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The following post is courtesy of Dr. Julia Rosebush, one of the on-call doctors at Camp Hope 2009:
Camp Hope 2009: A Doctor’s Perspective
My first week working at the Botswana-Baylor Children’s Clincal Centre of Excellence (COE) was extremely intense albeit one of the most rewarding weeks I’ve had as a doctor thus far. Every morning at 7:00am our day begins with our patients, their families, and the COE staff singing gospel hymns, first in English, then in Setswana. It is easy to forget, if just for a moment, that these are nurses, pharmacists, secretaries, doctors, and directors making some of the most beautiful accapella music I have ever heard. If you close your eyes, if even for a moment, you will forget that you are at the Centre and that all of the children and their families surrounding you are struggling with the burden of HIV/AIDS. We aren’t allowed to photograph our patients, but if I could, these words would be unnecessary because the photos would say it all. They are infants, school-aged children, teenagers, and young adults. They are oftentimes severely malnourished, shy and unable to communicate their thoughts and feelings. Many of them have not been fully disclosed to regarding their HIV status. We teach this gradual process by describing the CD4 cells as “soldiers” and HIV as the “bad guy.” We tell the children that in order for their soldiers to put the bad guys to sleep, they need to take their medicines. Some of these children are in their early teenage years by the time they achieve full disclosure. Many suffer from developmental delay and are struggling with school performance because of a multitude of psychosocial situations and neurocognitive side-effects from the medications and the virus itself. I’m studying WHO protocols, guidelines, algorithms… and I’m encouraged to construct some of my very own based upon what I encounter each day at the Centre. I’m participating in a clinical trial, learning about multi-drug-resistant TB, and I’m learning Setswana so that I can better relate to my patients. I’m told that when the guidelines say, “Consult an infectious disease expert,” that we’re to discuss these issues with our colleagues… we are the experts. But if only we were required to just know about HIV…
This week Raheel and I participated in Camp Hope, a Baylor-sponsored event for HIV-positive preteens as a way to build confidence, self-esteem, friendships, and to learn life skills. Early last Sunday morning we braved the bitter cold and registered 50 youths between the ages of 9 and 13 outside Maruapula Secondary School struggling with medication adherence, being ostracized at school, and dealing with poverty, malnutrition, and broken homes. They came from villages, nearby towns, and from Gaborone itself. They are what the Centre refers to as their “challenge” population, kids who have failed their first line therapy, kids who rely on social workers just to make it through the week, and kids with behavioral disorders resulting from HIV and lack of supervision in the home. With plastic bags full of antiretroviral (ARV) medication they lined up one-by-one offering them to me so that I could prepare them for their twice daily routine of directly observed therapy. Red. Yellow. Green. Blue. Purple. Orange. Black. Raheel handed each of them a bandana signifying the group with which they would eat, sleep, and bond with over the next 5 days. For most of them, this was their first time away from home and for many of them, it was their first time receiving their medicines on a routine basis with supervision. For some, this was their first time meeting other children who took medicines just as they did. What surprised me the most was that many of the campers did not know their HIV status… and what’s more amazing, is that it might be several years before they find out. You see, Camp Hope is a place of refuge, a place for kids to go where they are accepted for who they are. The activities that they participate in don’t relate in any way to HIV, instead, they focus on things such as performing arts, feelings and emotions, character building, cooking, sports, and arts & crafts… things that kids like to do.
Throughout the week of Camp Hope, Raheel and I witnessed an amazing transformation. Little by little these shy and awkward preteens came crawling out of their shells. They became leaders, friends, dancers, actors, and emotional support systems for each other. They took part in a talent show, singing solo and showing off their amazingly graceful bodies through dance routines. They were smiling and more energetic than they had probably ever been. One child mentioned that he was so “thankful for the food” because Camp Hope gave him the opportunity to eat things he had never eaten before. A group of 10-year-old girls picked up their tortillas one night at dinner and looked at them quizzically. They giggled when I told them that it was called a “tortilla” and that they needed to wrap their chicken in it. They thought it looked like a pizza and that it tasted like nothing. As the on-call doctor for a 24-hour period, I was able to participate in a hip-hop dance class with the kids and help organize a donor tea for local businesses and corporations to learn more about Baylor’s work with the adolescent population in Botswana, the first African country to see their HIV-positive children turn into young adults with the help of ARVs. After graduation from Camp Hope, the teens are ready to join Teen Club which occurs in various towns and villages throughout the country on Saturdays. My first one will be the 29th of August and I was already forewarned to expect over 100 teens and some pretty crazy times. I can’t wait. These kids are already keeping me young.