three when their mama is gone?

The day continues, I speak to three groups of people, we plan, we budget, we talk, I lecture kids who aren’t doing what they should be doing, I congratulate those who are doing well, I warn girls to stay away from boys and boys to stay away from girls, I hug, I kiss, I cuddle babies, and I melt in the humidity.  All the time, Vero types away or is on her phone or answers questions. We are exhausted when 6:30pm rolls around.  We decide to call it a day and we’ll meet again tomorrow morning.  Let’s have an early dinner, Veronica says.  I quickly agree and we head out.  Two hours of sitting in the worst traffic I’ve ever seen, we have cancelled all dinner plans and I am deposited at my hotel while Veronica fights the traffic home.